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    Summary
    EudraCT Number:2018-004843-22
    Sponsor's Protocol Code Number:MK-7339-005
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2019-10-02
    Trial results View 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 number2018-004843-22
    A.3Full title of the trial
    A Phase 3 Study of Pembrolizumab in Combination with Etoposide/Platinum (Cisplatin or Carboplatin) Followed by Pembrolizumab with or without Maintenance Olaparib in the First-line Treatment of Participants with Extensive Stage Small Cell Lung Cancer (ES-SCLC)
    Estudio de fase 3 de pembrolizumab en combinación con etopósido/platino (cisplatino o carboplatino) seguido de pembrolizumab con o sin olaparib de mantenimiento en el tratamiento de primera línea de participantes con cáncer microcítico de pulmón en estadio avanzado (CMP-EA)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Phase 3 Study of Pembrolizumab with or without Maintenance Olaparib in 1L ES SCLC
    Estudio de fase 3 de pembrolizumab con o sin olaparib de mantenimiento en el tratamiento de primera línea del (CMP-EA)
    A.3.2Name or abbreviated title of the trial where available
    Phase 3 Study of Pembrolizumab with or without Maintenance Olaparib in 1L ES SCLC
    • Estudio de pembrolizumab con o sin olaparib de mantenimiento en el 1L CPM EA
    A.4.1Sponsor's protocol code numberMK-7339-005
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorMerck Sharp & Dohme Corp., a subsidiary of Merck & Co.,Inc
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportMerck Sharp & Dohme Corp., a subsidiary of Merck & Co.,Inc
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMerck Sharp & Dohme de España S.A.
    B.5.2Functional name of contact pointInvestigación Clínica
    B.5.3 Address:
    B.5.3.1Street AddressC/ Josefa Valcárcel, 38
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28027
    B.5.3.4CountrySpain
    B.5.4Telephone number+34913210600
    B.5.5Fax number+34913210590
    B.5.6E-mailensayos_clinicos@merck.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namePEMBROLIZUMAB
    D.3.2Product code MK-3475
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNPEMBROLIZUMAB
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.4EV Substance CodeSUB167136
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 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 KEYTRUDA (pembrolizumab, MK-3475)
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp & Dohme B.V.
    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.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNPEMBROLIZUMAB
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.4EV Substance CodeSUB167136
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 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 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 nameOlaparib
    D.3.2Product code MK-7339
    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 INNOLAPARIB
    D.3.9.1CAS number 763113-22-0
    D.3.9.2Current sponsor codeMK-7339
    D.3.9.3Other descriptive nameOLAPARIB
    D.3.9.4EV Substance CodeSUB32234
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    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: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameOlaparib
    D.3.2Product code MK-7339
    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 INNOLAPARIB
    D.3.9.1CAS number 763113-22-0
    D.3.9.2Current sponsor codeMK-7339
    D.3.9.3Other descriptive nameOLAPARIB
    D.3.9.4EV Substance CodeSUB32234
    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.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Extensive Stage Small Cell Lung Cancer
    Cáncer microcítico de pulmón en estadio avanzado
    E.1.1.1Medical condition in easily understood language
    Stage IV lung cancer condition
    Cáncer de pulmón en estadio IV
    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 10041068
    E.1.2Term Small cell lung cancer extensive stage
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    1. To compare pembrolizumab (MK-3475) plus maintenance olaparib (MK-7339) with pembrolizumab plus placebo with respect to progression-free survival (PFS) assessed according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) by blinded independent central review (BICR) in participants with extensive stage small cell lung cancer (ES-SCLC) with stable disease (SD),partial response (PR), or complete response (CR) following induction treatment with pembrolizumab combined with etoposide and carboplatin or cisplatin
    2. To compare pembrolizumab plus maintenance olaparib with pembrolizumab plus placebo with respect to overall survival (OS)
    1.Comparar pembrolizumab más olaparib de mantenimiento con pembrolizumab más placebo en cuanto a la supervivencia sin progresión (SSP)evaluada conforme a los Criterios de evaluación de la respuesta en tumores sólidos, versión 1.1 (RECIST 1.1),revisión central independiente y enmascarada (RCIE).Comparar pembrolizumab (MK-3475) más olaparib(MK-7339) de mantenimiento con pembrolizumab más placebo en cuanto a la supervivencia sin progresión(SSP)evaluada conforme a los Criterios de evaluación de la respuesta en tumores sólidos, versión 1.1(RECIST 1.1),según una revisión central independiente y enmascarada (RCIE)en pacientes con cáncer microcítico de pulmón en estadio avanzado (CMP-EA) con enfermedad estable (EE), respuesta parcial (RP) o respuesta completa (RC) después del tratamiento de inducción con pembrolizumab combinado con etopósido y carboplatino o cisplatino
    2.Comparar pembrolizumab más olaparib de mantenimiento con pembrolizumab más placebo en cuanto a la supervivencia global SG)
    E.2.2Secondary objectives of the trial
    1. To evaluate the safety and tolerability of pembrolizumab plus maintenance olaparib compared to pembrolizumab plus placebo
    2. To evaluate the change from Baseline (at randomization) and the time to true deterioration (TTD) in global health status/quality of life (QoL), cough, chest pain, dyspnea and physical functioning following treatment with pembrolizumab plus maintenance olaparib compared to pembrolizumab plus placebo
    1. Evaluar la seguridad y la tolerabilidad de pembrolizumab más olaparib de mantenimiento en comparación con pembrolizumab más placebo.
    2. Evaluar la variación con respecto al momento basal (en la aleatorización) y el tiempo hasta el deterioro real (THD) en las escalas de estado de salud general/calidad de vida, tos, dolor torácico, disnea y función física después del tratamiento con pembrolizumab más olaparib de mantenimiento en comparación con pembrolizumab más placebo.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Merck will conduct Future Biomedical Research on DNA (Blood, tissue) specimens collected during this clinical trial. Such research is for biomarker testing to address emergent questions not described elsewhere in the protocol (as part of the main trial) and will only be conducted on specimens from appropriately consented subjects. The objective of collecting specimens for Future Biomedical Research is to explore and identify biomarkers that inform the scientific understanding of diseases and/or their therapeutic treatments. The overarching goal is to use such information to develop safer, more effective drugs, and/or to ensure that subjects receive the correct dose of the correct drug at the correct time
    Spanish Merck llevará a cabo investigaciones biomédicas futuras con las muestras de ADN (sangre y tejido)obtenidas para tal fin durante este ensayo clínico. Estas investigaciones tendrán por objeto el análisis de biomarcadores con el fin de abordar aspectos nuevos que no se describen en otras partes del protocolo (como parte del ensayo principal) y solo se llevarán a cabo en muestras de los sujetos que hayan otorgado el consentimiento correspondiente. El objetivo de la obtención de muestras para investigaciones biomédicas futuras consiste en estudiar e identificar biomarcadores que proporcionen información a los científicos sobre las enfermedades y sus tratamientos. El objetivo último es utilizar tal información para desarrollar vacunas y fármacos más seguros y eficaces o para garantizar que los sujetos reciban la dosis correcta del fármaco o
    la vacuna adecuados en el momento preciso
    E.3Principal inclusion criteria
    1. Have a documented new diagnosis of SCLC by histology or cytology from brushing, washing, or needle aspiration of a defined lesion. Participants who do not have histology samples (defined as core or incisional biopsy, or resections) will need to undergo a new biopsy to provide a tissue sample
    2. Have extensive stage disease defined as Stage IV (T any, N any, M 1a/b/c) by the American Joint Committee on Cancer, Eighth Edition
    3. Have at least 1 lesion that meets the criteria for being measurable, as defined by RECIST 1.1, and is appropriate for selection as a target lesion, as determined by local site investigator/radiology review. Lesions that appear measurable, but have undergone palliative irradiation, cannot be target lesions
    4. Have provided archival tumor tissue sample or newly obtained core or incisional biopsy of a tumor lesion not previously irradiated. Formalin-fixed, paraffin-embedded tissue blocks are preferred to slides. Newly obtained biopsies are preferred to archived tissue
    5. Have an ECOG Performance Status of 0 to 1 assessed within 7 days prior to the administration of study intervention
    6. Have a life expectancy of at least 3 months
    7. Have adequate organ function; all screening laboratory tests should be performed within 10 days prior to initiation of study intervention
    8. Be at least 18 years of age at the time of signing the informed consent
    9. A male participant must agree to use contraception during the treatment period and for at least 180 days following the last dose of pembrolizumab and olaparib or at least 180 days following the last dose of cytotoxic chemotherapy
    10. A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least 1 of the following conditions applies:
    - Not a woman of childbearing potential (WOCBP)
    OR
    - A WOCBP who agrees to follow the contraceptive guidance during the treatment period and for at least 180 days following the last dose of pembrolizumab and olaparib or at least 180 days following the last dose of cytotoxic chemotherapy
    11. Has (or legally acceptable representative if applicable) provided written informed consent/assent for the study. The participant may also provide consent/assent for future biomedical research. However, the participant may participate in the main study without participating in future biomedical research

    Additional Criteria Applicable to Maintenance Phase Only – Prior to Randomization
    12. Have a CR/PR or stable disease of their SCLC after completion of the study-specified Induction Phase, as determined by central imaging review
    13. Have an ECOG score of 0 or 1
    14. All AEs (except alopecia, Grade 2 fatigue, and endocrine-related AEs Grade ≤2 requiring treatment or hormone replacement) resolved to Grade ≤1 or baseline following Induction Phase treatment
    15. Have adequate organ function
    16. Are not taking medications or vaccinations specifically prohibited in the Exclusion Criteria
    17. Are not pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting from the pre-randomization visit through 180 days after the last dose of study intervention
    18. Have not withdrawn consent to continue treatment
    19. Continue to derive clinical benefit from study participation according to investigator’s discretion
    1. Tener un diagnóstico nuevo documentado de CPM mediante examen histológico o citológico a partir del cepillado, lavado o aspiración con aguja de una lesión definida. Los participantes que no cuenten con muestras histológicas (definidas como biopsia con aguja gruesa o por incisión o resecciones) tendrán que someterse a una nueva biopsia para proporcionar una muestra de tejido.
    2. Tener un tumor en estadio avanzado, definido como estadio IV (cualquier T, cualquier N, M 1a/b) según el American Joint Committee on Cancer, octava edición.
    3. Tener al menos una lesión que cumpla los criterios de lesión mensurable, definidos por los criterios RECIST 1.1, y que sea adecuada para elección como lesión diana, según determine la evaluación radiológica o del investigador del centro. Las lesiones que parezcan mensurables, pero que hayan recibido radioterapia paliativa, no podrán ser lesiones diana.
    4. Proporcionar una muestra de tejido tumoral de archivo o de una biopsia reciente, con aguja gruesa o por escisión, de una lesión tumoral no irradiada previamente. Se prefiere el uso de bloques de tejido fijados en formol e incluidos en parafina a los cortes para microscopio. Se prefiere el uso de biopsias recientes al tejido de archivo.
    5. Tener una puntuación de estado funcional del ECOG de 0 o 1 en los 7 días previos a la administración de la intervención del estudio.
    6. Tener una esperanza de vida mínima de tres meses.
    7. Presentar una función orgánica adecuada, tal como se detalla en la Tabla 2; todas las pruebas analíticas de selección deberán realizarse en los 10 días previos al comienzo de la intervención del estudio.
    8. Edad mínima de 18 años en el momento de firmar el consentimiento informado.
    9. Los varones deben comprometerse a utilizar métodos anticonceptivos, durante el período de tratamiento y hasta, como mínimo, 180 días después de la última dosis de pembrolizumab y olaparib, o al menos 180 días después de la última dosis de quimioterapia citotóxica.
    10. Las mujeres podrán participar en el estudio las mujeres que no estén embarazadas (apéndice 5), no estén dando el pecho y cumplan al menos una de las condiciones siguientes:
    • No es una mujer en edad fértil (MEF), según la definición del apéndice 5.
    O BIEN
    • Es una MEF que se compromete a seguir las normas sobre métodos anticonceptivos que se detallan en el apéndice 5 durante el período de tratamiento y hasta, como mínimo, 180 días después de la última dosis de pembrolizumab y olaparib, o al menos 180 días después de la última dosis de quimioterapia citotóxica.
    11. El participante (o su representante legal cuando proceda) otorga su consentimiento/asentimiento informado por escrito para el estudio. El participante también podrá otorgar su consentimiento/asentimiento para las investigaciones biomédicas futuras. No obstante, el participante podrá participar en el estudio principal sin necesidad de hacerlo en las investigaciones biomédicas futuras.

    Otros criterios aplicables exclusivamente a la fase de mantenimiento: antes de la aleatorización:
    12. Presencia de una RC/RP o enfermedad estable del CPM una vez finalizada la fase de inducción especificada en el estudio, según lo determinado mediante una revisión centralizada de las imágenes.
    13. Puntuación de estado funcional del ECOG de 0 o 1.
    14. Resolución de todos los AA (excepto alopecia, cansancio de grado 2 y AA relacionados con el sistema endocrino de grado ≤ 2 con necesidad de tratamiento o reposición hormonal) a un grado ≤ 1 o la situación basal después del tratamiento de la fase de inducción.
    15. Función orgánica adecuada, conforme a lo indicado por los valores analíticos que se recogen en la Tabla 2.
    16. No estar recibiendo medicamentos o vacunas prohibidos expresamente en los criterios de exclusión.
    17. No estar embarazada o en período de lactancia ni tener intención de concebir o engendrar un hijo durante el período previsto del estudio, desde la visita previa a la aleatorización hasta 180 días después de la última dosis de la intervención del estudio.
    18. No haber retirado el consentimiento para continuar con el tratamiento.
    19. Seguir obteniendo beneficios clínicos de la participación en el estudio según el criterio del investigador.
    E.4Principal exclusion criteria
    1. Has received prior systemic therapy for the treatment of SCLC
    2. Is expected to require any other form of antineoplastic therapy for SCLC, including radiation therapy, while on study
    3. Has a known history of interstitial lung disease. Lymphangitic spread of the SCLC is not exclusionary
    4. Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis
    5. Has a known central nervous system (ie, brain and/or spinal cord) metastases and/or carcinomatous meningitis
    6. Has had major surgery within 3 weeks of starting study intervention or has not recovered from any effects of any major surgery
    7. Has a known additional malignancy that is progressing or requires active treatment
    8. Has a known hypersensitivity to the components or excipients of cisplatin, carboplatin, etoposide, or olaparib
    9. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study intervention
    10. Has active autoimmune disease that has required systemic treatment in the past 2 years (ie, with use of disease-modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment
    11. Has a known history of, or active, neurologic paraneoplastic syndrome
    12. Has severe hypersensitivity (Grade ≥3) to pembrolizumab and/or any of its excipients
    13. Has active infection requiring systemic therapy
    14. Has a known history of HIV infection. No HIV testing is required unless mandated by local health authority
    15. Has a known history of hepatitis B (defined as hepatitis B surface antigen reactive) or known active hepatitis C virus (defined as hepatitis C virus RNA [qualitative] is detected) infection
    16. Has a known history of active tuberculosis (TB; Mycobacterium tuberculosis)
    17. Has symptomatic ascites or pleural effusion. A participant who is clinically stable following treatment for these conditions (including therapeutic thoraco- or paracentesis) is eligible
    18. Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the Screening visit through 180 days after the last dose of study intervention
    19. Has a known psychiatric or substance abuse disorder that would interfere with cooperation with the requirements of the study
    20. Has myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) or with features suggestive of MDS/AML
    21. Has received colony-stimulating factors (eg, granulocyte colony-stimulating factor [G-CSF], granulocyte-macrophage colony-stimulating factor or recombinant erythropoietin) within 28 days prior to the first dose of study intervention
    22. Is considered a poor medical risk due to a serious, uncontrolled medical disorder or nonmalignant systemic disease. Examples include, but are not limited to, uncontrolled ventricular arrhythmia, recent (within 3 months) myocardial infarction, uncontrolled major seizure disorder, unstable spinal cord compression, or superior vena cava syndrome
    23. Is unable to swallow orally administered medication or has a gastrointestinal disorder affecting absorption (eg, gastrectomy, partial bowel obstruction, malabsorption)
    24. Has received a live vaccine within 30 days prior to the first dose of study intervention
    25. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another co-inhibitory T-cell receptor (ie, CTLA-4, OX-40, CD137)
    26. Has received prior therapy with olaparib or with any other PARP inhibitor
    27. Is currently receiving either strong or moderate inhibitors of CYP3A4 that cannot be discontinued for the duration of the study. The required washout period prior to starting olaparib is 2 weeks.
    28. Is currently receiving either strong or moderate inducers of CYP3A4 that cannot be discontinued for the duration of the study. The required washout period prior to starting olaparib is 5 weeks for phenobarbital and 3 weeks for other agents.

    Read in the protocol
    1. Recepción de tratamiento sistémico previo contra el CPM.
    2. Previsión de necesitar cualquier otra forma de tratamiento antineoplásico contra el CPM, incluida la radioterapia, durante el estudio
    3. Antecedentes conocidos de neumopatía intersticial. La diseminación linfangítica del CPM no será motivo de exclusión.
    4. Antecedentes de neumonitis (no infecciosa) que haya precisado la administración de esteroides o presencia de una neumonitis activa.
    5. Presencia de metástasis conocidas en el sistema nervioso central (es decir, cerebro y/o médula espinal) y/o meningitis carcinomatosa.
    6. Intervención de cirugía mayor en las tres semanas previas al comienzo de la intervención del estudio o ausencia de recuperación de los efectos de una intervención de cirugía mayor.
    7. Presencia de otra neoplasia maligna conocida que está en progresión o que precisa tratamiento activo.
    8. Hipersensibilidad conocida a cualquiera de los componentes o excipientes de cisplatino, carboplatino, etopósido u olaparib.
    9. Diagnóstico de inmunodeficiencia o recepción de tratamiento sistémico crónico con esteroides (en dosis superiores a 10 mg diarios de prednisona o equivalente) o cualquier otra forma de tratamiento inmunodepresor en los siete días previos a la primera dosis de la intervención del estudio.
    10. Presencia de una enfermedad autoinmunitaria activa que ha precisado tratamiento sistémico (es decir, fármacos modificadores de la enfermedad, corticoides o inmunodepresores) en los dos últimos años. El tratamiento de reposición (por ejemplo, tiroxina, insulina o corticoides fisiológicos por insuficiencia suprarrenal o hipofisaria) no se considera una forma de tratamiento sistémico.
    11. Antecedentes o presencia activa de un síndrome paraneoplásico neurológico.
    12. Hipersensibilidad grave (grado ≥ 3) a pembrolizumab y/o a cualquiera de sus excipientes.
    13. Infección activa con necesidad de tratamiento sistémico.
    14. Antecedentes de infección por el virus de la inmunodeficiencia humana (VIH). No será necesario realizar pruebas del VIH a menos que lo exijan las autoridades sanitarias locales.
    15. Antecedentes de infección por el virus de la hepatitis B (reactividad del antígeno de superficie del virus de la hepatitis B [HBsAg]) o de infección activa por el virus de la hepatitis C (definida como detección de ARN del virus de la hepatitis C [VHC] [cualitativo]).
    16. Antecedentes de tuberculosis activa (Mycobacterium tuberculosis).
    17. Presencia de ascitis o derrame pleural sintomático. Podrán participar pacientes que se encuentren clínicamente estables tras recibir tratamiento por estos procesos (como toracocentesis o paracentesis terapéuticas).
    18. Embarazo, período de lactancia o intención de concebir o engendrar un hijo durante el período previsto del estudio, desde la visita de selección hasta 180 días después de la última dosis de la intervención del estudio.
    19. Trastorno psiquiátrico o por abuso de sustancias que pueda dificultar el cumplimiento de los requisitos del estudio.
    20. Presencia de un síndrome mielodisplásico (SMD)/leucemia mielógena aguda (LMA) o signos indicativos de SMD/LMA.
    21. Recepción de factores estimulantes de colonias (por ejemplo, factor estimulante de las colonias de granulocitos [G-CSF], factor estimulante de las colonias de granulocitos y macrófagos o eritropoyetina recombinante) en los 28 días previos a la primera dosis de la intervención del estudio.
    22. Se considera que el participante tiene un riesgo médico elevado debido a un trastorno médico grave y no controlado o una enfermedad sistémica no maligna. Algunos ejemplos son, entre otros, arritmia ventricular no controlada, infarto de miocardio reciente (en los últimos 3 meses), trastorno convulsivo importante no controlado, compresión medular inestable o síndrome de la vena cava superior.
    23. Incapacidad de tragar medicación administrada por vía oral o presencia de un trastorno digestivo que afecta a la absorción (por ejemplo, gastrectomía, obstrucción intestinal parcial o malabsorción).
    24. Recepción de una vacuna de microorganismos vivos en los 30 días previos a la administración de la primera dosis de la intervención del estudio.
    25. Recepción de tratamiento previo con un fármaco anti-PD-1, anti-PD-L1 o anti-PD-L2 o con un fármaco dirigido contra otro receptor de los linfocitos T coinhibidor (como CTLA-4, OX-40 o CD137).
    26. Recepción de tratamiento previo con olaparib o cualquier otro inhibidor de la PARP.
    27. Recepción activa de inhibidores potentes de la enzima CYP3A4 que no pueden suspenderse durante el estudio.El período de lavado necesario antes de comenzar el tratamiento con olaparib es de 2 semanas
    28. Recepción activa de inductores potentes o moderados de la enzima CYP3A4 que no puedan suspenderse durante el estudio. El período de lavado necesario antes de comenzar el tratamiento con olaparib es de 5 semanas en el caso de fenobarbital y de 3 semanas en el de otros fármacos.

    Leer en el protocolo
    E.5 End points
    E.5.1Primary end point(s)
    1. Progression-free Survival (PFS) per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) by Blinded Independent Central Review (BICR)
    2. Overall Survival (OS)
    1. supervivencia sin progresión (SSP) para la respuesta en tumores sólidos, versión 1.1 (RECIST 1.1) según una revisión cent central independiente y enmascarada (RCIE)
    2. Supervivencia global
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 33 months
    2. Up to approximately 42 months
    1. Hasta 33 meses aproximadamente
    2. Hasta 42 meses aproximadamente
    E.5.2Secondary end point(s)
    1. Number of Participants Who Experience an Adverse Event (AE)
    2. Number of Participants Who Discontinue Study Treatment Due to an Adverse Event (AE)
    3. Change from Baseline in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Global Health Status (Item 29) and Quality of Life (Item 30) Combined Score
    4. Change from Baseline in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Lung Cancer Module 13 (EORTC QLQ-LC13) Cough (Item 1) Score
    5. Change from Baseline in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Lung Cancer Module 13 (EORTC QLQ-LC13) Chest Pain (Item 10) Score
    6. Change from Baseline in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Dyspnea (Item 8) Score
    7. Change from Baseline in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) Physical Functioning (Items 1-5) Combined Score
    8. Time to Deterioration (TTD) in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Global Health Status (Item 29) and Quality of Life (Item 30) Combined Score
    9. Time to Deterioration (TTD) in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Lung Cancer Module 13 (EORTC QLQ-LC13) Cough (Item 1) Score
    10. Time to Deterioration (TTD) in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Lung Cancer Module 13 (EORTC QLQ-LC13) Chest Pain (Item 10) Score
    11. Time to Deterioration (TTD) in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Dyspnea (Item 8) Score
    12. Time to Deterioration (TTD) in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) Physical Functioning (Items 1-5) Combined Score
    13. Time to Deterioration (TTD) in European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Lung Cancer Module 13 (EORTC QLQ-LC13) Cough (Item 1); Chest Pain (Item 10) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) Dyspnea (Item 8) Combined Score
    1. Número de pacientes con Acontecimientos Adversos
    2. Número de pacientes que discontinúen el tratamiento debido a un acontecimiento adverso
    3. Variación con respecto al momento basal en los cuestionarios de Calidad de vida de la Organización Europea para la investigación y el Tratamiento del Cáncer (EORTC), módulo básico de 30 apartados, Estado de salud general/calidad de vida (C30/apartados 29 y 30).
    4. Variación con respecto al momento basal en los cuestionarios de calidad de vida la Organización Europea para la investigación y el Tratamiento del Cáncer (EORTC), modulo 13 Tos (LC13/apartado 1).
    5. Variación con respecto al momento basal en los cuestionarios de calidad de vida de la Organización Europea para la investigación y el Tratamiento del Cáncer (EORTC), modulo 13 dolor torácico (LC13/apartado 10.
    6. Variación con respecto al momento basal en los cuestionarios de calidad de vida de la Organización Europea para la investigación y el Tratamiento del Cáncer (EORTC), modulo básico de 30 aparatados (EORTC- calidad de vida) , Disnea (C30/apartado 8).
    7. Variación con respecto al momento basal en los cuestionarios de la Organización Europea para la investigación y el Tratamiento del Cáncer (EORTC), modulo básico de 30 aparatados (EORTC- calidad de vida) , Función física (C30/apartados 1 a 5).
    8. Tiempo de deterioro en los cuestionarios de Calidad de vida de la Organización Europea para la investigación. Estado de salud general (C30/apartados 29 y 30)
    9. Tiempo de deterioro en los cuestionarios de calidad de vida la Organización Europea para la investigación y el Tratamiento del Cáncer (EORTC), modulo 13 Tos (LC13/apartado 1).
    10. tiempo de deterioro en los cuestionarios de calidad de vida de la Organización Europea para la investigación y el Tratamiento del Cáncer (EORTC), modulo 13 dolor torácico (LC13/apartado 10).
    11. Tiempo de deterioro en los cuestionarios de calidad de vida de la Organización Europea para la investigación y el Tratamiento del Cáncer (EORTC), modulo básico de 30 aparatados (EORTC- calidad de vida) , Disnea (C30/apartado 8).
    12. Tiempo de deterioro en los cuestionarios de la Organización Europea para la investigación y el Tratamiento del Cáncer (EORTC), modulo básico de 30 aparatados (EORTC- calidad de vida) , Función física (C30/apartados 1 a 5).
    13. - Tiempo de deterioro en los cuestionarios de calidad de vida de la Organización Europea para la investigación y el Tratamiento del Cáncer (EORTC), modulo básico de 30 aparatados (EORTC- calidad de vida) , tos (apartado 1), dolor torácico (apartado 10) y Disnea (C30/apartado 8).
    E.5.2.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 42 months
    2. Up to approximately 24 months
    3. Baseline (at randomization) and Week 18 post-randomization
    4. Baseline (at randomization) and Week 18 post-randomization
    5. Baseline (at randomization) and Week 18 post-randomization
    6. Baseline (at randomization) and Week 18 post-randomization
    7. Baseline (at randomization) and Week 18 post-randomization
    8. Up to approximately 42 months
    9. Up to approximately 42 months
    10. Up to approximately 42 months
    11. Up to approximately 42 months
    12. Up to approximately 42 months
    13. Up to approximately 42 months
    1. Hasta 42 meses aproximadamente
    2. Hasta 24 meses aproximadamente
    3. Momento basal (en la aleatorización) y semana 18 después de la aleatorización
    4. Momento basal (en la aleatorización) y semana 18 después de la aleatorización
    5. Momento basal (en la aleatorización) y semana 18 después de la aleatorización
    6. Momento basal (en la aleatorización) y semana 18 después de la aleatorización
    7. Momento basal (en la aleatorización) y semana 18 después de la aleatorización
    8. Hasta 42 meses aproximadamente
    9. Hasta 42 meses aproximadamente
    10. Hasta 42 meses aproximadamente
    11. Hasta 42 meses aproximadamente
    12. Hasta 42 meses aproximadamente
    13. Hasta 42 meses aproximadamente
    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 Yes
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA65
    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
    Australia
    Austria
    Belgium
    Brazil
    Canada
    China
    Colombia
    Czech Republic
    France
    Hungary
    Israel
    Italy
    Japan
    Korea, Republic of
    New Zealand
    Poland
    Romania
    Spain
    Switzerland
    Turkey
    Ukraine
    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 years5
    E.8.9.1In the Member State concerned months
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years5
    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: 366
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 333
    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 state24
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 307
    F.4.2.2In the whole clinical trial 699
    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
    Ninguno
    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 Decision2019-09-27
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-09-18
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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