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    Summary
    EudraCT Number:2019-004315-31
    Sponsor's Protocol Code Number:CaEP-B
    National Competent Authority:Denmark - DHMA
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2019-11-08
    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 ConcernedDenmark - DHMA
    A.2EudraCT number2019-004315-31
    A.3Full title of the trial
    PHASE II INVESTIGATION OF THE HISTOPATHOLOGIC EFFECT OF CALCIUM ELECTROPORATION ON CANCER IN THE SKIN
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    PHASE II INVESTIGATION OF THE HISTOPATHOLOGIC EFFECT OF CALCIUM ELECTROPORATION ON CANCER IN THE SKIN
    A.4.1Sponsor's protocol code numberCaEP-B
    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 SponsorJulie Gehl
    B.1.3.4CountryDenmark
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportRegion Zealand
    B.4.2CountryDenmark
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationZealand University Hospital
    B.5.2Functional name of contact pointMille Vissing
    B.5.3 Address:
    B.5.3.1Street AddressSygehusvej 10
    B.5.3.2Town/ cityRoskilde
    B.5.3.3Post code4000
    B.5.3.4CountryDenmark
    B.5.6E-mailemlh@regionsjaelland.dk
    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 Yes
    D.2.1.1.1Trade name Calcium chloride SAD
    D.2.1.1.2Name of the Marketing Authorisation holderAmgros I/S
    D.2.1.2Country which granted the Marketing AuthorisationDenmark
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntratumoral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNcalcium chloride dihydrate in sterile water
    D.3.9.3Other descriptive nameCALCIUM CHLORIDE
    D.3.9.4EV Substance CodeSUB11767MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    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
    Cutaneous metastases from solid cancer of any histology
    E.1.1.1Medical condition in easily understood language
    Cutaneous metastases from solid cancer of any histology
    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 10026693
    E.1.2Term Malignant skin neoplasm NOS
    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 endpoint of this study is to evaluate differences in TIL population in tissue samples from treated cancer tumours two days after calcium electroporation treatment compared to before treatment (biopsy taken on the day of treatment before the calcium electroporation procedure). TIL content in biopsies will be evaluated by pathological examination and expressed as percent of cells.
    E.2.2Secondary objectives of the trial
    Secondary endpoints include: Secondary endpoints are:
    • To investigate the adaptive tumour immune response by different methods including, protein expression levels of immune markers, tumour inflammation signature (TIS) score and molecular subtype classification.
    • To clinically evaluate treatment response 1, 2 and 3 months after treatment measuring changes in size of the treated lesions.
    • To describe any relation between change in TIL population and tumour type.
    • To assess regressive changes including necrosis.
    • To establish number of treated tumours with complete response depending on tumour type.
    • To detect signs of systemic immunologic response from any routine scans before and after treatment in the inclusion period.
    • To investigate differences in effect depending whether the treated tumour was in a previously irradiated area.
    • To evaluate effect on adjacent non-tumour tissue.
    • To assess PD-L1 expression over time by biopsy.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Inclusion criteria:
    • Trial subject ≥ 18 years.
    • Trial subject must be able to understand the participant information.
    • Histologically verified cutaneous or subcutaneous, primary or secondary cancer of any histology.
    • The patient can undergo any simultaneous medical treatment (endocrine therapy, chemotherapy, immunotherapy etc.).
    • The patient can undergo radiation therapy during the study period, provided that the treatment field does not involve the treated area.
    • Performance status ECOG/WHO ≤2
    • At least one cutaneous or subcutaneous tumour measuring at least 5 mm.
    • Both men and women who are sexually active must use safe contraception (contraceptive coil, deposit injection of gestagen, subdermal implantation, hormonal vaginal ring or transdermal patch.)
    • Signed informed consent.
    E.4Principal exclusion criteria
    Exclusion criteria

    • Pregnancy or lactation
    • Allergy to local anaesthesia
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoint of this study is change in TIL population before versus two days after calcium electroporation. TIL content will be measured in % (range 0-100%). One-way ANOVA will be used for analysis to assess differences in TIL content before and 2 days after treatment in all metastases and in subgroups based on cancer type.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Two days compared to before treatment (day 0) biopsy
    E.5.2Secondary end point(s)
    Secondary endpoints are:
    • To investigate the adaptive tumour immune response by different methods including, protein expression levels of immune markers, tumour inflammation signature (TIS) score and molecular subtype classification.
    • To clinically evaluate treatment response 1, 2 and 3 months after treatment measuring changes in size of the treated lesions.
    • To describe any relation between change in TIL population and tumour type.
    • To assess regressive changes including necrosis.
    • To describe presence of residual tumour and its topographical location.
    • To investigate vascular effects of calcium electroporation including changes in capillary structures.
    • To document tumours before and after treatment using digital photography including a ruler.
    • To establish number of treated tumours with complete response after one or two treatments, respectively.
    • To establish number of treated tumours with complete response depending on tumour type.
    • To detect signs of systemic immunologic response from any routine scans before and after treatment in the inclusion period.
    • To investigate differences in effect depending whether the treated tumour was in a previously irradiated area.
    • To evaluate effect on adjacent non-tumour tissue.
    • To assess PD-L1 expression over time by biopsy.
    • To investigate any relation between change in PD-L1 expression and tumour response.
    • To describe PD-L1 expression in relation to cell types found in the tumour environment.
    • To describe PD-L1 expression on different cell types of the different tumour histologies investigated.
    • To examine frozen tissues samples by e.g. western blotting and PCR in order to support any of the above mentioned endpoints.
    • To examine blood samples for immune factors and other relevant markers, and compare levels before and after treatment.
    • To measure current during treatment as indicated by the pulse generator.
    E.5.2.1Timepoint(s) of evaluation of this end point
    The endpoints will be followed up (depending on endpoint) at day 0, 2 and 7 and at follow up at 1, 2, and 3 months after treatment
    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 No
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    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 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) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.3 The trial involves single site in the Member State concerned Yes
    E.8.4 The trial involves multiple sites in the Member State concerned No
    E.8.5The trial involves multiple Member States No
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    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 trial is planned to end on August 1, 2022
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years
    E.8.9.1In the Member State concerned months
    E.8.9.1In the Member State concerned days
    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: 12
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 12
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state24
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    None (normal care)
    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 Decision2019-12-05
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-04-20
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
    P.Date of the global end of the trial2023-07-27
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