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    Summary
    EudraCT Number:2019-002113-19
    Sponsor's Protocol Code Number:42756493CAN2002
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2021-06-17
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2019-002113-19
    A.3Full title of the trial
    A Phase 2 Study of Erdafitinib in Subjects with Advanced Solid Tumors and FGFR Gene Alterations
    Studio di Fase II su Erdafitinib in pazienti con tumori solidi in stadio avanzato e alterazioni del gene FGFR
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 2 Study of Erdafitinib in Subjects with Advanced Solid Tumors and FGFR Gene Alterations
    Studio di Fase II su Erdafitinib in pazienti con tumori solidi in stadio avanzato e alterazioni del gene FGFR
    A.3.2Name or abbreviated title of the trial where available
    RAGNAR
    RAGNAR
    A.4.1Sponsor's protocol code number42756493CAN2002
    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 SponsorJANSSEN CILAG INTERNATIONAL NV
    B.1.3.4CountryBelgium
    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 supportJanssen Research & Development LLC
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationJanssen-Cilag International NV
    B.5.2Functional name of contact pointClinical Registry Group
    B.5.3 Address:
    B.5.3.1Street AddressArchimedesweg 29
    B.5.3.2Town/ cityLeiden
    B.5.3.3Post code2333 CM
    B.5.3.4CountryNetherlands
    B.5.4Telephone number0031715242166
    B.5.5Fax number0031715242110
    B.5.6E-mailClinicalTrialsEU@its.jnj.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.2.1.1.1Trade name N/A
    D.2.1.1.2Name of the Marketing Authorisation holderN/A
    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 nameerdafitinib
    D.3.2Product code [JNJ-42756493]
    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.3.9.1CAS number 1346242-81-6
    D.3.9.2Current sponsor codeJNJ-42756493
    D.3.9.3Other descriptive nameErdafitinib
    D.3.9.4EV Substance CodeSUB167731
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number3
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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.2.1.1.1Trade name N/A
    D.2.1.1.2Name of the Marketing Authorisation holderN/A
    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 nameErdafitinib
    D.3.2Product code [JNJ-42756493]
    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.3.9.1CAS number 1346242-81-6
    D.3.9.2Current sponsor codeJNJ-42756493
    D.3.9.3Other descriptive nameERDAFITINIB
    D.3.9.4EV Substance CodeSUB167731
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.1.1.1Trade name N/A
    D.2.1.1.2Name of the Marketing Authorisation holderN/A
    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 nameerdafitinib
    D.3.2Product code [JNJ-42756493]
    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.3.9.1CAS number 1346242-81-6
    D.3.9.2Current sponsor codeJNJ-42756493
    D.3.9.3Other descriptive nameERDAFITINIB
    D.3.9.4EV Substance CodeSUB167731
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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
    Advanced solid tumors (other than Urothelial tumors), and FGFR gene alterations.
    tumore solido in fase avanzata (diverso da tumore uroteliale) con alterazione genica del FGFR
    E.1.1.1Medical condition in easily understood language
    Advanced solid tumors (other than Urothelial tumors), and FGFR gene alterations.
    tumore solido in fase avanzata (diverso da tumore uroteliale) con alterazione genica del FGFR
    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 LLT
    E.1.2Classification code 10065143
    E.1.2Term Malignant solid tumour
    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
    To evaluate the efficacy of erdafitinib in terms of overall response rate (ORR) as assessed by the Independent Review Committee (IRC) in subjects with advanced solid tumors with target FGFR mutations and any gene fusions (Broad Panel Cohort), or in a pre-specified subgroup of subjects with a selected panel of FGFR markers (Core Panel Cohort), or in both cohorts
    valutare l'efficacia di erdafitinib in termini di risposta totale (ORR), come valutato dal Independent Review Committee (IRC), nei soggetti con tumori solidi in stadio avanzano che presenzano mutazioni specifiche (target) per il gene del FGFR o una qualsiasi fusione genica (Broad Panel Cohort) o in sottogruppi predeterminati o in soggetti con un pannello selezionato di marker FGFR (Core Panel Cohort), o in entrambe le coorti.
