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    Summary
    EudraCT Number:2018-003794-98
    Sponsor's Protocol Code Number:MK-7902-007
    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:2021-01-25
    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 number2018-003794-98
    A.3Full title of the trial
    A Phase 3, randomized, double-blind trial of pembrolizumab (MK-3475) with or without lenvatinib (E7080/MK-7902) in participants with treatment-naïve, metastatic non-small cell lung cancer (NSCLC) whose tumors have a tumor proportion score (TPS)
    greater than or equal to 1% (LEAP-007)
    Studio di Fase 3, randomizzato, in doppio cieco di pembrolizumab (MK-3475) con o senza lenvatinib (E7080/MK-7902) in partecipanti con tumore polmonare
    metastatico non a piccole cellule (non-small cell lung cancer, NSCLC) naïve al trattamento, i cui tumori presentano un punteggio di proporzione tumorale
    (tumor proportion score, TPS) maggiore o uguale all’1% (LEAP-007)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 3 Study of Pembrolizumab with or without Lenvatinib in Metastatic NSCLC
    Studio di fase 3 su Pembrolizumab con o senza Lenvatinib in metastasi NSCLC
    A.3.2Name or abbreviated title of the trial where available
    Pembrolizumab with or without lenvatinib in TPS =1% NSCLC
    Pembrolizumab con o senza lenvatinib in NSCLC TPS =1%
    A.4.1Sponsor's protocol code numberMK-7902-007
    A.5.4Other Identifiers
    Name:INDNumber:140221
    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 SponsorMERCK SHARP & DOHME CORP. UNA SUSSIDIARIA DI MERCK & CO. INC.
    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 supportMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
    B.4.2CountryUnited States
    B.4.1Name of organisation providing supportEisai Limited
    B.4.2CountryUnited Kingdom
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMSD Italia Srl
    B.5.2Functional name of contact pointDivisione Ricerca Clinica
    B.5.3 Address:
    B.5.3.1Street AddressVia Vitorchiano, 151
    B.5.3.2Town/ cityROMA
    B.5.3.3Post code00189
    B.5.3.4CountryItaly
    B.5.4Telephone number00636191371
    B.5.5Fax number0636380371
    B.5.6E-mailgcto.italy@merck.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 nameLenvatinib
    D.3.2Product code [E7080]
    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 INNLENVATINIB MESILATE
    D.3.9.1CAS number 857890-39-2
    D.3.9.2Current sponsor codeMK-7902
    D.3.9.3Other descriptive nameLENVATINIB MESILATE
    D.3.9.4EV Substance CodeSUB72971
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    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 nameLenvatinib
    D.3.2Product code [E7080]
    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 INNLENVATINIB MESILATE
    D.3.9.1CAS number 857890-39-2
    D.3.9.2Current sponsor codeMK-7902
    D.3.9.3Other descriptive nameLENVATINIB MESILATE
    D.3.9.4EV Substance CodeSUB72971
    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 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 Yes
    D.2.1.1.1Trade name KEYTRUDA (pembrolizumab, MK-3475)
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp & Dohme B.V.
