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    Summary
    EudraCT Number:2018-004648-44
    Sponsor's Protocol Code Number:MedOPP253
    National Competent Authority:Portugal - INFARMED
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2020-04-23
    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 ConcernedPortugal - INFARMED
    A.2EudraCT number2018-004648-44
    A.3Full title of the trial
    A multicentre, Open-Label, Non-comparative, three-arm, phase IIa trial of Ipatasertib (GDC-0068) in Combination with non-Taxane chemotherapy agents for taxane-pretreated unresectable locally advanced or metastatic triple-negative breast cancer patients (PATHFINDER
    Ensaio clínico multicêntrico, Não comparative, de três grupos de Fase IIa, para estudiar o IPatasertib (GDC-0068) em combinação com agentes quimioterápicos sem taxano para pacientes com cancro da mama triplo-negativo localmente avançado ou metastásico não passível de ressecção que foram tratados anteriormente com taxxano. (PATHFINDER
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Clinical trial with Ipatasertib in combination with chemoterapy agents for unresectable locally advanced or metastatic triple-negative breast cancer patients
    Ensaio clínico com Ipatasertib em combinação com quimioterapia para
    pacientes com câncer de mama triplo negativo localmente avançado irressecável ou metastático.
    A.4.1Sponsor's protocol code numberMedOPP253
    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 SponsorMedica Scientia Innovation Research S.L (MEDSIR)
    B.1.3.4CountrySpain
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportF.Hoffmann-La Roche Ltd.
    B.4.2CountrySwitzerland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMedica Scientia Innovation Research S.L (MEDSIR)
    B.5.2Functional name of contact pointMelissa Fernández
    B.5.3 Address:
    B.5.3.1Street AddressTorre Glòries, Avda.Diagonal 211, planta 27
    B.5.3.2Town/ cityBarcelona
    B.5.3.3Post code08018
    B.5.3.4CountrySpain
    B.5.4Telephone number34932214135
    B.5.6E-mailmelissa.fernandez@medsir.org
    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 nameIpatasertib
    D.3.2Product code GDC-0068
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNIPATASERTIB
    D.3.9.2Current sponsor codeGDC-0068
    D.3.9.4EV Substance CodeSUB189203
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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 nameIpatasertib
    D.3.2Product code GDC-0068
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNIPATASERTIB
    D.3.9.2Current sponsor codeGDC-0068
    D.3.9.4EV Substance CodeSUB189203
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    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
    UNRESECTABLE LOCALLY ADVANCED OR METASTATIC RIPLE-NEGATIVE BREAST CANCER PATIENTS
    CÂNCER DE MAMA TRIPLO-NEGATIVO LOCALMENTE AVANÇADO IRRESECABLE OU METASTASIC
    E.1.1.1Medical condition in easily understood language
    UNRESECTABLE LOCALLY ADVANCED OR METASTATIC TRIPLE-NEGATIVE BREAST CANCER PATIENTS
    CÂNCER DE MAMA TRIPLO-NEGATIVO LOCALMENTE AVANÇADO IRRESECABLE OY METASTASIC
    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 10006187
    E.1.2Term Breast 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 LLT
    E.1.2Classification code 10027475
    E.1.2Term Metastatic breast 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 21.1
    E.1.2Level LLT
    E.1.2Classification code 10072740
    E.1.2Term Locally advanced breast 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 10075566
    E.1.2Term Triple negative breast cancer
    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
    To evaluate the safety and tolerability of ipatasertib (GDC-0068) in combination with capecitabine, eribulin, or carboplatin plus gemcitabine in the intention-to-treat (ITT) population of patients with taxanepretreated unresectable locally advanced or metastatic triple-negative breast cancer (TNBC).
    Avaliar a segurança e a tolerabilidade do ipatasertib (GDC-0068) em combinação com capecitabina, eribulina ou carboplatina e gencitabina em a população de pacientes com intenção de tratar (ITT) com câncer Mama tripla negativa irressecável localmente avançada (CMTN) ou metastático previamente tratado com taxanos.
    E.2.2Secondary objectives of the trial
    • To determine the efficacy of ipatasertib (GDC-0068) in combination with capecitabine, eribulin, or carboplatin plus gemcitabine in the subset of patients with phosphatidylinositol 3-kinase catalytic subunit (PIK3CA)/AKT1/phosphatase and tensin homolog (PTEN)-altered tumors.
    Exploratory objectives:
    To determine the efficacy of ipatasertib (GDC-0068) in combination with capecitabine, eribulin, or carboplatin plus gemcitabine in the subset of patients with phosphatidylinositol 3-kinase catalytic subunit (PIK3CA)/AKT1/phosphatase and tensin homolog (PTEN)-altered tumors.
    • To evaluate predictive or prognostic biomarkers (plasma or tissue) associated with disease activity status or response to treatment.
    • To identify possible mechanisms of resistance to study treatments through the comparative analysis of potential biomarkers from paired pre-treatment and post-progression tumor and blood samples.
    •Determinar a eficacia do Ipatasertib (GDC-0068) em combinação com capecitabina, eribulina ou carboplatina mais gemcitabina na população ITT e em cada grupo de tratamento.
    Objetivos exploratórios:
    • Determinar a eficácia do ipatasertib (GDC-0068) em combinação com capecitabina, eribulina ou carboplatina mais gemcitabina no subconjunto de pacientes com tumores alterados pela subunidade catalítica de fosfatidilinositol 3-quinase (PIK3CA)/AKT1/homólogo de fosfatase e tensina (PTEN)
    •Avaliar biomarcadores preditivos ou prognósticos (plasma ou tecido) associados ao estado de atividade da doença ou à resposta ao tratamento.
    •Identificar possíveis mecanismos de resistencia aos tratamentos do estudo através de uma análise comparativa de potenciais biomarcadores provenientes de amostras de sangue e tumor pré-tratamento e pós-progressão combinadas.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Histologically confirmed TNBC per American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) criterio based on local testing on the most recent analyzed biopsy.
    Triplenegative is defined as <1% expression for estrogen receptor (ER) and progesterone receptor (PgR) and negative for human epidermal growth factor receptor 2 (HER2) (0–1+ by IHC or 2+ and negative by in situ hybridization [ISH) test].
    2. Unresectable locally advanced or metastatic disease documented by computerized tomography (CT) scan or magnetic resonance imaging (MRI) that is not amenable to resection with curative intent.
    3. Measurable or evaluable disease as per RECIST v.1.1. Patients with bone-only metastases are also eligible.
    4. Refractory to or relapsed after one or two prior standard of care chemotherapy regimens for unresectable locally advanced or MBC. Earlier adjuvant or neoadjuvant therapy for more limited disease Will be considered as one of the required prior regimens if the development of unresectable locally advanced or metastatic disease occurred within a 12-month period of time after completion of
    chemotherapy. Note: Exclusive tumor marker elevation will not be considered sufficient for diagnosis of disease progression.
    5. Prior therapy must have included a taxane in any combination or order and either in the early, locally advanced, or metastatic setting. Note: Exclusive prior taxane-based therapy as adjuvant or neoadjuvant treatment is also allowed if the patient had a diseasefree interval of less than 12 months after completing this treatment.
    6. Eligible for one of the chemotherapy options (capecitabine, eribulin, carboplatin plus gemcitabine) as per local investigator assessment and slots availability. Patients treated with (neo)adjuvant platinum
    salts or capecitabine and who have relapsed more than one year after the last dose of either treatment may be allowed to be included in the treatment arms based on ipatasertib (GDC-0068) in combination with carboplatin plus gemcitabine and capecitabine, respectively.
    7. Previous treatment with androgen receptor antagonists, poly ADPribose Polymerase (PARP) inhibitors, and immunotherapy is allowed. Those patients who have previously received a PARP inhibitor will not be included in the carboplatin and gemcitabine arm unless PARP inhibitors were used in the early breast cancer setting and the period between the end of PARP inhibitor-based regimen and onset of
    metastatic disease is at least of 12 months.
    8. Willingness and ability to provide a tumor biopsy from a metastatic site or the primary breast tumor at the time of the inclusion in order to perform exploratory studies. If not feasible, patient eligibility should be evaluated by a Sponsor's qualified designee. Note: Subjects for whom tumor biopsies cannot be obtained (e.g.,inaccessible tumor or subject safety concern) may submit an archived metastatic tumor specimen only upon agreement from the Sponsor.
    9. Patients agree to give blood samples (liquid biopsy) at the time of inclusion, after two cycles of study treatment, and upon progression or study termination.
    10. Adequate hematologic and organ function within 14 days before the first study treatment on Day 1 of Cycle 1, defined by the following:
    a) Hematological: White blood cell (WBC) count > 3.0 x 109/L, absolute neutrophil count (ANC) > 1.5 x 109/L, platelet count >100.0 x109/L, and hemoglobin > 9.0 g/dL.
    b) Hepatic: Serum albumin ≥ 3 g/dL; Bilirubin ≤ 1.5 times the upper limit of normal (× ULN) (≤ 3 x ULN in the case of Gilbert's disease); aspartate transaminase (AST) and alanine transaminase (ALT) ≤ 2.5 × ULN (in the case of liver metastases ≤ 5 × ULN); alkaline phosphatase (ALP) ≤ 2 × ULN (≤ 5 × ULN in
    the case of liver and/or bone metastases).
    c) Renal: Serum creatinine < 1.5 × ULN or creatinine clearance ≥ 50 mL/min based on Cockcroft−Gault glomerular filtration rate estimation.
    d) Coagulation: Partial Thromboplastin Time (PTT) (or activated Partial Thromboplastin Time [aPTT]) and International Normalized Ratio (INR) ≤ 1.5 × ULN (except for patients receiving anticoagulation therapy). Note: Patients receiving heparin treatment should have a PTT (or aPTT) ≤ 2.5 × ULN (or patient value before starting heparin treatment). Patients receiving coumarin derivatives should have
    an INR between 2.0 and 3.0 assessed in two consecutive measurements one to four days apart. Patients should be on a stable anticoagulant régimen
    1. CMTN confirmada histologicamente de acordo com os critérios da ASCO / CAP com base em evidências locais da biópsia analisada mais recentemente.Triplo negativo é definido como uma expressão do ER) e PgR <1% e HER2 negativo (0-1 + por IHC ou 2+ e negativo via ISH)
    2. Doença metastática ou localmente avançada não passível de ressecção, documentada por tomografia computadorizada (TC) ou por ressonância magnética (RM) que não é passível de ressecção com intenção curative
    3.Doença mensurável ou avaliável segundo os critérios RECIST v.1.1. Os pacientes com metástases apenas ósseas também são elegíveis.
    4.Refratários ou recidivados após um ou dois regimes anteriores de quimioterapia segundo o tratamento convencional para cancro da mama metastático ou localmente avançado. A terapia adjuvante ou neoadjuvante anterior para doenças mais limitadas será considerada um dos regimes anteriores necessários se o desenvolvimento da doença metastática ou localmente avançada não passível de ressecção tiver ocorrido num período de 12 meses após o término da quimioterapia.* Nota sipnose
    5. A terapia anterior tem de ter incluído um taxano em qualquer combinação ou ordem, seja no contexto de doença inicial, localmente avançada ou metastática. *Nota sipnose
    6.Elegível para uma das opções de quimioterapia (capecitabina, eribulina, carboplatina mais gemcitabina) segundo a avaliação do investigador local e a disponibilidade de vagas. Os pacientes tratados com sais (neo)adjuvantes de platina ou capecitabina e que tiveram uma recidiva mais de um ano após a última dose de qualquer um dos tratamentos podem ser incluídos nos grupos de tratamento à base de ipatasertib (GDC-0068) em combinação com carboplatina e gemcitabina e capecitabina, respetivamente.
    7. É permitido o tratamento anterior com antagonistas dos recetores de andrógenos, inibidores da poli(ADP-ribose)polimerase (PARP) e imunoterapia. Os pacientes que receberam anteriormente um inibidor da PARP não serão incluídos no grupo de tratamento com carboplatina e gemcitabina, a menos que os inibidores da PARP tenham sido utilizados na fase inicial do cancro da mama e que o período entre o término do regime à base de inibidores da PARP e o início da doença metastática seja de pelo menos 12 meses.
    8. Disposição e capacidade de fornecer uma biopsia tumoral de um local metastático ou do tumor da mama primário no momento da inclusão, a fim de realizar estudos exploratórios. Se não for viável, a elegibilidade do paciente deve ser avaliada por uma pessoa qualificada designada pelo patrocinador.
    9. Os pacientes concordam em fornecer amostras de sangue (biopsia líquida) no momento da inclusão, após dois ciclos de tratamento do estudo e mediante a progressão ou o término do estudo.
    10. Função hematológica satisfatória e funcionamento dos órgãos adequado no espaço de 14 dias antes do primeiro tratamento do estudo, no dia 1 do ciclo 1, que se define pelo seguinte:
    a) Função hematológica: contagem de leucócitos (glóbulos brancos) > 3,0 x 109/l, contagem absoluta de neutrófilos (CAN)> 1,5 x 109/l, contagem de plaquetas >100,0 x 109/l e hemoglobina > 9,0 g/dl.
    b) Função hepática: albumina sérica ≥ 3 g/dl; bilirrubina ≤ 1,5 vezes o limite superior da normalidade (× LSN) (≤ 3 x LSN no caso da doença de Gilbert); aspartato transaminase (AST) e alanina transaminase (ALT) ≤ 2,5 × LSN (no caso de metástases hepáticas≤ 5 × LSN); fosfatase alcalina (ALP) ≤ 2 × LSN (≤ 5 × LSN no caso de metástases hepáticas e/ou ósseas).
    c) Função renal: creatinina sérica < 1,5 × LSN ou depuração de creatinina ≥ 50 ml/min com base na estimativa da taxa de filtração glomerular de Cockcroft-Gault.
    d) Coagulação: tempo de tromboplastina parcial (TTP) (ou tempo de tromboplastina parcial ativada [TTPa]) e índice internacional normalizado (IIN) ≤ 1,5 × LSN (exceto para pacientes que estejam a receber terapia de anticoagulação).*Nota sipnose
    E.4Principal exclusion criteria
    1. Previous treatment with PI3K, mTOR, or AKT inhibitors
    2. Known active uncontrolled or symptomatic central nervous system (CNS) metastases, carcinomatous meningitis, or leptomeningeal disease as indicated by clinical symptoms, cerebral edema, and/or progressive growth. Patients with a history of CNS metastases or cord compression are eligible if they have been definitively treated (e.g.,radiotherapy, stereotactic surgery), are clinically stable, and off anticonvulsants and steroids for at least two weeks before first dose of study treatment.
    3. Radiotherapy or limited-field palliative radiotherapy within seven days prior to study enrolment, or patients who have not recovered from radiotherapy-related toxicities to baseline or grade ≤ 1 and/or from whom ≥ 25% of the bone marrow has been previously irradiated.
    4. Major surgery (defined as requiring general anesthesia) or significant traumatic injury within 28 days of start of study drug, or patients who have not recovered from the side effects of any major surgery.
    5. Grade ≥ 2 peripheral neuropathy.
    6. Grade ≥ 2 uncontrolled or untreated hypercholesterolemia or hypertriglyceridemia.
    7. History of type I or type II diabetes mellitus either requiring insulin or with a baseline fasting glucose > 150 mg/dL (8.3 mmol/L) or high hemoglobin A1c (HbA1c) as defined as > 7%. Patients who are on a
    stable dose of oral diabetes medication during at least two weeks prior to initiation of study treatment are eligible for enrolment.
    8. Lung disease: pneumonitis, interstitial lung disease, idiopathic pulmonary fibrosis, cystic fibrosis, spergillosis, active tuberculosis, or history of opportunistic infections (pneumocystis pneumonia or cytomegalovirus pneumonia).
    9. Patients have a concurrent malignancy or malignancy within five years of study enrollment with the exception of carcinoma in situ of the cervix, non-melanoma skin carcinoma, or stage I uterine cancer.
    For other cancers considered to have a low risk of recurrence, discussion with the Medical Monitor is required.
    10. Current known infection with HIV, hepatitis B virus (HBV), or hepatitis C virus (HCV). Patients with past HBV infection or resolved HBV infection (defined as having a negative hepatitis B surface antibody
    [HBsAg] test and a positive hepatitis B core antibody [HBcAb] test, accompanied by a negative HBV DNA test) are eligible. Patients positive for HCV antibody are eligible only if polymerase chain reaction (PCR) is
    negative for HCV RNA.
    11. Congenital long QT syndrome or screening QT interval corrected using Fridericia's formula (QTcF) > 480 milliseconds.
    12. Patients have an active cardiac disease or a history of cardiac dysfunction.
    13. Patients have any of the following cardiac conduction abnormalities:
    a) Ventricular arrhythmias except for benign premature ventricular contractions.
    b) Supraventricular and nodal arrhythmias requiring a pacemaker or not controlled with medication.
    c) Conduction abnormality requiring a pacemaker.
    d) Other cardiac arrhythmia not controlled with medication.
    14. Treatment with strong CYP3A inhibitors or strong CYP3A inducers within 14 days or five drug-elimination half-lives, whichever is longer, prior to initiation of study treatment.

    1.Tratamento prévio com inibidores de PI3K, mTOR ou AKT.
    2. Metástases ativas não controladas ou sintomáticas do sistema nervoso central (SNC), meningite carcinomatosa ou doença leptomeníngea, conforme indicado pelos sintomas clínicos, edema cerebral e/ou crescimento progressivo. Pacientes com historial de metástases no SNC ou compressão da medula espinal são elegíveis se tiverem sido tratados definitivamente (p. ex., por radioterapia, cirurgia estereotáxica), se estiverem clinicamente estáveis e não estiverem a tomar anticonvulsivantes nem esteroides há pelo menos duas semanas antes da primeira dose do tratamento do estudo.
    3. Radioterapia ou radioterapia paliativa de campo limitado no espaço de sete dias antes da admissão no estudo, ou pacientes que não recuperaram das toxicidades relacionadas com a radioterapia até ao nível basal ou até ao grau ≤ 1 e/ou pacientes que foram submetidos anteriormente a radiação de ≥ 25% da medula óssea.
    4. Cirurgias de grande importância (ou seja, aquelas que requerem anestesia geral) ou lesão traumática significativa no espaço de 28 dias do início do medicamento do estudo, ou pacientes que não recuperaram dos efeitos secundários de uma cirurgia de grande importância.
    5. Neuropatia periférica de grau ≥ 2.
    6. Hipercolesterolemia ou hipertrigliceridemia não controlada ou não tratada de grau ≥ 2.
    7. Historial de diabetes mellitus tipo I ou II com necessidade de insulina ou com glicemia de jejum basal de > 150 mg/dl (8,3 mmol/l) ou hemoglobina A1c (HbA1c) elevada, que se define como > 7%. Os pacientes que estiverem a tomar uma dose estável de medicação oral para diabetes durante pelo menos duas semanas antes do início do tratamento do estudo são elegíveis para admissão.
    8. Doenças pulmonares: pneumonite, doença pulmonar intersticial, fibrose pulmonar idiopática, fibrose cística, aspergilose, tuberculose ativa ou historial de infeções oportunistas (pneumocystis pneumonia ou citomegalovírus).
    9. Pacientes que apresentam malignidade concomitante no espaço de cinco anos da admissão no estudo,
    10. Infeção atual conhecida por VIH, vírus da hepatite B (VHB) ou vírus da hepatite C (VHC)
    11. Síndrome do QT longo congénita ou intervalo QT na triagem corrigido com a fórmula de Fridericia (QTcF) > 480 milissegundos.
    12. O paciente tem uma doença cardíaca ativa ou um historial de disfunção cardíaca.
    13. Os pacientes que apresentam uma das seguintes anomalias no sistema de condução cardíaca:
    a) Arritmias ventriculares, exceto contrações ventriculares prematuras benignas.
    b) Arritmias supraventriculares e nodais que requerem um pacemaker ou que não são controladas por medicação.
    c) Anomalia de condução que requer um pacemaker.
    d) Outras arritmias cardíacas não controladas com medicação
    14. Tratamento com fortes inibidores de CYP3A ou fortes indutores de CYP3A no espaço de 14 dias ou cinco semividas de eliminação do medicamento, o que for maior, antes do início do tratamento do estudo
    E.5 End points
    E.5.1Primary end point(s)
    Incidence of adverse events (AEs) as assessed by the investigator, with severity determined through the use of US National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE) v.5.0.
    Incidência de eventos adversos (EA), avaliada pelo investigador, sendo a gravidade determinada através dos Critérios de Terminologia Comuns para Eventos Adversos do Instituto Nacional do Cancro dos EUA [National Cancer Institute] (NCI-CTCAE) v.5.0.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Pending
    Pendente
    E.5.2Secondary end point(s)
    • Progression-free survival (PFS), defined as the period of time from treatment initiation to the first occurrence of disease progression or death from any cause, whichever occurs first, as determined locally by the investigator through the use of RECIST v.1.1.
    • Time to response (TTR), defined as the time from the treatment initiation to time of the first objective tumor response (tumor shrinkage of ≥ 30%) observed for patients who achieved a
    complete response (CR) or partial response (PR), as determined locally by the investigator through the use of RECIST v.1.1.
    • Objective response rate (ORR), defined as a CR or PR as determined locally by the investigator through the use of RECIST v.1.1.
    • Duration of response (DoR), defined as the time from the first occurrence of a documented objective response to disease progression or death from any cause, whichever occurs first, as
    determined locally by the investigator through use of RECIST v.1.1.
    • Clinical benefit rate (CBR), defined as an objective response (CR or PR), or stable disease (SD) for at least 24 weeks, as determined locally by the investigator through the use of RECIST v.1.1.
    • Overall survival (OS), defined as the time from treatment initiation to death from any cause, as determined locally by the investigator through use of RECIST v.1.1.
    • Best percentage of change from baseline in the size of target tumor lesions, defined as the biggest decrease, or smallest increase if no decrease will be observed, as determined locally by
    the investigator through use of RECIST v.1.1.
    Exploratory endpoints:
    • PFS, TTR, ORR, DoR, CBR, OS, and best percentage of change in target tumor lesions determined locally by the investigator through the use of RECIST v.1.1 in the subset of patients with PIK3CA/AKT1/PTEN-altered tumors.
    • Relationship between tissue- and blood-based biomarkers and patient clinical features (e.g., baseline features) and outcome (e.g., duration of PFS).
    • Changes in mutation and copy number in oncogenes, tumor suppressors, and/or other genes associated with disease progression assessed by deoxyribonucleic acid (DNA) sequencing.
    • Changes in levels of tumor suppressors, immune checkpoints, mitotic index, apoptotic index, and/or immune-cell infiltration assessed by immunohistochemistry (IHC).
    • Associations of breast cancer subtypes defined by molecular signatures with patient outcomes.
    • Sobrevivência livre de progressão (SLP), que se define como o período de tempo desde o início do tratamento até à primeira ocorrência de progressão da doença ou morte por qualquer causa, o que ocorrer primeiro, conforme determinado localmente pelo investigador através dos critérios RECIST v.1.1.
    • Tempo de resposta (TR), que se define como o período de tempo desde o início do tratamento até ao momento da primeira resposta objetiva do tumor (redução do tumor de ≥ 30%) observada nos pacientes que atingiram uma resposta completa (RC) ou resposta parcial (RP), conforme determinado localmente pelo investigador através dos critérios RECIST v.1.1.
    • Taxa de resposta objetiva (TRO), que se define como RC ou RP, conforme determinado localmente pelo investigador através dos critérios RECIST v.1.1.
    • Duração da resposta (DR), que se define como o período de tempo desde a primeira ocorrência de uma resposta objetiva documentada até à progressão da doença ou morte por qualquer causa, o que ocorrer primeiro, conforme determinado localmente pelo investigador através dos critérios RECIST v.1.1.
    • Taxa de benefício clínico (TBC), que se define como uma resposta objetiva (RC ou RP) ou doença estável (DE) durante pelo menos 24 semanas, conforme determinado localmente pelo investigador através dos critérios RECIST v.1.1.
    • Sobrevivência global (SG), que se define como o período de tempo desde o início do tratamento até à morte por qualquer causa, conforme determinado localmente pelo investigador através dos critérios RECIST v.1.1.
    • Melhor percentagem de alteração em relação à avaliação inicial em termos de tamanho das lesões tumorais alvo, que se define como a maior redução ou o menor aumento (caso não seja observada uma redução), conforme determinado localmente pelo investigador através dos critérios RECIST v.1.1.
    Endpoints exploratórios:
    • SLP, TR, TRO, DR, TBC, SG e melhor percentagem de alteração das lesões tumorais alvo, determinados localmente pelo investigador através dos critérios RECIST v.1.1 no subconjunto de pacientes com tumores alterados por PIK3CA/AKT1/PTEN.
    • Relação entre os biomarcadores baseados em tecido e sangue e as características clínicas do paciente (p. ex., características basais) e resultado/desfecho (p. ex., duração da SLP).
    • Alterações em termos de mutação e número de cópias em oncogenes, supressores tumorais e/ou outros genes associados à progressão da doença, avaliados pelo sequenciamento do ácido desoxirribonucleico (ADN).
    • Alterações dos níveis de supressores tumorais, checkpoints imunológicos, índice mitótico, índice apoptótico e/ou infiltração de células imunitárias, avaliados por imuno-histoquímica (IHQ).
    • Associações de subtipos de cancro da mama definidas por assinaturas moleculares com os resultados/desfechos dos pacientes.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Pending
    Pendente
    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 No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Tolerability
    Tolerabilidade
    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 No
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other 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 concerned3
    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 No
    E.8.6.2Trial being conducted completely outside of the EEA No
    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
    LPLV
    Última visita do ultimo paciente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months7
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months7
    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: 48
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 6
    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 state10
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 54
    F.4.2.2In the whole clinical trial 54
    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)
    standard of care
    prática clínica de rotina
    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 Decision2020-06-19
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-07-06
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2023-11-10
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