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    Summary
    EudraCT Number:2018-004186-14
    Sponsor's Protocol Code Number:CORT125134-552
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2019-06-11
    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 ConcernedSpain - AEMPS
    A.2EudraCT number2018-004186-14
    A.3Full title of the trial
    A Phase 2, Randomized, Open-label, 3-arm Study of Relacorilant in Combination with Nab-Paclitaxel for Patients with Platinum Resistant Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
    Estudio de fase II, aleatorizado, sin enmascaramiento y de 3 grupos de relacorilant en combinación con nab-paclitaxel en pacientes con cáncer de ovario, de trompas de Falopio o peritoneal primario recurrente y resistente al platino
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A clinical trial of relacorilant (study drug) with nab-paclitaxel in patients with ovarian, fallopian tube or peritoneal cancer
    Estudio de relacorilant (fármaco del estudio) con nab-paclitaxel en pacientes con cáncer de ovario, trompas de Falopio o peritoneal
    A.4.1Sponsor's protocol code numberCORT125134-552
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT03776812
    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 SponsorCorcept Therapeutics 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 supportCorcept Therapeutics Incorporated
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCorcept Therapeutics Incorporated
    B.5.2Functional name of contact pointClinical Operations
    B.5.3 Address:
    B.5.3.1Street Address149 Commonwealth Drive
    B.5.3.2Town/ cityMenlo Park, California
    B.5.3.3Post code94025
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1650327-3270
    B.5.6E-mailcorceptstudy552@corcept.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 nameRelacorilant
    D.3.2Product code CORT125134
    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 INNRELACORILANT
    D.3.9.1CAS number 1496510-51-0
    D.3.9.2Current sponsor codeCORT125134
    D.3.9.3Other descriptive name(R)-(1-(4-FLUOROPHENYL)-6-((1-METHYL-1H-PYRAZOL-4-YL)SULFONYL)4,4A,5,6,7,8-HEXAHYDRO-1H-PYRAZOLO[3,4-G]ISOQUINOLIN-4AYL)(4(TRIFLUOROMETHYL)PYRIDIN-2-YL)METHANONE
    D.3.9.4EV Substance CodeSUB168996
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product 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 nameRelacorilant
    D.3.2Product code CORT125134
    D.3.4Pharmaceutical form Capsule, soft
    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 INNRELACORILANT
    D.3.9.1CAS number 1496510-51-0
    D.3.9.2Current sponsor codeCORT125134
    D.3.9.3Other descriptive name(R)-1-(4-FLUOROPHENYL)-6-(1-METHYL-1H-PYRAZOL-4-YL)SULFONYL)4,4A,5,6,7,8-HEXAHYDRO-1H-PYRAZOLO[3,4-G]ISOQUINOLIN-4A-YL][4-(TRIFLUOROMETHYL)PYRIDIN-2-YL]METHANONE
    D.3.9.4EV Substance CodeSUB168996
    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 No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product 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 Abraxane
    D.2.1.1.2Name of the Marketing Authorisation holderCelgene
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameAbraxane
    D.3.2Product code Nab-paclitaxel
    D.3.4Pharmaceutical form Powder for suspension for injection
    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 INNNab-paclitaxel
    D.3.9.1CAS number 33069-62-4
    D.3.9.2Current sponsor codeAbraxane
    D.3.9.3Other descriptive namePACLITAXEL ALBUMIN-BOUND
    D.3.9.4EV Substance CodeSUB127678
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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 No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product 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
    Recurrent Platinum-Resistant Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
    Cáncer de ovario, trompas de Falopio y peritoneal recurrente y resistente al platino
    E.1.1.1Medical condition in easily understood language
    Recurrent Platinum-Resistant Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
    Cáncer de ovario, trompas de Falopio y peritoneal recurrente y resistente al platino
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10033128
    E.1.2Term Ovarian cancer
    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 20.0
    E.1.2Level PT
    E.1.2Classification code 10016180
    E.1.2Term Fallopian tube cancer
    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 20.0
    E.1.2Level PT
    E.1.2Classification code 10061344
    E.1.2Term Peritoneal neoplasm
    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 is to evaluate progression-free survival (PFS) in patients treated with intermittent or continuous regimens of relacorilant in combination with nab-paclitaxel compared with patients treated with nab-paclitaxel alone.