    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 namePEMBROLIZUMAB
    D.3.2Product code [MK-3475]
    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 INNPembrolizumab
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.4EV Substance CodeSUB167136
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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 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) Yes
    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: 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 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 namePembrolizumab
    D.3.2Product code [MK-3475]
    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 INNPembrolizumab
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.3Other descriptive nameHumanized IgG4 PD-1 blocking antibody
    D.3.9.4EV Substance CodeSUB167136
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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 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) Yes
    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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Metastatic non-small cell lung cancer (NSCLC)
    Carcinoma polmonare non a piccole cellule metastatico (NSCLC)
    E.1.1.1Medical condition in easily understood language
    Metastatic non-small cell lung cancer
    Carcinoma polmonare non a piccole cellule metastatico
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10059515
    E.1.2Term Non-small cell lung cancer metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    1. To compare Progression-free Survival (PFS) as assessed by blinded independent central review according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1), modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, for the combinations of pembrolizumab (MK-3475) + lenvatinib (MK-7902) versus pembrolizumab + matching placebo
    2. To compare Overall Survival (OS) for the combinations of pembrolizumab + lenvatinib versus pembrolizumab + matching placebo
    1. Confrontare la sopravvivenza libera da progressione (PFS) valutata mediante revisione centrale indipendente in cieco secondo i criteri di valutazione della risposta nei tumori solidi versione 1.1 (RECIST 1.1), modificati per seguire un massimo di 10 lesioni target e un massimo di 5 lesioni target per organo per le combinazioni di pembrolizumab + lenvatinib rispetto a pembrolizumab + placebo corrispondente
    2. Confrontare la sopravvivenza complessiva (OS) per le combinazioni di pembrolizumab + lenvatinib rispetto a pembrolizumab + placebo corrispondente.
    E.2.2Secondary objectives of the trial
    1. To compare Objective Response Rate (ORR) as assessed by blinded independent central review using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1), modified to follow a maximum of 10 target lesions and a maximum of 5 target lesions per organ, for the combinations of pembrolizumab + lenvatinib versus pembrolizumab + matching placebo
    2. To evaluate the safety and tolerability for the combinations of pembrolizumab + lenvatinib versus pembrolizumab + matching placebo
    3. To compare the mean change from Baseline in the global health status/quality of life, cough, chest pain, dyspnea, and physical functioning for the combinations of pembrolizumab + lenvatinib versus pembrolizumab + matching placebo
    4. To compare the Time to True Deterioration in global health status/quality of life, cough, chest pain, dyspnea, and physical functioning for the combinations of pembrolizumab + lenvatinib versus pembrolizumab + matching placebo
    1. Confrontare il tasso di risposta obiettiva (ORR) secondo la valutazione mediante BICR secondo i criteri RECIST 1.1, per le combinazioni di pembrolizumab + lenvatinib rispetto a pembrolizumab + placebo corrispondente
    2.Valutare la sicurezza e la tollerabilità delle combinazioni di pembrolizumab + lenvatinib rispetto a pembrolizumab + placebo corrispondente.
    3.Confrontare la variazione media rispetto al basale in termini di stato di salute globale/qualità della vita, tosse, dolore al torace, dispnea e funzionalità fisica per le combinazioni di pembrolizumab + lenvatinib rispetto a pembrolizumab + placebo corrispondente
    4.Confrontare il tempo al vero deterioramento in termini di stato di salute globale/QoL, tosse, dolore al torace, dispnea e funzionalità fisica per le combinazioni di pembrolizumab + lenvatinib rispetto a pembrolizumab + placebo corrispondente
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Have a histologically or cytologically confirmed diagnosis of NSCLC.
    2. Have Stage IV NSCLC (American Joint Committee on Cancer [AJCC], version 8).
    3. Have confirmation that EGFR-, ALK-, or ROS1-directed therapy is not indicated as primary therapy (documentation of the absence of tumor-activating EGFR mutations [eg,
    DEL19 or L858R], AND absence of ALK and ROS1 gene rearrangements OR presence of a Kirsten rat sarcoma [K-ras] mutation).
    4. Have measurable disease based on RECIST 1.1, as determined by the local site.
    5. Tumor tissue that demonstrates PD-L1 expression in > o =1% of tumor cells (TPS>o =1%) as assessed by IHC 22C3 pharmDx at a central laboratory.
    6. Be 18 years of age, inclusive, at the time of signing the ICF.
    7. Have a life expectancy of at least 3 months.
    8. Have an ECOG performance status of 0 or 1 within 7 days before the first dose of study intervention but before randomization.
    Contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
    Male Participants
    9. Male participants are eligible to participate if they agree to the following during the intervention period and for at least 120 days after the last dose of study intervention:
    - Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis) and agree to remain abstinent
    OR
    - Must agree to use contraception unless confirmed to be azoospermic (vasectomized or secondary to medical cause [Appendix 5]) as detailed below:
    - Agree to use a male condom plus partner use of an additional contraceptive method when having penile-vaginal intercourse with a woman of childbearing potential (WOCBP) who is not currently pregnant. Refrain from donating sperm for at least 120 days after the last dose of lenvatinib.
    Female Participants
    10. A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies:
    -Is not a WOCBP.
    OR
    -Is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of <1% per year), with low user dependency, or be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis), as described in Appendix 5 during the intervention period and for at least 120 days after the last dose of study intervention The investigator should evaluate the potential for contraceptive method failure (ie, noncompliance, recently initiated) in relationship to the first dose of study intervention.
    -A WOCBP must have a negative highly sensitive pregnancy test (urine or serum as required by local regulations) within 72 hours before the first dose of study intervention.
    - If a urine test cannot be confirmed as negative (eg, an ambiguous result), a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive.
    - Additional requirements for pregnancy testing during and after study intervention are located in Appendix 2.
    - The investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy.
    11. The participant (or legally acceptable representative if applicable) provides written informed consent/assent for the study.
    12. Have adequately controlled blood pressure (BP) with or without antihypertensive medications, defined as BP =150/90 mm Hg and no change in antihypertensive medications within 1 week before randomization.
    13.Have adequate organ function. Specimens must be collected within 10 days before the start of study intervention
    1Presentare una diagnosi confermata dal punto di vista istologico o citol diNSCLC
    2PresentareNSCLC di stadioIV(Comitato americano congiunto sul cancro[AJCC],vers8)
    3Avere ricevuto conferma che la terapia mirata a EGFR, ALK o ROS1 non è indicata come terapia primaria (documentaz di assenza di mutazioniEGFRche attivano il tumore[ad es. DEL19 o L858R]E che mostrano assenza di riarrang del gene ALK e ROS1OPPURE presenza di una mutaz di un sarcoma di Kirsten nel ratto[K-ras])
    4Presentare una mal misur in base ai criteri RECIST1.1,come determinato sulla base della valutaz dello speriment
    5Il tessuto tumorale che dimostra espressione di PDL1magg o =1% nelle cellule tumorali(TPSmagg o =1%)in base all’immunoistochim (IIC)22C3pharmDx presso un lab centr
    6Avere18anni di età compiuti,al mom della firma del cons inform
    7Aspettativa di vita pari almeno a 3mesi
    8Stato di validitàECOG di 0o1 entro7g prima della prima dose di tratt di stu ma prima della randomiz
    L’uso di contraccet da parte di uomini e donne deve essere in linea con le normative locali riguardanti i metodi di contraccez per coloro che partecipano agli stu clinici
    9I partecipanti di sesso masch sono idonei a partecip se acconsentono a quanto segue durante il periodo di tratt e per almeno30g dopo l’ultima dose di lenva/placebo:
    -Essere in astinenza da rapporti eterosess come stile di vita preferito e abituale(astinenti a lungo termine e in modo persistente)e acconsentire a continuare l’astinenza
    O
    -Accettare di usare un metodo contrac a meno che non abbia azoospermia confermata(da vasectomia o secondaria a causa medica[App5 del prot]):
    - Acconsentire a utilizzare un preservat maschile assieme all’uso da parte della partner di un metodo contraccet supplement durante rapporti sessuali penili-vaginali con una donna in età fertile (WOCBP)che attualmente non è incinta
    -Not che dopo30gg da interr lenva/plac, se partec sta assum solo pembro, non sono neces mis contrac masch
    10Una partecip di sesso fem è idonea alla partecipaz qualora non sia in stato di gravidanza, non stia allattando al seno e soddisfi almeno una delle condizioni che seguono:
    - Non è una donna in età fertile
    O
    -È una donna in età fertile e sta utilizzando un metodo contrac altamente efficace (con un tasso di insuccesso< all’1% all’anno),scarsamente utilizzatore-dipendente,o essere in astinenza dai rapporti eterosessuali come stile di vita preferito e abituale (astinenza a lungo termine e persistente),come descritto nell’App5 durante il periodo di trattamento e per almeno 120 giorni dopo pembro o30gg dopo lenva/placebo, qual si verif per ultimo. Lo speriment deve valutare il potenziale di fallimento del metodo contrac(vale a dire, non aderenza,inizio recente)in relazione alla prima dose di trattamento di studio
    -Una donna in età fertile deve present un risultato negativo a un test di gravid altamente sensibile (sul siero o sulle urine come richiesto dalle normative locali)entro le 72h preced la prima dose di tratt di studio
    -In caso non sia possibile conferm la neg del test sulle urine(per es.in caso di risultato ambiguo),è richiesto un test di gravidanza sul siero.In tali casi,la partecip deve essere esclusa dalla partecipaz se il risultato del test di gravidanza sul siero è posit
    -Ulteriori requisiti per il test di gravid durante e dopo l’intervento dello studio si trovano nell’App2 del prot
    -Lo sperim è responsabile della revis dell’anamnesi medica,anamnesi mestruale e recente attività sess al fine di ridurre il rischio di inclusione di una donna con una gravidanza precoce non rilevata
    11Il part(o il rappr legale,se applicab)fornisce il consenso/assenso informato scritto per lo studio
    12 Press arteriosa(PA)adeguatamente controllata con o senza farmaci antipertensivi,definita come PA =150/90 mm Hg,in assenza di modifiche ai farmaci antipertensivi entro 1 settimana prima della randomiz
    13Present una funz d’organo adeguata.I campioni devono essere prelevati entro10g prima dell’avvio del tratt di studio
    E.4Principal exclusion criteria
    1Has known untreated central nervous system metastases and/or carcinomatous meningitis. Particip with prev treated brain metast may particip provided they are radiolog stable (ie, without evid of progression for at least4ws by repeat imaging (note: repeat imaging should be performed during study screening), clinically stable, and without requirement of steroid treatment for at least 14 days before first dose of study intervention
    2Has clinically signif hemoptysis (at least0.5teaspoon of bright red blood)or tumor bleeding within2ws before first dose of study interv
    3Has Radiogr evid of encasement or invasion of a major blood vessel, or of intratumoral cavitation. The degree of tumor inva/infiltr of major blood vessels should be consid bec of the pot risk of sev hemorr ass with tumor shrinkage/necrosis after lenva therapy
    4Has known hist of add malignancy, exc if particip has undergone potentially curat therapy with no evid of that disease recurr for at least3ys since init of that therapy
    5Has active autoimm disease that has required syst treatm in past 2 y (use of disease-modifying agents, corticost or immunosuppr drugs).Replac therapy( thyroxine, insulin or physiologic corticost replacement ther for adrenal or pituitary insuff etc) isnt consid a form of syst treatm and is allowed
    6Has had allogeneic tissue/solid organ transplant
    7Has known history of HIV infection; HIV testing isnt requir unless mandated by local health authority
    8Has hist of (noninfectious) pneumonitis that required syst ster or cur pneumonitis/interstitial lung disease
    9Has known hist of hep B (defined as hepB surface antigen [HBsAg] react or hep B virus [HBV]-DNA detected) or known act hep C virus (HCV, defined as HCV-RNA [qualitative] detected or HCV antibody reactive, if HCV-RNA is not the local SOC) infect
    10Has hist of gastroint condit or proced that in the opinion of investig may affect oral study drug absorption
    11Has signif cardiovasc impairment within12months of first dose of study interv, such as hist of congestive heart failure greater than New York Heart Association Class II, unstable angina, myocard infarct, cerebrovasc accid(CVA)/stroke, or card arrhyth assoc with hemodyn instab
    12Hasnt recovered adeq from any tox and/or complications from major surgery bef starting ther
    13Has known hist of act tuberc(TB)
    14Has act infec requiring syst ther
    15Has known psychiatric or subst abuse disorder that would interf with particip's cooperation for requirem of study
    16Prev had sev hypers reac to treatm with mAb or known sensit or intoler to any component of lenva or pembro
    17WOCBP who has pos urine pregn test within24h bef first dose of study interv
    18Has received prior syst chemoth or other targeted or biolog antineopl therapy for metastatic NSCLC
    19Has rec pr therapy with anti-PD-1, anti-PD-L1, or anti-PDL2 ag or agent direct to another stimulatory or coinhibitory T-cell rec( CTLA-4,OX 40,CD137)or has rec lenva as monoth or in comb with anti-PD-1 agents
    20Has rec radioth within14d before first dose of study interv or lung radiation ther of >30Gy within6months bef first dose of st interv
    21Has diagn of immunodef or is receiv any form of immunosuppr ther within7d bef first dose of study interv
    22Is rec syst steroid therapy(doses exceeding10mg daily of prednisone equivalent)within7d bef first dose of study interv
    23Has rec live vaccine within30d bef first dose of study interv
    24Particips with proteinuria >1+on urine dipstick testing/urinalysis will undergo 24hour urine collect for quantit assessm of proteinuria. Particip withurine protein>=1 g/24h will be inelig
    25Prolong of QTc inter to>480ms and/or left ventricular eject fract(LVEF)below institut normal range as determ by multigated acquis scan(MUGA)or echocardiogram (ECHO)
    27Has had major surgery within3week prior to first dose of study interv
    28Has preexistin >=Grade3 gastroint or non-gastroint fistula
    1.Pres metastasi non tratt note al sist nerv cent e/o meningite carcinomatosa. I partecip con metast cerebr preced tratt possono partec a cond che siano radiologic stab(ovvero senza evid di progres)per alm4sett in base a ripetute valutaz di imaging(valut di imaging dev essere ripet durante screening studio), clinic stabili e senza neces di trattsteroid per alm14gg prima di prima dose di trattam di stud
    2.Pres emottisi o sanguin tumorale clinica signific entro2sett prima della prima dose di tratt di studio
    3.Pres evid radiologica di rivestimento o infiltrazione di vaso sang maggiore, o di cavitazione intratumorale. Deve ess preso in consid il grado di invas/infiltr tumor dei princ vasi sang per via del potenz rischio di grave emor assoc alla contr/necrosi tum succes alla terap a base di lenva
    4.Pres anamnesi nota di ult neopl maligna, tranne nel caso in cui il partec abbia ricev terap potenz curativa senza evidenza di ricorr della malattia per almeno3anni da inizio di tale ter
    5.Pres una malattia autoimm in fase att che abbia rich un tratt per via sist negli ult2anni(con impiego di ag modif la malattia, corticost o farm immunosoppr). La terap di sostituz(es.terap di sostit con tiroxina, insulina o corticost fisiologici in caso di insuff surren o ipofisaria ecc.)non è consid una forma di tratt sistem ed è consentita
    6.Ha subito trapianto di org solido/tess allogenico
    7.Pres anamni nota di infez da virus dell’immunodef umana( HIV); il test per l’HIV non è necess a meno che non sia rich da autorità sanitarie locali
    8.Pres anamn di polmonite(non infet) che ha rich l’uso di steroidi per via sist o pres una polm/malatt polm interst corrente
    9.Pres un’anamnesi nota di epatite B (reattività all’antig di superf dell’epat B[ HBsAg] o rilevabilità dell’ac desossiribonucleico del virus dell’epat B [HBV-DNA]) o infez attiva nota da virus dell’epatite C (rilevabilità [qualitativa] dell’acido ribonucleico del virus dell’epatite C [HCV-RNA] o reatt agli anticorpi anti-HCV, se la ricerca dell’HCV RNA non rientra nello stand di cura [ SOC] locale)
    10.Pres anamnesi di condiz o proced gastroint che, a giud dello sperim, potreb infl sull’assorb orale del farm in studio
    11.Pres comprom cardiovasc signific nei12mesi prec alla prima dose di tratt di studio,es anamn di insuff card congest di classe sup a II sec la classif della New York Heart Association, angina instab, inf miocardico o ictus cerebrovasc(CVA) o aritm card ass a inst emodin
    12.Pres ripresa non compl da event tossic e/o complic dovute a interv chirur imp prima di iniz la terap
    13.Pres anamnesi nota di tubercolosi (TBC) attiva
    14.Pres un’infez att con neces di terap sist
    15.Pres dist psich o di abuso di sost noti che interf con la collabor del partecip a soddisf i req dello studio
    16.Prec grave reaz ipersens al tratt con mAb o nota sens o intol a quals comp di lenva o pembro
    17.WOCBP con test gravid pos entro24ore da prima dose tratt di studio
    18.Ricev prec terap sist chemiot o altra ter antineopl mir o biolog perNSCLC mestat
    19.Ricev prec terap con agen antiPD1, antiPD-L1,antiPD-L2 o ag diret su altro rec T-cel stim o coinib(CTLA4,OX40,CD137)o ricev lenva in monoter o comb con ag antiPD1
    20.Ricev radiot entro14gg o radiot al polm>30Gy entro 6mesi da prima dose di tratt di stud
    21.Ricev diagn di immunodef o terap immunosop entro7gg da prima dose tratt di stud
    22.Ricev terap steroidea sistem(dosi>10mg al giorno di prednisone equiv)entro7gg da prima dose tratt di stud
    23.Ricev vacc vivo entro30gg da prima dose tratt di stud
    24.Partec cn proteinuria>1+ test dell'asta delle urine/anal urine saranno sottop a racc urine nelle24ore per valut quant proteinuria
    25.Prolung di interv QTc>480ms e/o fraz eiez ventr sinis(LVEF) sotto val norm istit come determ con MUGA o eco card(ECHO)
    27.Ricev int di chir magg entro3sett dalla prima dose di tratt di stud
    28.Preesist fistola gastroint o non-gastroint grado>3
    E.5 End points
    E.5.1Primary end point(s)
    1. Progression-free Survival (PFS) as Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)
    2. Overall Survival (OS)
    1. Sopravvivenza libera da progressione (PFS) valutata mediante i criteri di valutazione della risposta in tumori solidi versione 1.1 (RECIST 1.1)
    2. Sopravvivenza complessiva (OS)
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 24 months
    2. Up to approximately 60 months
    1. Fino a circa 24 mesi
    2. Fino a circa 60 mesi
    E.5.2Secondary end point(s)
    1. Objective Response Rate (ORR) as Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)
    2. Number of participants who experience an adverse event (AE)
    3. Number of participants who discontinue study treatment due to an AE
    4. Change from Baseline in Global Health Status (GHS)(European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 [EORTC QLQ-C30] Item 29) Score
    5. Change from Baseline in Quality of Life (QoL)(EORTC QLQ-C30 Item 30) Score
    6. Change from Baseline in Cough (EORTC Quality of Life Questionnaire-LungCancer Module 13 [QLQ-LC13] Item 31) Score
    7. Change from Baseline in Chest Pain (EORTC QLQ-LC13 Item 40) Score
    8. Change from Baseline in Dyspnea (EORTC QLQ-C30 Item 8) Score
    9. Change from Baseline in Physical Functioning (EORTC QLQ-C30 Items 1-5) Score
    10. Time to True Deterioration (TTD) Based on Change from Baseline in Global Health Status (GHS)(EORTC QLQ-C30 Item 29) Score
    11. Time to True Deterioration (TTD) Based on Change from Baseline in Quality of Life (QoL)(EORTC QLQ-C30 Item 30) Score
    12. Time to True Deterioration (TTD) Based on Change from Baseline in the Composite Endpoint of Cough & Chest Pain (EORTC QLQ-LC13 Items 31 & 40) or Dyspnea (EORTC QLQ-C30 Item 8)
    13. Time to True Deterioration (TTD) Based on Change from Baseline in EORTC QLQ-C30 Physical Functioning (Items 1-5) Score
    1. Tasso di risposta obiettiva (ORR) valutato mediante i criteri di valutazione della risposta in Tumori solidi versione 1.1 (RECIST 1.1)
    2. Numero di partecipanti che sperimentano un evento avverso (AE)
    3. Numero di partecipanti che interrompono il trattamento di studio a causa di un AE
    4. Cambiamento rispetto al basale del punteggio Global Health Status (GHS)(European Organization for Research and Treatment of Cancer Questionario sulla qualità della vita C-30 [EORTC QLQ-C30] Articolo 29)
    5. Cambiamento rispetto al basale del punteggio Quality of Life (QoL)(EORTC QLQ-C30 Articolo 30)
    6. Cambiamento rispetto al basale del grado di Tosse (EORTC Quality of Life Questionnaire-LungCancer Module 13 [QLQ-LC13] Articolo 31)
    7. Cambiamento rispetto al basale del grado di Dolore Toracico (EORTC QLQ-LC13 Articolo 40)
    8. Cambiamento rispetto al basale del grado di Dispnea (EORTC QLQ-C30 Articolo 8)
    9. Cambiamento rispetto al basale del grado di Funzionamento Fisico (EORTC QLQ-C30 Articoli 1-5)
    10. Time to True Deterioration (TTD) valutato dal cambiamento rispetto al basale nel punteggio Global Health Status (GHS)(EORTC QLQ-C30 Articolo 29)
    11. Time to True Deterioration (TTD) valutato dal cambiamento rispetto al basale nel punteggio Quality of Life (QoL)(EORTC QLQ-C30 Articolo 30)
    12. Time to True Deterioration (TTD) valutato dal cambiamento rispetto al basale dell’endpoint combinato di Tosse e Dolore toracico (EORTC QLQ-LC13 Articoli 31 & 40) o Dispnea (EORTC QLQ-C30 Articolo 8)
    13. Time to True Deterioration (TTD) valutato dal cambiamento rispetto al basale del grado di Funzionamento Fisico (EORTC QLQ-C30 Articoli 1-5)
    E.5.2.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 24 months
    2. Through 90 days post last dose of study treatment (Up to approximately 27 months)
    3. Through last dose of study treatment (Up to approximately 24 months)
    4-13. Baseline (Cycle 1 Day 1: Predose) and at designated timepoints (Predose) up to 30 days post last dose. Each cycle is 21 days. (Up to approximately 25 months)
    1. Fino a circa 24 mesi
    2. Fino a 90 giorni dopo l'ultima dose del trattamento di studio (fino a circa 27 mesi)
    3. Attraverso l'ultima dose di trattamento di studio (fino a circa 24 mesi)
    4-13. Linea di base (ciclo 1 giorno 1: predose) e a intervalli di tempo prestabiliti (predose) fino a 30 giorni dopo l'ultima dose. Ogni ciclo è di 21 giorni. (Fino a circa 25 mesi)
    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 No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic Yes
    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) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    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 No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    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) No
    E.8.2.2Placebo Yes
    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 concerned8
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA76
    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
    Canada
    China
    Colombia
    Israel
    Japan
    Korea, Republic of
    Malaysia
    Mexico
    Russian Federation
    Taiwan
    Turkey
    Ukraine
    United States
    Estonia
    France
    Germany
    Hungary
    Italy
    Poland
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    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: 340
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 280
    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 state27
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 315
    F.4.2.2In the whole clinical trial 620
    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 Decision2019-04-09
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-02-22
    P. End of Trial
    P.End of Trial StatusOngoing
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