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    Summary
    EudraCT Number:2019-001164-30
    Sponsor's Protocol Code Number:TAS-120-201
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2019-09-04
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2019-001164-30
    A.3Full title of the trial
    A Phase 2 Study of TAS-120 in Metastatic Breast Cancers Harboring Fibroblast Growth Factor Receptor (FGFR) Amplifications
    Estudio fase II de TAS-120 en cáncer de mama metastásico que presenta amplificaciones del receptor del factor de crecimiento de fibroblastos (FGFR)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study to evaluate the effects of TAS-120 in patients with Metastatic Breast Cancers Harboring Fibroblast Growth Factor Receptor (FGFR) Amplifications
    Un estudio para evaluar los efectos de TAS-120 en cáncer de mama metastásico que presenta amplificaciones del receptor del factor de crecimiento de fibroblastos (FGFR)
    A.3.2Name or abbreviated title of the trial where available
    FOENIX
    FOENIX
    A.4.1Sponsor's protocol code numberTAS-120-201
    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 SponsorTaiho Oncology, 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 supportTaiho Pharma Europe Limited
    B.4.2CountryUnited Kingdom
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationUnited BioSource Corporation, S.L.
    B.5.2Functional name of contact pointClinical Trials Information
    B.5.3 Address:
    B.5.3.1Street AddressRegus Maria de Molina, 8th floor Maria de Molina 39
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28006
    B.5.3.4CountrySpain
    B.5.4Telephone number+34673127 583
    B.5.5Fax number+34932935842
    B.5.6E-mailsilvia.rodergas@ubc.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 nameFutibatinib
    D.3.2Product code TAS-120
    D.3.4Pharmaceutical form 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 INNFutibatinib
    D.3.9.1CAS number 1448169-71-8
    D.3.9.2Current sponsor codeTAS-120
    D.3.9.3Other descriptive nameTAS-120
    D.3.9.4EV Substance CodeSUB130443
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number4
    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 Yes
    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 nameFulvestrant 250 mg (Faslodex or generic equivalent)
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntramuscular use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNAs Per SmPC
    D.3.9.1CAS number As Per SmPC
    D.3.9.2Current sponsor codeAs Per SmPC
    D.3.9.3Other descriptive nameFULVESTRANT
    D.3.9.4EV Substance CodeSUB13933MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number250
    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
    Metastatic Breast Cancers Harboring Fibroblast Growth Factor Receptor (FGFR) Amplifications
    Cáncer de mama metastásico que presenta amplificaciones del receptor del factor de crecimiento de fibroblastos (FGFR)
    E.1.1.1Medical condition in easily understood language
    Breast Cancers harboring amplifications of a Fibroblast Growth Factor Receptor (FGFR)
    Cáncer de mama que presenta amplificaciones del receptor del factor de crecimiento de fibroblastos (FGFR)
    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 LLT
    E.1.2Classification code 10027475
    E.1.2Term Metastatic breast cancer
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective of this study is to assess the anti-tumor activity of TAS-120 as mono-therapy or in combination with fulvestrant in the treatment of patients with metastatic breast cancer harboring Fibroblast Growth Factor Receptor (FGFR) amplifications, as measured by:

    1. Objective response rate (ORR) in patients with centrally confirmed FGFR2 amplification and measurable disease (Cohorts 1, 2);
    2. Clinical benefit rate (CBR) in patients with centrally confirmed FGFR2 amplification and non-measurable, evaluable disease (Cohort 3); and
    3. 6-month progression-free survival (PFS) rate in patients with centrally confirmed high level FGFR1 amplification and measurable disease (Cohort 4)
    El objetivo principal de este estudio es evaluar la actividad antitumoral de TAS-120 en monoterapia o en combinación con fulvestrant en el tratamiento de pacientes con cáncer de mama metastásico portador de amplificaciones genéticas del FGFR, medidas por:

    1. Tasa de respuesta objetiva (TRO) en pacientes con amplificación del FGFR2 y enfermedad medible (cohortes 1, 2);
    2. Tasa de beneficio clínico (TBC) en pacientes con amplificación del FGFR2 y enfermedad evaluable y no medible (cohorte 3); y
    3. Tasa de supervivencia sin progresión (SSP) a los 6 meses en pacientes con amplificación de alto nivel del FGFR1 y enfermedad medible (cohorte 4)
    E.2.2Secondary objectives of the trial
    Secondary:

    1. To determine the complete response (CR) rate in Cohort 3, the ORR in Cohort 4, the CBR in Cohorts 1, 2, and 4, and the 6-month PFS rate in Cohorts 1-3.
    2. To evaluate the duration of response (DOR) among patients with objective response in any cohort.
    3. To evaluate the PFS and overall survival (OS) in all cohorts.
    4. To investigate the safety of TAS-120 as monotherapy and in combination with fulvestrant.

    Exploratory:

    5. To investigate the downstream pharmacodynamic effects of treatment with TAS-120.
    6. To explore markers of response and mechanisms of resistance in tumor tissue biopsies and/or blood
    7. To explore PK of TAS-120 by population pharmacokinetics (PopPK) analysis and exposure-response analyses.
    Secundarios:

    1. Determinar la tasa de respuesta completa (RC) en la cohorte 3, la TRO en la cohorte 4, la TBC en las cohortes 1, 2 y 4 y la tasa de SSP a los 6 meses en las cohortes 1-3.
    2. Evaluar la duración de la respuesta (DR) entre los pacientes con respuesta objetiva en cualquier cohorte.
    3. Evaluar la SSP y la supervivencia general (SG) en todas las cohortes.
    4. Investigar la seguridad de TAS-120 en monoterapia y en combinación con fulvestrant.

    Exploratorios:

    5. Investigar los efectos farmacodinámicos posteriores del tratamiento con TAS-120.
    6. Explorar los marcadores de la respuesta y los mecanismos de resistencia en las biopsias de tejido tumoral y/o sangre.
    7. Explorar la FC de TAS-120 mediante el análisis farmacocinético de la población (FCPob) y el análisis de la exposición-respuesta.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Patient provides written informed consent.

    2. Patient is ≥18 years of age (or meets the country’s regulatory definition for legal adult age, whichever is greater)

    3. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.

