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    Summary
    EudraCT Number:2018-002625-38
    Sponsor's Protocol Code Number:ADCT-402-103
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-01-22
    Trial results View 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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2018-002625-38
    A.3Full title of the trial
    A Phase 1/2 Open-Label Study to Evaluate the Safety and Efficacy of Loncastuximab Tesirine and Ibrutinib in Patients with Advanced Diffuse Large B-Cell Lymphoma or Mantle Cell Lymphoma
    Studio in aperto di fase 1/2 per valutare la sicurezza e l’efficacia di loncastuximab tesirina e ibrutinib in pazienti con linfoma diffuso a grandi cellule B o linfoma a cellule mantellari in stadio avanzato
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    study to assess how safe and how effective is Loncastuximab Tesirine together with Ibrutinib in patients with Advanced Diffuse Large B Cell Lymphoma or Mantle Cell Lymphoma
    studio per valutare la sicurezza e l'efficacia di Loncastuximab Tesirina insieme a Ibrutinib in pazienti con linfoma diffuso a grandi cellule B o linfoma a cellule mantellari in stadio avanzato
    A.3.2Name or abbreviated title of the trial where available
    ADCT-402-103
    ADCT-402-103
    A.4.1Sponsor's protocol code numberADCT-402-103
    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 SponsorADC THERAPEUTICS SA
    B.1.3.4CountrySwitzerland
    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 supportADC Therapeutics SA
    B.4.2CountrySwitzerland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationADC Therapeutics SA
    B.5.2Functional name of contact pointClinical Trials Information
    B.5.3 Address:
    B.5.3.1Street AddressRoute de la Corniche, 3B
    B.5.3.2Town/ cityEpalinges
    B.5.3.3Post code1066
    B.5.3.4CountrySwitzerland
    B.5.6E-mailclinicaltrials@adctherapeutics.com
    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 No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameLoncastuximab Tesirine
    D.3.2Product code [ADCT-402]
    D.3.4Pharmaceutical form 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 INNLoncastuximab Tesirine
    D.3.9.2Current sponsor codeADCT-402
    D.3.9.4EV Substance CodeSUB181458
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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 No
    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 Yes
    D.2.1.1.1Trade name Imbruvica
    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 Yes
    D.2.5.1Orphan drug designation numberEU/3/13/1115
    D.3 Description of the IMP
    D.3.1Product nameIbrutinib
    D.3.2Product code [Ibrutinib]
    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 INNIbrutinib
    D.3.9.1CAS number 936563-96-1
    D.3.9.2Current sponsor codeIBRUTINIB
    D.3.9.4EV Substance CodeSUB120863
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number140
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 No
    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 nameLoncastuximab Tesirine
    D.3.2Product code [ADCT-402]
    D.3.4Pharmaceutical form 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 INNLoncastuximab Tesirine
    D.3.9.2Current sponsor codeADCT-402
    D.3.9.4EV Substance CodeSUB181458
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Yes
    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 No
    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
    Diffuse large B-Cell lymphoma (DLBCL) or mantle cell lymphoma (MCL)
    linfoma diffuso a grandi cellule B (DLBCL) o linfoma a cellule mantellari (MCL)
    E.1.1.1Medical condition in easily understood language
    Diffuse large B-Cell lymphoma (DLBCL) or mantle cell lymphoma (MCL)
    linfoma diffuso a grandi cellule B (DLBCL) o linfoma a cellule mantellari (MCL)
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10061275
    E.1.2Term Mantle cell lymphoma
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level PT
    E.1.2Classification code 10012818
    E.1.2Term Diffuse large B-cell lymphoma
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Phase 1:
    To characterize the safety and tolerability of loncastuximab tesirine in combination with ibrutinib, and to identify the Maximum tolerated dose (MTD) /recommended dose and schedule for future studies
    Phase 2:
    To evaluate the efficacy of loncastuximab tesirine in combination with ibrutinib in patients with relapsed or refractory nongerminal center B-cell (GCB) DLBCL by assessing the complete response rate (CRR)
    Fase 1:
    • Caratterizzare la sicurezza e la tollerabilità di loncastuximab tesirina in combinazione con ibrutinib e identificare la dose massima tollerata (MTD)/dose raccomandata e il relativo schema per studi futuri
    Fase 2:
    • Valutare l’efficacia di loncastuximab tesirina in combinazione con ibrutinib in pazienti con DLBCL non a cellule B del centro germinativo (GCB) recidivante o refrattario calcolando il tasso di risposta completa complessiva (CRR)
    E.2.2Secondary objectives of the trial
    Phase 1
    •To evaluate the antitumor effect of the combination of loncastuximab tesirine with ibrutinib
    •To characterize the pharmacokinetic (PK) profile of loncastuximab tesirine when given in combination with ibrutinib
    •To evaluate the immunogenicity of loncastuximab tesirine when given in combination with ibrutinib
    Phase 2
    •To further evaluate the safety and efficacy of loncastuximab tesirine in combination with ibrutinib in non-GCB DLBCL, GCB DLBCL and MCL patients
    •To further evaluate the PK profile and immunogenicity of loncastuximab tesirine when given in combination with ibrutinib
    •To evaluate the impact of the combination on patient-reported outcomes (PROs)
    Fase 1:
    • Valutare l’effetto antitumorale della combinazione di loncastuximab tesirina con ibrutinib
    • Caratterizzare il profilo farmacocinetico (PK) di loncastuximab tesirina quando somministrato in combinazione con ibrutinib
    • Valutare l’immunogenicità di loncastuximab tesirina quando somministrato in combinazione con ibrutinib
    Fase 2:
    • Valutare ulteriormente la sicurezza e l’efficacia di loncastuximab tesirina in combinazione con ibrutinib in pazienti con DLBCL non-GCB, DLBCL GCB e MCL
    • Valutare ulteriormente il profilo PK e l’immunogenicità di loncastuximab tesirina quando somministrato in combinazione con ibrutinib
    • Valutare l’impatto della combinazione sugli esiti riferiti dal paziente (PRO)
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1.Male or female patient aged 18 years or older
    2.Pathologic diagnosis of DLBCL, or MCL (Note: MCL patients are not eligible in Italy.)
    3.Patients with DLBCL must have relapsed or refractory disease and have failed or been intolerant to available standard therapy
    4.Patients with MCL must have relapsed or refractory disease and have received at least one prior line of therapy (Note: MCL patients are not eligible in Italy.)
    5.Patients who have received previous CD19-directed therapy must have a biopsy which shows CD19 expression after completion of the CD19-directed therapy
    6.Measurable disease as defined by the 2014 Lugano Classification
    7.Availability of formalin-fixed paraffin-embedded (FFPE) tumor tissue block (or minimum 10 freshly cut unstained slides if block is not available)
    Note: Any biopsy since initial diagnosis is acceptable, but if several samples are available, the most recent sample is preferred.
    8.ECOG performance status 0 to 2
    9.Screening laboratory values within the following parameters:
    a.Absolute neutrophil count (ANC) =1.0 × 10^3/µL (off growth factors at least 72 hours)
    b.Platelet count =75 × 10^3/µL without transfusion in the past 7 days
    c.Hemoglobin =8 g/dL (4.96 mmol/L), transfusion allowed
    d.Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma glutamyl transferase (GGT) =2.5 × the upper limit of normal (ULN);
    e.Total bilirubin =1.5 × ULN (patients with known Gilbert’s syndrome may have a total bilirubin up to =3 × ULN)
    f.Blood creatinine =1.5 × ULN or calculated creatinine clearance =60 mL/min by the Cockcroft and Gault equation
    Note: A laboratory assessment may be repeated a maximum of two times during the Screening period to confirm eligibility.
