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    Summary
    EudraCT Number:2018-003964-30
    Sponsor's Protocol Code Number:RPL-002-18
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2021-09-02
    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 number2018-003964-30
    A.3Full title of the trial
    A Randomized, Controlled, Open-label, Phase 2 Study of Cemiplimab as a Single Agent and in Combination with RP1 in Patients with Advanced Cutaneous Squamous Cell Carcinoma [CERPASS]
    Studio randomizzato, controllato, in aperto, di fase 2 su cemiplimab in monoterapia e in combinazione con RP1 in pazienti con carcinoma cutaneo a cellule squamose in stadio avanzato [CERPASS]
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study evaluating the clinical benefit of cemiplimab versus cemiplimab in combination with RP1 in patients with skin cancer
    Studio per la valutazione del beneficio clinico di cemiplimab rispetto a cemiplimab in combinazione con RP1 in pazienti con cancro della pelle
    A.3.2Name or abbreviated title of the trial where available
    CERPASS
    CERPASS
    A.4.1Sponsor's protocol code numberRPL-002-18
    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 SponsorReplimune, 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 supportReplimune, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationRepliune, Inc.
    B.5.2Functional name of contact pointAnne-Marie Woodland
    B.5.3 Address:
    B.5.3.1Street Address500 Unicorn Park Drive, 3rd Floor
    B.5.3.2Town/ cityWoburn
    B.5.3.3Post codeMA 01801
    B.5.3.4CountryUnited States
    B.5.4Telephone number17812229608
    B.5.5Fax number17819260871
    B.5.6E-mailra@replimune.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 nameRP1
    D.3.2Product code [RP1]
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntratumoral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNvusolimogene oderparepvec
    D.3.9.2Current sponsor codeRP1
    D.3.9.4EV Substance CodeSUB187321
    D.3.10 Strength
    D.3.10.1Concentration unit PFU/ml plaque forming unit(s)/millilitre
    D.3.10.2Concentration typeup to
    D.3.10.3Concentration number10000000
    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) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Yes
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product Yes
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms Yes
    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 LIBTAYO
    D.2.1.1.2Name of the Marketing Authorisation holderRegeneron Ireland U.C.
    D.2.1.2Country which granted the Marketing AuthorisationIreland
    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 nameLIBTAYO
    D.3.2Product code [LIBTAYO]
    D.3.4Pharmaceutical form Concentrate for solution for injection/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 INNcemiplimab
    D.3.9.2Current sponsor codecemiplimab
    D.3.9.4EV Substance CodeSUB189482
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin 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
    Advanced Cutaneous Squamous Cell Carcinoma
    Carcinoma cutaneo a cellule squamose in stadio avanzato
    E.1.1.1Medical condition in easily understood language
    Advanced skin cancer
    Cancro della pelle in stadio avanzato
    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 10077314
    E.1.2Term Skin squamous cell carcinoma 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
    The primary objective of this study is to estimate the clinical benefit of cemiplimab monotherapy versus cemiplimab in combination with RP1 for patients with locally advanced or nodal or distant metastatic cutaneous squamous cell carcinoma (CSCC), as assessed by overall response rate (ORR) and complete response rate (CRR) according to blinded independent review
    L’obiettivo primario di questo studio è stimare il beneficio clinico di cemiplimab in monoterapia rispetto a cemiplimab in combinazione con RP1 per i pazienti con carcinoma cutaneo a cellule squamose (cutaneous squamous cell carcinoma, CSCC) localmente avanzato o metastatico linfonodale o a distanza, valutato mediante il tasso di risposta globale (overall response rate, ORR) e il tasso di risposta completa (complete response rate, CRR) in base alla revisione indipendente in cieco
    E.2.2Secondary objectives of the trial
    Estimate• the treatm effect on PFS according to blinded independent review ORR/CRR(App1and2) according to investiging. review•ORR/CRR for patients with metastatic(nodal or distant)CSCC according to investiging and blinded independent review•ORR/CRR for patients with locally advanced CSCC according to investig and blinded independent review•ORR/CRR for patients having previously received systemic CSCC-directed therapy according to investig and blinded independent review•ORR/CRR for patients not having previously received systemicCSCC-directed therapy according to investig and blinded independent review•the duration of response (DOR) according to investig and blinded independent review•PFS according to investig review•overall survival (OS)•3 year survival
    Assess:•the effects of cemiplimab and cemiplimab combined with RP1 on the changes in scores of patient reported outcomes on quality of life using the EORTC QLQ-C30•the safety and tolerab of cemiplimab alone and combined with RP1
    Stimar•l’eff del tratt sulla progression-free survival in base alla rev indip in cieco•l’ORR/CRR (App1e2) in base alla rev dello sperim.•l’ORR/CRR per i pz con CSCC metast (linfonod o a dist) in base alla rev dello sperim e alla rev indipend in cieco•l’ORR/CRR per i pz con CSCC localm avanz in base alla rev dello sperim e alla rev indipend in cieco•l’ORR/CRR per i pz preced sottopost a terapia sistemica per il CSCC in base alla rev dello speriment e alla rev indipend in cieco•l’ORR/CRR per i pz non prec sottoposti a terap sistem per il CSCC in base alla rev dello speriment e alla rev indipend in cieco•la durata della risp in base alla rev dello speriment e alla rev indipend in cieco•la PFS in base alla rev dello speriment•la sopravv globale•la sopravv a 3 y/Valut•gli effetti di cemiplimab e di cemiplimab in comb con RP1 sulle variaz nei punt degli esiti rif dal pz relat alla qualità della vita utiliz il quest EORTC QLQ C30•la sicur e la tollerab di cemiplimab in monot e in comb con RP1
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Voluntary agreement to provide written informed consent and willingness and ability to comply with protocol requirements.
    2. Histologically confirmed diagnosis of locally advanced or metastatic (nodal or distant) CSCC by local pathology report. Metastatic (nodal or distant) disease is defined as disseminated disease distant to the
    initial/primary site of diagnosis. The locally recurrent disease is defined as previously treated disease (with either surgery, radiotherapy, or systemic therapy) and is not amenable to either curative surgery, radiotherapy, or concurrent chemoradiotherapy treatment.
    3. At least 1 measurable lesion and lesion(s) that are injectable. There is no minimum tumor size for injection, provided there are injectable tumors that are in the aggregate of = 1 cm at baseline.
    4. Eastern Cooperative Oncology Group (ECOG) performance status =1 (Appendix 4).
    5. Male or female =18 years old.
    6. Hepatic function:
    a. Total bilirubin =1.5 x upper limit of normal (ULN); (if liver metastases =3 x ULN). Patients with Gilbert's Disease and total bilirubin up to 3 x ULN may be eligible after communication with and approval from the
    medical monitor.
    b. Transaminases (ALT or AST) =3 x ULN (or =5.0 x ULN, if liver metastases)
    c. Alkaline phosphatase (ALP) =2.5 x ULN (or =5.0 x ULN, if liver or bone metastases)
    Note for patients with hepatic metastases who wish to enroll: If transaminase levels (AST and/or ALT) are >3 x but =5 x ULN, total bilirubin must be =1.5 x ULN. If total bilirubin is >1.5 x but =3 x ULN,
    both transaminases (AST and ALT) must be =3 x ULN.
    7. Renal function: Serum creatinine =1.5 x ULN OR, if serum creatinine >1.5XULN, calculated creatinine clearance =30mL/min (using Cockcroft).
    8. Bone marrow function:
    a. Hemoglobin =9.0 g/dL
    b. Absolute neutrophil count (ANC) =1.5 x 109/L
    c. Platelet count =100 x 109/L
    9. Prothrombin time (PT) = 1.5 x ULN (or international normalization ratio [INR] = 1.3) and
    partial thromboplastin time (PTT) or activated PTT (aPTT) = 1.5 x ULN.
    10. Anticipated life expectancy >12 weeks.
    11. Female and male patients of reproductive potential must agree to avoid becoming pregnant or impregnating a partner and adhere to highly effective contraception methods for 6 months after the last dose of cemiplimab or cemiplimab and RP1 combination treatment. In addition,
    male patients must refrain from donating sperm during this study treatment and for up to 6 months after the last dose of cemiplimab or cemiplimab and RP1 combination treatment. For a definition of highly effect contraceptive methods and instructions of patients and partners, see Section 9.3.4.9.
    12 . Locally advanced CSCC only (Surgery) must be deemed as not appropriate candidates for curative surgery in the opinion of either a medical oncologist with experience in cutaneous malignancy management, a dermatologist, a head and neck surgeon, or a multidisciplinary disease management team, or documented to have refused surgery despite consultation.
    13 . Locally advanced CSCC only (Radiotherapy): Patients must be deemed as not appropriate candidates for curative radiation therapy or documented as having refused radiotherapy despite consultation. This must include the opinion of either a radiation oncologist, a medical oncologist, a head and neck surgeon, a dermatologist with expertise in cutaneous malignancies, or a multidisciplinary team.
    14. All patients must consent to provide archived (within 12 months [6 months preferred] of screening date) or newly obtained tumor material (either formalin-fixed, paraffin-embedded [FFPE] block or unstained slides) for central pathology review and biomarker analyses.
    15. Tumor biopsies will be taken as specified in the Schedules of Events (Section 9.1).
    1.Acc volont di fornire il consenso inf scritto ed essere disposto e in grado di risp quanto richiesto nel prot
    2.Diagn conf istolog di CSCC local avanz o metastatico(linfonodale o a distanza) in base al ref patologico locale.La Diagn metastatica(linfonodale o a distanza)è def come una Diagn disseminata a distanza dal sito iniz/primario di Diagn.La Diagn local recidivante è def come una Diagn prec trattata(mediante interv chirurgico,radioterap o terap sistem),che non può essere sottoposta a un interv chirurgico curativo,a radioterap curativa o a chemioradioterap concomitante
    3.Presenza di almeno1lesione misurab e1 o più lesioni iniett.Non esistono dim minime del tumore per l’iniez,a patto che vi siano tumori iniett che,complessivamente,misurino<=1cm al bas
    4. PS ECOG<= 1(App 4)
    5. Pz di sesso masc o femm di età>=18anni
    6. Funz epatica:
    a.Bilirub tot<=1,5volte il lim superiore della norma(ULN);(in caso di metastasi epatiche,<=3volte l’ULN).I pz con sindrome di Gilbert e Bilirub tot fino a3volte l’ULN potrebbero essere idonei dopo com con il monitor medico e sua appr
    b.Transaminasi(ALT o AST)<=3 volte l’ULN(o<=5volte l’ULN,in caso di metastasi ep)
    c.Fosfatasi alcalina(ALP)<=2,5 volte l’ULN(o<=5volte l’ULN,in caso di metastasi ep od ossee)
    Nota per i pz con metastasi ep che desiderano arr nello studio:qualora i liv di ASTe/oALT siano>3volte,ma<=5volte l’ULN,la Bilirub tot deve essere<=1,5 volte l’ULN.Se la Bilirub tot è >1,5 volte,ma<=3volte l’ULN,entrambe le transaminasi devono essere<=3volte l’ULN
    7.Funz renale:creatinina sierica<= 1,5volte l’ULN OPPURE,in caso di creatinina sierica>1,5volte l’ULN, clearance della creatinina calcolata>=30 ml/min(utilizzando Cockcroft)
    8. Funzione del midollo osseo:
    a.Hb>=9,0 g/dL
    b.ANC>=1,5×109/l
    c.Conta piastr>=100×109/l
    9.PT<=1,5 volte l’ULN(oppure INR<=1,3)e PTT o aPTT<=1,5 volte l’ULN
    10.Aspett di vita prev>12sett
    11.I pz di sesso femm e masc in età fertile devono evit di iniz una gravid o di fecondare una partner e accettare di utiliz metodi contracc altamente eff per6mesi dopo l’ultima dose di cemiplimab o del trattam comb con cemiplimab+RP1.Inoltre,i pz di sesso masc devono astenersi dall’eff donazioni di sperma durante il tratt ogg di questo studio e per un periodo fino a6mesi dopo l’ultima dose di cemiplimab o del trattam comb con cemiplimab+RP1.Per una def dei metodi contracc altamente eff e per istruzioni per i pz e i loro partner,vedere la Sez 9.3.4.9
