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    Summary
    EudraCT Number:2018-003340-24
    Sponsor's Protocol Code Number:LOXO-BTK-18001
    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:2021-01-28
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2018-003340-24
    A.3Full title of the trial
    A Phase 1/2 Study of Oral LOXO-305 in Patients with Previously Treated Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) or Non-Hodgkin Lymphoma (NHL)
    Studio di fase 1/2 su LOXO-305 per via orale in pazienti affetti da leucemia linfatica cronica/linfoma a piccoli linfociti (LLC/SLL) o linfoma non Hodgkin (LNH) precedentemente trattati
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    An Early Phase Study with the Drug LOXO-305 in Patients with Previously Treated Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) or Non-Hodgkin Lymphoma (NHL)
    Uno studio di fase precoce con il farmaco LOXO-305 in pazienti con leucemia linfatica cronica / linfoma linfocitario piccolo (CLL / SLL) o linfoma non-Hodgkin (NHL) precedentemente trattati
    A.3.2Name or abbreviated title of the trial where available
    -
    -
    A.4.1Sponsor's protocol code numberLOXO-BTK-18001
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT03740529
    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 SponsorLOXO ONCOLOGY INCORPORATED
    B.1.3.4CountryUnited States
    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 supportLoxo Oncology, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCovance Clinical and Periapproval Services Ltd.
    B.5.2Functional name of contact pointGlobal Regulatory Submissions
    B.5.3 Address:
    B.5.3.1Street AddressOsprey House, Maidenhead Office Park, Westacott Way
    B.5.3.2Town/ cityMaidenhead
    B.5.3.3Post codeSL6 3QH
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number000000
    B.5.5Fax number000000
    B.5.6E-mailsubmissions@covance.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 name-
    D.3.2Product code [LOXO-305]
    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.3.9.1CAS number 21101700-15-
    D.3.9.2Current sponsor codeLOXO-305
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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: 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 No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product name-
    D.3.2Product code [LOXO-305]
    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.3.9.1CAS number 21101700-15-
    D.3.9.2Current sponsor codeLOXO-305
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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.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
    Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) and Non-Hodgkin Lymphoma (NHL)
    Leucemia linfatica cronica/linfoma a piccoli linfociti (LLC/SLL) o linfoma non Hodgkin (LNH)
    E.1.1.1Medical condition in easily understood language
    Malignant Cancers of the Lymphatic System of the Types Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL) and Non-Hodgkin Lymphoma (NHL)
    Tumori maligni del sistema linfatico del tipo leucemia linfatica cronica/linfoma a piccoli linfociti (LLC/SLL) o linfoma non Hodgkin (LNH)
    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 10008976
    E.1.2Term Chronic lymphocytic leukemia
    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 21.1
    E.1.2Level PT
    E.1.2Classification code 10003908
    E.1.2Term B-cell small lymphocytic 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 22.0
    E.1.2Level PT
    E.1.2Classification code 10029547
    E.1.2Term Non-Hodgkin's 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 – Dose Escalation:
    To determine the maximum tolerated dose (MTD)/recommended Phase 2 dose (RP2D) of oral LOXO-305 in patients with previously treated chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and non-B-cell Hodgkin lymphoma (NHL).

    Phase 2 – Dose Expansion:
    To assess the preliminary anti-tumor activity of LOXO-305 based on ORR as assessed by an Independent Review Committee (IRC).
    Fase 1 – Intensificazione della dose:
    Determinare la dose massima tollerata (MTD)/dose raccomandata per la fase 2 (RP2D) di LOXO-305 per via orale in pazienti con leucemia linfatica cronica/linfoma a piccoli linfociti (LLC/SLL) e linfoma non-Hodgkin a cellule B (LNH) già sottoposti a trattamento.

    Fase 2 – Espansione della dose:
    Valutare l’attività antitumorale preliminare di LOXO-305 in base all’ORR misurato da un Comitato di revisione indipendente (IRC).
    E.2.2Secondary objectives of the trial
    • To determine the safety profile and tolerability of LOXO-305 as monotherapy including acute and chronic toxicities.
    • To characterize the pharmacokinetics (PK) properties of LOXO-305 as monotherapy
    • To assess the preliminary anti-tumor activity of LOXO-305 as monotherapy based on overall response rate (ORR) according to International Workshop Guidelines for CLL (IWCLL 2018, (Appendix C) and Waldenstrom Macroglobulinemia (WM) (IWWM8, Appendix D), Lugano Treatment Response Criteria for Mantle Cell Lymphoma (MCL), Marginal Zone Lymphoma (MZL), Small Lymphocytic Lymphoma (SLL) and other NHL (Appendix E), or other criteria as appropriate to tumor type, as assessed by the Investigator
    • Determinare il profilo di sicurezza e la tollerabilità di LOXO-305, comprese le tossicità acute e croniche
    • Caratterizzare le proprietà farmacocinetiche (PK) di LOXO-305 in monoterapia
    • Valutare l’attività antitumorale preliminare di LOXO-305 in monoterapia in base al tasso di risposta complessiva (ORR) misurato secondo le Linee guida del Seminario internazionale su LLC (IWCLL 2018, Appendice C) e macroglobulinemia di Waldenström (MW) (IWWM8, Appendice D), Criteri di Lugano per la valutazione della risposta al trattamento per linfoma a cellule mantellari (LCM), linfoma della zona marginale (LZM), linfoma a piccoli linfociti (SLL) e altro LNH (Appendice E) o altri criteri appropriati per il tipo di tumore, in base alla valutazione dello sperimentatore.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Phase 1
    1. Phase 1 dose escalation prior to PK trigger: Able to tolerate potentially subtherapeutic doses of LOXO-305 for the 28-day DLT window in the opinion of Investigator and with documented Sponsor approval
    All Patients:
    2. Histologically confirmed CLL/SLL or NHL failed or intolerant to standard of care therapies
    3. = 2 prior lines of therapy
    4. Eastern Cooperative Oncology Group (ECOG) 0-2
    5. At least 18 years of age
    6. Confirmation of availability of tumor sample obtained after most recent treatment as described in Protocol Section 7.4
    7. Adequate hematologic status, defined as the following on C1D1 prior to treatment:
    a. Absolute neutrophil count (ANC) = 0.75× 10^9/L and not requiring growth factors; if there is documented bone marrow involvement, growth factors (pegfilgastrim preferred) may be used at any time prior to C1D1 to achieve this ANC threshold
    b. Platelet count = 50 × 10^9/L not requiring transfusion support; if there is documented bone marrow involvement, platelet transfusions or growth factors may be used prior to 7 days before C1D1 to achieve this platelet threshold
    c. Hemoglobin (Hb) = 8 mg/dL not requiring transfusion support or growth factors; if there is documented bone marrow involvement, growth factors (e.g., epoetin alpha) may be used at any time prior to C1D1 to achieve this Hb threshold
    d. Adequate coagulation, defined as activated partial thromboplastin time (aPTT) and prothrombin time (PT) (international normalized ratio [INR]) not greater than 1.5 × upper limit of normal (ULN)
    8. Adequate hepatic function, defined as:
    a. ALT or AST = 2.5 × the ULN or = 5 × ULN with documented liver metastases
    b. Total bilirubin = 1.5 × ULN or = 3 × ULN with documented liver metastases and/or Gilbert's Disease
    9. Adequate renal function defined as creatinine clearance = 30 mL/minute using Cockcroft/Gault Formula: (140 – age) × body weight (kg) × 0.85 (if female) / serum creatinine (mg/dL) × 72
    10. Ability to swallow tablets and comply with outpatient treatment, laboratory monitoring, and required clinic visits for the duration of study participation
    11. Willingness of men and women of reproductive potential to observe conventional and effective birth control for the duration of treatment and for 3 months following the last dose of study treatment; this may include barrier methods such as condom or diaphragm with spermicidal gel. For male subjects with a non-pregnant female partner of child-bearing potential and a woman of child-bearing potential one of the following highly effective birth control methods with a failure rate of less than 1% per year when used consistently and correctly are recommended:
    a. Combined estrogen and progestin containing hormonal contraception associated with inhibition of ovulation given orally, intravaginally, or transdermally
    b. Progestin-only hormonal contraception associated with inhibition of ovulation given orally, by injection, or by implant
    c. Intrauterine device (IUD)
    d. Intrauterine hormone-releasing system (IUS)
    e. Bilateral tubal occlusion
    f. Vasectomized partner
    g. Sexual abstinence: considered a highly effective method only if defined as refraining from heterosexual intercourse during an entire period of risk associated with the study treatment. The reliability of sexual abstinence will be evaluated in relation to the duration of the study and to the usual lifestyle of the subject (CTFG 2014).