    10.Negative beta-human chorionic gonadotropin (ß-HCG) pregnancy test within 7 days prior to start of study drugs on C1D1 (cycle 1 day 1) for women of childbearing potential
    11.Women of childbearing potential must agree to use a highly effective method of contraception from the time of giving informed consent until at least 16 weeks after the last dose of study therapy. Men with female partners who are of childbearing potential must agree that they will use a highly effective method of contraception from the time of giving informed consent until at least 20 weeks after the patient receives his last dose of study therapy
    1. Pazienti di sesso maschile o femminile, di età pari o superiore a 18 anni
    2. Diagnosi patologica di DLBCL, o MCL (Nota: i pazienti con MCL non sono idonei in Italia.)
    NOTA: pazienti con MCL non possono essere arruolati in Italia
    3. I pazienti con DLBCL devono presentare malattia recidivante o refrattaria e non devono aver risposto o essere stati intolleranti alla terapia standard disponibile
    4. I pazienti con MCL devono presentare malattia recidivante o refrattaria e devono aver ricevuto almeno una precedente linea di terapia (Nota: i pazienti con MCL non sono idonei in Italia.)
    NOTA: pazienti con MCL non possono essere arruolati in Italia
    5. I pazienti che hanno ricevuto una precedente terapia diretta a CD19 devono presentare una biopsia che dimostri l’espressione di CD19 dopo il completamento della terapia diretta a CD19
    6. Malattia misurabile, definita secondo la classificazione di Lugano del 2014
    7. Disponibilità di un blocchetto di tessuto tumorale fissato in formalina e incluso in paraffina (FFPE) (o, se il blocchetto non è disponibile, almeno 10 vetrini non colorati, appena preparati)
    Nota: è accettabile qualsiasi biopsia dalla diagnosi iniziale; tuttavia, in presenza di più campioni, è preferibile il campione più recente.
    8. Stato di validità secondo il Gruppo cooperativo orientale di oncologia (ECOG) da 0 a 2
    9. Valori di laboratorio allo screening all’interno dei seguenti parametri:
    a. Conta assoluta dei neutrofili (ANC) =1,0 × 10^3/µl (a distanza dai fattori di crescita di almeno 72 ore)
    b. Conta piastrinica =75 × 10^3/µl senza trasfusione nei 7 giorni precedenti
    c. Emoglobina =8 g/dl (4,96 mmol/l); sono consentite le trasfusioni
    d. Alanina aminotransferasi (ALT), aspartato aminotransferasi (AST) e gamma-glutamil transferasi (GGT) =2,5 volte il limite superiore della normalità (ULN);
    e. Bilirubina totale =1,5 volte l’ULN (i pazienti affetti da sindrome di Gilbert nota possono presentare un livello di bilirubina totale fino a =3 volte l’ULN)
    f. Creatinina nel sangue =1,5 volte l’ULN o clearance della creatinina calcolata =60 ml/min in base all’equazione di Cockcroft e Gault
    Nota: per la conferma dell’idoneità, una valutazione di laboratorio può essere ripetuta al massimo due volte durante il periodo di screening.
    10. Test di gravidanza negativo alla beta-gonadotropina corionica umana (ß-HCG) nei 7 giorni precedenti l’inizio dei farmaci dello studio il C1G1 (Giorno 1 del Ciclo 1) per le donne in età fertile
    11. Le donne in età fertile devono accettare di utilizzare un metodo contraccettivo altamente efficace a partire dal momento del rilascio del consenso informato fino ad almeno 16 settimane dopo l’ultima dose di terapia dello studio. Gli uomini con compagne in età fertile devono accettare di utilizzare un metodo contraccettivo altamente efficace a partire dal momento del rilascio del consenso informato fino ad almeno 20 settimane dopo l’ultima dose di terapia dello studio ricevuta dal paziente
    E.4Principal exclusion criteria
    1.Known history of hypersensitivity to or positive serum human ADA to a CD19 antibody
    2.Known history of hypersensitivity to ibrutinib
    3.Previous therapy with ibrutinib or other BTK inhibitors
    4.Previous therapy with loncastuximab tesirine
    5.Requires treatment or prophylaxis with a moderate or strong cytochrome P450 (CYP) 3A inhibitor
    6.Allogenic or autologous transplant within 60 days prior to start of study drugs (C1D1)
    7.Active graft-versus-host disease
    8.Post-transplantation lymphoproliferative disorder
    9.Active autoimmune disease, including motor neuropathy considered of autoimmune origin and other central nervous system (CNS) autoimmune disease
    10.Known seropositive and requiring anti-viral therapy for human immunodeficiency (HIV) virus, hepatitis B virus (HBV), or hepatitis C virus (HCV).
    11.History of Stevens-Johnson syndrome or toxic epidermal necrolysis
    12.Lymphoma with active CNS involvement at the time of screening, including leptomeningeal disease
    13.Clinically significant third space fluid accumulation (i.e., ascites requiring drainage or pleural effusion that is either requiring drainage or associated with shortness of breath)
    14.Breastfeeding or pregnant
    15.Significant medical comorbidities, including but not limited to, uncontrolled hypertension (blood pressure [BP] =160/100 mmHg repeatedly), unstable angina, congestive heart failure (greater than New York Heart Association class II), electrocardiographic evidence of acute ischemia, coronary angioplasty or myocardial infarction within 6 months prior to screening, uncontrolled atrial or ventricular cardiac arrhythmia, poorly controlled diabetes mellitus, or severe chronic pulmonary diseaseor tuberculosis infection (tuberculosis screening based on local standards)
    16.Major surgery, radiotherapy, chemotherapy, or other anti-neoplastic therapy within 14 days prior to start of study drugs (C1D1), except shorter if approved by the Sponsor
    17.Use of any other experimental medication within 14 days prior to start of study drugs (C1D1)
    18.Planned live vaccine administration after starting study drugs (C1D1)
    19.Any condition that could interfere with the absorption or metabolism of ibrutinib including malabsorption syndrome, disease significantly affecting gastrointestinal function, or resection of the stomach or small bowel
    20.Inherited or acquired bleeding disorders
    21.Ongoing anticoagulation treatment, except for low dose heparinisation or equivalent
    22.Failure to recover to Grade =1 (Common Terminology Criteria for Adverse Events [CTCAE] version 4.0) from acute non-hematologic toxicity (Grade =2 neuropathy or alopecia) due to previous therapy prior to screening
    23.Congenital long QT syndrome or a corrected QTcF interval of >480 ms at screening (unless secondary to pacemaker or bundle branch block)
    24.Active second primary malignancy other than non-melanoma skin cancers, non-metastatic prostate cancer, in situ cervical cancer, ductal or lobular carcinoma in situ of the breast, or other malignancy that the Sponsor’s medical monitor and Investigator agree, and document should not be exclusionary
    25.Any other significant medical illness, abnormality, or condition that would, in the Investigator’s judgment, make the patient inappropriate for study participation or put the patient at risk
    1. Nota anamnesi di ipersensibilità o sieropositività della ADA umana a un anticorpo anti-CD19
    2. Nota anamnesi di ipersensibilità a ibrutinib
    3. Precedente terapia con ibrutinib o altri inibitori di BTK
    4. Precedente terapia con loncastuximab tesirina
    5. Necessità di trattamento o profilassi con un inibitore forte o moderato del citocromo P450 (CYP) 3A
    6. Trapianto allogenico o autologo di cellule staminali nei 60 giorni precedenti l’inizio della somministrazione dei farmaci dello studio (C1G1)
    7. Malattia da trapianto contro l’ospite attiva
    8. Disturbo linfoproliferativo post-trapianto
    9. Malattia autoimmune attiva, tra cui neuropatia motoria considerata di origine autoimmune e altra malattia autoimmune a carico del sistema nervoso centrale (SNC)
    10. Nota sieropositività, con necessità di terapia antivirale, al virus dell’immunodeficienza umana (HIV), al virus dell’epatite B (HBV) o al virus dell’epatite C (HCV).
    11. Anamnesi di sindrome di Steven-Johnson o necrolisi epidermica tossica
    12. Linfoma con coinvolgimento attivo del SNC al momento dello screening, tra cui malattia leptomeningea
    13. Accumulo di liquidi nel terzo spazio clinicamente significativo (ovvero, ascite che necessita di drenaggio o effusione pleurica che necessita di drenaggio o associata a respiro affannoso)
    14. Allattamento al seno o gravidanza
    15. Comorbilità di significatività medica, tra cui, a titolo non esaustivo, ipertensione non controllata (pressione sanguigna [PS] ripetutamente =160/100 mmHg), angina instabile, insufficienza cardiaca congestizia (superiore alla classe II dell’Associazione dei cardiologi di New York), evidenza elettrocardiografica di ischemia acuta, angioplastica coronarica o infarto miocardico nei 6 mesi precedenti lo screening, aritmia cardiaca atriale o ventricolare non controllata, diabete mellito scarsamente controllato o grave malattia polmonare cronica o infezione da tubercolosi (screening per la tunercolosi in base agli standard locali)
    16. Intervento chirurgico maggiore, radioterapia, chemioterapia o altra terapia antineoplastica nei 14 giorni precedenti l’inizio della somministrazione dei farmaci dello studio (C1G1), o prima se approvato dallo sponsor
    17. Utilizzo di qualsiasi altro farmaco sperimentale nei 14 giorni precedenti l’inizio della somministrazione dei farmaci dello studio (C1G1)
    18. Somministrazione di un vaccino vivo programmata dopo l’inizio della somministrazione dei farmaci dello studio (C1G1)
    19. Qualsiasi condizione che potrebbe interferire con l’assorbimento o il metabolismo di ibrutinib, tra cui sindrome da malassorbimento, malattia che compromette significativamente la funzione gastrointestinale o resezione dello stomaco o dell’intestino tenue
    20. Disturbi emorragici ereditari o acquisiti
    21. Terapia anticoagulante in corso corso, fatta eccezione per agenti eparinizzanti a basso dosaggio o equivalenti
    22. Mancata guarigione di grado =1 (Criteri terminologici comuni per gli eventi avversi [CTCAE] versione 4.0) da tossicità acuta non ematologica (neuropatia di grado =2 o alopecia) dovuta a una precedente terapia, antecedente lo screening
    23. Sindrome congenita dell’intervallo QT lungo o un intervallo QTcF corretto >480 ms allo screening (se non secondaria all’impianto di pacemaker o blocco del plesso brachiale)
    24. Secondo tumore maligno primario attivo diverso da tumori cutanei non melanomatosi, carcinoma prostatico non metastatico, carcinoma cervicale in situ, carcinoma mammario duttale o lobulare in situ o altri tumori maligni che il responsabile del monitoraggio medico dello sponsor e lo sperimentatore convengono e documentano come criterio non esclusorio
    25. Qualsiasi altra patologia di significatività medica, anomalia o condizione che, secondo l’opinione dello sperimentatore, renderebbe il paziente non idoneo alla partecipazione allo studio o metterebbe il paziente a rischio
    E.5 End points
    E.5.1Primary end point(s)
    Phase 1:
    •Frequency and severity of adverse events (AEs) and serious adverse events (SAEs)
    •Incidence of dose limiting toxicities (DLTs) (dose escalation only)
    •Frequency of dose interruptions and dose reductions
    •Changes from baseline of safety laboratory values, vital signs, Eastern Cooperative Oncology Group (ECOG) performance status, and 12-lead electrocardiograms (ECGs)
    Phase 2:
    •Complete response rate (CRR) according to the 2014 Lugano
    classification (Cheson et al., 2014) as determined by investigator and/or
    Independent Review Committee (IRC) in non GCB DLBCL patient cohort
    only; CRR defined as the proportion of patients with a best overall
    response (BOR) of CR.