    4. Histologically or cytologically confirmed recurrent locally advanced or metastatic breast cancer not amenable to treatment with curative intent, meeting all of the criteria for 1 of the following cohorts:
    A. Cohort 1
    i. HR+ HER2- breast cancer harboring an FGFR2 gene amplification. HR+ HER2- breast cancer is defined per the local pathology report as estrogen receptor (ER) >1% and/or progesterone receptor (PR) >1%, HER2-negative per American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) guidelines, 2018.
    ii. Measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1
    iii. Has received 1-3 prior endocrine-containing therapies and up to 2 prior chemotherapy regimens for advanced/metastatic disease
    iv. Has received prior treatment with a CDK4/6 inhibitor or is ineligible for such treatment (per Investigator decision)
    v. Has experienced disease progression/recurrence within 1 month following the completion of any endocrine therapy for advanced/metastatic breast cancer
    B. Cohort 2
    i. TNBC harboring an FGFR2 gene amplification. TNBC is defined as negative for ER, PR and HER2. Negative for ER and PR includes the following: local pathology report classifies them as negative, Allred Score of 2 or below or <1% staining. HER2-negative per ASCO / CAP guidelines, 2018.
    ii. Measurable disease per RECIST 1.1
    iii. Has received at least 1 prior chemotherapy regimen for advanced/metastatic disease
    iv. Has experienced disease progression/recurrence during or after the most recent prior chemotherapy for advanced/metastatic breast cancer
    C. Cohort 3
    i. TNBC or HR+ HER2- breast cancer (defined as above) harboring an FGFR2 gene amplification
    ii. Non-measurable, evaluable disease per RECIST 1.1. Patients with bone-only disease must have lytic or mixed lytic-blastic lesions
    iii. Other criteria for either HR+ HER2- breast cancer or TNBC should be met as described for Cohort 1 and 2, respectively
    D. Cohort 4
    i. HR+ HER2- breast cancer (defined as above) harboring an FGFR1 high-level gene amplification as defined in Section 6.1.1.1
    ii. Measurable disease per RECIST 1.1
    iii. Has received 1-2 prior endocrine-containing therapies and no more than 1 prior chemotherapy regimen for advanced/metastatic disease. Prior treatment with fulvestrant is not permitted.
    iv. Has received prior treatment with a CDK4/6 inhibitor or is ineligible for such treatment (per Investigator decision)
    v. Pre/peri-menopausal patients must be on goserelin. Patients must have commenced treatment with goserelin or an alternative GnRH agonist at least 4 weeks prior to the first dose of fulvestrant. If patients have received an alternative GnRH agonist prior to study entry, they must switch to goserelin for the duration of the trial. Postmenopausal is defined as at least one of the following criteria: age ≥60 years; age <60 years and cessation of regular menses for at least 12 consecutive months with no alternative pathological or physiological cause; and serum estradiol and follicle-stimulating hormone level within the laboratory’s reference range for postmenopausal females; or documented bilateral oophorectomy.
    vi. Has experienced disease progression/recurrence within 1 month following the completion of any endocrine therapy for advanced/metastatic breast cancer.

    5. Archival or (preferably) fresh tumor tissue must be available for central laboratory confirmation of FGFR amplification.

    6. The patient is able to take medications orally (a feeding tube is not permitted).

    7. The patient has adequate organ function as defined by the following criteria:
    a. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤3.0 × the upper limit of normal (ULN); if liver function abnormalities are due to underlying liver metastases, AST and ALT ≤5 × ULN
    b. Total bilirubin ≤1.5 × ULN or ≤3 × ULN in case of Gilbert’s syndrome
    c. Absolute neutrophil count (ANC) ≥1.0 × 109/L without hematopoietic growth factor support
    d. Platelet count ≥75 × 109/L without transfusion support (that is, excluding measurements obtained within 3 days after transfusion of platelets)
    e. Hemoglobin ≥9.0 g/dL without transfusion support (that is, excluding measurements within 7 days after transfusion of packed red blood cells or whole blood)
    f. Serum phosphorus ≤ ULN
    g. Creatinine clearance (calculated or measured value): ≥40 mL/min

    (For more inclusion criteria's please refer to Section 4 of the Study Protocol TAS-120-201, version 2.0)
    1. El paciente proporciona el consentimiento informado por escrito.

    2. El paciente tiene ≥18 años de edad (o cumple la definición de cada país para la mayoría de edad legal, lo que sea mayor).

    3. Estado funcional según el Grupo Oncológico Cooperativo del Este (ECOG) de 0 o 1.

    4. Cáncer de mama localmente avanzado o metastásico y recurrente, confirmado histológica o citológicamente, no susceptible al tratamiento con intención curativa, que cumple todos los criterios de 1 de las siguientes cohortes:

    A. Cohorte 1
    i. Cáncer de mama positivo para los receptores hormonales (HR+), negativo para el receptor del factor de crecimiento epidérmico humano 2 (HER2-) y que presenta una amplificación genética del FGFR2. El cáncer de mama HR+ HER2- se define, según el informe de anatomopatología local, como receptor de estrógenos (RE) >1 % y/o receptor de progesterona (RP) >1 %, negativo para HER2 según las directrices de la American Society of Clinical Oncology (ASCO) y el College of American Pathologists (CAP), 2018.
    ii. Enfermedad medible según los Criterios de evaluación de la respuesta en tumores sólidos (RECIST), versión 1.1
    iii. Haber recibido previamente 1-3 tratamientos endocrinos y un máximo de 2 pautas previas de quimioterapia para enfermedad avanzada/metastásica
    iv. Haber recibido tratamiento previo con un inhibidor CDK4/6 o no ser apto para dicho tratamiento (por decisión del investigador)
    v. Haber presentado progresión de la enfermedad/recidiva en el plazo de 1 mes después de la finalización de cualquier tratamiento endocrino para el cáncer de mama avanzado/metastásico

    B. Cohorte 2
    i. Cáncer de mama triple negativo (CMTN) que presenta amplificación genética del FGFR2. El CMTN se define como negativo para ER, PR y HER2. Negativo para ER y PR incluye lo siguiente: el informe de anatomopatología local lo clasifica como negativo, una puntuación de Allred de 2 o menos o una tinción <1 %. Negativo para HER2 según las directrices de la ASCO/CAP, 2018.
    ii. Enfermedad medible según los criterios RECIST 1.1
    iii. Haber recibido al menos 1 pauta previa de quimioterapia o quimioterapia/inmunoterapia (inhibidores de PD-L1/PD-1) para la enfermedad avanzada/metastásica
    iv. Haber presentado progresión de la enfermedad/recidiva durante o después de la quimioterapia anterior más reciente para el cáncer de mama avanzado/metastásico

    C. Cohorte 3
    i. CMTN o cáncer de mama HR+ HER2- (definido como anteriormente) que presenta una amplificación genética del FGFR2
    ii. Enfermedad evaluable y no medible según los criterios RECIST 1.1. Los pacientes con enfermedad ósea solamente deben tener lesiones líticas o líticas-blásticas mixtas
    iii. Deben cumplirse otros criterios para el cáncer de mama HR+ HER2- o el CMTN, como se describe para las cohortes 1 y 2, respectivamente

    D. Cohorte 4
    i. Cáncer de mama HR+ HER2- (definido como anteriormente) que presenta una amplificación de alto nivel del gen del FGFR1, tal como se define en la Sección 6.1.1.1.
    ii. Enfermedad medible según los criterios RECIST 1.1
    iii. Haber recibido previamente 1-2 tratamientos endocrinos y no más de 1 pauta previa de quimioterapia para la enfermedad avanzada/metastásica. No está permitido el tratamiento previo con fulvestrant.
    iv. Haber recibido tratamiento previo con un inhibidor CDK4/6 o no ser apto para dicho tratamiento (por decisión del investigador)
    v. Las pacientes pre/perimenopáusicas deben estar recibiendo goserelina. Las pacientes deben haber comenzado el tratamiento con goserelina o un agonista de la GnRH alternativo al menos 4 semanas antes de la primera dosis de fulvestrant. Si las pacientes han recibido un agonista alternativo de la GnRH antes de entrar en el estudio, tienen que cambiarse a goserelina durante todo el ensayo. Posmenopáusica se define como al menos uno de los siguientes criterios: edad ≥60 años; edad <60 años y cese de la menstruación periódica al menos durante 12 meses consecutivos sin una causa patológica o fisiológica alternativa; y niveles séricos de estradiol y de hormona foliculoestimulante dentro del intervalo de referencia del laboratorio para mujeres posmenopáusicas; u ovariectomía bilateral documentada.
    vi. Haber presentado progresión de la enfermedad/recidiva en el plazo de 1 mes después de la finalización de cualquier tratamiento endocrino para el cáncer de mama avanzado/metastásico.

    5. Debe haber disponible tejido tumoral fresco (preferiblemente) o de archivo para la confirmación del laboratorio central de amplificación del FGFR.