    El objetivo primario es evaluar la supervivencia sin progresión (SSP) en pacientes tratadas con pautas intermitentes o continuas de relacorilant en combinación con nab-paclitaxel en comparación con las pacientes tratadas con nab-paclitaxel en monoterapia.
    E.2.2Secondary objectives of the trial
    Efficacy
    *To evaluate objective response rate (ORR)
    *To evaluate duration of response (DoR)
    *To assess response according to cancer antigen 125 (CA-125) using GCIG criteria. A combined response endpoint based on RECIST v1.1 and GCIG will also be reported.
    *To evaluate PFS rate at 6 and 12 months
    *To evaluate overall survival (OS)
    *To evaluate PFS, ORR, DoR and best overall response (BoR) in patients who receive continuous relacorilant in combination with nab-paclitaxel following progression on nab-paclitaxel (crossover)
    * To assess response according to CA-125 using GCIG criteria in patients who crossover to continuous relacorilant+nab-paclitaxel
    Safety
    *To assess the safety of relacorilant treatment in combination with nab-paclitaxel
    *To model the exposure-toxicity and exposure-response of relacorilant and nab-paclitaxel in each treatment arm to recommend a dosing regimen of relacorilant in combination with nab-paclitaxel
    Pharmacokinetics
    *To assess (PK)
    Eficacia
    •Evaluar tasa respuesta objetiva (TRO)
    •Evaluar duración de la respuesta (DR)
    •Evaluar respuesta según antígeno tumoral 125 (CA-125) usando criterios GCIG. También se usará un criterio evaluación respuesta combinada de RECIST yGCIG.
    •Evaluar tasa de SSP a 6 y 12 meses.
    •Evaluar supervivencia global (SG)
    •Evaluar SSP, TRO, DR y mejor respuesta global (MRG) en pacientes que reciben relacorilant en combinación con nab-pac conitnuo después de la progresión con nab-paclitaxel.
    •Evaluar respuesta según CA-125 utilizando criterios del GCIG pacientes que pasen a relacorilant en combinación con nab-pac continuo
    Seguridad
    • Evaluar seguridad tto con relacorilant combinado con nab-pac.
    • Modelar relación exposición-toxicidad y exposición-respuesta de relacorilant y nab-pac en cada grupo de tratamiento.
    Farmacocinética
    • Evaluar farmacocinética (FC) de relacorilant y nab-pacl tras pautas intermitentes o continuas de relacorilant con nab-pac en comparación con nab-pac solo.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Signed and dated IRB/IEC-approved informed consent form (ICF) prior to study-specific screening procedures.
    2. Female patients aged ≥ 18 years old at time of consent.
    3. Histologic diagnosis of high grade serous or endometrioid epithelial ovarian, primary peritoneal, or fallopian tube cancer or ovarian carcinosarcoma. Clear cell, mucinous and borderline histologic subtypes are excluded.
    4. Received at least one line of therapy with progression within 6 months after platinum-based therapy, persistent disease at the completion of primary platinum-based therapy, or PD during platinum-based therapy. Patients with primary platinum resistance (progression after first-line chemotherapy) are considered eligible.
    5. Measurable or non-measurable disease by RECIST v1.1:
     Previously irradiated lesions are not allowed as measurable disease, unless there is documented evidence of progression in the lesions.
     To be eligible with non-measurable disease, patients must have evaluable disease with CA-125 of at least twice the upper limit of the reference range (or CA-125 ≥ 70 U/mL) along with radiographically evaluable disease by CT/MRI.
    6. Availability and consent to provide tumor tissue for GR immunohistochemistry (archival or recent biopsy).
    7. Up to 2 prior chemotherapeutic or myelosuppressive regimens for recurrent disease (not including maintenance therapy such as single-agent bevacizumab).
    8.Appropriate to treat with nab-paclitaxel, in the opinion of the Investigator.
    9. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
    10. Adequate organ and bone marrow function meeting the following criteria at the Screening Visit:
     Absolute neutrophil count (ANC) ≥ 1,500 cells/mm3.
     Platelet count ≥ 100,000/mm3.
     Hemoglobin ≥ 9 g/dL.
     AST or ALT ≤ 2.5 × upper limit of normal (ULN) (or ≤ 5 × ULN in the context of liver metastasis).
     Total bilirubin ≤ 1.5 × ULN.
     Serum creatinine ≤ 1 × ULN; creatinine clearance ≥ 50 mL/min/1.73 m2 for patients with creatinine levels above institutional normal.
     Albumin ≥ 3 g/dL (≥ 30 g/L) .
    11. If patient has undergone surgery of the gastrointestinal or hepatobiliary tract, adequate absorption as evidenced by: albumin ≥ 3.0 g/dL, controlled pancreatic insufficiency (if present), and lack of malabsorption.
    12. Able to swallow and retain oral medication and does not have uncontrolled emesis.
    13. Able to comply with protocol requirements.
    14. Negative pregnancy test for patients of childbearing potential. Patients of childbearing potential must use appropriate precautions to avoid pregnancy, defined as of nonchildbearing potential (i.e., postmenopausal or permanently sterilized) or using highly effective contraception with low user-dependency, for at least 3 months after the last dose of study drug. A woman is postmenopausal if it is more than 12 months since her last menstruation, without an alternative medical cause. Accepted methods of permanent sterilization methods are hysterectomy, bilateral salpingectomy and/or bilateral oophorectomy. Accepted methods of highly effective contraception with low user-dependency are:
     An IUD, provided that the subject has tolerated its use for at least 3 months before the first dose of study medication and undertakes not to have it removed for 1 month after the last dose.
     Abstinence from heterosexual intercourse, when it is in line with the subject’s preferred and usual lifestyle. Periodic abstinence and withdrawal is NOT acceptable.
     Vasectomized partner provided that the partner is the sole sexual partner of the trial participant and that the vasectomized partner has received medical assessment of the surgical success.
     Oral hormonal contraceptives are NOT permitted.
    1. Formulario de consentimiento informado (FCI) aprobado por el CEIm firmado y fechado antes de realizar los procedimientos de selección específicos del estudio.
    2. Pacientes de ≥18 años en el momento del consentimiento.
    3. Diagnóstico histológico de cáncer de ovario epitelial, peritoneal primario o de las trompas de Falopio u carcinosarcoma ovárico seroso o endometrioide de gran malignidad. Se excluyen los subtipos histológicos de células claras, mucinosos y limítrofes.
    4. Recibieron al menos una línea de tratamiento con progresión dentro de un plazo de 6 meses después del tratamiento basado en platino, enfermedad persistente en el momento de la finalización del tratamiento basado en platino o PE durante el tratamiento basado en platino. Las pacientes con resistencia primaria al platino (progresión con quimioterapia de primera línea) se consideran elegibles.
    5. Enfermedad mensurable o no mensurable según los criterios RECIST v1.1:
    • Las lesiones irradiadas previamente no están permitidas como enfermedad mensurable, salvo que haya signos documentados de progresión en las lesiones.
    • Para ser elegible con enfermedad no mensurable, las pacientes deben tener enfermedad evaluable con CA-125 de al menos el doble del límite superior del intervalo de referencia (o CA-125 ≥70 U/ml), junto con enfermedad radiográficamente evaluable mediante TC/RM.
    6. Disponibilidad y consentimiento para proporcionar tejido tumoral para la realización de inmunohistoquímica para RG (biopsia de archivo o reciente).
    7. Hasta 2 tratamientos quimioterapéuticos o mielosupresores previos para la enfermedad recurrente (sin incluir el tratamiento de mantenimiento como bevacizumab en monoterapia).
    8. Adecuación para tratamiento con nab-paclitaxel, en opinión del investigador.
    9. Estado funcional de 0 o 1 según el Eastern Cooperative Oncology Group (ECOG).
    10. Función adecuada de los órganos y la médula ósea que cumpla los criterios siguientes en la visita de selección:
    • Recuento absoluto de neutrófilos (RAN) ≤1 500 células/mm3.
    • Recuento de plaquetas ≥100 000/mm3.
    • Hemoglobina ≥9 g/dl.
    • AST o ALT ≤2,5 veces el límite superior de la normalidad (LSN) (o ≤5 veces el LSN en el contexto de metástasis hepáticas).
    • Bilirrubina total ≤1,5 × LSN
    • Creatinina sérica ≤1 × LSN; aclaramiento de creatinina ≥50 ml/min/1,73 m2 para pacientes con niveles de creatinina por encima de los valores institucionales normales.
    • Albúmina ≥3 g/dl (≥30 g/l).
    11. Si la paciente se ha sometido a cirugía del tubo digestivo o hepatobiliar, absorción adecuada demostrada por: albúmina ≥3,0 g/dl, insuficiencia pancreática controlada (si estuviera presente) y ausencia de hipoabsorción.
    12. Capacidad para tragar y mantener medicamentos orales y no presentar emesis no controlada.
    13. Poder cumplir con los requisitos del protocolo.
    14. Prueba de embarazo negativa en las pacientes con capacidad para procrear. Las pacientes con posibilidad de quedar embarazadas deben utilizar las precauciones adecuadas para evitar el embarazo, como no poder concebir (es decir, posmenopáusicas o esterilizadas de forma permanente) o el empleo de métodos anticonceptivos muy eficaces con poca dependencia del usuario, durante al menos 3 meses después de la última dosis del fármaco del estudio. Una mujer es posmenopáusica si han transcurrido más de 12 meses desde la última menstruación, sin una causa médica alternativa. Los métodos aceptados de esterilización permanente son histerectomía, salpingectomía bilateral u ovariectomía bilateral. Los métodos anticonceptivos muy eficaces con baja dependencia del usuario son:
    • DIU, siempre que la mujer haya tolerado su uso durante al menos 3 meses antes de la primera dosis del medicamento del estudio y se comprometa a no retirárselo en el mes posterior a la última dosis.
    • Abstinencia sexual en las relaciones heterosexuales, cuando se corresponde con el estilo de vida habitual y preferido de la paciente. La abstinencia periódica y el coito interrumpido NO son aceptables.
    • Vasectomía de la pareja siempre y cuando la pareja fuera la única pareja sexual de la participante del ensayo y la pareja vasectomizada haya recibido evaluación médica del éxito de la intervención.
    • NO se permite el uso de anticonceptivos hormonales orales.
    E.4Principal exclusion criteria
    1. Clinically relevant toxicity from prior systemic anticancer therapies or radiotherapy that in the opinion of the Investigator has not resolved to Grade 1 or less prior to randomization.
    2. Any major surgery within 4 weeks prior to randomization. If subject received major surgery including (curative or palliative surgery), they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy.
    3. Treatment with the following prior to randomization:
     Concurrent treatment with other anticancer therapy including other chemotherapy, immunotherapy, radiotherapy, chemo-embolization, targeted therapy, an investigational agent or the non-approved use of a drug or device within 28 days before the first dose of study drug.
     Hormonal anticancer therapies within 7 days of the first dose of study drug.
     Systemic, inhaled, or prescription strength topical corticosteroids within 21 days of the first dose of study drug. Short courses (≤ 5 days) for non-cancer-related reasons are allowed if clinically required (such as prophylaxis for CT).
    4. Received radiation to more than 25% of marrow-bearing areas.
    5. Toxicities of prior therapies (except alopecia) that have not resolved to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0 ≤ Grade 1.
    6. Requirement for treatment with chronic or frequently used oral corticosteroids for medical conditions or illnesses (e.g., rheumatoid arthritis, immunosuppression after organ transplantation).
    7. History of severe hypersensitivity or severe reaction to either study drug.
    8. Peripheral neuropathy from any cause > Grade 1.
    9. Pregnant or lactating patients or patients expecting to conceive children within the projected duration of the trial, starting with screening visit through 90 days after the last dose of trial treatment.
    10. Human immunodeficiency virus or current chronic/active infection with hepatitis C virus or hepatitis B virus, including:
     Patients with chronic or active hepatitis B as diagnosed by serologic tests are excluded from the study. In equivocal cases, hepatitis B or C polymerase chain reaction may be performed and must be negative for enrollment.
    11. Patient has a clinically significant uncontrolled condition(s) or which in the opinion of the Investigator may confound the results of the trial or interfere with the patient’s participation, including but not limited to:
     Unstable angina pectoris, angioplasty, cardiac stenting, or myocardial infarction 6 months before study entry.
     Uncontrolled hypertension (sustained systolic blood pressure > 150 mmHg or diastolic pressure > 100 mmHg despite optimal management). Patients will be considered eligible if hypertension is treated and controlled during Screening.
     Active infection that requires parenteral antibiotics.
     Bowel obstruction or gastric outlet obstruction.
     Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
    12. Untreated parenchymal central nervous system metastases.
    13. Any other concurrent cancer or a history of another invasive malignancy within the last 3 years that has a likelihood of recurrence of > 30% within the next 5 years. Adequately treated non-melanoma skin cancers or non-muscle invasive urothelial cancer or other tumors curatively treated with no evidence of disease are permissible.
    14. Drugs with a narrow therapeutic ratio that are highly dependent on CYP3A for clearance should be avoided. Caution should be exercised when co-administering known inhibitors of CYP3A with relacorilant. Medicines/food known to strongly inhibit CYP3A should be avoided.
    15. Concurrent treatment on other investigational treatment studies for the treatment of ovarian, fallopian tube, or primary peritoneal cancer.
    16. Has received a live vaccine within 30 days of planned start of study therapy. Note: Seasonal influenza vaccines for injection are generally inactivated flu vaccines and are allowed; however intranasal influenza vaccines (e.g., Flu-Mist®) are live attenuated vaccines, and are not allowed.
    1. Toxicidad clínicamente significativa a partir de tratamientos antineoplásicos sistémicos previos o radioterapia que en la opinión del investigador no se haya resuelto hasta un grado 1 o inferior antes de la aleatorización.
    2. Cirugía mayor en las 4 semanas previas a la aleatorización. Si la paciente se sometió a cirugía mayor (incluidas cirugía curativa o paliativa), se debe haber recuperado de forma suficiente de la toxicidad y/u otras complicaciones de la intervención antes de iniciar el tratamiento.
    3. Tratamiento con los siguientes antes de la aleatorización:
    • Tratamiento concomitante con otros antineoplásicos, incluidos otra quimioterapia, inmunoterapia, radioterapia, quimioembolización, tratamiento dirigido, un medicamento en investigación o el uso no aprobado de un fármaco o dispositivo en los 28 días anteriores a la primera dosis del fármaco del estudio.
    • Tratamientos antineoplásicos hormonales en los 7 días previos a la primera dosis del fármaco del estudio.
    • Corticoesteroides sistémicos, inhalados o tópicos de venta con receta en los 21 días previos a la primera dosis del fármaco del estudio. Se permiten ciclos breves (≤5 días) por razones no relacionadas con el cáncer, si fuera necesario clínicamente (como profilaxis para la TC).
    4. Recibieron radioterapia en más del 25 % de las zonas medulares.
    5. Toxicidades de tratamientos anteriores (excepto alopecia) que no se hayan resuelto a grado ≤1 según los Criterios terminológicos comunes para acontecimientos adversos del Instituto Nacional del Cáncer (NCI-CTCAE) v5.0.
    6. Necesidad de tratamiento con corticosteroides orales crónicos o de uso frecuente para enfermedades o afecciones médicas (p. ej., artritis reumatoide, inmunosupresión tras el trasplante de órganos).
    7. Antecedentes de hipersensibilidad o reacción intensa al fármaco del estudio.
    8. Neuropatía periférica de cualquier causa de grado >1.
    9. Pacientes embarazadas o en período de lactancia, o pacientes que desean concebir durante la duración prevista del estudio, a partir de la visita de selección hasta 90 días después de la última dosis del tratamiento del estudio.
    10. Virus de la inmunodeficiencia humana o infección crónica/activa actual por el virus de la hepatitis C o virus de la hepatitis B, que incluye:
    • Las pacientes con hepatitis B crónica o activa según el diagnóstico mediante pruebas serológicas serán excluidas del estudio. En casos ambiguos, puede realizarse una prueba de reacción en cadena de la polimerasa para la hepatitis B o C y debe ser negativa para la inscripción.
    11. La paciente presenta una o más enfermedades no controladas clínicamente significativas o que, en opinión del investigador, puedan confundir los resultados del estudio o interferir en la participación de la paciente, incluidos, entre otros:
    • Angina de pecho inestable, angioplastia, endoprótesis vascular (stent) cardíaca o infarto de miocardio 6 meses antes de la inclusión en el estudio.
    • Hipertensión no controlada (presión arterial sistólica mantenida >150 mmHg o presión diastólica >100 mmHg a pesar del tratamiento óptimo). Las pacientes se considerarán elegibles si la hipertensión se trata y controla durante la selección.
    • Infección activa que requiera antibióticos parenterales.
    • Obstrucción intestinal u obstrucción al tracto gástrico de salida
    • Pacientes con trastornos psiquiátricos o de abuso de sustancias que interferirían en la cooperación con los requisitos del ensayo.
    12. Metástasis parenquimatosas en el sistema nervioso central no tratadas.
    13. Cualquier otro cáncer concomitante o antecedentes de otra neoplasia maligna invasiva en los últimos 3 años que tiene probabilidad de recidiva >30 % en los siguientes 5 años. Se permiten los cánceres de piel distintos de melanoma o el cáncer urotelial invasivo no muscular tratados de forma suficiente u otros tumores tratados de forma curativa sin signos de enfermedad.
    14. Se evitará el uso de fármacos con un índice terapéutico estrecho que dependan en gran medida de CYP3A para su eliminación. Se debe tener precaución al administrar simultáneamente inhibidores conocidos de CYP3A con relacorilant. Deben evitarse los medicamentos/alimentos inhibidores potentes de CYP3A.
    15. Tratamiento concomitante en otros estudios de tratamiento en investigación para el tratamiento del cáncer de ovario, de las trompas de Falopio o peritoneal primario.
    16. Haber recibido una vacuna con microbios vivos en los 30 días previos al inicio previsto del tratamiento del estudio. Nota: Las vacunas contra la gripe estacional para inyección son vacunas de la gripe inactivadas generalmente y están permitidas; sin embargo, las vacunas contra la gripe intranasales (p. ej., Flu-Mist®) son vacunas con microbios vivos atenuados y no están permitidas.
    E.5 End points
    E.5.1Primary end point(s)
    Progression free survival: the time from the date of randomization until the date of first documented PD by RECIST v1.1, (as determined by the Investigator at the local site) or death due to any cause, whichever occurs first
    Supervivencia sin progresión: tiempo transcurrido desde la aleatorización hasta la fecha de primera documentación de PE según los criterios RECIST v1.1 (según la opinión del investigador del centro local), o muerte por cualquier causa, lo que ocurra primero.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Every 8 weeks (± 7 days) from Cycle 1, Day 1 irrespective of treatment delays until unequivocal PD is documented, including in patients who discontinue treatment prematurely.
    Cada 8 semanas (± 7 días) desde Ciclo 1, Día 1 independientemente de los retrasos en el tratamiento hasta que se document una progresión de la enfermedad inequívoca, incluyendo pacientes que han discontinuado el tratamiento de manera prematura.
    E.5.2Secondary end point(s)
    • ORR: proportion of patients with measurable disease at baseline who attain complete response (CR) or partial response (PR) by RECIST 1.1 (confirmation not required).
    • DoR: time from when response (CR or PR) was first documented to first objectively documented PD or death (whichever occurs first)
    • BoR: the best response recorded from the date of randomization until PD/recurrence (or death).
    • CA-125 response will be assessed per GCIG criteria (Rustin 2011) defined as ≥50% reduction in CA-125 from a pre-treatment sample and maintained for ≥28 days in patients with a pretreatment sample that is at least twice the upper limit of the reference range and within 2 weeks before starting the treatment. In addition, patients who have a CA-125 response and whose CA 125 level falls to within the reference range will be classified as CA -125 complete responders.
    • Combined response according to RECIST v1.1 + GCIG criteria. Response will be reported separately and combined for RECIST 1.1 and CA-125/GCIG criteria.
    • Progression-free rate (proportion of patients who have not progressed) at 6 and 12 months
    • PFS, ORR, DoR, BoR in patients who crossover to the continuous treatment regimen of relacorilant in combination with nab-paclitaxel from the time of PD (baseline for combination therapy) on nab-paclitaxel alone.
    • Overall survival: time from randomization to death by any cause.
    • TRO: porcentaje de pacientes con enfermedad mensurable al inicio que alcanzan respuesta completa (RC) o respuesta parcial (RP) según los criterios RECIST v1.1 (no requiere confirmación).
    • DR: el tiempo transcurrido desde la primera respuesta (RC o RP) documentada hasta la primera confirmación objetiva de la PE o la muerte (lo que ocurra primero).
    • MRG: la mejor respuesta documentada desde la fecha de la aleatorización hasta la PE/recurrencia (o la muerte).
    • Respuesta combinada según los criterios RECIST v1.1 + los criterios de GCIG. La respuesta se notificará por separado y se combinará para los criterios RECIST 1.1 y CA-125/GCIG.
    • La respuesta CA-125 se evaluará según los criterios de GCIG (Rustin, 2011), definida como una reducción ≥50 % en CA-125 a partir de una muestra previa al tratamiento y mantenida durante ≥28 días en pacientes con una muestra previa al tratamiento que sea al menos dos veces el límite superior del intervalo de referencia en las 2 semanas anteriores al inicio del tratamiento. Además, las pacientes con una respuesta CA-125 y cuyos niveles de CA-125 caigan dentro del intervalo de referencia se clasificarán como pacientes con respuesta CA-125 completa.
    • Tasa de ausencia de progresión (porcentaje de pacientes sin progresión) a los 6 y 12 meses.
    • SSP, TRG, DR, MRG en pacientes que cambiaron al tratamiento con relacorilant en pauta continua en combinación con nab-paclitaxel desde el momento de la PE (inicio para el tratamiento combinado) con solo nab-paclitaxel.
    • Supervivencia global: tiempo transcurrido desde la aleatorización hasta la muerte por cualquier causa.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Assessment using the appropriate response criteria per disease at the time points shown in Table 9 of the protocol
    Medida usando los criterios de respuesta adecuados según la patología sengún los puntos que se muestran en la Tabla 9 del protocolo.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic 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) 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 No
    E.8.1.6Cross over Yes
    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 trial3
    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 concerned4
    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 No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Belgium
    Canada
    Germany
    Italy
    Spain
    United States
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    LVLS
    UVUP
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years
    E.8.9.1In the Member State concerned months43
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial months43
    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: 124
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 53
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male No
    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 state21
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 91
    F.4.2.2In the whole clinical trial 177
    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)
    Not applicable
    No aplica
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2019-08-19
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-08-01
    P. End of Trial
    P.End of Trial StatusOngoing
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