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    Summary
    EudraCT Number:2019-002409-23
    Sponsor's Protocol Code Number:CLN-081-001
    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:2023-01-16
    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 number2019-002409-23
    A.3Full title of the trial
    A Phase 1/2, Open-Label, Multi-Center Trial to Assess Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, and Efficacy of CLN-081 in Patients with Locally-Advanced or Metastatic Non-Small Cell Lung Cancer Harboring EGFR Exon 20 Insertion Mutations who have Previously Received Platinum-Based Systemic Chemotherapy
    Estudio en fase I/II, abierto, multicéntrico para evaluar la seguridad, la tolerabilidad, la farmacocinética, la farmacodinámica y la eficacia de CLN-081 en pacientes con carcinoma pulmonar no microcítico localmente avanzado o metastásico con mutaciones por inserción en el exón 20 del EGFR que han recibido anteriormente quimioterapia sistémica con un derivado del platino
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Phase 1/2 Study of CLN-081 in Patients with Lung Cancer
    Estudio en fase I/II de CLN-081 en pacientes con carcinoma pulmonar
    A.4.1Sponsor's protocol code numberCLN-081-001
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04036682
    A.5.4Other Identifiers
    Name:IND number:Number:144052
    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 SponsorCullinan 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 supportCullinan Oncology Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCullinan Oncology Inc.
    B.5.2Functional name of contact pointCLN-081-001 Trial Information
    B.5.3 Address:
    B.5.3.1Street Address1 Main Street, Suite 520
    B.5.3.2Town/ cityCambridge
    B.5.3.3Post codeMA 02142
    B.5.3.4CountryUnited States
    B.5.4Telephone number+16174104650
    B.5.6E-mailCLN081001trial@cullinanoncology.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.3.2Product code CLN-081
    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 INNCLN-081
    D.3.9.2Current sponsor codeCLN-081
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number15
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.2Product code CLN-081
    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 INNCLN-081
    D.3.9.2Current sponsor codeCLN-081
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    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
    Non-Small Cell Lung Cancer Harboring EGFR Exon 20 Insertion Mutations
    Carcinoma pulmonar no microcítico con mutaciones por inserción en el exón 20 del EGFR
    E.1.1.1Medical condition in easily understood language
    Lung Cancer
    Carcinoma pulmonar
    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 10029515
    E.1.2Term Non-small cell lung cancer recurrent
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10059515
    E.1.2Term Non-small cell lung cancer metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Phase I
    • Assess safety, tolerability and define maximum tolerated dose (MTD) of orally administered CLN-081

    Phase 2a - Dose Expansion
    • Evaluate objective response rate (ORR) and define recommended phase 2 dose (RP2D) of orally administered CLN-081

    Module A
    • Investigate PK profile of single doses of 150 mg of CLN-081 with or without a high fat meal in patients with solid tumors

    Module B, Part 1
    • Define safety, tolerability and PK profile of CLN-081 administered as repeat doses of 150 mg BID with food to patients with locally-advanced or metastatic NSCLC harboring EGFR ex20ins mutations
    • Investigate effect of food on CLN-081 tolerability at 150 mg BID

    Module B, Part 2
    • Evaluate ORR and duration of response (DOR) by ICR of orally administered CLN-081 at RP2D

    Module C
    • Evaluate ORR and DOR by ICR of orally administered CLN-081 100 mg BID in patients whose disease has progressed after prior treatment with an agent for the treatment of EGFR ex20ins mutant NSCLC
    Fase I
    •Valorar la seguridad, tolerabilidad y definir la máxima dosis tolerada (MDT) de CLN-081 administrado por vía oral
    Fase IIa–Ampliación de dosis
    •Evaluar la tasa de respuesta objetiva (TRO) y definir la dosis recomendada para la fase II (DRFII) de CLN-081 administrado por vía oral
    Módulo A
    •Estudiar el perfil FC de las dosis únicas por vía oral de 150 mg de CLN-081, acompañadas o no de una comida con alto contenido en grasa, en pacientes con tumores sólidos
    Módulo B, parte 1
    •Definir seguridad, tolerabilidad y perfil FC de CLN-081 administrado en dosis de repetición de 150 mg (2VD), acompañadas de comida, a pacientes con carcinoma pulmonar no microcítico (CPNM) localmente avanzado o metastásico con mutaciones por ex20ins del EGFR
    •Estudiar el efecto de la comida en la tolerabilidad de CLN-081 con dosis de 150 mg 2VD
    Módulo B, parte 2
    •Evaluar la TRO y la duración de la respuesta (DR), valorada mediante RCI, de la DRFII de CLN-081 administrada por vía oral
    E.2.2Secondary objectives of the trial
    Phase I
    • Assess anti-tumor activity
    • Characterize select PK parameters

    Phase 2a
    • Evaluate DOR, DCR
    • Determine median PFS, median OS, landmark PFS, landmark OS
    • Confirm safety and tolerability
    • Characterize select PK parameters and relationships to response

    Module A
    • Assess safety
    • Assess PK of single doses of 150 mg of CLN-081 with or without food

    Module B, Part 1
    • Evaluate ORR by ICR of repeat doses of 150 mg BID
    • Investigate antitumor activity of CLN-081 150 mg BID given with food
    • Evaluate concordance between local and central biomarker determination via CDx assay.

    Module B, Part 2 (CLN-081 RP2D) and Module C (CLN-081 100 mg BID)
    • Evaluate ORR and DOR by Investigator assessment
    • Evaluate DCR, median PFS and OS, landmark PFS and OS rates by ICR
    • Confirm safety and tolerability
    • Characterize select PK parameters and relationships with response
    • Evaluate concordance between local and central biomarker determination via CDx assay.
    Fase I
    •Valorar la actividad antitumoral/Describir determinados parámetros FC
    Fase IIa
    •Evaluar la DR, TCE/Determinar la mediana de SSP y de SG, y tasas de SSP y SG/Confirmar la seguridad y la tolerabilidad/Describir determinados parámetros FC y relaciones con medidas de respuesta
    Módulo A
    •Valorar la seguridad/Valorar la FC de las dosis únicas de 150 mg de CLN-081, acompañadas o no de una comida
    Módulo B, parte 1
    •Evaluar la TRO mediante una RCI en dosis de repetición de 150 mg 2VD/Investigar la actividad antitumoral de CLN-081 de 150 mg 2VD administrada con comida/Evaluar la concordancia entre las valoraciones local y central de los biomarcadores mediante prueba diagnóstica acompañante
    Módulo B, parte 2 y Módulo C
    •Evaluar la TRO y la DR, mediante valoración por parte del investigador/Evaluar la TCE, la mediana de la SSP y la SG, y tasas de SSP y SG mediante RCI/Confirmar la seguridad y tolerabilidad/Describir determinados parámetros FC y relaciones con respuesta
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Histologically or cytologically confirmed locally advanced or metastatic NSCLC (all patients). For module A only, histologically or cytologically confirmed solid tumor with the exception of esophageal, gastric, pancreatic, hepatobiliary, or small bowel carcinomas, or history of gastric resection.
    2. Documented EGFR exon 20 insertion (ex20ins) mutation demonstrated by a validated test (per protocol) and performed in a Clinical Laboratory Improvement Amendments (CLIA)-certified or equivalent laboratory (all patients other than Module A Food Effect PK Assessment Module).
    3. Prior treatment in the recurrent/metastatic disease setting including:
    a. A platinum-based chemotherapy regiment (or other chemotherapy regimen if platinum-based chemotherapy is contra-indicated)
    b. Any other approved standard therapy that is available to the patient, unless this therapy is contraindicated, intolerable to the patient, or is declined by the patient. In the case of a patient declining such therapy, documentation that the patient has been informed and declined should be documented in the medical record.
    c. No prior therapy is required for patients enrolled on Module A.
    d. Prior therapy with an agent approved by the local regulatory authorities for the treatment of EGFR ex20ins mutant NSCLC (Module C only).
    4. Measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 (except for patients enrolled on Module A).
    5. Age ≥ 18 years.
    6. Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
    7. Ability to take pills by mouth.
    8. Have the following laboratory values:
    a. Serum creatinine < 1.5 × upper limit of normal (ULN) or if higher than normal range, calculated creatinine clearance (CrCl) must be ≥ 50 mL/min/1.73 m2 (by Cockroft-Gault formula); actual body weight must be used for CrCl unless body mass index (BMI) >30 kg/m2 then lean body weight must be used.
    b. Total bilirubin ≤ 1.5 × ULN unless prior history of Gilbert’s syndrome.
    c. AST and ALT ≤ 2.5 × ULN, or ≤ 5 × ULN if due to liver involvement by tumor.
    d. Hemoglobin ≥ 9.0 g/dL in the absence of transfusion ≤ 14 days prior to the first dose of study drug on C1D1.
    e. Platelets ≥ 100 × 10E9 cells/L in the absence of transfusion <14 days prior to the first dose of study drug on Cycle 1 Day 1 (C1D1).
