E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Synovial Sarcoma |
Sarcoma sinovial |
|
E.1.1.1 | Medical condition in easily understood language |
Synovial Sarcoma |
Sarcoma sinovial |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10042863 |
E.1.2 | Term | Synovial sarcoma |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
|
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the efficacy of ramucirumab in combination with gemcitabine and docetaxel compared with gemcitabine and docetaxel in pediatric and young adult patients with SS (SS = synovial sarcoma). |
Comparar la eficacia de ramucirumab en combinación con gemcitabina y docetaxel con la de gemcitabina y docetaxel en el tratamiento de pacientes menores de edad y adultos jóvenes con SS (sarcoma sinovial). |
|
E.2.2 | Secondary objectives of the trial |
- To evaluate the safety and tolerability of ramucirumab in combination with gemcitabine and docetaxel compared with gemcitabine and docetaxel in pediatric and young adult patients with SS. - To characterize the PK of ramucirumab when co-administered with gemcitabine and docetaxel in pediatric and young adult patients with SS. - To assess the immunogenicity of ramucirumab when co-administered with gemcitabine and docetaxel in pediatric and young adult patients with SS. |
Comparar la seguridad y la tolerabilidad de ramucirumab en combinación con gemcitabina y docetaxel con la de gemcitabina y docetaxel en el tratamiento de pacientes menores de edad y adultos jóvenes con SS. - Caracterizar la FC de ramucirumab cuando se administra de forma concomitante con gemcitabina y docetaxel a pacientes menores de edad y adultos jóvenes con SS. - Evaluar la inmunogenia de ramucirumab cuando se administra de forma concomitante con gemcitabina y docetaxel a pacientes menores de edad y adultos jóvenes con SS. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Patients with either relapsed, recurrent, or refractory SS. - Patients must be >11 kg at the time of study enrollment. - The patient has a Lansky (<16 years of age; Lansky et al. 1987) or Karnofsky (≥16 years of age; Karnofsky et al. 1948) performance score of at least 50. - Patients must be 36 months to ≤29 years of age at the time of study enrolment. - Patients must •have measurable disease by RECIST 1.1 •have received at least one prior line of systemic treatment (including neoadjuvant and adjuvant chemotherapy) that contains ifosfamide and/or doxorubicin, and any approved therapies for which they are eligible, unless the patient is not a suitable candidate for the approved therapy. •not be eligible for surgical resection at time of enrollment - Patients must not have received prior exposure to ramucirumab. - Patient with adequate laboratory values and hematologic, coagulation, liver, cardiac, renal and bladder function, and adequate blood pressure (BP) control as per protocol. |
- Sufrir SS recidivante, recurrente o resistente al tratamiento. - Los pacientes deben pesar más de 11 kg en el momento del reclutamiento en el estudio. - Tener una puntuación del estado funcional de al menos 50 en la escala de Lansky (<16 años; Lansky et al. 1987) o en la de Karnofsky (≥16 años; Karnofsky et al. 1948). - Tener entre 36 meses y ≤29 años de edad en el momento del reclutamiento en el estudio. - Los pacientes deben: • presentar enfermedad mensurable de acuerdo con los criterios RECIST 1.1. • haber recibido al menos una línea previa de tratamiento sistémico (se contabiliza también la quimioterapia neoadyuvante y adyuvante) que incluyera ifosfamida y/o doxorubicina, así como cualquier terapia aprobada para la que el paciente sea tributario, a menos que este no sea un candidato idóneo para la terapia aprobada. • no ser tributario de una intervención de resección quirúrgica en el momento del reclutamiento. - Los pacientes no deben haber recibido anteriormente ramucirumab. - Tener una función hematológica, hepática, cardiaca y renal suficientes, así como una coagulación y un control de la tensión arterial (TA) aceptables, de acuerdo con el protocolo. |
|
E.4 | Principal exclusion criteria |
- Patients who have had allogeneic bone marrow or solid organ transplant are excluded. - Patients who have active infections requiring therapy. - Patients who have a history of fistula, gastrointestinal (GI) ulcer or perforation, or intra-abdominal abscess within 3 months of study enrolment are not eligible. - Patients with a bowel obstruction, extensive intestinal resection or history or presence of inflammatory enteropathy or other GI pathology as per protocol. - Patients with a history of hepatorenal syndrome. - Patients with a known hypersensitivity to ramucirumab , gemcitabine, docetaxel or agents formulated with Polysorbate 80. - Patients with evidence of active bleeding or a history of significant (≥ Grade 3) bleeding event, deep vein thrombosis requiring medical intervention (including pulmonary embolism), hemoptysis or other signs of pulmonary haemorrhage, or esophageal varices within 3 months of enrollment are not eligible. - Patients with a bleeding diathesis or vasculitis are not eligible. - Patients with a history of central nervous system (CNS) arterial/venous thromboembolic events (VTEs) including transient ischemic attack (TIA) or cerebrovascular accident (CVA) within 6 months of study enrolment are not eligible. - Patients with myocardial infarction or unstable angina within the prior 6 months. - Patients with significant vascular disease or peripheral vascular disease. - Patients with a history of hypertensive crisis or hypertensive encephalopathy within 6 months of study enrolment are not eligible. - Patients who have non-healing wound, unhealed or incompletely healed fracture, or a compound (open) bone fracture at the time of enrolment are not eligible. - Patients previously treated and progressed on combination gemcitabine or docetaxel. (Patients who received combination as maintenance therapy, without progression, would be eligible.) - Patients who have previously received any exposure to ramucirumab are not eligible. - Patients with clinical or radiologic findings consistent with interstitial pneumonia or pulmonary fibrosis. - Patients with CNS involvement are ineligible. |
Se excluirá a los pacientes que hayan recibido un alotrasplante de médula ósea o un trasplante de víscera maciza. - Pacientes que presenten infecciones activas que requieran tratamiento. - No se considerarán idóneos los pacientes con antecedentes de fístulas, úlceras o perforaciones gastrointestinales (GI) o abscesos intraabdominales en el transcurso de los 3 meses anteriores al reclutamiento en el estudio. - Pacientes con obstrucción intestinal, amplia resección intestinal o antecedentes o presencia de enteropatía inflamatoria u otras patologías gastrointestinales, de conformidad con el protocolo. - Pacientes con antecedentes de síndrome hepatorrenal. - Pacientes con hipersensibilidad a gemcitabina, docetaxel o a medicamentos que incluyan polisorbato 80.
- No se considerarán idóneos los pacientes con signos de hemorragia activa o antecedentes de episodios hemorrágicos importantes (grado ≥3), trombosis venosa profunda que requiera una intervención médica (incluidos los casos de embolia pulmonar), hemoptisis u otros signos de hemorragia pulmonar o varices esofágicas en el transcurso de los 3 meses anteriores al reclutamiento. - No se considerarán idóneos los pacientes con diátesis hemorrágica o vasculitis. - No se considerarán idóneos los pacientes con antecedentes de episodios tromboembólicos venosos/arteriales (ETV/ETA) en el sistema nervioso central, incluidos los casos de accidente isquémico transitorio (AIT) o de accidente cerebrovascular (ACV) en el transcurso de los 6 meses anteriores al reclutamiento en el estudio. - Pacientes que hayan sufrido un infarto de miocardio o angina de pecho inestable en el transcurso de los 6 meses anteriores. - Pacientes con vasculopatía o vasculopatía periférica importante. - No se considerarán idóneos los pacientes con antecedentes de crisis hipertensiva o encefalopatía hipertensiva en el transcurso de los 6 meses anteriores al reclutamiento en el estudio. - No se considerarán idóneos los pacientes que en el momento del reclutamiento presenten heridas tórpidas, fracturas sin consolidar o consolidadas parcialmente, o fracturas óseas abiertas. - Pacientes que anteriormente hayan recibido tratamiento politerápico con gemcitabina o doctaxel y hayan sufrido progresión de la enfermedad durante este tratamiento (se considerarán idóneos para participar los pacientes que hayan recibido esta politerapia como tratamiento de mantenimiento y no hayan presentado progresión de la enfermedad). - No se considerarán idóneos los pacientes que anteriormente hayan recibido ramucirumab. - Pacientes con manifestaciones clínicas o resultados en las pruebas radiográficas compatibles con neumonía intersticial o fibrosis pulmonar. - Los pacientes que presenten afectación en el SNC no se considerarán idóneos. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
progression-free survival (PFS) |
Supervivencia sin progresión (SSP) |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
The primary analysis will be triggered when PFS events have occurred for approximately 80% of the enrolled patients. |
El análisis principal se realizará cuando se hayan observado eventos de SSP aproximadamente en el 80 % de los pacientes reclutados. |
|
E.5.2 | Secondary end point(s) |
Serious adverse event, Adverse event, Safety laboratory assessments, Vital signs, overall response rate, Duration of response, Complete response, Cmax (maximum concentration), Cmin (minimum concentration) and Incidence of immunogenicity |
Acontecimientos adversos graves, acontecimientos adversos, parámetros analíticos de seguridad, constantes vitales, tasa global de respuesta, duración de la respuesta, respuesta completa, Cmáx (concentración máxima) y Cmín (concentración mínima) e incidencia de casos de inmunogenia. |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Throughout study. |
A lo largo del estudio. |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
Therapeutic exploratory |
Exploratorio terapeutico |
|
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 21 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Belgium |
France |
Germany |
Italy |
Japan |
Netherlands |
Spain |
United Kingdom |
United States |
|
E.8.7 | Trial 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 - Last visit or last scheduled procedure for the last patient. |
UVUP: última visita o último procedimiento programado del último paciente. |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |