E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Cervical cancer with positive para-aortic lymph nodes |
Cancer du col de l'utérus avec envahissement ganglionnaire aortique |
|
E.1.1.1 | Medical condition in easily understood language |
Cervical cancer |
Cancer du col de l'utérus |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10008229 |
E.1.2 | Term | Cervical cancer |
E.1.2 | System Organ Class | 100000004864 |
|
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate whether the addition of induction chemotherapy with three cycles of Carboplatin and Paclitaxel plus standard concomitant radiotherapy and chemotherapy improves overall survival compared to standard therapy in patients with cervical cancer with positive para-aortic lymph nodes |
Evaluer si l'addition d'une chimiothérapie d'induction comprenant 3 cycles de Carboplatine et Paclitaxel suivie du traitement standard par radio-chimiothérapie concomitante améliore la survie globale en comparaison au traitement standard actuel chez des patientes présentant un cancer du col utérin avec envahissement ganglionnaire aortiques |
|
E.2.2 | Secondary objectives of the trial |
- compare progression-free survival between the two treatment arms
- compare tumour responses between the two treatment arms
- compare the quality of life between the two treatment arms
- compare types of relapse between the two treatment arms
- evaluate the tolerance
- to evaluate the local and aortic lymph node response after induction chemotherapy in the experimental arm only |
- comparer les survies sans progression entre les deux bras de traitement
- comparer les réponses tumorales entre les deux bras de traitement
- comparer la qualité de vie entre les deux bras de traitement
- comparer les types de récidive entre les deux bras de traitement
- évaluer la tolérance
- évaluer la réponse locale et ganglionnaire aortique après chimiothérapie d'induction dans le bras expérimental uniquement |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Patient with cervical cancer WITH positive para-aortic lymph nodes determined by either a positive 18F-FDG PET-CT, or a negative PET-CT, by histological examination of para-aortic lymph nodes.
- Age ≥18 years
- WHO performance status: stages 0 to 2
- FIGO stage IB1 to IVA at the time of diagnosis WITH positive para-aortic lymph nodes
- Adenocarcinoma or squamous cell carcinoma or adenosquamous or mixed carcinoma
- Normal renal function (creatinine clearance <80 ml/min)
- Normal liver function (bilirubin <1.5 times the upper limit of normal (ULN) and AST <3 times ULN)
- Normal haematological assessment (platelets >75x109/l and neutrophils >1X109/l)
- Women of childbearing and non-menopausal age must have a negative blood serum or urine pregnancy test before starting the study treatment
- Having given his/her written consent
- Affiliated to a social security scheme or equivalent |
- Patiente présentant un cancer du col de l’utérus AVEC un envahissement ganglionnaire aortique déterminé par soit un PET-CT au 18F-FDG positif, ou si le PET-CT est négatif, par un examen histologique des ganglions para aortiques.
- Age ≥18 ans
- OMS performance status : stades 0 à 2
- Stade FIGO IB1 à IVA au moment du diagnostic AVEC envahissement ganglionnaire aortique
- Adénocarcinome ou carcinome épidermoïde ou carcinome adénosquameux ou mixte
- Fonction rénale normale (clairance de la créatinine < 2.0 mg/dl80 ml/min)
- Fonction hépatique normale (bilirubine <1.5 fois la limite supérieure de la normale (LSN) et AST < 3 fois la LSN)
- Bilan hématologique normal (plaquettes > 75x109 /l et neutrophiles > 1X109/l)
- Les femmes en âge de procréer et non ménopausées doivent avoir un test de grossesse sérique ou urinaire négatif avant de commencer le traitement à l'étude
- Ayant donné son consentement écrit
- Affiliée à un régime de sécurité sociale ou équivalent |
|
E.4 | Principal exclusion criteria |
- Patients who have first received chemotherapy or radiotherapy for their cervical cancer
- Pregnant or breastfeeding women
- History of invasive cancer (in the last five years) other than non-melanoma skin cancer
- Patient under legal protection
- Acute, uncontrolled cardiovascular disease
- Peripheral neuropathy of grade 2 or higher
- Known hypersensitivity to Paclitaxel, Cisplatin or products containing platinum |
- Patientes ayant reçu un premier traitement par chimiothérapie ou radiothérapie pour leur cancer du col de l’utérus
- Femmes enceintes ou allaitantes
- Antécédent de cancer invasif (dans les 5 dernières années) autres que cancer de la peau non mélanome
- Patiente sous protection juridique
- Pathologie cardiovasculaire aigüe non contrôlée
- Neuropathie périphérique de grade supérieur à 2
- Hypersensibilité connue au Cisplatine ou aux produits contenant du platine, ou au Paclitaxel |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Overall survival |
Survie globale |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Defined as the time from the date of randomisation to the date of death, regardless of the cause. |
Délai depuis la randomisation jusqu'au décès, quelle qu'en soit la cause |
|
E.5.2 | Secondary end point(s) |
- tumour response according to the RECIST v1.1 and PERCIST criteria
- progression-free survival, time from the date of randomisation to the date of progression (according to the RECIST v1.1 and/or PERCIST criteria) or the date of death, regardless of the cause, depending on which event occurs first
- location of the relapse (local, pelvic and/or aortic lymph node, distant)
- quality of life (QLQ-C30 and QLQ-CX24)
- adverse events that occur during the trial after the informed consent forms have been signed, as defined in NCI-CTCAE version 5.0 |
- réponse tumorale selon les critères RECIST v1.1.et PERCIST
- survie sans progression, le délai depuis la date de randomisation jusqu’à la date de progression (évaluée selon les critères RECIST v1.1 et/ou PERCIST) ou la date de décès quelle qu’en soit la cause, selon l’évènement se produisant en premier
- localisation de la récidive
- qualité de vie (QLQ-C30 et QLQ-CX24)
- évènements indésirables survenus pendant l’essai depuis la signature du consentement éclairé, tels que définis dans la version 5.0 du NCI-CTCAE |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
- At the end of study treatment
- Before induction chemotherapy, before and at the end of concomitant radiochemotherapy, at the first follow-up visit and once a year for the first three years of follow-up |
- A la fin de la phase de traitement
- avant la chimiothérapie d'induction, avant et après la radio chimiothérapie concomitante, à la première visite de suivi et une fois par an les 3 premières années du suivi |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 15 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 50 |
E.8.9.1 | In the Member State concerned days | |