    Fase 1:
    • Frequenza e gravità degli eventi avversi (EA) e degli eventi avversi seri (SAE)
    • Incidenza di tossicità dose-limitanti (DLT) (solo per l’incremento della dose)
    • Frequenza di interruzioni della dose e riduzioni della dose
    • Variazioni rispetto al basale nei valori di laboratorio relativi alla sicurezza, segni vitali, stato di validità del Gruppo cooperativo orientale di oncologia (ECOG) ed elettrocardiogrammi (ECG) a 12 derivazioni
    Fase 2:
    • Tasso di risposta completa (CRR) secondo la Classificazione di Lugano 2014 (Cheson etr al. 2014) determinato dallo sperimentatore e/o dal Comitato di revisione indipendente (IRC) solo nella coorte di pazienti con DLBCL non-GCB; il CRR è definito come la percentuale di pazienti con una migliore risposta complessiva (BOR) di CR solo nella coorte di pazienti con DLBCL non-GCB
    E.5.1.1Timepoint(s) of evaluation of this end point
    there are different timepoints for the evaluation of the primary endpoints
    ci sono diverse tempistiche per la valutazione degli endpoint primari
    E.5.2Secondary end point(s)
    Phase 1:
    •Overall response rate (ORR) according to the 2014 Lugano classification as determined by investigator. Overall response rate defined as the proportion of patients with a best overall response (BOR) of complete response (CR) or partial response (PR)
    Phase 1 and Phase 2:
    •Duration of response (DOR) defined as the time from the
    documentation of first tumor response to disease progression or death in
    the non-GCB DLBCL, GCB DLBCL, all DLBCL and MCL patients
    •Relapse-free survival (RFS) defined as the time from the
    documentation of CR to disease progression or death
    in the non GCB DLBCL, GCB DLBCL, all DLBCL, and MCL patients
    •Progression-free survival (PFS) defined as the time between start of
    treatment and the first documentation of progression, or death
    in the non GCB DLBCL, GCB DLBCL, all DLBCL, and MCL patients
    •Overall survival (OS) defined as the time between the start of
    treatment and death from any cause in the non GCB DLBCL, GCB DLBCL,
    all DLBCL, and MCL patients
    •Concentrations and PK parameters of loncastuximab tesirine (total
    antibody, pyrrolobenzodiazepine (PBD)-conjugated antibody, and
    unconjugated cytotoxin SG3199) in the non GCB DLBCL, GCB DLBCL, all
    DLBCL, and MCL patients
    •Anti-drug antibody (ADA) titers and, if applicable, neutralizing activity
    to loncastuximab tesirinei n the non GCB DLBCL, GCB DLBCL, all DLBCL,
    and MCL patients
    Phase 2:
    •ORR according to the 2014 Lugano classification in the non GCB DLBCL,
    GCB DLBCL, all DLBCL, and MCL patients. ORR as determined by
    Investigator and/or IRC.
    •CRR according to the 2014 Lugano classification (Cheson et al., 2014)
    as determined by Investigator and/or IRC in GCB DLBCL, all DLBCL, MCL
    patients.
    •CRR according to the 2014 Lugano classification (Cheson et al., 2014)
    as determined by Investigator in non-GCB DLBCL patients.
    •Frequency and severity of AEs and SAEs, in the non GCB DLBCL, GCB
    DLBCL, all DLBCL, and MCL patients
    •Changes from baseline of safety laboratory values, vital signs, ECOG
    performance status, and 12-lead ECGs in the non GCB DLBCL, GCB
    DLBCL, all DLBCL and MCL patients
    •Change from baseline in symptoms, functions and overall health status
    as measured by The European Organization for Research and Treatment
    of Cancer (EORTC) quality of life questionnaire (QLQ) C30, LymS of
    FACT-Lym, and EQ-5D-5L in the non GCB DLBCL, GCB DLBCL, all DLBCL
    and MCL patients
    Fase 1:
    • Tasso di risposta complessiva (ORR) secondo la classificazione di Lugano 2014 determinato dallo sperimentatore. Tasso di risposta complessiva definito come la percentuale di pazienti con una risposta complessiva migliore (BOR) di risposta completa (CR) o risposta parziale (PR)
    Fase 1 e Fase 2:
    • Durata della risposta (DOR) definita come il tempo dalla documentazione della prima risposta del tumore alla progressione della malattia o al decesso nei pazienti con DLBCL non-GCB, DLBCL GCB, tutti i DLBCL e MCL
    • Sopravvivenza libera da recidiva (RFS) definita come il tempo dalla documentazione della CR alla progressione della malattia o al decesso nei pazienti con DLBCL non-GCB, DLBCL GCB, tutti i DLBCL e MCL
    • Sopravvivenza libera da progressione (PFS) definita come il tempo tra l’inizio del trattamento e la prima documentazione di progressione o decesso nei pazienti con DLBCL non-GCB, DLBCL GCB, tutti i DLBCL e MCL
    • Sopravvivenza complessiva (OS) definita come il tempo tra l’inizio del trattamento e il decesso per qualsiasi causa nei pazienti con DLBCL non-GCB, DLBCL GCB, tutti i DLBCL e MCL
    • Concentrazioni e parametri PK di loncastuximab tesirina (anticorpo totale, anticorpo coniugato con pirrolobenzodiazepina [PBD] e citotossina non coniugata SG3199) nei pazienti con DLBCL non-GCB, DLBCL GCB, tutti i DLBCL e MCL
    • Titoli dell’anticorpo anti-farmaco (ADA) e, se pertinente, attività neutralizzante verso loncastuximab tesirina nei pazienti con DLBCL non-GCB, DLBCL GCB, tutti i DLBCL e MCL
    Fase 2:
    • ORR secondo la Classificazione di Lugano 2014 nei pazienti con DLBCL non-GCB, DLBCL GCB, tutti i DLBCL e MCL. L’ORR è definito come la percentuale di pazienti con una BOR di CR o PR per tutti i pazienti trattati ed è determinato dallo sperimentatore e/o dall’IRC
    • CRR secondo la Classificazione di Lugano 2014 (Cheson et al. 2014), come determinato dallo sperimentatore e/o dall’IRC in pazienti con DLBCL GCB, tutti i DLBCL e MCL
    • CRR secondo la Classificazione di Lugano 2014 (Cheson et al. 2014), come determinato dallo sperimentatore in pazienti con DLBCL non-GCB
    • Frequenza e gravità di EA e SAE nei pazienti con DLBCL non-GCB, DLBCL GCB, tutti i DLBCL e MCL
    • Variazioni rispetto al basale nei valori di laboratori di sicurezza, segni vitali, stato di validità ECOG ed ECG a 12 derivazioni nei pazienti con DLBCL non-GCB, DLBCL GCB, tutti i DLBCL e MCL
    • Variazioni rispetto al basale nei sintomi, nelle funzioni e nello stato di salute generale come misurato mediante il Questionario sulla qualità della vita-Modulo principale a 30 voci (QLQ-C30) dell’Organizzazione europea per la ricerca e il trattamento dei tumori (EORTC), la Sottoscala sul linfoma (LymS) della Valutazione funzionale della terapia antitumorale per il linfoma (FACT-Lym) e il Questionario europeo sulla qualità della vita a 5 dimensioni e 5 livelli (EQ-5D-5L) nei pazienti con DLBCL non-GCB, DLBCL GCB, tutti i DLBCL e MCL
    E.5.2.1Timepoint(s) of evaluation of this end point
    there are different timepoints for the evaluation of secondary endpoints
    ci sono diverse tempistiche per la valutazione degli endpoint primari
    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 No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    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) Yes
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other Yes
    E.7.1.3.1Other trial type description
    phase Ib dose escalation + dose expansion
    fase 1b di aumento della dose + espansione della dose
    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 No
    E.8.1.1Randomised No
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    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) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial1
    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 concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA14
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    United States
    Belgium
    France
    Italy
    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
    last visit or last scheduled procedure for the last patient
    ultima visita o ultima procedura programmata per l'ultimo paziente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    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 years4
    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: 113
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 48
    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 Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    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 state45
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 95
    F.4.2.2In the whole clinical trial 161
    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)
    after the patient has ended participation on the study, standard of care treatment by their physician is expected
    dopo che il paziente ha terminato la partecipazione allo studio, si prevede il trattamento standard da parte del proprio medico
    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 Decision2019-01-22
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-11-27
    P. End of Trial
    P.End of Trial StatusOngoing
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