    12.Solo CSCC loc avanz(interv chirurgico): i pz devono essere considerati candidati non idonei per un interv chirurgico curativo a giudizio di un oncologo med con esp nella gestione delle neoplasie maligne cutanee,di un dermatologo,di uno special in chirurgia di testa e collo o di un team multidisciplinare di gestione della Diagn oppure deve essere documentato il rifiuto dei pz di sottoporsi all’interv chirurgico nonostante un consulto.Vedere laSez 4.2.1del prot per le def delle controindic accettabili per l’interv chirurgico
    13.Solo CSCC loc avanz(radioterap):i pz devono essere considerati candidati non idonei per la radioterap curativa in base alle definizioni riportate nella Sez del prot relativa all’inclusione oppure deve essere documentato il loro rifiuto di sottoporsi alla radioterap nonostante un consulto.In questa val deve essere coinvolto un oncologo radioterapista,un oncologo medico,uno special in chirurgia di testa e collo,un dermatologo con esp nelle neoplasie maligne cutanee o un team multidisciplinare.Vedere laSez 4.2.1del prot per le def delle controindicazioni accettabili per la radioterap
    14.Tutti i pz devono acconsentire a fornire mat tumorale d’archivio(raccolto entro12mesi[preferibilmente6 mesi]dalla data dello screening)od ottenuto di recente(blocco fissato in formalina e incluso in paraffina [FFPE]oppure vetrini non colorati)per una revisione patologica centralizz fin a confermare la Diagn di CSCC ed eseguire l’anal dei biomarc
    15.Le biopsie saranno ottenute come specificato nei Calendari degli eventi(Sez 9.1)
    E.4Principal exclusion criteria
    1.Prior treatm with an oncolytic therap
    2.Pt with active significant herpetic infections or prior complications of HSV-1infection(e.g.herpetic keratitis or encephalitis or disseminated herpes infection)
    3.Pt who require intermittent or chronic use of systemic(oral or IV)anti-virals with known antiherpetic activity(e.g.acyclovir)
    4.Ongoing or recent(within5y) evidence of significant autoimmune disease that required treatm with systemic immunosuppressive treatms,which may suggest risk for imAE or has a diagnosis of immunodeficiency disorders(such as HIV disease or organ transplantation or hematologic malignancies associated with immune suppression)
    5.Prior treatm with an agent that blocks thePD-1/PD-L1pathway
    6.Prior treatm with other immune modulating agents other than as adjuvant or neoadjuvant therapy within3y.Examples of immune modulating agents include therapeutic anti-cancer vaccines,cytokine treatms(other than G-CSFor erythropoietin),or agents that targetCTLA-4,4-1BB(CD137),PI 3-K-delta, or OX-40
    7.Untreated brain metastasis(es)that may be considered active
    8.Immunosuppressive corticosteroid doses(>10mg prednisone daily or equivalent)within2w prior to randomisation
    9.Pt who has acute or chronic active hepatitisB or known history of hepatitisB(defined as hepatitisB surface antigen[HBsAg]reactive)or HCV or HIV infection
    10.Active infection requiring systemic therapy with14dd prior to randomisation
    11.History of interstitial lung disease(ILD)/pneumonitis within the last 5y or a history of ILD/pneumonitis requiring treatm with systemic steroids
    12.History of myocarditis or congestive heart failure(as defined by the NYHA Classification III or IV),or unstable angina,serious uncontrolled cardiac arrhythmia,uncontrolled infection or myocardial infarction within 6 months of randomisation
    13.Grade>=3hypercalcemia at time of enrollment
    14.Any systemic anticancer treatm(chemotherapy,targeted systemic therapy,photodynamic therapy),investigational or standard of care, within 28dd of randomisation or planned to occur during the study period(Pt receiving bisphosphonates or denosumab are not excluded).Radiation therapy within14dd of randomisation or planned to occur during the study period.Any major surgical procedure <=28dd before randomization.Pt must have recovered adequately from the toxicity and/or complications from prior interventions prior to randomization
    15.Was administered a live vaccine<=28dd before randomisation
    16.History of documented allergic reactions or acute hypersensitivity reaction attributed to ab treatms
    17.Pt with allergy or hypersensitivity toRP1or cemiplimab's excipients must be excluded.Specifically,cause of the presence of trace components in cemiplimab,Pt with allergy or hypersensitivity to doxycycline or tetracycline are exclud
    18.Female who has a positive serumß-hCG pregnancy(at screening<=72h prior to first study treatm)and urine pregnancy test(Cycle1Day1)or is breast feeding or planning to become pregnant
    19.Concurrent malignancy other thanCSCCand/or history of malignancy other thanCSCC within 3y of date of first planned dose of cemiplimab,except for tumors with negligible risk of metastasis or death.Examples are provided in section 4.2.2. of the study protocol
    20.Any acute or chronic psychiatric problems or substance abuse disorders that in the opinion of the investigator,would interfer with the pt cooperating with the requirements of the study
    21.Any medical co-morbidity,physical examination finding,or metabolic dysfunction,or clinical laboratory abnormality that,in the opinion of the investigator,renders the pt unsuitable for participation in a CT due to high safety risks and/or potential to affect interpretation of results of the study
    22.Inability to undergo any contrast-enhanced radiologic response assessment
    23.Is currently participating in or has participated in a study of an investig agent or has used an investig device within 4w prior to randomisation.See exc criteria in the protocol for Except
    1.Trattam prec con una terap oncolitica
    2.PZ con infez erpetiche signific in fase att o prec complicanze di un’infez daHSV-1(ad es.cheratite erpetica,encefalite o infez erpetica disseminata)
    3.PZ con nec di uso intermitt o cronico di antivir sistem (x via orale o e.v.)con att antierp nota(ad es.aciclovir)
    4.Evid attuali o rec(entro 5anni)di malat autoimm signific che ha richiesto il Trattam con terap immunosop sistemiche,che potrebbe sugg il rischio di imAE,o una diag di disturbi da immunodef(come malat da HIV o trapianto d’organo o neoplasie maligne emate ass a immunosop)
    5.Trattam prec con un ag che blocca il path PD-1/PD-L1
    6.Trattam prec con altri agenti immunomod non somm come terap adiuv o neoadiuv entro3anni.Tra gli es di agenti immunomodi si annoverano vaccini terap antitumorali,trattam con citochine(diversi da G-CSF o dall’eritropoietina)o agenti diretti contro CTLA-4,4-1BB (CD137),PI 3-K-delta od OX-40
    7.Metastasi cereb non tratt consid att
    8.Dosi di corticosteroidi immunosoppr (>10mg di prednisone al g o eq)nelle2sett e prec la randomiz
    9.PZ con epatiteB att acuta o cronica oppure con anam nota di epatiteB(definita come reatt all’antigene di sup dell’epatite B[HBsAg])o infez da HCV o da HIV
    10.Infez att con necessità di terap sistemica nei14gg prec la randomiz
    11.Anamnesi di malat ILD/polmonite negli ultimi5anni oppure anamnesi di ILD/polmonite con nec di trattam con steroidi sistem
    12.Anamnesi di miocardite o insuff cardiaca congest(di class III o IV in base alle def di NYHA)oppure angina instabile,aritmia cardiaca grave non cont,infez non cont o infarto miocardico entro6mesi dalla randomiz
    13.Ipercalcemia di grado>=3al momento dell’arruolam
    14.Quals Trattam antitumsistemico(chemioterap,terap sistem mirata o terap fotodinamica),sperimentale o standard di cura,entro 28gg dalla randomiz oppure in prog durante il per dello studio(i PZ trat con bifosfonati o denosumab non sono esclusi).Radioterap entro14gg dalla randomiz o in progr durante il per dello studio.Qualsiasi proced chirurg maggiore<=28 giorni prima della randomiz.I PZ devono aver recuperato in maniera adeg dalla tox e/o dalle complicanze di interv prec prima della randomiz
    15.PZ a cui è stato somm un vaccino vivo<=28 giorni prima della randomiz
    16.Anamnesi di reaz allergiche o reaz di ipersensibilità acuta documentate,attrib a trattam con anticorpi
    17.I PZ con allergia o ipersensib agli ecc di RP1 o di cemiplimab devono essere esclusi.Specificamente,a causa della pres di componenti in tracce in cemiplimab,i PZ con allergia o ipersensib alla doxiciclina o alla tetraciclina sono esclusi
    18.Donne che ottengono un risul positivo a un test di gravidanza che misura i livelli sierici di ß hCG(allo screening nelle 72h prec i la somm) e a un test di gravidanza sulle urine(giorno1 del ciclo1)o stanno allattando oppure hanno in progr a di iniziare una gravidanza
    19.Neoplasia maligna concomit diversa dal CSCC e/o anamnesi di neoplasia maligna diversa dal CSCC entro3anni dalla data della1dose programmata di cemiplimab,ad eccezione dei tumori che pres un rischio trascurabile di metastasi o decesso. Es sono forniti nella Sezione 4.2.2
    20.Qualsiasi problema psichiatrico acuto o cronico o dist da abuso di sost che,a giudizio dello sperim,potrebbe interferire con la collab del PZ in relazione a quanto richiesto nello studio
    21.Quals comorbilità med,reperto all’es obiett o disfun metab o risul anomalo in anal di lab che,a giudizio dello speriment,renda il PZ non idoneo per la partecip a una sperim clin a causa di rischi el per la sicur e/o la poss di influire sull’interpret dei risul dello studio
    22.Imposs di sottoporsi a una quals val della risp radiologica con mezzo di contrasto(ad ecc di quanto indicato nella sez del prot relativa ai criteri di esclusione[Sezione 4.2.2]).
    23.PZ che stanno attualmente partecip o hanno partecip a uno studio su un ag sperime o hanno utilizzato un disp sperim nelle4settimane prec la randomiz.Vedere i criteri di esclusione nel prot per le ecc
    E.5 End points
    E.5.1Primary end point(s)
    The primary efficacy endpoint for this study are ORR and CRR according to blinded independent review:
    • ORR/ CRR will be determined using modified Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as specified in Appendix 1 for radiologically accessible lesions and clinical and composite response criteria as specified in Appendix 2 for clinically accessible lesions. These criteria include that PD must be confirmed by documentation of further progression >=4 weeks following the documentation of objective response or PD.
    • In patients suspected of achieving a CR By clinical assessment, tumor biopsies may be used in the final determination of CR.
    L'endpoint primario di efficacia per questo studio sono ORR e CRR in base alla revisione indipendente in cieco:
    • ORR/ CRR saranno determinati utilizzando criteri di valutazione della risposta modificati nei tumori solidi versione 1.1 (RECIST 1.1) come specificato nell'appendice 1 per lesioni radiologicamente accessibili e criteri di risposta clinica e criteri di risposta composita come specificato nell'appendice 2 per lesioni clinicamente accessibili. Questi criteri includono che PD deve essere confermato dalla documentazione di ulteriori progressi >=4 settimane dopo la documentazione di risposta oggettiva o PD.
    • Nei pazienti sospettati di ottenere un CR attraverso valutazione clinica, le biopsie tumorali possono essere utilizzate nella determinazione finale di CR.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Patients should be re-evaluated for response every 9 weeks from randomization. Confirmatory scans should also be obtained >=4 weeks following initial documentation of objective response or progressive disease
    Ai fini di questo studio, i pazienti devono essere rivalutati per quanto riguarda la risposta ogni 9 settimane dalla randomizzazione.
    Dovranno anche essere ottenute scansioni di conferma > =4 settimane dopo la documentazione iniziale di risposta obiettiva o progressione della malattia
    E.5.2Secondary end point(s)
    The secondary efficacy outcome measures is PFS by blinded independent review. Other secondary efficacy outcome measures are:
    • ORR/CRR by investigator review
    •ORR/CRR for patients with metastatic disease (nodal or distant) by investigator and blinded independent review
    • ORR/CRR for patients with locally advanced disease by blinded independent review
    • ORR/CRR for patients having previously received systemic CSCC-directed therapy by investigator and blinded independent review
    • ORR/ CRR for patients not having previously received systemic CSCC directed therapy by investigator and blinded independent review
    • PFS by investigator review
    • DOR by investigator and blinded independent review: DOR is for responders only and defined as the length of time from the date of 1st documented response to the date of the initial disease progression or death. For those patients who did not have disease progression or death, DOR is calculated from the date of 1st documented response to the date of the last valid disease assessment (before any subsequence anti-cancer therapy) and will be censored. •OS (OS will be calculated for the ITT population and is defined as the length of time from the date of randomization to the date of death. For those patients who remain alive at the time of the data cut-off or those who discontinued for reasons other than death, OS is calculate from the date of randomization to the last date they are known to be alive and will be censored on that date.)
    • 3 year survival
    • Change in scores of patient-reported outcomes on EORTC QLQ-C30
    • Safety and tolerability of cemiplimab alone and combined with RP1
    Stimare l’effetto del trattamento sulla sopravvivenza libera da progressione (progression-free survival, PFS) in base alla revisione indipendente in cieco. Altre misure secondarie di risultato dell'efficacia sono:
    • ORR/CRR in base alla revisione dello sperimentatore
    •ORR/CRR per pazienti con malattia metastatica (nodale o distante) in base alla revisione dello sperimentatore e alla revisione indipendente in cieco
    • ORR/CRR per pazienti con malattia localmente avanzata in base alla revisione indipendente in cieco
    • ORR/CRR per pazienti che hanno precedentemente ricevuto una terapia sistemica CSCC-diretta in base alla revisione dello sperimentatore e alla revisione indipendente in cieco
    • ORR/ CRR per pazienti che non hanno precedentemente ricevuto la terapia sistemica CSCC-diretta CSCC in base alla revisione dello sperimentatore e alla revisione indipendente in cieco
    • PFS in base alla revisione dello sperimentatore
    • DOR in base alla revisione dello sperimentatore e alla revisione indipendente in cieco: DOR è solo per i riceventi ed è definita come il periodo di tempo dalla data della prima risposta documentata alla data della progressione iniziale della malattia o della morte. Per i pazienti che non hanno avuto progressione della malattia o morte, il DOR viene calcolato dalla data della prima risposta documentata alla data dell'ultima valutazione valida della malattia (prima di qualsiasi terapia anti-cancro di sottosequenza) e sarà registrato.
    •OS (OS sarà calcolato per la popolazione ITT ed è definito come il periodo di tempo dalla data di randomizzazione alla data del decesso. Per quei pazienti che rimangono in vita al momento della data cut-off o per coloro che hanno interrotto per motivi diversi dalla morte, OS viene calcolato dalla data di randomizzazione all'ultima data in cui è noto che sono vivi e saranno registrati in quella data.)
    • Sopravvivenza a 3 anni
    • Variazione dei punteggi dei risultati riportati dal paziente sul EORTC QLQ-C30
    • Sicurezza e tollerabilità del cemiplimab da solo e combinato con RP1
    E.5.2.1Timepoint(s) of evaluation of this end point
    Patients should be re-evaluated for response every 9 weeks from the date of randomization. Confirmatory scans should also be obtained >= 4 weeks following initial documentation of objective response or progressive disease.
    I pazienti devono essere rivalutati per quanto riguarda la risposta ogni 9 settimane dalla data di randomizzazione. Dovranno anche essere ottenute scansioni di conferma >= 4 settimane dopo la documentazione iniziale di risposta obiettiva o progressione della malattia.
    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 No
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA48
    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
    Canada
    United States
    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 years3
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days28
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months6
    E.8.9.2In all countries concerned by the trial days28
    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: 74
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 106
    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 state15
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 100
    F.4.2.2In the whole clinical trial 180
    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 Decision2022-03-04
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-09-29
    P. End of Trial
    P.End of Trial StatusCompleted
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