E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Acute Myeloid Leukemia |
Leucemia mieloide aguda |
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E.1.1.1 | Medical condition in easily understood language |
A blood cancer called Acute Myeloid Leukemia |
Un tipo de cáncer llamado leucemia mieloide aguda |
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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 | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10000880 |
E.1.2 | Term | Acute myeloid leukaemia |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To determine efficacy of CHAM in terms of complete remission (CR) and compare with HAM (control). CR will be determined as per standard response criteria for AML (Döhner et al. 2010; 115[3]:453-474). |
Determinar la eficacia de CHAM en términos de remisión completa (RC) y comparar con HAM (control). La RC se determinará según los criterios de respuesta estándar para la LMA (Döhner et al. 2010; 115[3]:453-474). |
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E.2.2 | Secondary objectives of the trial |
1. To determine efficacy of CHAM in terms of overall survival (OS) and complete remission with partial hematologic recovery (CRh) as the two key secondary objectives to compare with HAM (control). The OS and CRh will be determined as per standard response criteria for AML (Döhner et al. 2010; 115[3]:453-474). 2. Safety: The assessment of safety will be based mainly on the frequency of adverse events (AEs) based on the Common Terminology Criteria for AEs (version 5.0 or later) grade. Adverse events will be coded according to the Medical Dictionary for Regulatory Activities. The safety outcomes will include the occurrence of at least one serious AE, of at least one Grade 3/4 AE, and of at least one AE requiring the discontinuation of study treatment. Electrocardiogram QTc intervals will also be evaluated. |
1. Determinar la eficacia de CHAM en términos de supervivencia general (SG) y remisión completa con recuperación hematológica parcial (RCh) como los dos objetivos secundarios clave para comparar con HAM (control). La SG y la RCh se determinarán según los criterios de respuesta estándar para la LMA (Döhner et al. 2010; 115[3]:453-474). 2. Seguridad: La evaluación de la seguridad se basará principalmente en la frecuencia de los acontecimientos adversos (AA) según el grado de los Criterios terminológicos comunes para AA (v5.0 o posterior). Los acontecimientos adversos se codificarán según el Diccionario Médico para Actividades Reguladoras (MedRA). Los resultados de seguridad incluirán la aparición de al menos un AA grave, de al menos un AA de grado 3/4 y de al menos un AA que requiera la interrupción del tratamiento del estudio. También se evaluarán los intervalos QTc del electrocardiograma. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Males and females age ≥ 60 years must have histologically documented AML that is relapsed from, or refractory to, prior standard therapies. 2. Refractory is defined as failure to achieve CR or complete remission with incomplete recovery (CRi) following: -Two standard dose Cytarabine based induction cycles or one High Dose Cytarabine (HiDAC) based cycle, or -Failure to respond to one cycle of either standard dose or HiDAC; defined as no decrease in marrow blast percentage from diagnosis on Day 14 marrow), or -No response after at least 3 cycles of a hypomethylating agent (azacytidine or decitabine). 3. Relapse is defined as development of recurrent AML (Döhner et al. 2010; 115[3]:453-474) after CR or CRi has been achieved with a prior chemotherapy or after disease progression on a hypomethylating agent. 4. ECOG PS (performance score) 0-2. 5. Expected survival >3 months. |
1. Los hombres y mujeres con edad superior o igual a los 60 años tienen que haber documentado histológicamente LMA en la que se haya recaído o que se haya resistido antes de los tratamientos estándar. 2. Resistirse quiere decir que no se ha conseguido RC ni se ha completado la remisión, de manera que se produce una recuperación incompleta (RCi) después de lo siguiente: - dos dosis estándar de ciclos de inducción con citarabina o un ciclo con una dosis alta de citarabina (HiDAC), - no se responde a un ciclo de la dosis estándar o HiDAC; es decir, un aumento en el porcentaje de médula según el diagnóstico de la médula el día 14), - no hay respuesta después de 3 ciclos con un fármaco hipometilante (azacitidina o decitabina). 3. La recaída quiere decir que se ha desarrollado la LMA recurrente (Döhner et al. 2010; 115[3]:453-474) después de que RC o RCi se haya conseguido con una quimioterapia previa o después de una evolución de la enfermedad con un fármaco hipometilante. 4. EG ECOG (puntuación del estado general) 0-2. 5. Supervivencia prevista de más de 3 meses. |
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E.4 | Principal exclusion criteria |
1. Patients who have received previous cytotoxic chemotherapy treatment for their relapsed or refractory AML. Previous treatment with hypomethylating agents (decitabine or azacytidine) either alone or in combination with Venetoclax is allowed. Targeted therapies including FLT3 or IDH1/2 inhibitors or Hydrea are allowed. Targeted therapies and Hydrea may be taken until the day prior to starting CHAM or HAM therapy. 2. Female patients who are pregnant or breastfeeding or planning to become pregnant or breastfeed during treatment and for an additional 6 months after the last dose of CHAM or HAM therapy (the teratogenic potential of CPI-613 is unknown). Female patients of childbearing potential with a positive pregnancy test assessed by a serum pregnancy test at Screening. 3. Patients receiving any other standard or investigational treatment for AML, or any other investigational agent for any indication within the past 2 weeks prior to initiation of CPI-613 treatment (the use of Hydrea and/or oral tyrosine kinase inhibitors FLT3 or IDH 1/2 inhibitors is allowed until the day prior to starting CHAM or HAM therapy). Previous exposure to a hypomethylating agent either alone or in combination with Venetoclax is allowed. 4. Patients who have received immunotherapy of any type within the past 2 weeks prior to initiation of CPI-613 treatment. 5. Requirement for immediate palliative treatment of any kind including minor surgery. 6. Patients who have received a chemotherapy regimen with autologous stem cell support (bone marrow transplantation) within 6 months of starting CHAM or HAM therapy. 7. Patients who have had allogenic bone marrow transplantation. |
1. Pacientes que hayan recibido un tratamiento previo de quimioterapia citotóxica por su LMA que se resiste o que recae. Está permitido el tratamiento previo con fármacos hipometilantes (decitabina o azacitidina) individualmente o en combinación con venetoclax. Están permitidos los tratamientos dirigidos como los inhibidores FLT3 o IDH1/2 o Hydrea. Los tratamientos dirigidos y Hydrea se pueden tomar hasta el día antes de comenzar el tratamiento con CHAM o HAM. 2. Las pacientes que estén embarazadas, que estén amamantando o que estén planeando quedarse embarazadas durante el tratamiento y por un periodoadicional de 6 meses después de la última dosis del tratamiento con CHAM o HAM (el potencial teratogénico de CPI-613 se desconoce). Las pacientes en edad fértil con un test de embarazo positivo que se ha evaluado con un test de embarazo en suero en la selección. 3. Los pacientes que reciben cualquier otro tratamiento en investigación o estándar para la LMA o cualquier otro fármaco en investigación para cualquier indicación en las dos últimas semanas antes del tratamiento de CPI-613 (el uso de Hydrea y de los inhibidores de la tirosina quinasa oral FLT3 o los inhibidores IDH 1/2 se permite hasta el día anterior al inicio del tratamiento con CHAM o HAM). Está permitida la exposición previa a un fármaco hipometilante, ya sea en monoterapia o en combinación con venetoclax. 4. Los pacientes que han recibido inmunoterapia de cualquier tipo, en las últimas 2 semanas antes del inicio del tratamiento de CPI-613. 5. Necesidad de tratamiento paliativo inmediato de cualquier tipo, incluida la cirugía menor. 6. Los pacientes que han recibido una pauta de quimioterapia con apoyo de autotrasplante de células madre (trasplante de médula ósea) dentro de los 6 meses de iniciar el tratamiento con CHAM o HAM. 7. Los pacientes que hayan tenido un trasplante alogénico de médula ósea. |
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E.5 End points |
E.5.1 | Primary end point(s) |
CR (Complete Remission). |
RC (Remisión completa) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1st Interim Analysis, 2nd Interim Analysis and Final Analysis |
Primer análisis intermedio, segundo análisis intermedio y análisis final |
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E.5.2 | Secondary end point(s) |
1. OS (key secondary) 2. CRh (key secondary) 3. Safety 4. PK 5. PRO by EORTC QLQ C30 6. Cancer-associated mutations and/or genetic alterations in bone marrow aspirate/biopsy and/or peripheral blood. |
1. SG (secundario clave) 2. Remisión completa con recuperación hematológica parcial (secundario clave) 3. Seguridad 4. Farmacocinética 5. Resultados informados por los pacientes mediante cuestionario EORTC QLQ C30 6. Mutaciones asociadas al cáncer y / o alteraciones genéticas en el aspirado / biopsia de médula ósea y / o sangre periférica. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
End of study |
Final del estudio |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
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 | No |
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 | Yes |
E.8.2.3.1 | Comparator description |
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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 | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 48 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Belgium |
Canada |
France |
Germany |
Italy |
Korea, Republic of |
Poland |
Spain |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
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
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LVLS |
Última visita del último paciente |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |