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    Summary
    EudraCT Number:2018-002089-37
    Sponsor's Protocol Code Number:EMN18
    National Competent Authority:Czechia - SUKL
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2019-03-07
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedCzechia - SUKL
    A.2EudraCT number2018-002089-37
    A.3Full title of the trial
    A MULTICENTER, OPEN LABEL, RANDOMIZED PHASE II STUDY COMPARING DARATUMUMAB
    combined with BORTEZOMIB-CYCLOPHOSPHAMIDE-DEXAMETHASONE (Dara-VCd) VERSUS
    THE ASSOCIATION OF BORTEZOMIB-THALIDOMIDE-DEXAMETHASONE (VTd) AS PRE
    TRANSPLANT INDUCTION AND POST TRANSPLANT CONSOLIDATION, BOTH FOLLOWED BY
    A MAINTENANCE PHASE WITH IXAZOMIB ALONE OR IN COMBINATION WITH DARATUMUMAB,
    IN NEWLY DIAGNOSED MULTIPLE MYELOMA (MM) YOUNG PATIENTS eligible for
    AUTOLOGOUS STEM CELL TRANSPLANTATION
    MULTICENTRICKÁ, RANDOMIZOVANÁ,OTEVŘENÁ STUDIE FÁZE II SROVNÁVAJÍCÍ DARATUMUMAB V KOMBINACI S BORTEZOMIBEM-CYKLOFOSFAMIDEM-DEXAMETASONEM (DARA-VCD) OPROTI BORTEZOMIBU-THALIDOMIDU-DEXAMETASONU (VTD) JAKO INDUKČNÍ PRETRANSPLANTAČNÍ A KONSOLIDAČNÍ POTRANSPLANTAČNÍ LÉČBĚ, OBĚ RAMENA JSOU NÁSLEDOVÁNA UDRŽOVACÍ LÉČBOU IXAZOMIBEM V MONOTERAPII NEBO IXAZOMIBEM V KOMBINACI S DARATUMUMABEM U NOVĚ DIAGNOSTIKOVANÝCH MLADÝCH PACIENTŮ S MNOHOČETNÝM MYELOMEM VHODNÝCH PRO AUTOLOGNÍ TRANSPLANTACI KMENOVÝCH BUNĚK
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A MULTICENTER, OPEN LABEL, RANDOMIZED PHASE II STUDY COMPARING DARATUMUMAB
    combined with BORTEZOMIB-CYCLOPHOSPHAMIDE-DEXAMETHASONE (Dara-VCd) VERSUS
    THE ASSOCIATION OF BORTEZOMIB-THALIDOMIDE-DEXAMETHASONE (VTd) AS PRE
    TRANSPLANT INDUCTION AND POST TRANSPLANT CONSOLIDATION, BOTH FOLLOWED BY
    A MAINTENANCE PHASE WITH IXAZOMIB ALONE OR IN COMBINATION WITH DARATUMUMAB,
    IN NEWLY DIAGNOSED MULTIPLE MYELOMA (MM) YOUNG PATIENTS eligible for
    AUTOLOGOUS STEM CELL TRANSPLANTATION
    MULTICENTRICKÁ, RANDOMIZOVANÁ,OTEVŘENÁ STUDIE FÁZE II SROVNÁVAJÍCÍ DARATUMUMAB V KOMBINACI S BORTEZOMIBEM-CYKLOFOSFAMIDEM-DEXAMETASONEM (DARA-VCD) OPROTI BORTEZOMIBU-THALIDOMIDU-DEXAMETASONU (VTD) JAKO INDUKČNÍ PRETRANSPLANTAČNÍ A KONSOLIDAČNÍ POTRANSPLANTAČNÍ LÉČBĚ, OBĚ RAMENA JSOU NÁSLEDOVÁNA UDRŽOVACÍ LÉČBOU IXAZOMIBEM V MONOTERAPII NEBO IXAZOMIBEM V KOMBINACI S DARATUMUMABEM U NOVĚ DIAGNOSTIKOVANÝCH MLADÝCH PACIENTŮ S MNOHOČETNÝM MYELOMEM VHODNÝCH PRO AUTOLOGNÍ TRANSPLANTACI KMENOVÝCH BUNĚK
    A.4.1Sponsor's protocol code numberEMN18
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorEUROPEAN MYELOMA NETWORK
    B.1.3.4CountryNetherlands
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportJANSSEN PHARMACEUTICA NV
    B.4.2CountryBelgium
    B.4.1Name of organisation providing supportTAKEDA PHARMACEUTICALS INTERNATIONAL CO.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationEMN Research Italy I.S. S.r.l.
    B.5.2Functional name of contact pointClinical Trial Office
    B.5.3 Address:
    B.5.3.1Street AddressVia Saluzzo I/A
    B.5.3.2Town/ cityTorino
    B.5.3.3Post code10125
    B.5.3.4CountryItaly
    B.5.4Telephone number00393924398409
    B.5.5Fax number00390110133182
    B.5.6E-mailamministrazione@emnresearch.it
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/1/16/1101
    D.3 Description of the IMP
    D.3.1Product nameDARATUMUMAB
    D.3.2Product code JNJ-54767414
    D.3.4Pharmaceutical form Concentrate for concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDARATUMUMAB
    D.3.9.1CAS number 945721-28-8
    D.3.9.2Current sponsor codeDARATUMUMAB
    D.3.9.3Other descriptive nameDARATUMUMAB
    D.3.9.4EV Substance CodeSUB175772
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typehuman monoclonal antibody
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/1/16/1094
    D.3 Description of the IMP
    D.3.1Product nameIXAZOMIB 4 MG
    D.3.2Product code IXAZOMIB 4 MG
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNIXAZOMIB
    D.3.9.1CAS number 1072833-77-2
    D.3.9.2Current sponsor codeMLN9708
    D.3.9.3Other descriptive nameIXAZOMIB
    D.3.9.4EV Substance CodeSUB121332
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number4
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeANTINEOPLASTIC AGENTS
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameENDOXAN
    D.3.2Product code ENDOXAN
    D.3.4Pharmaceutical form Coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCYCLOPHOSPHAMIDE
    D.3.9.1CAS number 50-18-0
    D.3.9.4EV Substance CodeSUB06859MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeCytotoxic
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name VELCADE
    D.2.1.1.2Name of the Marketing Authorisation holderJANSSEN-CILAG INTERNATIONAL NV
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameBORTEZOMIB
    D.3.2Product code 26866138
    D.3.4Pharmaceutical form Powder for solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNBORTEZOMIB
    D.3.9.1CAS number 179324-69-7
    D.3.9.2Current sponsor codeBORTEZOMIB
    D.3.9.3Other descriptive nameBORTEZOMIB
    D.3.9.4EV Substance CodeSUB20020
    D.3.10 Strength
    D.3.10.1Concentration unit mg/m2 milligram(s)/square meter
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number3,5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typePROTEOSOMA INHIBITOR
    D.IMP: 5
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name THALIDOMIDE CELGENE
    D.2.1.1.2Name of the Marketing Authorisation holderCelgene Europe B.V., Utrecht
    D.2.1.2Country which granted the Marketing AuthorisationNetherlands
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameTHALIDOMIDE
    D.3.2Product code THALIDOMIDE
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTHALIDOMIDE
    D.3.9.1CAS number 50-35-1
    D.3.9.4EV Substance CodeSUB10958MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeIMMUNOMODULATORY
    D.IMP: 6
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name DEXAMETHASONE KRKA
    D.2.1.1.2Name of the Marketing Authorisation holderKRKA
    D.2.1.2Country which granted the Marketing AuthorisationCzech Republic
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/10/745
    D.3 Description of the IMP
    D.3.1Product nameDESAMETASONE
    D.3.2Product code DESAMETASONE
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDEXAMETHASONE
    D.3.9.1CAS number 50-02-2
    D.3.9.4EV Substance CodeSUB07017MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeCORTICOSTEROID
    D.IMP: 7
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/1/16/1094
    D.3 Description of the IMP
    D.3.1Product nameIXAZOMIB 3 MG
    D.3.2Product code IXAZOMIB 3 MG
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNIXAZOMIB
    D.3.9.1CAS number 1072833-77-2
    D.3.9.2Current sponsor codeMLN9708
    D.3.9.3Other descriptive nameIXAZOMIB
    D.3.9.4EV Substance CodeSUB121332
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number3
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeANTINEOPLASTIC AGENTS
    D.IMP: 8
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/1/16/1094
    D.3 Description of the IMP
    D.3.1Product nameIXAZOMIB 2300 μg
    D.3.2Product code IXAZOMIB 2300 μg
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNIXAZOMIB
    D.3.9.1CAS number 1072833-77-2
    D.3.9.2Current sponsor codeMLN9708
    D.3.9.3Other descriptive nameIXAZOMIB
    D.3.9.4EV Substance CodeSUB121332
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2300
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeANTINEOPLASTIC AGENTS
    D.IMP: 9
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name DEXAMETHASONE KRKA
    D.2.1.1.2Name of the Marketing Authorisation holderKRKA
    D.2.1.2Country which granted the Marketing AuthorisationCzech Republic
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/10/745
    D.3 Description of the IMP
    D.3.1Product nameDEXAMETHASONE
    D.3.2Product code DEXAMETHASONE
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDEXAMETHASONE
    D.3.9.1CAS number 50-02-2
    D.3.9.4EV Substance CodeSUB07017MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeCORTICOSTEROID
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    YOUNG PATIENTS AFFECTED BY MULTIPLE MYELOMA (MM) TO THE DIAGNOSIS ELIGIBLE TO THE AUTOLOGOUS TRANSMISSION OF STEM CELLS
    Mladí pacienti s nově diagnostikovaným mnohočetným myelomem
    vhodní pro autologní transpantaci kmenových buněk
    E.1.1.1Medical condition in easily understood language
    YOUNG PATIENTS WITH NEW DIAGNOSIS OF MULTIPLE MYELOMA ELIGIBLE TO THE AUTOLOGOUS TRANSMISSION OF STEM CELLS
    Mladí pacienti s nově diagnostikovaným mnohočetným myelomem
    vhodní pro autologní transpantaci kmenových buněk
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10028228
    E.1.2Term Multiple myeloma
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    -Determine the progression free survival (PFS) at 36 months from first randomization (24 months from second).
    -Determine minimal residual disease (MRD) negativity rate after consolidation according to IMWG criteria, by means of next generation sequencing (NGS)
    -Determine MRD negativity rate during maintenance according to IMWG criteria, by means of next generation sequencing (NGS)
    -Určit přežití bez progrese (PFS) po 36 měsících od první
    randomizace (24 měsíců od druhé)
    -Určit míru negativity minimální reziduální nemoci (MRD) po
    konsolidační léčbě podle kritérií IMWG pomocí příští generace
    sekventování (NGS)
    -Určit míru MRD negativity během udržovací léčby podle kritérií IMWG
    pomocí sekventování příští generace (NGS)
    E.2.2Secondary objectives of the trial
    Determine the overall response rate.
    Determine the VGPR rate
    Determine the CR rate
    Determine the PFS2.
    Determine the safety.
    Determine the duration of response.
    Determine the overall survival.
    Determine the time to progression.
    Determine the time to next therapy
    Determine MRD negativity rate by next generation flow cytometry (NGF) and PET/CT after induction, consolidation and during maintenance
    Determine the role of MRD on OS.
    Determine the MRD duration
    Determine the conversion rate of MRD negativity in MRD positivity and viceversa
    Determine whether tumor response and outcome may change in subgroups with different prognosis according to current prognostic factors.
    Determine the impact of maintenance treatment on MRD (conversion of MRD positive to MRD negative, maintenance of MRD negativity, correlations between MRD and outcome and evaluations in specific subgroups of patients).
    Definition of prognostic factors, as assessed by NGS (MM-panel)
    Evaluate Quality of Life.
    -VGPR
    -CR a sCR
    -PFS2
    -bezpečnost
    -délku léčebné odpovědi (DoR)
    -délku přežití (OS)
    -dobu do progrese (TTP)
    -dobu do další léčby (TNT) (tohle je sekundární cíl 2 části studijního
    protokolu)
    -MRD pomocí průtokové cytometrie NGF a imaging negativitu pomocí
    PET/CT po indukční léčbě, konsolidační léčbě a během udržovací léčby
    -prognostickou roli různé senzitivity MRD (např. dopad na TTP, PFS a OS)
    -dobu trvání MRD
    -míru přechodu na MRD negativitu z MRD pozitivity
    -zda se léčebné odpovědi a výsledky mohou lišit v podskupinách s
    různou prognózou podle aktuálních prognostických faktorů
    -zda se léčebné odpovědi a výsledky mohou lišit v podskupinách s
    různou prognózou podle nových prognostických faktorů, hodnocených
    podle NGS (next-generation sequencing)
    -dopad udržovací léčby na MRD (přechod z MRD pozitivity na negativitu,
    udržení MRD negativity, korelace MRD a výsledků a evaluace
    jednotlivých podskupin pacientů)
    -kvalitu života (QoL)
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    - LIQUID BIOPSY. To compare the quantification of tumor load of BM and PBL by sequencing the NGS gene of the rearrangement of the IgH gene, in order to evaluate whether cfDNA can be used to evaluate MRD in MM patients. PROTOCOL VERSION 1.0, 16/07/2018
    PHENOTYPE AND GENOMIC CHARACTERIZATION OF NEOPLASTIC CLONE (S). To define the plasticity of the MM neoplastic clone at diagnosis and throughout the course of the disease, analyzing both its immunophenotype and the genomic profile. PROTOCOL VERSION 1.0, 16/07/2018
    - TRANSVERSAL SUBJECTS. 1) Qualitative and quantitative analysis of cells derived from the medullary niche (BM) and peripheral blood (PBM) cells obtained from patients enrolled at different times and stages of the disease; 2) Analysis of adenosine levels (ADO) in BM plasma samples of patients enrolled at different times and stages of the disease; 3) Analysis of micro vesicles (MV) derived from peripheral blood and medullary niche of patients enrolled at different times and stages of the disease. The goal is to demonstrate that MV is a carrier of molecular information. PROTOCOL VERSION 1.0, 16/07/2018
    TEKUTÁ BIOPSIE. Porovnat kvantifikaci nádorového zatížení BM a
    PBL sekventováním NGS genu přeskupením genu IgH,
    aby bylo možné vyhodnotit, zda může být cDNA použita k vyhodnocení
    MRD u MM pacientů. Protokol verze 1.0, 16/07/2018. FENOTYP A
    GENOMICKÁ CHARAKTERIZACE NEOPLASTICKÉHO KLONU(S). Určit
    poddajnost neoplastického klonu mnohočetného myelomu MM při
    diagnóze a v průběhu onemocnění, analyzovat jak jeho
    imunofenotyp tak i genomický profil. Protokol verze
    1.0, 16/07/2018. Trasverzální subjekty. 1) Kvalitativní a kvantitativní
    analýza buněk odvozených z medulární niky (KD) a periferní krve (PK)
    buněk získaných od pacientů zařazených v různém období a stadiu
    onemocnění; 2) Analýza hladiny adenosinu v plazmových vzorcích KD
    pacientů zařazených v různém období a stadiu onemocnění; 3) Analýza
    mikrokrystalů odebraných z periferní krve a medulární niky u pacientů
    zařazených v různém období a stadiu onemocnění. Cílem je prokázat, že
    medulární nika je nosičem molekulární informace. PROTOKOL VERZE 1.0,
    16.7.2018
    E.3Principal inclusion criteria
    Patient at least 18 years of age and ≤ 65 years.
     Patient eligible for ASCT.
     LVEF ≥ 40%. 2-D transthoracic echocardiogram (ECHO) is the preferred method of evaluation. Multigated Acquisition Scan (MUGA) is acceptable if ECHO is not available.
     Newly diagnosed multiple myeloma patient.
     Patient has given voluntary written informed consent before performance of any study related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to future medical care.
     Patient with documented multiple myeloma and measurable disease as defined by:
    - Monoclonal plasma cells in the bone marrow ≥10% or presence of a biopsy proven plasmacytoma
    - Measurable disease as defined by at least one of the following:
     serum M-protein level ≥1 g/dL or urine M-protein level ≥200 mg/24 hours; or
     Light chain multiple myeloma: Serum immunoglobulin free light chain ≥10 mg/dL and abnormal serum immunoglobulin kappa lambda free light chain ratio.
    - Evidence of end organ damage/presence of biomarkers of malignancies, specifically:
    - Hypercalcaemia: serum calcium >0.25 mmol/L (>1 mg/dL) higher than the upper limit of normal or >2.75 mmol/L (>11 mg/dL)
    - Renal insufficiency: creatinine clearance <40 mL per min or serum creatinine >177 μmol/L (>2 mg/dL)
    - Anaemia: haemoglobin value of >2 g/dL below the lower limit of normal, or haemoglobin value <10 g/dL
    - Bone lesions: one or more osteolytic lesions on skeletal radiography, CT, or PET-CT or >1 focal lesion on MRI studies (each focal lesion must be 5 mm or more in size)
    - Involved/uninvolved serum free light chain ratio ≥100. The involved free light chain must be ≥100 mg/L.
    - Monoclonal plasma cells in the bone marrow ≥60%
    - Patient is, in the investigator(s) opinion willing and able to comply with the protocol requirements.
    - Women of childbearing potential must commit to either abstain continuously from heterosexual intercourse or to use 2 methods of reliable birth control simultaneously. This includes one highly effective form of contraception (tubal ligation, intrauterine device, hormonal [birth control pills, hormonal patches, vaginal rings or implants] or partner’s vasectomy) and one additional effective contraceptive method (male latex or synthetic condom, diaphragm, or cervical cap). Contraception must begin prior to dosing and 4 weeks before the first dose of thalidomide through 90 days after the last dose of study drug and 6 months after the last dose of cyclophosphamide. Reliable contraception is indicated even where there has been a history of infertility, unless due to hysterectomy or bilateral oophorectomy.
    - Male patient agrees to use an acceptable method for contraception
    (i.e., condom or abstinence) during study drug therapy (including dose
    interruption) and for 90days after the last dose of study drug and 6
    months after the last dose of cyclophosphamide.
    - Patient with an ECOG performance status score of 0, 1, or 2 or Karnofsky performance status ≥ 60%.
    - Pretreatment clinical laboratory values within 30 days of enrolment:
    - Platelet count ≥75 x 109/L;
    - Absolute neutrophil count (ANC) ≥ 1 x 109/L (G-CSF use is permitted);
    - Corrected serum calcium <14 mg/dL (<3.5 mmol/L);
    - Aspartate transaminase (AST) ≤ 2.5 x the upper limit of normal (ULN);
    - Alanine transaminase (ALT) ≤ 2.5 x the ULN;
    - Total bilirubin ≤ 1.5 x the ULN;
    - Calculated or measured creatinine clearance ≥ 30 mL/minute.
     Patient has a life-expectancy >3 months.
    -Pacienti vhodní k provedení ASCT
    -Ejekční frakce levé komory ≥ 40%. 2-D transtorakální echokardiogram
    (ECHO) je preferovanou metodou hodnocení, MultiGated Acquisition
    Scan (MUGA) je přijatelný, pokud ECHO není k dispozici
    -Nově diagnostikovaný pacient s mnohočetným myelomem
    -Podepsaný informovaný souhlas
    -Pacient dobrovolně poskytne písemný informovaný souhlas před
    provedením jakéhokoli procesu souvisejícím se studií, který není
    součástí standardní lékařské péče s tím, že pacient může souhlas kdykoli
    odvolat, aniž by to ovlivnilo následující lékařskou péči
    -Pacient s prokázaným mnohočetným myelomem a měřitelným
    onemocněním podle definice:
    -v kostní dřeni je přítomno ≥10% klonálních plazmocytů, nebo
    plasmocytom prokázán biopsií tkáně
    -měřitelné onemocnění je definováno alespoň jedním z následujících
    znaků:
    -hladina M-proteinu v séru ≥ 1 g/dL, nebo hladina M-proteinů v moči ≥
    200mg/24hodin; nebo
    -mnohočetný myelom lehkých řetězců: volné lehké řetězce séra ≥10
    mg/dL a abnormální poměr volných lehkých řetězců kappa a lambda.
    -Průkaz orgánového postižení / přítomnost biomarkerů malignity,
    konkrétně:
    -hyperkalcémie: vápník v séru o > 0,25 mmol/l (> 1 mg/dL) vyšší než
    horní hranice normální hodnoty, nebo > 2,75 mmol/l (> 11 mg/dL)
    -renální insuficience: clearance kreatininu (CLcr) < 40 ml/min (měřeno
    nebo odhadnuto schválenými rovnicemi) nebo sérový kreatinin > 177
    μmol/l (> 2 mg/dL)
    -anémie: hodnota hemoglobinu > 20g/L pod dolní mezní hodnotou, nebo
    hodnota hemoglobinu < 100 g/L
    -kostní léze: jedna nebo více osteolytických lézí na RTG, CT nebo PET-CT.
    Jestliže je v kostní dřeni <10% klonálních plazmatických buněk, je k
    rozeznání od solitárního plasmacytomu s minimální infiltrací dřeně
    požadován nález více než jedné kostní léze.
    -Jakýkoliv z následujících biomarkerů malignity:
    -≥ 60% klonálních plazmatických buněk v kostní dřeni (Klonalita by
    měla být stanovena flowcytometricky, imunohistochemicky, nebo
    immunofluorescenčně na základě restrikce κ/λ lehkých řetězců.
    Procento plazmatických buněk v kostní dřeni by mělo být přednostně
    XML File Identifier: RwW7uDMt5BSGzh5ApHOEVQli3F0=
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    evaluováno pomocí trepanobiopsie; v případě diskrepance mezi
    aspirátem a trepanobiopsií by měla být použita vyšší hodnota.)
    -poměr mezi postiženými a nepostiženými lehkými řetězci v séru ≥100
    (Hodnoceno Freelite assay. Postižené lehké řetězce musí být ≥100
    mg/L)
    -> 1 fokální léze na MR, každá fokální léze musí mít velikost ≥ 5mm
    -Pacient je dle názoru zkoušejícího ochoten a schopen splnit požadavky
    protokolu
    -Ženy v plodném věku se musí zavázat, že se buď budou trvale zdržovat
    heterosexuálního pohlavního styku, nebo budou používat současně 2
    metody spolehlivé antikoncepce. To zahrnuje jednu vysoce účinnou
    formu kontracepce (ligace vejcovodů, intrauterinní tělísko, hormonální
    formu kontracepce, nebo vasektomii u partnera) a navíc další účinnou
    metodu (mužský latexový nebo syntetický kondom, poševní pesar nebo
    cervikální klobouček). Kontracepci nutno zahájit před podáním léčby a nejméně 4 týdny před podáním thlidomidu 90 dní po podání poslední dávky a 6měsíců po poslední dávky cyklofosfamidu. Účinná antikoncepce je indikována i v
    případě neplodnosti v anamnéze, mimo stavy po hysterektomii či
    oboustranné ovariektomii.
    -Muži souhlasí s používáním akceptovatelné metody antikoncepce (např.
    kondom nebo sexuální absence) během užívání studivé léčby (včetně
    přerušení dávky) a 90 dní po poslední dávce studiového léčby a 6 měsíců po poslední dávce cyklofosfamidu.
    -Pacient hodnocen škálou ECOG skóre 0, 1, nebo 2, nebo Karnovského
    indexem ≥ 60%.
    -Klinické laboratorní hodnoty od 30 dnů před zařazením do studie:
    -počet trombocytů ≥ 75x109/l;
    -absolutní počet neutrofilů (APN) ≥ 1x109/l (použití G-CSF je povoleno);
    -korigovaný sérový vápník <14 mg/dL (< 3,5 mmol/l);
    -aspartátaminotransferáza (AST) ≤ 2,5x vyšší než horní hranice normy
    (ULN);
    -alaninaminotransferáza (ALT) ≤ 2,5x vyšší než ULN;
    -celkový bilirubin ≤ 1,5x vyšší než ULN;
    -vypočítaný nebo změřený clearance kreatininu ≥ 30 ml/min
    -Pacient s očekávanou délkou přežití > 3 měsíce
    E.4Principal exclusion criteria
    - Patient with a diagnosis of primary amyloidosis, monoclonal gammopathy of undetermined significance, plasma cell leukemia or smoldering multiple myeloma. Monoclonal gammopathy of undetermined significance is defined by presence of serum M-protein <3 g/dL; clonal bone marrow plasma cells <10%, and absence of end-organ damage; or amyloidosis that can be attributed to the plasma cell proliferative disorder. Smoldering multiple myeloma is defined as serum monoclonal protein ≥ 30 g/L or urinary monoclonal protein ≥ 500 mg per 24 h and/or clonal bone marrow plasma cell 10-60% with absence of related organ or tissue impairment or end-organ damage or amyloidosis. Plasma cell leukemia is defined as the presence of circulating plasmacells (PCs) >2×109/L in peripheral blood or a peripheral blood plasmacytosis >20%.
    - Patient with a diagnosis of Waldenström’s disease, or other conditions in which IgM M-protein is present in the absence of a clonal plasma cell infiltration with lytic bone lesions.
    - Patient has prior or current systemic therapy or SCT for multiple myeloma, with the exception of an emergency use of a short course (equivalent of dexamethasone 40 mg/day for a maximum 4 days) of corticosteroids before treatment.
    - Patient has peripheral neuropathy of grade 2 or higher as defined by National Cancer Institute Common Toxicity Criteria (NCI CTC) 4.0.
    - Patient is exhibiting clinical signs of meningeal involvement of multiple myeloma.
    - Clinical active infectious hepatitis type A, B, C or HIV.
    - Subject has known chronic obstructive pulmonary disease (COPD) (defined as a forced expiratory volume in 1 second [FEV1] <60% of predicted normal), persistent asthma, or a history of asthma within the last 2 years. Subjects with known or suspected COPD or asthma must have a FEV1 test during screening.
    - Evidence of current uncontrolled cardiovascular conditions, including uncontrolled hypertension, uncontrolled cardiac arrhythmias, symptomatic congestive heart failure, unstable angina, or myocardial infarction within the past 6 months.
    - Known allergy to any of the study medications, their analogues, or excipients in the various formulations.
    Page 36 of 102
    - Contraindication to any of the required concomitant drugs or supportive treatments.
    - Pregnant or lactating females.
    - Acute active infection requiring antibiotics or infiltrative pulmonary disease.
    - Serious medical condition, laboratory abnormality or psychiatric illness that prevented the subject from the enrolment or place the subject at unacceptable risk.
    - Incidence of gastrointestinal disease that may significantly alter the absorption of oral drugs.
    - Invasive malignancy within the past 5 years.
    - Major surgery within 14 days before enrollment.
    - Radiotherapy within 14 days before enrollment. If the involved field is small, 7 days will be considered a sufficient interval between treatment and administration of the ixazomib.
    - Live vaccine 30 days before start of treatment and 90 days after the end of study treatment.
    - Infection requiring systemic antibiotic therapy or other serious infection within 14 days before study enrollment.
    - Systemic treatment, within 14 days before the first dose of ixazomib, with strong CYP3A inducers (rifampin, rifapentine, rifabutin, carbamazepine, phenytoin, phenobarbital), or use of St. John’s wort.
    - Participation in other clinical trials, including those with other investigational agents not included in this trial, within 30 days of the start of this trial and throughout the duration of this trial.
    - Patients that have previously been treated with ixazomib, or participated in a study with ixazomib whether treated with ixazomib or not.
    -Pacient s diagnózou primární amyloidózy, monoklonální gamapatií
    nejasného významu, plazmocelulární leukémie, nebo doutnajícím
    mnohočetným myelomem. Monoklonální gamapatie nejasného významu
    je definována přítomností sérového M-proteinu < 3 g/dl; < 10%
    klonálních plazmocytů v kostní dřeni a nepřítomností poškození orgánů;
    nebo amyloidózou, která může být spojena s plasmocelulární dyskázií.
    Doutnající mnohočetný myelom je definován jako množství sérového
    monoklonálního proteinu ≥ 30 g/l nebo monoklonálního proteinu v moči
    ≥ 500 mg za 24 hodin a/nebo 10-60% klonálních plazmatických buněk v
    kostní dřeni, dále nepřítomností poškození orgánů nebo amyloidózy.
    Plazmacelulární leukémie je definována přítomností > 2×109/l
    cirkulujících plazmatických buněk (PC) v periferní krvi, nebo plazmatické
    buňky tvoří > 20% všech krvinek bílé řady v periferní krvi.
    -Pacient s diagnózou Waldenströmovy choroby nebo jiných stavů, u
    nichž je přítomen IgM M-protein bez infiltrace klonálních plazmatických
    buněk s lytickými kostními lézemi.
    -Pacient podstoupil nebo v současné době podstupuje systémovou
    terapii nebo transplantaci kostní dřeně pro mnohočetný myelom, vyjíma
    akutního podání krátkého cyklu (ekvivalent 40 mg dexametazonu za den
    po dobu maximálně 4 dnů) kortikosteroidů před léčbou.
    -Pacient má periferní neuropatii stupně 2 a výše na základě kritérií
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    Page 48/62
    stanovených v National Cancer Institute Common Toxicity Criteria (NCI
    CTC) 4.0.
    -Pacient vykazuje klinické příznaky meningeálního postižení
    mnohočetným myelomem.
    -Klinicky aktivní infekční hepatitida typu A, B, C nebo HIV.
    -Pacient má diagnostikovanou chronickou obstrukční plicní nemoc
    (CHOPN) s usilovně vydechnutým objemem za 1 sekundu (FEV1) < 60%
    předpokládané normy, persistující astma nebo anamnézu astmatu v
    posledních 2 letech. Subjekty se známou nebo suspektní CHOPN nebo
    astma musí mít FEV1 test během screeningu.
    -Průkaz současných dekompenzovaných kardiovaskulárních stavů,
    včetně dekompenzované hypertenze, dekompenzované srdeční arytmie,
    symptomatického městnavého srdečního selhání, nestabilní angíny
    pectoris nebo infarktu myokardu během posledních 6 měsíců.
    -Známá alergie na kterýkoli ze studiových léků, jejich analoga nebo užité
    pomocné látky.
    -Kontraindikace k jakémukoli z požadovaných konkomitantních léků
    nebo k podpůrné léčbě.
    -Těhotné nebo kojící ženy.
    -Akutní aktivní infekce vyžadující antibiotika nebo plicní zánětlivá
    onemocnění.
    -Závažný zdravotní stav, laboratorní abnormality nebo psychiatrické
    onemocnění, které by mohly subjektu bránit ve vstupu do studie nebo
    vystavily subjekt nepřijatelnému riziku.
    -Přítomnost gastrointestinálního onemocnění, které může významně
    změnit absorpci perorálních léků.
    -Invazivní maligní onemocnění během posledních 5 let.
    -Závažná operace během 14 dnů před zařazením do studie.
    -Radioterapie během 14 dnů před zařazením do studie. Pokud je
    ozařovaná oblast malá, považuje se 7 dnů za dostatečný interval mezi
    léčbou a podáním ixazomibu.
    - Žívá vakcína30 dní před začátkem léčbya 90 dnů po spončení studie.
    - Infekce vyžadující systémovou antibiotickou léčbu nebo jiná závažná
    infekce během 14 dnů před zařazením do studie.
    -Systémová léčba silnými induktory CYP3A (rifampin, rifapentin,
    rifabutin, karbamazepin, fenytoin, fenobarbital) nebo užívání třezalky
    tečkované během 14 dnů před první dávkou ixazomibu.
    -Účast v jiných klinických studiích, včetně těch s jinými látkami, které
    nejsou zahrnuty do této studie, během 30 dnů od zahájení této studie a
    po celou dobu trvání této studie.
    -Pacienti, kteří byli dříve léčeni ixazomibem, nebo se účastnili studie s
    ixazomibem, ať už zde byli léčeni ixazomibem nebo ne.
    E.5 End points
    E.5.1Primary end point(s)
    -Progression free survival (PFS)
    -MRD negativity
    -přežití bez progrese (PFS)
    -minimální reziduální nemoc MRD negativita
    E.5.1.1Timepoint(s) of evaluation of this end point
    NA
    NA
    E.5.2Secondary end point(s)
    - Overall response rate (ORR)
    -Progression free survival 2 (PFS2)
    - Duration of response (DoR)
    - Overall survival (OS)
    - Time to the next anti-myeloma therapy (TNT)
    -MRD by NGF and PET/CT
    -Definition of prognostic factors, as assessed by NGS (MM-panel)
    - celková léčebná odpověď
    - přežití bez progrese 2 (PFS2)
    - délka léčebné odpovědi
    - délka přežití
    - doba do další proti- myelomové léčby
    - MRD pomocí NGF a PET/CT
    - Definice prognostických faktorů, stanovená NGS (MM-panel)
    E.5.2.1Timepoint(s) of evaluation of this end point
    NA
    NA
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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.8.4.1Number of sites anticipated in Member State concerned20
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA50
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.7Trial 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
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years5
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years5
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 400
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state184
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 400
    F.4.2.2In the whole clinical trial 400
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    CURRENT CLINICAL PRACTICE
    Současná klinická praxe
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2019-08-21
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-10-08
    P. End of Trial
    P.End of Trial StatusOngoing
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