    6. El paciente es capaz de tomar medicamentos por vía oral (una sonda de alimentación no está permitida).

    7. El paciente tiene una función orgánica adecuada según lo definido en el protocolo.

    (En la Sección 4 del Protocolo del estudio TAS-120-201, versión 2.0, se encuentra una lista completa de todos los criterios de inclusión)
    E.4Principal exclusion criteria
    1. History and/or current evidence of any of the following disorders:
    a. Non-tumor related alteration of the calcium-phosphorus homeostasis that is considered clinically significant in the opinion of the Investigator
    b. Ectopic mineralization/calcification, including but not limited to soft tissue, kidneys, intestine, or myocardia and lung, considered clinically significant in the opinion of the Investigator
    c. Retinal or corneal disorder confirmed by retinal/corneal examination and considered clinically significant in the opinion of the Investigator.

    2. Corrected QT interval using Fridericia’s formula (QTcF) >470 msec. Patients with an atrioventricular pacemaker or other condition (for example, right bundle branch block) that renders the QT measurement invalid are an exception and the criterion does not apply.

    3. Treatment with any of the following within the specified time frame prior to the first dose of TAS-120:
    a. Major surgery within 4 weeks (the surgical incision should be fully healed)
    b. Radiotherapy for extended field within 4 weeks or limited field radiotherapy within 2 weeks
    c. Any prior systemic therapy regardless of the stop date, but the patient must have recovered to eligibility levels from prior toxicity
    d. Any investigational agent received within 30 days or 5 half-lives (whichever is shorter)

    4. Prior treatment with an FGFR inhibitor

    5. Cohort 4 only: Prior treatment with fulvestrant, or known hypersensitivity to fulvestrant.

    6. A serious illness or medical condition(s) including but not limited to the following:
    a. Known acute systemic infection
    b. Myocardial infarction, severe/unstable angina, or symptomatic congestive heart failure within the previous 6 months
    c. History or current evidence of serious uncontrolled ventricular arrhythmia
    d. Chronic diarrhea diseases considered to be clinically significant in the opinion of the Investigator
    e. Congenital long QT syndrome, or any known history of torsade de pointes, or family history of unexplained sudden death
    f. Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or TAS-120 administration, or may interfere with the interpretation of study results, and in the judgment of the Investigator would make the patient inappropriate for entry into this study

    7. Brain metastases that are untreated or clinically or radiologically unstable (that is, have been stable for <1 month)

    8. History of another primary malignancy that is currently clinically significant or currently requires active intervention

    9. Pregnant or lactating female
    1. Antecedentes o indicios actuales de alguno de los trastornos siguientes:
    a. Alteración de la homeostasis de fósforo-calcio no relacionada con el tumor, que se considera clínicamente significativa en opinión del investigador
    b. Mineralización/calcificación ectópica, incluidos, entre otros, tejidos blandos, riñones, intestino o miocardio y pulmón, que se considera clínicamente significativa en opinión del investigador
    c. Trastorno de retina o corneal confirmado por una exploración de la retina/córnea, que se considera clínicamente significativo en opinión del investigador.

    2. Intervalo QT corregido utilizando la fórmula de Fridericia (QTcF) >470 ms. Los pacientes con marcapasos auriculoventricular u otra afección (por ejemplo, bloqueo de rama derecho) que invalide la medición de QT son una excepción y no se aplica el criterio.

    3. Tratamiento con alguno de los siguientes dentro del periodo de tiempo especificado antes de la primera dosis de TAS-120:
    a. Cirugía mayor en las 4 semanas anteriores (la incisión quirúrgica debe haber curado completamente)
    b. Radioterapia de campo extendido en las 4 semanas anteriores o radioterapia de campo limitado en las 2 semanas previas
    c. Cualquier tratamiento sistémico previo con independencia de la fecha de interrupción, pero el paciente debe haberse recuperado de la toxicidad anterior a los niveles de elegibilidad
    d. Cualquier fármaco en investigación recibido en el plazo de 30 días o 5 semividas (lo que sea más corto)

    4. Tratamiento previo con un inhibidor del FGFR

    5. Cohorte 4 solamente: Tratamiento previo con fulvestrant o hipersensibilidad conocida a fulvestrant.

    6. Enfermedad o afección médica grave, incluido, entre otros, lo siguiente:
    a.Infección sistémica aguda conocida
    b. Infarto de miocardio, angina grave/inestable o insuficiencia cardíaca congestiva sintomática en los 6 meses anteriores
    c. Antecedentes o indicios actuales de arritmia ventricular no controlada grave
    d. Enfermedades de diarrea crónica que se consideran clínicamente significativas en opinión del investigador
    e. Síndrome de QT largo congénito o cualquier antecedente conocido de torsade de pointes o antecedentes familiares de muerte súbita sin explicación
    f. Otros problemas médicos o psiquiátricos graves agudos o crónicos, o anomalía analítica que pueda aumentar el riesgo asociado a la participación en el estudio o la administración de TAS-120, o que pueda interferir con la interpretación de los resultados del estudio y, en opinión del investigador, haría que el paciente fuese inadecuado para incorporarse a este estudio

    7. Metástasis cerebrales que no reciban tratamiento o radiológicamente o clínicamente inestables (es decir, han sido estables durante <1 mes)

    8. Antecedentes de otra neoplasia maligna primaria que actualmente es clínicamente significativa o requiere actualmente intervención activa

    9. Mujer embarazada o en periodo de lactancia
    E.5 End points
    E.5.1Primary end point(s)
    1. Objective response rate (ORR), defined as the proportion of patients with a confirmed response of either complete response (CR) or partial response (PR) per Investigator assessment.
    2. Clinical benefit rate (CBR), defined as the proportion of patients with a confirmed response of CR, or stable disease (SD) lasting at least 24 weeks, per Investigator assessment.
    3. 6-month progression-free survival (PFS) rate, defined as the proportion of patients who are alive and progression-free 6 months after the first dose of study therapy.
    1. Tasa de respuesta objetiva (TRO), definida como la proporción de pacientes con respuesta confirmada ya sea completa (RC) o parcial (RP), según la evaluación del investigador.
    2. Tasa de beneficio clínico (TBC), definida como la proporción de pacientes con respuesta confirmada (RC) o enfermedad estable (EE) con al menos 24 semanas de duración, según la evaluación del investigador.
    3. Tasa de supervivencia libre progresión (SSP), definida como la proporción de pacientes vivos y libres de progresión a los 6 meses después de la primera dosis del estudio.
    E.5.1.1Timepoint(s) of evaluation of this end point
    1,2&3) At baseline and at the end of every 8 weeks/2 cycles (±1 week) or as clinically indicated until disease progression, death, or withdrawal of consent, and at the end of therapy.
    1,2&3) Al inicio y al final de cada 8 semanas/2 ciclos (±1 semana) o según indicado clínicamente hasta progresión de la enfermedad, fallecimiento, o retirada de consentimiento y al final del tratamiento.
    E.5.2Secondary end point(s)
    Secondary:

    1) Objective response rate (ORR), Complete response (CR rate), Clinical benefit rate (CBR), and 6-month PFS rate,
    2) Duration Of Response (DOR), defined as the time from first documentation of objective response to the date of death (any cause) or disease progression per Investigator assessment.
    3) Progression-free survival (PFS), defined as the time from first dose of study therapy to the date of death (any cause) or disease progression per Investigator assessment. Overall survival (OS), defined as the time from first dose of study therapy to the date of death (any cause).
    4) Adverse events, graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), Version 5.0. Evaluation of dose-limiting toxicity (DLT) in Cohort 4 only.

    Exploratory:
    5) Changes in pharmacodynamic markers assessed in fresh tumor tissue biopsies.
    6) Exploratory association of tissue and/or blood markers with tumor efficacy endpoints and/or tumor resistance to TAS-120.
    7) Estimation of individual PK parameters such as area under the plasma concentration time curve (AUC) and exploratory association of the exposure with clinical parameters.
    Secundarios:

    1) Tasa de respuesta objetiva (TRO), Respuesta completa (tasa RC), tasa de beneficio clínico (TBC), y Tasa SSP a los 6 meses,
    2) Duración de la respuesta (DR), definida como el tiempo desde la documentación de la primera respuesta objetiva hasta la fecha de fallecimiento (por cualquier causa) o progresión de la enfermedad, según la evaluación del investigador.
    3) Supervivencia sin progresión (SSP) definida como el tiempo desde la primera dosis del estudio hasta la fecha de fallecimiento (por cualquier causa) o progresión de la enfermedad, según la evaluación del investigador. Supervivencia general (SG) definida como el tiempo desde la primera dosis del estudio hasta la fecha de fallecimiento (por cualquier causa).
    4) Acontecimientos adversos, graduados de acuerdo con el National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), Versión 5.0. Evaluación de la toxicidades limitantes de la dosis (TLD) sólo en la cohorte 4.

    Exploratorios:
    5) Cambios en marcadores farmacodinámicos evaluados en biopsias de tejido tumoral.
    6) Explorar los marcadores de la respuesta y los mecanismos de resistencia en las biopsias de tejido tumoral y/o sangre.
    7) Estimar los parámetros de FC individual de TAS-120, tales como el área bajo curva (AUC) y la asociación exploratoria de exposición a parámetros clínicos.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Secondary:

    1,2,3& 4) At baseline and at the end of every 8 weeks/2 cycles (±1 week) or as clinically indicated until disease progression, death, or withdrawal of consent, and at the end of therapy.

    Exploratory:

    5&6) prior to the first TAS-120 administration on Day 1 of Cycle 1, on Day 1 of each alternative uneven cycle (Cycle 3, 5, 7 and ongoing), at time of disease progression, and at the end of trial (EOT) visit.

    7) Cycle 2, Day 1 (C2D1), within 1 hour prior to dosing and at 2 hours (±1 hour) and 5 hours (at least 3 hours apart from sampling at 2 hours) post dose.
    Secundarios:

    1,2,3& 4) Al inicio y al final de cada 8 semanas/2 ciclos (±1 semana) o según indicado clínicamente hasta progresión de la enfermedad, fallecimiento, o retirada de consentimiento y al final del tratamiento.

    Exploratorios:

    5&6) Antes de la primera administración de TAS-120 en el Día 1 del Ciclo 1, en el Día 1 de cada ciclo impar (Ciclos 3, 5, 7 y sucesivos), en el momento de progresión de la enfermedad y en la visita de fin de tratamiento.

    7) Día 1 del Ciclo 2 (D1C2), en el plazo de 1 hora antes de la administración de la dosis y 2 horas (± 1 hora) y 5 horas (con al menos 3 horas de diferencia a la obtención de muestras a las 2 horas) después de la dosis.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised 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 trial4
    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 EEA70
    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
    Canada
    France
    Italy
    Portugal
    Spain
    United Kingdom
    United States
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    LVLS
    Última Visita Último Paciente (UVUP)
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months6
    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: 84
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 84
    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 state10
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 23
    F.4.2.2In the whole clinical trial 45
    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)
    Following Study Completion, patients still receiving and deriving benefit from study therapy in the opinion of the Investigator and Sponsor will be permitted to continue treatment in a Study Extension phase. During the Study Extension, patients may receive treatment until withdrawal
    criteria are met.
    Después del fin del estudio, se permitirá continuar con el tratamiento en un estudio de fase de extensión, a los pacientes que sigan recibiendo y obteniendo beneficios del tratamiento del estudio según el criterio del Investigador y del Promotor. Durante la extensión los pacientes recibirán el tratamiento hasta que se cumpla alguno de los criterios de retirada.
    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 Decision2019-11-12
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-10-15
    P. End of Trial
    P.End of Trial StatusOngoing
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