    E.2.2Secondary objectives of the trial
    - To evaluate the efficacy of erdafitinib, in terms of the ORR, as assessed by investigator
    - To evaluate the efficacy of erdafitinib in terms of DOR
    - To evaluate other measures of efficacy including DCR, PFS, and OS
    - To evaluate erdafitinib PK
    - To evaluate Health-Related Quality of Life

    Cholangiocarcinoma Expansion Cohort
    -To evaluate the efficacy and safety of erdafitinib in subjects with cholangiocarcinoma with target FGFR mutations and any gene fusions
    valutare efficacia di erdafitinib in termini di ORR come valutato dallo sperimentatore
    valotare l'efficacia di erdafinitib in termini di DOR
    valutare altre misure di efficacia, includendo DCR PFS e OS
    valutare la farmacocinetica di erdafitinib
    valutare la qualità della vita relativa

    Coorte di espansione - colangiocarcinoma
    valutare la sicurezza e l'efficacia di erdafitinib in pazienti con colangiocarcinoma con mutazione target FGFR e una qualsiasi fusione genica
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Please refer to protocol section 5.1
    1. >=12 years of age
    2. crterion ameded per Amendment1 and per Amendment2
    2.1 Histologic demonstration of an unresectable, locally advanced, or metastatic solid tumor malignancy bearing an FGFR mutation or fusion, as determined by local* or central laboratory screening (Section 8.1.1.1).
    *Locally performed or commercial testing results with NGS tests, direct digital counting methods, or the Qiagen therascreen® FGFR RT-PCR test performed in Clinical laboratory Improvement Amendments (CLIA)-certified or regional equivalent lab.
    **FGFR gene fusions :
    - Have a report suggesting the presence of an intact FGFR kinase domain.
    - FGFR fusion with a 3-prime partner (FGFR gene is listed first, eg FGFRGENE or FGFR3-TACC3):
    -The FGFR portion of the fusion must involve exon 17 or greater (=17)
    - FGFR fusion with a 5-prime partner (Partner gene is listed first and FGFR gene is second, eg GENE-FGFR or KLK2-FGFR2):
    - The FGFR portion of the fusion must involve less than or equal to exon 11 (=11)
    - Have a named FGFR fusion partner gene (self-fusions or rearrangements, eg FGFR-FGFR, are not eligible)
    -FGFR gene identifiers, canonical transcript identifiers, and kinase domain positions are provided below for reference (see protocol)
    3. Measurable disease according to RECIST v1.1 or RANO for primary brain tumors.
    4. Criterion modified per Amendment 2
    4.1 Subject must have received at least one prior line of systemic therapy in the advanced, unresectable, or metastatic setting.
    5. Subject does not have standard of care options that have shown meaningful clinical benefit for the relevant underlying histology and line of therapy or the subject is unable to tolerate the therapy
    6. Progression of disease, defined as any progression that requires a change in treatment, prior to full study screening
    7. Toxicities from anticancer therapies must be resolved to baseline levels or to Grade 1 or less except for alopecia, peripheral neuropathy,
    8. For adults (=18 years of age), ECOG performance status Grade 0 or 1 (Section 10.5) For adolescents (=12 to <16 years of age), Lansky Score of =80 (Section 10.6). For adolescents (=16 to <18 years of age), Karnofsky Score of =80
    (Section 10.6).
    9. Adequate bone marrow, liver, and renal function:
    a. Bone marrow function (without the support of cytokines or erythropoiesis-stimulating agent in preceding 2 weeks): -Asolute neutrophil count (ANC) >=1,000/mm3 -Patelet count >=75,000/mm3 -Hemoglobin >=8.0 g/dL
    b. Liver function: -Total bilirubin =1.5 x institutional ULN OR direct bilirubin =ULN for subjects with total bilirubin levels >1.5xULN -Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =2.5x nstitutional ULN or =5x institutional ULN for subjects with liver metastases
    c. Renal function: Creatinine clearance >30 mL/min/1,73m2 either directly measured via 24-hour urine collection or calculated using the Cockcroft- Gault formula for adult subjects or the CKiD (Chronic Kidney
    Disease in Children)Schwartz formula for adolescent subjects (Section 10.7)
    d. Phosphate: <ULN within 14 days of treatment and prior to Cycle 1 Day 1 medical management allowed)
    10. Must sign an ICF. For adolescent subjects, parent(s) (preferably both if available) (or their legally acceptable representative) must sign an ICF . Assent is also required of adolescent subjects as described in Informed Consent Process in Section 10.3,
    11. A female of childbearing potential must have a negative pregnancy test (ß-human chorionic gonadotropin [hCG]) at Screening (urine or serum).