    f. Absolute neutrophil count ≥ 1.5 ×10E9 cells/L.
    9. For Module A patients only: patients must have a negative coronavirus disease 2019 (COVID-19) polymerase chain reaction test prior to enrolment.
    10. For Module B and Module C patients only: verification of suitable archived tumor tissue available at the participating center for biomarker analysis. A fresh biopsy is required if an archived sample is not available.
    11. Ability to understand and the willingness to sign a written informed consent document.
    1. CPNM localmente avanzado o metastásico confirmado mediante histología o citología (todos los pacientes). Solo para el módulo A, tumores sólidos confirmados mediante histología o citología a excepción de carcinomas esofágicos, gástricos, pancreáticos, hepatobiliares o del intestino delgado, o bien antecedentes de resección gástrica.
    2. Mutación por ex20ins del EGFR demostrada mediante una prueba validada (ver protocolo) y realizada en un laboratorio certificado conforme a las Enmiendas de mejora de laboratorios clínicos (CLIA) o equivalente (todos los pacientes a excepción del módulo A de valoración del efecto de la comida en la FC).
    3. Tratamiento previo de enfermedad recurrente/metastásica, de los siguientes tipos:
    a. Quimioterapia con un derivado del platino (u otra quimioterapia si la quimioterapia con un derivado del platino está contraindicada).
    b. Cualquier otro tratamiento habitual aprobado que el paciente tenga a su disposición, a menos que esté contraindicado o el paciente no lo tolere o lo rechace. En caso de rechazo del tratamiento por parte del paciente, debe incluirse en la historia clínica documentación de que el paciente ha sido informado y ha rechazado el tratamiento.
    c. No se requiere ningún tratamiento previo en el caso de los pacientes inscritos en el módulo A.
    d. Tratamiento previo con un fármaco aprobado por las autoridades sanitarias locales para el tratamiento del CPNM con mutaciones por ex20ins del EGFR (solo para el módulo C).
    4. Enfermedad cuantificable conforme a los RECIST 1.1 (excepto en el caso de los pacientes inscritos en el módulo A).
    5. ≥18 años de edad.
    6. Estado funcional de 0 o 1 conforme al Grupo Oncológico Cooperativo de la Costa Este (ECOG).
    7. Capacidad para tomar pastillas por vía oral.
    8. Presentar los siguientes valores analíticos:
    a. Creatinina en suero <1,5 × el límite superior de la normalidad (LSN) o, si supera el intervalo de la normalidad, el aclaramiento calculado de la creatinina (ACr) debe ser ≥50 ml/min/1,73 m2 (conforme a la fórmula de Cockroft-Gault); debe usarse el peso corporal real para el ACr a menos que el índice de masa corporal (IMC) >30 kg/m2, en cuyo caso se debe usar el peso magro corporal.
    b. Bilirrubina total ≤1,5 × LSN a menos que existan antecedentes de síndrome de Gilbert.
    c. Aspartato transaminasa (AST) y alanina transaminasa (ALT) ≤2,5 × LSN o ≤5 × LSN si se debe a la afectación del hígado por un tumor.
    d. Hemoglobina ≥9,0 g/dl sin transfusión ≤14 días antes de la primera dosis del fármaco del estudio el día 1 del ciclo 1 (D1C1).
    e. Plaquetas ≥100 × 10^9 celdas/l sin transfusión ≤14 días antes de la primera dosis del fármaco del estudio el día 1 del ciclo 1 (D1C1).
    f. Cifra absoluta de neutrófilos ≥1,5 ×10^9 celdas/l.
    9. Solo para los pacientes del módulo A: los pacientes deben dar negativo en una prueba de reacción en cadena de la polimerasa para la enfermedad coronavírica de 2019 (COVID-19) antes de la inscripción.
    10. Solo para los pacientes de los módulos B y C: confirmación de que el centro participante dispone de tejido tumoral de archivo adecuado para el análisis de biomarcadores. Si no es así, se requerirá una biopsia en fresco.
    11. Capacidad de comprensión y voluntad de firmar un documento de consentimiento informado escrito y cumplir los procedimientos del estudio.
    E.4Principal exclusion criteria
    R6, Phase 1 Expansion, Phase 2a, Module A and Module B Patients Only
    1. Prior treatment with an EGFR ex20ins-targeting drug (see protocol for examples). Note: enrolment of patients treated previously with EGFR ex20ins-targeting drugs allowed selectively during accelerated titration dose escalation and Module C only.

    Module A Patients Only
    2. Conditions that compromise esophageal or gastrointestinal (GI) function.
    3. Recurrent diarrhea, nausea, or vomiting.
    4. Unable to refrain from or anticipates use of any drug, including prescription and non-prescription medications (see protocol for further details) for the periods defined in the protocol.
    5. Any allergies to the composition of the high fat meal.
    6. Patients who use tobacco products.

    All Patients
    7. History of COVID-19-related pneumonitis requiring hospitalization.
    8. History of COVID-19 infection within 4 weeks prior to enrolment, or clinically significant pulmonary symptoms related to prior COVID-19 pneumonitis.
    9. Treatment with any of the following:
    a. An EGFR TKIs ≤ 8 days or 5 x the terminal phase elimination half-lives, whichever is longer, prior to first dose of study drug on C1D1
    b. Systemic anticancer treatment (excluding EGFR-TKIs as described above) within 14 days prior to the first dose of study drug on C1D1.
    c. Immunotherapy ≤ 28 days prior to the first dose of study drug on C1D1.
    d. Radiotherapy ≤ 28 days and palliative radiation ≤ 14 days prior to the first dose of study drug on C1D1. If irradiated, lesions must have demonstrated clear-cut progression prior to being eligible for evaluation as target lesions.
    e. Major surgery (excluding placement of vascular access) ≤ 28 days of the first dose of study drug on C1D1.
    10. Have any unresolved toxicity of Grade ≥ 2 from previous anti-cancer treatment, except for alopecia and skin pigmentation. Patients with chronic but stable Grade 2 toxicities may be allowed to enrol after agreement between the Investigator and Sponsor.
    11. Have known or suspected brain metastases or spinal cord compression, unless the condition has been asymptomatic, treated with surgery and/or radiation, and has been stable without requiring escalating corticosteroids or anti-convulsant medications for at least four weeks prior to the first dose of study drug on C1D1.
    12. Prior therapy with CLN-081.
    13. Known hypersensitivity to CLN-081 or any drugs similar in structure or class.
    14. Past medical history of interstitial lung disease, drug-induced interstitial lung disease, treatment-related pneumonitis, or any evidence of clinically active interstitial lung disease.
    15. Cardiac conditions as follows: Patient has a history of CHF Class III/IV according to the NYHA Functional Classification or serious cardiac arrhythmias requiring treatment.
    16. Resting QTc > 470 msec.
    17. Patient is unable to take drugs orally due to disorders or diseases that may affect GI function, including but not limited to inflammatory bowel diseases (e.g., Crohn's disease, ulcerative colitis) or malabsorption syndrome, or procedures that may affect gastrointestinal function, such as gastrectomy, enterectomy, or colectomy.
    18. Have any condition or illness that, in the opinion of the Investigator, might compromise patient safety or interfere with the evaluation of the safety of the drug.
    19. Pregnant or lactating women; WOCBP must have a negative serum pregnancy test at within seven days prior to receiving study drug on C1D1. WOCBP and males with partners of child-bearing potential must agree to use adequate birth control throughout their participation and for six months following the last dose of study treatment.
    20. History of another primary malignancy within 2 years prior to starting study drug on C1D1, except for adequately treated basal or squamous cell carcinoma of the skin or cancer of the cervix in situ.
    21. Uncontrolled intercurrent illness including, but not limited to, uncompensated respiratory, cardiac, hepatic, or renal disease, active infection (including HIV and active clinical tuberculosis), or renal transplant; ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, active peptic ulcer disease or gastritis, or psychiatric illness/social situations that would limit compliance with study requirements.
    22. For patients with a history of hepatitis B, active infection as defined by a positive HBsAg test and detectable HBV DNA. Patients ineligible due to detectable levels of HBV DNA at baseline may be rescreened for enrolment if their HBV DNA levels become undetectable after treatment with antiviral agents, and upon agreement between the Investigator and Sponsor.
    23. For patients with a history of hepatitis C, active infection as defined by a reactive HCV antibody test and detectable HCV RNA.
    24. Active bleeding disorders.
    25. The patient is, in the Investigator’s opinion, unable or unwilling to comply with the trial procedure
    Solo pacientes de R6, ampliación de fase I, fase IIa, módulo A y módulo B
    1.Tratamiento previo con un fármaco para ex20ins del EGFR (consultar ejemplos en el protocolo). Nota: Se permitirá la inscripción selectiva de pacientes tratados previamente con fármacos para ex20ins del EGFR únicamente durante el ajuste acelerado de dosis, el aumento de dosis y el módulo C.
    Solo pacientes del módulo A
    2.Enfermedades que afecten al funcionamiento esofágico o GI.
    3.Diarrea, náuseas o vómitos recurrentes.
    4.Incapacidad de abstenerse de consumir o prevenir el consumo de cualquier fármaco, ya sea con o sin receta (consultar protocolo para más detalles) para los períodos definidos en el protocolo.
    5.Cualquier alergia a la composición de la comida con alto contenido en grasa.
    6.Consumo de tabaco.
    Todos los pacientes
    7.Antecedentes de neumonitis relacionada con la COVID-19 que requirió hospitalización.
    8.Antecedentes de infección por COVID-19 en el plazo de 4 semanas antes de la inscripción; síntomas pulmonares clínicamente significativos relacionados con una neumonitis previa por COVID-19.
    9.Cualquiera de los siguientes tratamientos:
    a.TKI del EGFR ≤8 días o 5 x semividas de eliminación de fase terminal, lo que dure más tiempo, antes de la primera dosis del fármaco del estudio el D1C1.
    b.Tratamiento sistémico contra el cáncer (a excepción de los TKI del EGFR descritos anteriormente) ≤14 días antes de la primera dosis del fármaco del estudio el D1C1.
    c.Inmunoterapia ≤28 días antes de la primera dosis del fármaco del estudio el D1C1.
    d.Radioterapia ≤28 días y radiación paliativa ≤14 días antes de la primera dosis del fármaco del estudio el D1C1. En el caso de haber recibido radiación, debe haberse demostrado la clara progresión de las lesiones antes de considerarlas aptas para la evaluación como lesiones indicadoras.
    e.Cirugía mayor (a excepción de la implantación de accesos vasculares) ≤28 días antes de la primera dosis del fármaco del estudio el D1C1.
    10.Presentar cualquier acontecimiento adverso de grado ≥2 sin resolver de un tratamiento previo para el cáncer, excepto la alopecia y la pigmentación cutánea. Se podrá permitir inscribir a los pacientes con acontecimientos adversos de grado 2 crónicos pero estables si el investigador y el promotor así lo acuerdan.
    11.Padecer metástasis cerebral o compresión de la médula espinal confirmadas o presuntas, a menos que el paciente haya sido asintomático, se haya tratado con cirugía o radiación y haya estado estable sin necesidad de aumentar los corticoesteroides o la medicación anticonvulsiva durante al menos cuatro semanas antes de la primera dosis del fármaco del estudio el D1C1.
    12.Tratamiento previo con CLN-081.
    13. Hipersensibilidad conocida a CLN-081 o cualquier fármaco de estructura o clase similares.
    14.Antecedentes médicos de enfermedad pulmonar intersticial, neumonitis relacionada con el tratamiento o cualquier evidencia de enfermedad pulmonar intersticial clínicamente activa.
    15.Patologías cardíacas, tales como: El paciente tiene antecedentes de insuficiencia cardíaca congestiva (ICC) de clase III/IV de conformidad con la clasificación funcional de la NYHA o arritmias cardíacas graves que requieren tratamiento.
    16.Intervalo QT corregido (QTc) en reposo >470 ms.
    17.El paciente no puede tomar fármacos por vía oral debido a trastornos o enfermedades que pueden afectar al funcionamiento GI, entre otros, enfermedades intestinales inflamatorias (como enfermedad de Crohn o colitis ulcerosa) o síndrome de absorción insuficiente, o bien procedimientos que pueden afectar al funcionamiento gastrointestinal, como gastrectomía, enterectomía o colectomía.
    18.Presentar cualquier patología o enfermedad que, en opinión del investigador, pueda poner en riesgo la seguridad del paciente o interferir con la evaluación de la seguridad del fármaco.
    19.Mujeres embarazadas o lactantes; las mujeres con capacidad para concebir deben dar negativo en una prueba de embarazo en suero ≤7 días antes de recibir el fármaco del estudio el D1C1. Las mujeres con capacidad para concebir y los hombres cuyas parejas puedan concebir deben acceder a usar un método anticonceptivo adecuado durante su participación y en los seis meses siguientes a la última dosis del tratamiento del estudio.
    20.Antecedentes de otro tumor maligno primario ≤2 años antes de empezar con el fármaco del estudio el D1C1, a excepción de un carcinoma basocelular o epidermoide de piel o un cáncer de cuello de útero localizado con el tratamiento adecuado.
    21.Enfermedad simultánea sin controlar, entre otras, enfermedad descompensada de carácter respiratorio, cardíaco, hepático o renal; infección activa (incluido el virus de la inmunodeficiencia humana [VIH] y la tuberculosis clínica activa); trasplante renal; infección en curso o activa; insuficiencia cardíaca congestiva sintomática; angina de pecho inestable; arritmia cardíaca; enfermedad ulcerosa péptica activa o gastritis;
    E.5 End points
    E.5.1Primary end point(s)
    Phase 1
    • The rate and severity of treatment emergent AEs (TEAEs), DLTs, SAEs, incidence of safety laboratory assessment abnormalities
    • Incidence of abnormalities in vital signs or other clinical safety assessments

    Phase 2a
    • ORR by independent central review and investigator assessment by RECIST v1.1
    • The rate and severity of TEAEs, DLTs, SAEs

    Module A
    • CLN-081 PK

    Module B, Part 1
    • The rate and severity of TEAEs, DLTs, SAEs, incidence of safety laboratory assessment abnormalities
    • Incidence of abnormalities in vital signs or other clinical safety assessments
    • CLN-081 PK

    Module B, Part 2 and Module C
    • ORR by independent central review assessment by RECIST v1.1
    • DOR by independent central review
    Fase I
    • Tasa y gravedad de los AA surgidos durante el tratamiento (AAST), TLD y AAG, e incidencia de las anomalías analíticas relativas a la seguridad
    • Incidencia de las anomalías en las constantes vitales u otras valoraciones clínicas de seguridad

    Fase IIa
    • TRO mediante revisión central independiente y valoración del investigador conforme a los RECIST v1.1
    • Tasa y gravedad de los AAST, TLD y AAG

    Módulo A
    • FC de CLN-081

    Módulo B, parte 1
    • Tasa y gravedad de los AAST, TLD y AAG, e incidencia de las anomalías analíticas relativas a la seguridad
    • Incidencia de las anomalías en las constantes vitales u otras valoraciones clínicas de seguridad
    • FC de CLN-081

    Módulo B, parte 2 y módulo C
    • TRO mediante revisión central independiente conforme a los RECIST v1.1
    • DR mediante revisión central independiente
    E.5.1.1Timepoint(s) of evaluation of this end point
    Throughout the study (refer to the protocol for further information)
    Durante el transcurso del estudio (consulte el protocolo para obtener más información)
    E.5.2Secondary end point(s)
    Phase 1
    • Tumor response characteristics including DOR, DCR, PFS, and time to tumor response based on investigator assessment and OS
    • CLN-081 PK

    Phase 2a
    • Tumor response characteristics including DOR, DCR, PFS, and time to tumor response based on investigator assessment and OS
    • CLN-081 PK
    • Incidence of safety laboratory assessment abnormalities
    • Incidence of abnormalities in vital signs or other clinical safety assessments

    Module A
    • The rate and severity of TEAEs, DLTs, SAEs, incidence of safety laboratory assessment abnormalities
    • Incidence of abnormalities in vital signs or other clinical safety assessments

    Module B, Part 1
    • ORR based on independent central review assessment by RECIST v1.1
    • Tumor response characteristics including DOR, DCR, PFS, and time to tumor response based on investigator assessment and OS
    • Concordance between local and central determination of EGFR ex20ins mutational status via CDx assay