    Birth control methods unacceptable for this clinical trial are:
    a. Periodic abstinence (calendar, symptothermal, or post-ovulation methods)
    b. Withdrawal (coitus interruptus)
    c. Spermicide only
    d. Lactational amenorrhea method
    Fase 1/2:
    1. Tumore maligno a cellule B confermato istologicamente (per es. LLC/SLL, MW, LNH), senza risposta o intollerante a = 2 precedenti regimi di terapia standard somministrati in combinazione o in sequenza OPPURE a precedente trattamento con 1 regime a base di BTK, laddove un inibitore di BTK sia stato approvato come terapia di prima linea.
    2. Durante l’intensificazione della dose e la valutazione di DLT: stato ematologico adeguato, secondo la seguente definizione al C1G1 ± 7 giorni prima del trattamento; vedi anche criteri di esclusione alla voce 8.
    a. Conta assoluta dei neutrofili (ANC) = 0,75 ¿ 109/l; il paziente potrà essere arruolatopuò arruolarsi al di sotto di questo valore soglia in caso di coinvolgimento documentato del midollo osseo che si ritiene possa compromettere l’ematopoiesi.
    b. Conta piastrinica = 50 ¿ 109/l senza necessità di supporto trasfusionale; il paziente potrà essere arruolato al di sotto di questo valore soglia in caso di coinvolgimento documentato del midollo osseo che si ritiene possa compromettere l’ematopoiesi.
    c. Emoglobina (Hb) = 8 mg/dl senza necessità di supporto trasfusionale o fattori di crescita; il paziente potrà essere arruolato al di sotto di questo valore soglia in caso di coinvolgimento documentato del midollo osseo che si ritiene possa compromettere l’ematopoiesi.
    d. Il paziente deve rispondere al supporto trasfusionale. I pazienti refrattari al supporto trasfusionale non sono idonei.
    Dopo l’intensificazione della dose di fase 1 e la valutazione di DLT: non sono applicabili i parametri ematologici, ma il paziente deve rispondere al supporto trasfusionale se somministrato per trombocitopenia o anemia. I pazienti refrattari al supporto trasfusionale non sono idonei. Vedi anche criteri di esclusione alla voce 8.

    Tutti i pazienti:
    1. Stato di validità secondo l’Eastern Cooperative Oncology Group (ECOG) pari a 0-2.
    2. Età pari almeno a 18 anni.
    3. Conferma della disponibilità di un campione tumorale ottenuto dopo il trattamento più recente, come descritto nella Sezione 7.4 del protocollo.
    4. Funzione epatica adeguata, definita come:
    a. ALT o AST =2,5 ¿ l’ULN o =5 ¿ l’ULN in presenza di metastasi epatiche documentate.
    b. Bilirubina totale =1,5 ¿ l’ULN o =3 ¿ l’ULN in presenza di metastasi epatiche documentate e/o malattia di Gilbert.
    5. Funzione renale adeguata, definita come clearance della creatinina =30 ml/minuto utilizzando la formula di Cockcroft/Gault:
    (140 – età) ¿ peso corporeo (kg) ¿ 0,85 (se paziente di sesso femminile)
    creatinina sierica (mg/dl) × 72
    6. Capacità di deglutire le compresse e di aderire al trattamento in regime ambulatoriale, al monitoraggio di laboratorio e alle visite in clinica richieste per la durata della partecipazione allo studio.
    7. Disponibilità da parte dei pazienti potenzialmente fertili di entrambi i sessi (ovvero pazienti che si trovano nel periodo successivo al menarca e non comprensivo della post-menopausa [che sono da 2 anni in amenorrea non indotta da terapia] o chirurgicamente sterili) ad adottare metodi contraccettivi convenzionali ed efficaci con tassi di fallimento < 1% per la durata del trattamento e per 6 mesi dopo l’ultima dose di trattamento dello studio; tra questi rientrano necessariamente metodi barriera quali preservativo o diaframma con gel spermicida. Vedi Sezione 4.1 del presente protocollo per un elenco dettagliato dei metodi contraccettivi accettabili. La donazione di spermatozoi è vietata per la durata della partecipazione a questo protocollo e per i 6 mesi successivi all’ultima dose di farmaco dello studio.
    (limite di caratteri-riferirsi al Protocollo)
    E.4Principal exclusion criteria
    Phase 1 and Phase 2
    All Patients:
    1. Investigational agent or anticancer therapy within 5 half-lives prior to planned start of LOXO 305 except therapeutic monoclonal antibody treatment must be discontinued a minimum of 4 weeks prior to the first dose of LOXO-305. In addition, no concurrent investigational therapy is permitted.
    a. Continuation of certain standard of care anticancer therapies, including hormonal therapy for breast and prostate cancer, is allowed, provided they are not on the list of prohibited concomitant medications. Refer to Section 6.3.2 for allowed and Section 6.3.3 for prohibited medications.
    2. Major surgery within 4 weeks prior to planned start of LOXO 305.
    3. Radiotherapy with a limited field of radiation for palliation within 7 days of the first dose of study treatment, except for patients receiving radiation to more than 30% of the bone marrow or receiving whole brain radiotherapy, which must be completed at least 4 weeks prior to the first dose of study treatment.
    4. Patients requiring therapeutic anticoagulation with warfarin.
    5. Any unresolved toxicities from prior therapy greater than CTCAE (version 5.0) Grade 2 at the time of starting study treatment except for alopecia.
    6. History of allogeneic or autologous stem cell transplant (SCT) or chimeric antigen receptor-modified T cell (CAR-T) therapy within the past 60 days (180 days before the PK trigger) or with any of the following:
    a. active graft versus host disease (GVHD);
    b. cytopenias from incomplete blood cell count recovery post-transplant;
    c. need for anti-cytokine therapy for toxicity from CAR-T therapy; residual symptoms of neurotoxicity > Grade 1 from CAR-T therapy;
    d. ongoing immunosuppressive therapy.
    7. Known central nervous system (CNS) involvement by systemic lymphoma. Patients with previous treatment for CNS involvement who are neurologically stable and without evidence of disease may be
    eligible if a compelling clinical rationale is provided by the Investigator and with documented Sponsor approval
    8. Active uncontrolled auto-immune cytopenia (e.g., autoimmune hemolytic anemia [AIHA], idiopathic thrombocytopenic purpura [ITP]) where new therapy introduced or concomitant therapy escalated within the 4 weeks prior to study enrollment is required to maintain adequate blood counts
    9. Clinically significant, uncontrolled cardiac, cardiovascular disease or history of myocardial infarction within 6 months prior to planned start of LOXO-305, or prolongation of the QT interval corrected for heart rate (QTcF) > 470 msec on at least 2/3 consecutive electrocardiograms (ECGs), and mean QTcF > 470 msec on all 3 ECGs, during Screening. QTcF is calculated using Fridericia’s Formula (QTcF): QTcF=QT/(RR0.33).
    a. Correction of suspected drug-induced QTcF prolongation can be attempted at the Investigator’s discretion and only if clinically safe to do so with either discontinuation of the offending drug or switch to another drug not known to be associated with QTcF prolongation.
    10. Active uncontrolled systemic bacterial, viral, fungal or parasitic infection (except for fungal nail infection), or other clinically significant active disease process which in the opinion of the Investigator and the Sponsor makes it undesirable for the patient to participate in the trial. Screening for chronic conditions is not required.
    11. Tested positive for Human Immunodeficiency Virus (HIV) is excluded (due to potential drug-drug interactions between anti-retroviral medications and LOXO-305 and risk of opportunistic infections with both HIV and irreversible BTK inhibitors). For patients with unknown HIV status, HIV testing will be performed at Screening.
    12. Clinically significant active malabsorption syndrome or other condition likely to affect gastrointestinal (GI) absorption of the study drug.
    13. Current treatment with certain strong cytochrome P450 3A4 (CYP3A4) inhibitors or inducers (refer to Appendix F) and
    (character's limit - please refer to the Synopsis)
    Fase 1 e fase 2
    Tutti i pazienti:
    1. Agente sperimentale o terapia antitumorale entro 5 emivite prima dell’avvio previsto di LOXO-305, ad eccezione del trattamento con anticorpi monoclonali terapeutici che deve essere interrotto almeno 4 settimane prima della prima dose di LOXO-305. Inoltre, non è consentita alcuna terapia sperimentale concomitante.
    a. È ammessa la prosecuzione di alcune terapie antitumorali standard, compresa la terapia ormonale per tumore mammario e prostatico, a condizione che non rientrino nell’elenco dei farmaci concomitanti vietati. Fare riferimento alla Sezione 6.3.2 per i farmaci consentiti e alla Sezione 6.3.3 per quelli vietati.
    2. Intervento chirurgico maggiore entro 4 settimane prima dell’avvio previsto di LOXO-305.
    3. Radioterapia con campo di irradiazione limitato somministrata a scopo palliativo entro 7 giorni dalla prima dose di trattamento dello studio, fatta eccezione per i pazienti sottoposti a radioterapia su più del 30% del midollo osseo o a radioterapia panencefalica, che deve essere completata almeno 4 settimane prima della prima dose di trattamento dello studio.
    4. Necessità di anticoagulazione terapeutica con warfarin.
    5. Qualsiasi tossicità non risolta della terapia precedente di grado CTCAE (versione 5.0) superiore a 2 al momento dell’avvio del trattamento dello studio, fatta eccezione per l’alopecia.
    6. Anamnesi di trapianto di cellule staminali (SCT) allogenico o autologo o di terapia a base di cellule T modificate con recettore antigenico chimerico (CAR-T) entro gli ultimi 60 giorni (180 giorni prima dell’innesco PK) o con uno qualsiasi dei seguenti:
    a. Malattia del trapianto contro l’ospite (GVHD) in fase attiva.
    b. Citopenie da incompleto recupero post-trapianto della conta delle cellule del sangue.
    c. Necessità di terapia anticitochinica per tossicità conseguente a terapia CAR-T; sintomi residui di neurotossicità di grado >1 da terapia CAR-T.
    d. Terapia immunosoppressiva in corso.
    7. Coinvolgimento noto del sistema nervoso centrale (SNC) da linfoma sistemico. Laddove lo sperimentatore fornisca un razionale clinico convincente e con la documentata approvazione dello sponsor, i pazienti già sottoposti a trattamento per coinvolgimento del SNC che sono neurologicamente stabili e non presentano evidenza di malattia potrebbero essere ritenuti idonei.
    8. Citopenia autoimmune attiva, non controllata (per es., anemia emolitica autoimmune [AEA], porpora trombocitopenica idiopatica [PTI]), laddove sia necessaria l’introduzione di una nuova terapia introdotta o l’intensificazione della terapia concomitante nelle 4 settimane precedenti all’arruolamento nello studio per mantenere adeguate conte ematiche.
    9. Malattia cardiaca/cardiovascolare clinicamente significativa, non controllata o anamnesi di infarto del miocardio entro 6 mesi prima dell’avvio previsto di LOXO-305, oppure prolungamento dell’intervallo QT corretto per la frequenza cardiaca (QTcF) >470 msec in almeno 2 elettrocardiogrammi (ECG) consecutivi su 3 e QTcF medio >470 msec in tutti e 3 gli ECG durante lo screening. Il QTcF sarà calcolato utilizzando la formula di Fridericia (QTcF): QTcF=QT/(RR0,33).
    a. A discrezione dello sperimentatore e solo se clinicamente sicuro, potrebbe essere tentata la correzione di un sospetto prolungamento farmaco-indotto del QTcF, mediante interruzione del farmaco responsabile o passaggio ad altro farmaco non notoriamente associato a prolungamento del QTcF.
    10. Infezione sistemica di natura batterica, virale, fungina o parassitaria, attiva e non controllata (fatta eccezione per l’infezione fungina delle unghie) o altro processo patologico attivo, clinicamente significativo che a giudizio dello sperimentatore e dello sponsor sconsigli la partecipazione del paziente alla sperimentazione. Per le condizioni croniche non è richiesto lo screening.

    (limite caratteri - riferirsi alla Sinossi)
    E.5 End points
    E.5.1Primary end point(s)
    Phase 1: MTD/RP2D
    Phase 2 (for each cohort): ORR by IRC
    Fase 1: MTD/RP2D
    Fase 2 (per ciascuna coorte): ORR secondo l’IRC
    E.5.1.1Timepoint(s) of evaluation of this end point
    Phase 1: MTD/RP2D will be assessed during Phase 1 of the Trial
    Phase 2: ORR will be assessed at the end of study Phase 2
    Fase 1: MTD/RP2D verrà valutato durante la fase 1 dello studio clinico
    Fase 2: ORR verrà valutato alla fine della fase 2 dello studio clinico
    E.5.2Secondary end point(s)
    Phase 1:
    • Adverse events (AEs) and serious adverse events (SAEs), changes in hematology and blood chemistry values, assessments of physical examinations, vital signs, and ECGs
    • Plasma concentration of LOXO-305 and PK parameters including, but not limited to, area under the concentration versus time curve (AUC), maximum drug concentration (Cmax), time to maximum plasma concentration (Tmax), terminal elimination half-life (T1/2), and degree of accumulation.
    • ORR by Investigator.

    Phase 2 (for each cohort):
    • ORR (by Investigator), BOR, DOR, PFS (by Investigator and IRC)
    • OS
    • AEs and SAEs, changes in hematology and blood chemistry values, assessments of physical examinations, vital signs, and ECGs.
    • Plasma concentration of LOXO-305 and PK parameters including, but not limited to AUC, Cmax, Tmax (time to maximum plasma concentration), T1/2, and degree of accumulation.
    Fase 1:
    • Eventi avversi (EA) ed eventi avversi seri (SAE), variazioni nei valori ematologici ed ematochimici, valutazioni degli esami obiettivi, segni vitali ed ECG.
    • Concentrazione plasmatica di LOXO-305 e parametri PK, tra cui, in modo non limitativo, area sotto la curva (AUC) della concentrazione rispetto al tempo, concentrazione massima (Cmax) del farmaco, tempo alla concentrazione plasmatica massima (Tmax), emivita di eliminazione terminale (T1/2) e grado di accumulo.
    • ORR secondo lo sperimentatore

    Fase 2 (per ciascuna coorte):
    • ORR (secondo lo sperimentatore), BOR, DOR, PFS (secondo lo sperimentatore e l’IRC).
    • OS.
    • EA e SAE, variazioni nei valori ematologici ed ematochimici, valutazioni degli esami obiettivi, segni vitali ed ECG.
    • Concentrazione plasmatica di LOXO-305 e parametri PK, tra cui, in modo non limitativo, AUC, Cmax, Tmax (tempo alla concentrazione plasmatica massima), T1/2 e grado di accumulo.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Phase 1:
    • AEs and SAEs: throughout study until incl Safety Follow Up (SFU) period; hematology and blood chemistry, physical examinations and vital signs: Screening, Cycle 1 Days 1/8/15, Day 1 each following Cycle, Intra-Patient Dose Escalation (IPDE) Days 1/8, End of Treatment Visit (EoT), SFU; ECGs: Screening, Cycle 1 Days 1/8, Day 1 Cycles 2-6 then as clinically indicated, IPDE Days 1/8, EoT, SFU
    • Plasma concentration of LOXO-305 and PK Parameters: Cycle 1 Days 1/8, Day 1 Cycles 2/4, IPDE Day 8
    • ORR (Investigator): Evaluated at end of Phase I
    -
    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 Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic Yes
    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 Yes
    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 No
    E.8.1.2Open Yes
    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 Yes
    E.8.1.7.1Other trial design description
    La fase 2 ha un disegno parallelo, la fase 1 no.
    Phase 2 is parallel design, Phase 1 is not.
    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 trial1
    E.8.3 The trial involves single site in the Member State concerned Yes
    E.8.4 The trial involves multiple sites in the Member State concerned No
    E.8.4.1Number of sites anticipated in Member State concerned1
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA20
    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
    Australia
    Korea, Republic of
    Singapore
    United States
    France
    Germany
    Italy
    Poland
    Switzerland
    United Kingdom
    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
    Individual patients will continue dosing until PD, unacceptable toxicity, or other reason for treatment discontinuation
    Ogni singolo paziente continuerà il trattamento fino a progressione della malattia, tossicità inaccettabile o per altre ragioni di interruzione
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months9
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months8
    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: 200
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 95
    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 state12
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 120
    F.4.2.2In the whole clinical trial 295
    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)
    None
    Nessuno
    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 Decision2019-12-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-12-12
    P. End of Trial
    P.End of Trial StatusOngoing
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