    12. Contraceptive use by male or female subjects should be consistent with local regulations regarding the use of contraceptive methods for subject participating in clinical studies. For females of childbearing potential (defined as: fertile, following menarche and until becoming post-menopausal unless permanently sterile. Permanent sterilization methods: hysterectomy, bilateral salpingectomy and bilateral oophorectomy.
    fare riferimento alla sezione 5.1 del protocollo
    1. età >=12 anni
    2. dimostrazione istologica di tumore solido non resecabile localmente avanzato o metastatico che presenta mutazione del gene FGFR o fusione, come determinato dal laboratorio centrale o locale tramite lo screening;(sezione 8.1.1.1);
    *pazienti con la mutazione target FGFR o qualsiasi** fusione genica del gene FGFR sono eleggibili per l'arruolamento nella Broad Panel Cohort;(v sez 10.11)
    pazienti con altre mutazioni FGFR*** sono eleggibili per l'arruiolamento nella coorte esplorativa
    *test locale o commerciale su tessuto o sangue con test NGS, digital counting, QIAGEN therascreen test, effettuati in laboratori CLIA o equivalenti
    **fusione genica FGFR:
    -risultati indicano la possibile presenza di un dominio chinasico intatto;
    -fusione con un 3-primer, in cui FGFR sia codificato prima;
    - la porzione FGFR deve essere coinvolta nell'esone 17 o maggiore
    -fusione con u 5-primer, FGFR codificato a valle del precedente;
    - porzione FGFR nella fusione deve coinvolgere 11 esoni o meno
    fusione con gene FGFR partiner
    - identificatori FGFR canonici, domini di posizione chinasica forniti per riferimento in protocollo
    3. malattia misurabile in accordo con il RECIST1.1 o il RANO per tumori cerebrali primari
    4. i soggetti devono aver ricevuto almeno una linea di trattamento sistemica per il tumore metastatico avanzano non resecabile
    5. il soggetti non hanno opzioni di normale pratica clinica che abbiano mostrato dei benefici clinici significativi per l'istologia e la linea di terapia, oppure il soggetto non è in grado di sopportare la terapia
    6. progressione documentata della malattia, definita come una qualsiasi progressione che richieda un cambio di trattamento, prima e fino a completamento dello screening
    7. tossicità significativa da terapie anticancro precedenti devono essere state risolte al grado 1 o inferiore in riferimento ad alopecia, neuropatia periferica, e al grado 2 per i valori di laboratorio riferiti al criterio di inclusione 9
    8. per adulti (=18 anni): ECOG di grado 0 o 1; per gli adolescenti (età =12 e <16), punteggio Lansky =80; per adolescenti (età =16 e <18), punteggio Karnofsky =80)
    9. funzionalità di midollo ossero, fegato e rene adeguate:
    per la funzione midollare, senza il supporto agenti stimolanti la citochinesi e l'eritropoiesi nelle 2 settimane precedenti) - conta ssoluta dei netrofili >=1,000/mm3 -conta piastrinica >=75,000/mm3 -emoglobina >=8.0 g/dL
    per la funzione epatica: bilirubina totale =1.5 x ULN nominale; O bilirubina diretta =ULN per i soggetti con livelli di bilirubina maggiore di 1.5xULN; alanina aminostrasferasi e aspartato aminotrasferasi =2.5x ULN o =5x ULN per soggetti con metastasi epatiche
    funzional renale: clearence della creatinina >30 mL/min sia con le urine delle 24h sia con la formula di Cockcroft- Gault per i soggetti adulti o la formula di CKiD Schwartz per i pazienti adolescenti (sez \10.7)
    fosfati: <ULN entri 14 giorni dal trattamento e prima del ciclo 1 day 1
    10 deve firmare un consenso informato indicando la sua volontà di partecipare allo studio; per i soggetti adolescenti, anche i genitori (preferibilmente entrambi) o il rappresentante legale devono firmare. l'assenso del soggetto adolescente è richiesto.
    11. un paziente di sesso femminile in età fertile deve avere un test di gravidanza negativo (gonadotropina corionica umana allo screening, su urine o siero)
    12. uso dei cotnraccettivi sia per pazienti maschili che femminili deve essere consistente con la legislazione locale, indipendentemente dal metodo di contraccezione utilizzato per partecipare allo studio, per donne potenzialmente fertilii metodi di sterlizzazione permanente includono l'isterectomia, la sapingectomia bilaterale e la ooforectomia bilaterale.
    E.4Principal exclusion criteria
    1. Has had prior chemotherapy, targeted therapy, or treatment with an investigational anticancer agent within 15 days or >=5 half-lives of the agent (whichever is longer) up to 30 days before the first dose of erdafitinib. Has had prior mAb therapy or immunotherapy within 30 days before the first dose of erdafitinib and/or has an ongoing Grade =2 immunotherapyrelated toxicity
    2. The known* presence of FGFR gatekeeper and resistance alterations. Mutations in the following positions: FGFR1 V561; FGFR2 V564; FGFR2 N549; FGFR3 V555; and FGFR4 V550
    *Observation of a gatekeeper/resistance alteration in the local or central report. If the test does not screen for all four FGFRs, eg FGFR4, the local report remains evaluable for molecular screening.
    3. For NSCLC subjects only - pathogenic somatic mutations or gene fusions in the following genes: EGFR, BRAF v600EALK, ROS1, and NTRK and BRAT V600E
    *Assessment of these genes may be performed per institutional standard and do not have to be assessed via NGS.
    4. Histologic demonstration of transitional cell urothelial carcinoma
    5. Hematologic malignancy (ie, myeloid and lymphoid neoplasms)
    6. Active malignancies other than for disease requiring therapy
    7. Symptomatic central nervous system metastases (except for subjects with primary CNS tumors)
    8. Received prior selective FGFR inhibitor treatment
    9. Known allergies, hypersensitivity, or intolerance to erdafitinib or its excipients.
    10. Current central serous retinopathy (CSR) or retinal pigment epithelial detachment of any grade.
    11. History of uncontrolled cardiovascular disease include: -Unstable angina, myocardial infarction, ventricular fibrillation, Torsades de Pointes, cardiac arrest, or known congestive heart failure Class III-IV (Section 10.8) within the preceding 3 months; cerebrovascular accident or transient ischemic attack within the preceding 3 months. -QTc prolongation as confirmed by triplicate assessment at screening (Fridericia; QTc >480 milliseconds; for adoloescent subjects, Bazett QTc >440 milliseconds).
    12. Known history of AIDS (human immunodeficiency virus (HIV) infection), unless the subject has been on a stable anti-retroviral therapy regimen for the last 6 months or more, has had no opportunistic infections in the last 6 months, and has CD4 count >350.
    13. Evidence of active hepatitis B or C infection (for example, subjects with history of hepatitis C infection but normal hepatitis C virus polymerase chain reaction test and subjects with inactive hepatitis B with positive HBsAg antibody are allowed).
    14. Not recovered from reversible toxicity of prior anticancer therapy (except toxicities which are not clinically significant such as alopecia, skin discoloration, neuropathy, hearing loss).
    15. Impaired wound healing capacity defined as skin/decubitus ulcers, chronic leg ulcers, known gastric ulcers, or unhealed incisions.
    16. Major surgery within 4 weeks before first dose of erdafitinib.
    17. Palliative radiation to the target lesionwithin 2 weeks before the first dose of erdafitinib.
    18. Pregnant, or breast-feeding, or planning to become pregnant while enrolled in this study or within 3 months after the last dose of drug.
    19. Plans to father a child while enrolled in this study or within 3 months after the last dose of drug.
    20. Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the subject (eg, compromise the well-being) or that could prevent, limit, or confound the
    protocol-specified assessments. Examples include ongoing active infection requiring systemic therapy and uncontrolled ongoing medical conditions.
    1. si è sottoposto a chemioterapia, terapia mirata o trattamento clinico nel 15 giorni precedenti alla prima dose di erdafitinib o a un numero pari o inferiore a 5 di emivite del farmaco con cui è stato trattato si è sottoposto a immunoterapia nei 30 giorni precedenti la prima dose di erdafitinib o ha una tossicità relativa all'immunoterpia di grado =2
    2 presenza conosciuta di FGFR gatekeeper e di mutazioni di resistenza; FGFR1 V561; FGFR2 V564; FGFR2 N549; FGFR3 V555; and FGFR4 V550
    osservazione di una resistenza al'alterazione nel report; se il test non indica presenza di tutti e 4 gli FGFR, il report resta valido per screening molecolare
    3 per soggetti NSCLC mutazioni somatiche patogeniche dei seguenti geni: EGFR, ALK, ROS1, and NTRK e BRAT V600E (PIK3CA and PTEN; la valutazione di questi geni deve essere effettuata secondo gli standard e non via NGS
    4 dimostrazione istologica di carcinoma uroteliane
    5. tumore ematologico
    6 metastasi diverse da quelle richiedenti terapia
    7 metastasi sintomatiche al CNS
    8 trattamento precedente con inibitori selettivi FGFR
    9 allergie, ipersensibilità, intolleranza conosciute ad erdafitinib o agli eccipienti
    10 retinopatia centrale seria o distacco del puigmento epiteliale retinico di qualsiasi grado
    11. storia di patologia cardiovascolare non controllata (angina instabile, infarto del miocardio, fibrillazione ventricolare, torsades des pointes, arresto caridaco, insufficienza cardiaca congestizia di classe 3- 4 entro i precedenti 3 mesi; infarto cerebrale o TIA nei precedenti 3 mesi; prolungamento del tratto QT confermato in triplice allo screening QTc >480 milliseconds; per pazienti adolescenti Bazett: QTc >440 millisecondi.
    12. storia di AIDS a meno che la patologia non sia stabile sotto terapia antiretrovirale negli ultimi 6 mesi, nessuna infezione opportunistica negli utlimi 6 mesi e conta dei CD4 >350
    13. iprove di epatite B o C attive (ad esempio: sono ammessi pazienti con storia di epatite C ma normali livelli di virus misurato per PCR e pazienti con epatite B inattiva con anticorpo anti HBsAg)
    14. non ripreso da tossicità reversibile da terapia anticancro precedente (accettabili: alopecia, decolorazione della pelle, neuropatia, perdita di capelli)
    15. mancanza di capacità di rigenerare le ferite, definita come ulcere da decubito, ulcere gastriche o incisioni non guarite
    16. chirurgia maggiore nelle 4 settimane precedenti la prima dose di erdafitinib
    17. radiazione palliativa alla lesione target nelle 2 settimane precedenti la prima dose di erdafitinib
    18. gravidanza o allattamento al seno; o programmaticità di maternità nei 3 mesi successive l'ultima dose di farmaco
    19. pianificazione di paternità nei 3 mesi successive l'ultima dose di farmaco
    20. qualsiasi condizione che, nell'opinione dello sperimentatore, può interferire con la partecipazione del soggetto o che potrebbe non essere nel miglior interesse del soggetto (esempio: infezioni ricorrenti richiedenti terapia sistemica o condizioni mediche non controllabili)
    E.5 End points
    E.5.1Primary end point(s)
    The proportion of subjects who achieve a complete response (CR) or partial response (PR) based on RECIST v1.1. or RANO as assessed by IRC
    la proporzione di soggetti che raggiungono la risposta completa (CR) o praziale (PR) in base al RECIST 1.1 o al RANO, per valutazione dell'IRC
    E.5.1.1Timepoint(s) of evaluation of this end point
    Throughout the study
    nel corso dello studio
    E.5.2Secondary end point(s)
    - The proportion of subjects who achieve a CR or PR based on RECIST v1.1. or RANO as assessed by investigator
    - DOR: the duration from the date of initial documentation of a response to the date of first documented evidence of progressive disease (or relapse for subjects who experience CR during the study) or death,
    whichever comes first. Data from subjects who are progression-free and alive or have unknown status will be censored at the last tumor assessment
    - DCR: the proportion of subjects with CR, PR or SD
    - PFS: the duration from the date of the first dose of study drug until the date of first documented evidence of progressive disease (or relapse for subjects who experience CR during the study) or death, whichever comes first. Data from subjects who are progression-free and alive or have unknown status will be censored at the last tumor assessment
    - OS: measured from the date of first dose of study drug to the date of the subject's death. If the subject is alive or the vital status is unknown, the subject's data will be censored at the date the subject was last
    known to be alive
    - PK exposure parameters derived using existing population PK model
    - Incidence and severity of AEs
    - Change from baseline in patient-reported health status and physical functioning scales of the EORTC-QLQ-C30, PGIS, PGIC, and EQ-5D-5L.

    Cholangiocarcinoma Expansion Cohort
    - Key efficacy endpoints will be evaluated including ORR assessed by IRC/investigator, DOR, PFS, and OS
    - Incidence and severity of AEs
    la proporzione di soggetti che raggiungono la risposta completa (CR) o parziale (PR) in base al RECIST 1.1 o al RANO, per valutazione del PI
    DOR: il periodo intercorso tra la data della documentazione iniziale di una risposta alla data della prima evidenza di patologia progressiva (o remittente, per soggetti che hanno avuto risposta completa durante lo studio) o morte, quale evento accade per primo. i dati dei soggetti che sono senza progressione e vivi o il cui status è sconosciuto verranno censurati all'ultima valutazione del tumore
    DCR la proporzione di soggetti con risposta completa, o patologia stabile
    PFS il periodo intercorso tra la data della prima dose del farmaco e la data della prima evidenza di patologia progressiva (o remittente, per soggetti che hanno avuto risposta completa durante lo studio) o morte, quale evento accade per primo. i dati dei soggetti che sono senza progressione e vivi o il cui status è sconosciuto verranno censurati all'ultima valutazione del tumore
    OS: misurata come la data dalla prima dose di farmaco di studio alla morte del soggetto; i dati dei soggetti che sono senza progressione e vivi o il cui status è sconosciuto verranno censurati all'ultima valutazione dello stato in vita
    PK: parametri di esposizione derivati dai modelli di PK di popolazione
    indicenza totale degli eventi avversi
    variazione dal baseline dello stato di salute riportato dai pazienti e delle scale della funzionalità fisica sulla base dei test EORTC-QLQ-C30, PGIS, PGIC, and EQ-5D-5L.

    coorte di espansione con colangiocarcinoma:
    - gli endpoint chiave verranno valutati includendo una valutazione ORR da IRC/PI, DOR, PFS e OS.
    - incidenza e severità degli AE
    E.5.2.1Timepoint(s) of evaluation of this end point
    Throughout the study
    nel corso dello studio
    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 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 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 No
    E.8.1.1Randomised No
    E.8.1.2Open No
    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) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial1
    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 concerned7
    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 Information not present in EudraCT
    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
    Brazil
    China
    Japan
    Korea, Republic of
    Taiwan
    United States
    Belgium
    France
    Germany
    Italy
    Poland
    Spain
    United Kingdom
    Argentina
    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
    The end of study is defined as 4 years from enrollment of the last subject into the study or the last follow-up visit of the last patient, whichever occurs first.
    la fine dello studio è definita come 4 anni dall'arruolamento dell'ultimo soggetto nello studio o l'ultima visita di follow up dell'ultimo paziente, a seconda di quale avviene per primo
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years6
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years6
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    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) Yes
    F.1.1.6.1Number of subjects for this age range: 20
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 210
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 80
    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 Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    For adolescents between 12-18yrs old
    soggetti di età compresa tra i 12 anni (compresi e i 18 (esclusi)
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state15
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 150
    F.4.2.2In the whole clinical trial 310
    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)
    The sponsor will ensure that subjects benefiting from treatment with erdafitinib continue to receive treatment after the end of the study. Subsequent therapy is left to the investigator's discretion.
    lo sponsor conferma che i soggetti che beneficiano del trattamento con erdafitinib continueranno a ricevere il trattamento anche dopo la fine dello studio. la terapia sucessiva è lasciata alla discrezione dello sperimentatore
    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 Decision2020-01-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-12-20
    P. End of Trial
    P.End of Trial StatusCompleted
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