    Module B, Part 2 and Module C
    • ORR based on Investigator assessment by RECIST v1.1
    • DOR based on Investigator assessment
    • DCR, median PFS and OS, landmark PFS and OS rates at 6, 12 and 24 months based on independent central review
    • The rate and severity of TEAEs, DLTs, SAEs, incidence of safety laboratory assessment abnormalities
    • Incidence of abnormalities in vital signs or other clinical safety assessments
    • CLN-081 PK
    • Concordance between local and central determination of EGFR ex20ins mutational status via CDx assay
    Fase I
    • Características de la respuesta tumoral, incluida la DR, TCE y SSP, así como el tiempo hasta la respuesta tumoral según la valoración del investigador y la SG
    • FC de CLN-081

    Fase IIa
    • Características de la respuesta tumoral, incluida la DR, TCE y SSP, así como el tiempo hasta la respuesta tumoral según la valoración del investigador y la SG
    • FC de CLN-081
    • Incidencia de las anomalías analíticas relativas a la seguridad
    • Incidencia de las anomalías en las constantes vitales u otras valoraciones clínicas de seguridad

    Módulo A
    • Tasa y gravedad de los AAST, TLD y AAG, e incidencia de las anomalías analíticas relativas a la seguridad
    • Incidencia de las anomalías en las constantes vitales u otras valoraciones clínicas de seguridad

    Módulo B, parte 1
    • TRO mediante revisión central independiente conforme a los RECIST v1.1
    • Características de la respuesta tumoral, incluida la DR, TCE y SSP, así como el tiempo hasta la respuesta tumoral según la valoración del investigador y la SG
    • Concordancia entre las valoraciones local y central acerca de la presencia de mutaciones por ex20ins del EGFR mediante prueba diagnóstica acompañante

    Módulo B, parte 2 y módulo C
    • TRO según valoración del investigador conforme a los RECIST v1.1
    • DR según valoración del investigador
    • TCE, mediana de la SSP y SG, y tasas de SSP y SG de referencia a los 6, 12 y 24 meses mediante revisión central independiente
    • Tasa y gravedad de los AAST, TLD y AAG, e incidencia de las anomalías analíticas relativas a la seguridad
    • Incidencia de las anomalías en las constantes vitales u otras valoraciones clínicas de seguridad
    • FC de CLN-081
    • Concordancia entre las valoraciones local y central acerca de la presencia de mutaciones por ex20ins del EGFR mediante prueba diagnóstica acompañante
    E.5.2.1Timepoint(s) of evaluation of this end point
    Throughout the study (refer to the protocol for further information)
    Durante el transcurso del estudio (consulte el protocolo para obtener más información)
    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) Yes
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other Yes
    E.7.1.3.1Other trial type description
    Phase 1/2 study (Phase I enrolment complete)
    Estudio en fase I/II (ha finalizado la inscripción en la fase I)
    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 Information not present in EudraCT
    E.8.1.2Open Information not present in EudraCT
    E.8.1.3Single blind Information not present in EudraCT
    E.8.1.4Double blind Information not present in EudraCT
    E.8.1.5Parallel group Information not present in EudraCT
    E.8.1.6Cross over Information not present in EudraCT
    E.8.1.7Other Information not present in EudraCT
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Information not present in EudraCT
    E.8.2.2Placebo Information not present in EudraCT
    E.8.2.3Other Information not present in EudraCT
    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 concerned8
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA13
    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
    Hong Kong
    Korea, Republic of
    Singapore
    Taiwan
    United States
    Netherlands
    Spain
    Italy
    United Kingdom
    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 (last visit of the last subject)
    Última visita del ultimo paciente
    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 months8
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years5
    E.8.9.2In all countries concerned by the trial months8
    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: 153
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 152
    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 state29
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 69
    F.4.2.2In the whole clinical trial 305
    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)
    Any patients still receiving investigational product at the time of study termination by the Sponsor will be able to continue to receive CLN-081 if they are deriving clinical benefit and after agreement between the Investigator and sponsor.
    Todos los pacientes que sigan recibiendo el producto en investigación cuando el promotor finalice el estudio podrán seguir tratándose con CLN-081 si obtienen beneficio clínico y así lo acuerdan el investigador y el promotor.
    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 Decision2023-08-21
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2023-08-21
    P. End of Trial
    P.End of Trial StatusOngoing
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