E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with advanced, histological and molecularly (presence of the HEY1-NCOA2 fusion) centrally confirmed diagnosis of MCS, with an evidence of RECIST progression within the 6 months prior to starting the study treatment and pre-treated with anthracycline-based chemotherapy |
Pazienti giovani adulti o adulti affetti da condrosarcoma mesenchimale HEY1-NCOA2 riarrangiato a partenza scheletrica o extra-scheletrica avanzato e in progressione |
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E.1.1.1 | Medical condition in easily understood language |
Advanced Mesenchimal Condrosarcoma |
Condrosarcoma mesenchimale in fase avanzata |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10041298 |
E.1.2 | Term | Soft tissue sarcomas histology unspecified |
E.1.2 | System Organ Class | 100000004864 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this study is to explore the activity of trabectedin from 2nd to 4th line, in patients aged ¿ 16 years with advanced HEY1-NOCA2 positive MCS pre-treated with anthracycline-based chemotherapy. Therefore, with reference to a study population of patients with progressive by RECIST v1.1, locally advanced or metastatic, HEY1-NCOA2 positive MCS pre- treated with one, two or three lines of medical treatment, the primary end-point of the study will be to assess: |
Tasso di risposta tumorale (Overall Tumour Response Rate) secondo RECIST v1.1 |
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E.2.2 | Secondary objectives of the trial |
1. Choi Response Rate 2. Overall Survival (OS) 3. Progression Free Survival (PFS) 4. Clinical Benefit Rate 5. Duration of response 6. Safety
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- Tasso di risposta tumorale secondo i criteri Choi - Sopravvivenza globale (OS) - Sopravvivenza libera da progressione (PFS) - Tasso di beneficio clinico (Clinical Benefit Rate) - Durata della risposta - Sicurezza del trattamento
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Pharmacogenetics Version: 1.0 Date: 16/09/2019 Title: Translational Optional study Objectives: To gain insights on MCS biology and to investigate molecular basis underlining MCS response to trabectedin, pre-treatment samples (FFPE and/or frozen samples with tumor cellularity greater than 70%) will be molecularly profiled. Moreover, in vitro models will be generated to identify HEY1-NCOA2-specific transcriptional targets involved in the response to trabectedin.
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Farmacogenetica Versione: 1.0 Data: 16/09/2019 Titolo: Studio translazionale opzionale Obiettivi: I campioni tumorali raccolti pre-trattamento, necessari per la revisione centralizzata della diagnosi, verranno profilati anche dal punto di vista molecolare per identificare eventuali prodotti trascrizionali del riarrangiamento HEY1-NCAO2 coinvolti nella risposta a trabectedina.
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E.3 | Principal inclusion criteria |
1. Age = 16 years old 2. Histological centrally confirmed diagnosis of skeletal or extra-skeletal MCS with the documented presence of HEY1-NCOA2 fusion (a paraffin embedded tumour block is required for centralized review) 3. Locally advanced disease (i.e. surgical resection of local disease unfeasible radically or unaccepted by the patient or amenable to become less demolitive or feasible or easier after cytoreduction) and/or metastatic disease 4. Measurable or evaluable disease with RECIST v1.1 5. Evidence of progression by RECIST v1.1 during the 6 months before study entry 6. Patients must be pre-treated with at least one prior chemotherapy treatment containing anthracyclines for the advanced phase of disease and with a maximum of 3 lines 7. Eastern Cooperative Oncology Group (ECOG) Performance Status = 2 8. Adequate bone marrow function 9. Adequate organ function 10. Female patients of childbearing potential must have negative pregnancy test within 7 days before initiation each cycle of chemotherapy. Post-menopausal women must be amenorrhoeic for at least 12 months to be considered of non-childbearing potential. Male and female patients of reproductive potential must agree to employ an effective method of birth control throughout the study 11. Cardiac ejection fraction >=50% as measured by echocardiogram 12. No history of arterial and/or venous thromboembolic event within the previous 12 months 13. The patient or legal representative must be able to read and understand the informed consent form and must have been willing to give written informed consent and any locally required authorisation before any study-specific procedures, including screening evaluations, sampling, and analyses. 14. Any other factors, that, at judgment of investigator, could affect the safety of the patients according to the available trabectedin safety data |
1) Età >= 16 anni 2) Diagnosi istologica e molecolare centralmente confermata di condrosarcoma mesenchimale HEY1-NCAO2 riarrangiato. Per l’arruolamento nello studio è necessario avere a disposizione l’inclusione in paraffina di materiale tumorale derivato da eventuale biopsia pre-trattamento (se effettuata per pratica clinica) o del materiale tumorale di archivio più recente disponibile 3) Malattia localmente avanzata e/o metastatica 4) Malattia misurabile secondo RECIST v1.1 5) Evidenza di progressione secondo RECIST v1.1 nei 6 mesi precedenti l’ingresso in studio 6) I pazienti devono essere stati pre-trattati con almeno un trattamento antitumorale contenente antraciclina per la malattia avanzata fino ad un massimo di 3 linee precedenti 7) ECOG PS <= 2 8) Adeguata funzionalità midollare 9) Adeguata funzionalità d’organo 10) Le pazienti di sesso femminile in età fertile devono avere un test di gravidanza negativo entro 7 giorni prima dell’inizio di ogni ciclo di chemioterapia. Le donne in post-menopausa devono essere amenorroiche da almeno 12 mesi per essere considerate potenzialmente non fertili. I pazienti maschi e femmine potenzialmente fertili devono accettare di utilizzare un metodo efficace di controllo delle nascite durante lo studio. 11) Frazione di eiezione cardiaca = 50% misurata mediante ecocardiogramma 12) Anamnesi negativa per eventi trombo-embolici arteriosi e/o venosi negli ultimi 12 mesi 13) Il paziente (o il suo rappresentante legale) deve essere in grado di leggere e comprendere il modulo di consenso informato e deve fornire il proprio consenso informato scritto prima di avviare qualsiasi procedura specifica per lo studio |
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E.4 | Principal exclusion criteria |
1. Other primary malignancy with <5 years clinically assessed disease free interval, except basal cell skin cancer, cervical carcinoma in situ or other neoplasm judged to entail a low risk of relapse 2. Previous treatment with radiation therapy within 14 days of first day of study drug dosing, or patients who have not recovered from adverse events due to agents previously administered 3. Previous radiotherapy to 25% of the bone marrow 4. Major surgery within 2 weeks prior to study entry 5. Participation in another clinical study with an investigational product, which last dose was taken less than 4 weeks prior to the start of the treatment. 6. Persistent toxicities (= NCI CTCAE v5.0 grade 2) with the exception of alopecia, caused by previous anticancer therapies. 7. Pregnancy or breast feeding 8. Grade III/IV cardiac problems as defined by the New York Heart Association Criteria (i.e. congestive heart failure, myocardial infarction within 6 months of study) 9. Medical history of arterial thrombotic or embolic events such as cerebrovascular accident (including transient ischemic attacks), or pulmonary embolism within 6 months prior to the initiation of study treatment 10. Known brain metastasis 11. Known chronic liver disease (i.e. chronic active hepatitis and cirrhosis) 12. Known diagnosis of human deficiency virus (HIV) infection 13. Active or chronic hepatitis B or C requiring treatment with antiviral therapy 14. Medical history of hemorrhage or a bleeding event = Grade 3 (NCI-CTCAE v 5.0) within 4 weeks prior to the initiation of study treatment 15. Evidence of any other serious or unstable illness, or medical, psychological, or social condition, that could jeopardize the safety of the subject and/or his/her compliance with study procedures, or may interfere with the subject’s participation in the study or evaluation of the study results 16. Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation of the study drugs 17. Expected non-compliance to medical regimens |
1) Pazienti mai trattati con chemioterapia contenente antracicline, a meno di controindicazioni maggiori 2) Più di 3 precedenti linee di trattamento antitumorale per la malattia avanzata 3) Anamnesi positiva per altre neoplasie maligne (eccetto carcinoma basocellulare della cute o carcinoma cervicale in situ, adeguatamente trattati), salvo che non siano in remissione da almeno 5 anni e giudicate a potenziale trascurabile di ricaduta 4) Trattamento radioterapico nei 14 giorni precedenti al primo giorno di assunzione di trabectedina; trattamento con qualsiasi agente antitumorale sperimentale nelle 4 settimane precedenti il primo giorno di assunzione di trabectedina. Sono inoltre esclusi i pazienti per i quali la tossicità dei precedenti trattamenti non sia risolta (NCI CTCAE v5.0 grado 2), eccetto l’alopecia 5) Precedente radioterapia che ha coinvolto il midollo osseo per il 25% o oltre 6) Chirurgia maggiore nelle 2 settimane precedenti l’ingresso in studio 7) Donne in gravidanza o in allattamento 8) Malattia cardiovascolare in atto con NYHA grado III/IV. Storia di insufficienza cardiaca o infarto miocardico meno di 6 mesi dall’inizio del trattamento. Sono esclusi pazienti con angina instabile e con aritmia severa a rischio di morte imminente 9) Anamnesi positiva per eventi trombo-embolici arteriosi come infarto cerebro-vascolare (compreso l’attacco ischemico transitorio – TIA) o embolia polmonare nei 6 mesi precedenti l’inizio del trattamento in studio 10) Pazienti con metastasi al sistema nervoso centrale note 11) Pazienti con malattie croniche del fegato (epatite cronica in fase attiva e/o cirrosi epatica) 12) Diagnosi nota di infezione da virus dell’immunodeficienza umana (HIV) 13) Diagnosi di epatite cronica o in fase attiva B o C che richiede una terapia antivirale 14) Anamnesi positiva per emorragia o sanguinamenti di grado ¿ 3 (secondo NCI CTCAE v5.0) nelle 4 settimane antecedenti l’inizio del trattamento in studio 15) Ipersensibilità nota al farmaco in studio o alla classe di appartenenza o ad eccipienti presenti nella formulazione del farmaco in studio 16) Ogni situazione che possa pregiudicare la compliance al trattamento 17) Evidenza di ogni malattia o condizione medica, psicologica o sociale grave o instabile che possa compromettere la sicurezza del paziente e/o la sua compliance alla partecipazione allo studio o alla valutazione dei risultati |
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E.5 End points |
E.5.1 | Primary end point(s) |
Response rate according Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 |
Tasso di risposta secondo RECIS versione 1.1 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Every 6 weeks up to week 18, then every 12 weeks |
Ogni 6 settimane fino a 18 settimane poi ogni 12 settimane |
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E.5.2 | Secondary end point(s) |
Overall Survival; Progression Free Survival; Duration of response; Adverse events related to the treatment; Choi criteria response rate |
Sopravvivenza Globale; Progressione libera da sopravvivenza; Durata della risposta; Tossicità del trattamento; Tasso di risposta secondo Choi criteria |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Overall Survival: At 3 and 5 years; Progression Free Survival (PFS) At 3 and 5 years; Duration of response At weeks 6, 12,18, 30, 42; Adverse events related to the treatment : at each cycle; Choi criteria response rate At weeks 6, 12,18, 30, 42 |
Sopravvivenza Globale a 3 e 5 anni; Progressione libera da sopravvivenza a 3 e 5 anni; Durata della risposta a settimane 6, 12,18, 30, 42; Tossicità del trattamento: ad ogni ciclo; Tasso di risposta secondo Choi criteria, a settimane 6, 12,18, 30, 42 |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial 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
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 6 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 6 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |