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    Summary
    EudraCT Number:2020-000138-16
    Sponsor's Protocol Code Number:D601HC00002
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Temporarily Halted
    Date on which this record was first entered in the EudraCT database:2021-02-17
    Trial results View 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 number2020-000138-16
    A.3Full title of the trial
    A Phase 2b, Open-label, Single-arm, Multi-centre Study Assessing the Efficacy and Safety of Adavosertib as Treatment for Recurrent or Persistent Uterine Serous Carcinoma (ADAGIO)
    Estudio en fase IIb, abierto, de un solo grupo y multicéntrico para evaluar la eficacia y la seguridad de adavosertib como tratamiento del carcinoma seroso uterino recurrente o persistente (ADAGIO)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study of Adavosertib as Treatment for Uterine Serous Carcinoma
    Estudio en fase IIb de adavosertib como tratamiento del carcinoma seroso uterino
    A.3.2Name or abbreviated title of the trial where available
    ADAGIO
    ADAGIO
    A.4.1Sponsor's protocol code numberD601HC00002
    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 SponsorAstraZeneca AB
    B.1.3.4CountrySweden
    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 supportAstraZeneca AB
    B.4.2CountrySweden
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAstraZeneca
    B.5.2Functional name of contact pointInformation Center
    B.5.3 Address:
    B.5.3.1Street AddressNot Applicable
    B.5.3.2Town/ cityNot Applicable
    B.5.3.3Post codeNot Applicable
    B.5.3.4CountryUnited States
    B.5.4Telephone numberNot Applicable
    B.5.5Fax numberNot Applicable
    B.5.6E-mailinformation.center@astrazeneca.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameAdavosertib capsule
    D.3.2Product code AZD1775
    D.3.4Pharmaceutical form Capsule
    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 INNAdavosertib
    D.3.9.1CAS number 1277170-60-1
    D.3.9.2Current sponsor codeAZD1775
    D.3.9.3Other descriptive nameAZD1775 hemihydrate; L001739996-008U; MK-1775
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number75
    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.3.1Product nameAdavosertib capsule
    D.3.2Product code AZD1775
    D.3.4Pharmaceutical form Capsule
    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 INNAdavosertib
    D.3.9.1CAS number 1277170-60-1
    D.3.9.2Current sponsor codeAZD1775
    D.3.9.3Other descriptive nameAZD1775 hemihydrate; L001739996-008U; MK-1775
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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
    Recurrent or persistent Uterine Serous Carcinoma (USC) in patients who have previously received at least 1 prior platinum-based chemotherapy regimen for the treatment of USC
    Carcinoma seroso uterino recurrente o persistente (CSU) en pacientes que han recibido previamente al menos 1 pauta de quimioterapia con platino para el tratamiento del CSU
    E.1.1.1Medical condition in easily understood language
    Cancer of the uterus
    Cáncer de útero
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level SOC
    E.1.2Classification code 10029104
    E.1.2Term Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    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 20.0
    E.1.2Level SOC
    E.1.2Classification code 10038604
    E.1.2Term Reproductive system and breast disorders
    E.1.2System Organ Class 10038604 - Reproductive system and breast disorders
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate the efficacy of adavosertib by the assessment of objective response rate (ORR).
    Evaluar la eficacia de adavosertib mediante la evaluación de la tasa de respuesta objetiva (TRO).
    E.2.2Secondary objectives of the trial
    - To evaluate efficacy of adavosertib by assessment of Duration of Response (DoR)
    - To evaluate efficacy of adavosertib by assessment of depth of response.
    - To evaluate the efficacy of adavosertib by assessment of Progression-Free Survival (PFS).
    - To evaluate the efficacy of adavosertib by assessment of Proportion of patients alive and progression free at 6 months (PFS6)
    - To evaluate the efficacy of adavosertib by assessment of Overall Survival (OS)
    - To evaluate the efficacy of adavosertib by assessment of Disease Control Rate (DCR)
    - To evaluate the pharmacokinetics of Adavosertib
    - To assess the safety and tolerability of adavosertib in participants with USC.
    - Evaluar la eficacia de adavosertib mediante la evaluación de la duración de la respuesta (DR).
    - Evaluar la eficacia de adavosertib mediante la evaluación de la profundidad de la respuesta.
    - Evaluar la eficacia de adavosertib mediante la evaluación de la supervivencia sin progresión (SSP).
    - Evaluar la eficacia de adavosertib mediante la evaluación de la proporción de participantes vivas y sin progresión a los 6 meses (SSP6).
    - Evaluar la eficacia de adavosertib mediante la evaluación de la supervivencia global (SG).
    - Evaluar la eficacia de adavosertib mediante la evaluación de la tasa de control de la enfermedad (TCE).
    - Evaluar la farmacocinética de adavosertib.
    - Evaluar la seguridad y tolerabilidad de adavosertib en participantes con CSU.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Capable of giving signed informed consent and has given signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.
    2. Provision of signed and dated written Optional Genetic Research Information informed consent prior to collection of samples for optional genetic research that supports Genomic Initiative.
    3. Participant must be aged >/= 18 years of age inclusive, at the time of signing the informed consent
    4. Histologically confirmed recurrent or persistent USC. For the purposes of this study, participants with endometrial carcinoma of mixed histology where the serous component comprises at least 10% of the tumour will be considered eligible. Participants with carcinosarcomas are not eligible.
    5. Evidence of measurable disease as per RECIST v1.1 defined as at least one lesion, not previously irradiated, that can be accurately measured in at least one dimension (longest diameter to be recorded) as >/= 10 mm with computed tomography (CT) scan or magnetic resonance imaging (MRI) (except lymph nodes which must have short axis >/= 15 mm) and which is suitable for accurate repeated measurements
    6. At least 1 prior platinum-based chemotherapy regimen for the management of USC (there is no restriction on the number of prior lines of systemic therapy that a participant may have previously received, and the platinum-based chemotherapy may have been given in the adjuvant setting). Chemotherapy administered only in conjunction with primary radiotherapy as a radiosensitiser should not count as a systemic regimen.
    Prior anticancer therapies (immune checkpoint inhibitors, vascular endothelial growth factor (VEGF) inhibitors and HER2 targeted therapy) are allowed.
    Participants who have known MSI-H or dMMR tumours will not be eligible unless they have already received prior therapy with pembrolizumab or another PD-1/PD-L1 immune checkpoint inhibitor, in territories where this treatment is available for this indication, or are deemed not to be a candidate for immune checkpoint therapy.
    7. Eastern Cooperative Oncology Group (ECOG) performance status 0-1
    8. Life expectancy ≥ 12 weeks.
    9. Participants must have normal organ and marrow function at baseline, as defined below by laboratory values within 7 days prior to study drug(s) administration:
    - Absolute neutrophil count (ANC) >/= 1.5 × 10^9 /L
    - Haemoglobin (Hb) >/= 9 g/dL
    - Platelet count >/= 100 × 10^9 /L
    - Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) </= 3 x upper limit of normal (ULN) or </= 5 x ULN if known hepatic metastases
    - Serum bilirubin within normal limits (WNL) or </= 1.5 x ULN in patients with liver metastases; or total bilirubin </=3.0 x ULN with direct bilirubin WNL in patients with documented Gilbert’s Syndrome
    - Serum creatinine </= 1.5 x ULN, or measured creatinine clearance (CrCl) >/= 45 mL/min as estimated using either the Cockcroft-Gault method, a 24-hour urine test or another validated test as per local practice (confirmation of creatinine clearance is only required when creatinine is > 1.5 x institutional ULN)
    10. Consent to submit and provide a mandatory FFPE tumour sample for central testing. The site must confirm that the FFPE sample is available prior to dosing
    11. Female patients who are not of childbearing potential and women of childbearing potential who agree to use adequate contraceptive measures from the time of signing the ICF and until 1 month after study treatment discontinuation, who are not breastfeeding, and who have a negative serum or urine pregnancy test during screening and confirmed on Cycle 1, Day 1 (prior to the start of study treatment)
    1. La participante es capaz de otorgar su consentimiento informado firmado, lo que comprende el cumplimiento de los requisitos y las restricciones que se señalan en el documento de consentimiento informado y en el protocolo.
    2. La participante firma y fecha el documento de consentimiento informado por escrito para una investigación genética opcional antes de la recogida de muestras para la investigación genética opcional que respalda la Iniciativa Genómica.
    3. Edad de la participante >/=18 años en el momento de firmar el consentimiento informado.
    4. Carcinoma uterino seroso confirmado histológicamente, recurrente o persistente. A efectos del estudio, se consideran elegibles las participantes con carcinoma endometrial de histología mixta cuyo componente seroso constituye como mínimo el 10% del tumor. No podrán participar las pacientes con carcinosarcomas.
    5. Evidencia de enfermedad medible según los criterios RECIST v1.1, definida por la presencia de como mínimo una lesión, no irradiada previamente, que puede medirse con precisión en al menos una dimensión (se registrará el diámetro mayor) como >/=10 mm mediante tomografía computarizada o resonancia magnética (excepto las adenopatías, cuyo eje menor debe ser >/=15 mm) y que permite mediciones repetidas precisas.
    6. Como mínimo un (1) régimen previo de quimioterapia con un derivado del platino para el tratamiento del carcinoma uterino seroso (no se establecen restricciones en el número de líneas previas de tratamiento sistémico que haya recibido la participante y la quimioterapia con un derivado del platino puede haberse administrado en el ámbito adyuvante). La administración de quimioterapia exclusivamente junto con la radioterapia primaria como radiosensibilizante no se considerará como régimen sistémico.
    Se permiten tratamientos antineoplásicos previos (inhibidores de los puntos de control inmunitario, inhibidores del factor de crecimiento endotelial vascular [VEGF] y terapias dirigidas anti-HER2).
    No podrán participar las pacientes con diagnóstico de tumores portadores de inestabilidad microsatelital alta (MSI-H) o deficiencias de la reparación de los errores de emparejamiento (dMMR), salvo que ya hayan recibido tratamiento con pembrolizumab u otro inhibidor de los puntos de control inmunitario del receptor de la muerte programada 1 (PD-1) o de su ligando (PD-L1), en lugares donde se disponga de este tratamiento para esta indicación, o que no se considere indicado en su caso el tratamiento con inhibidores de los puntos de control inmunitario.
    7. Estado funcional del Eastern Cooperative Oncology Group (ECOG) de 0-1.
    8. Esperanza de vida >/=12 semanas.
    9. Las participantes deben presentar una funcionalidad orgánica y de médula ósea normal en el momento basal, definida por los siguientes valores de laboratorio en el plazo de los 7 días previos a la administración de la medicación del estudio:
    - Cifra absoluta de neutrófilos >/=1,5 × 109/l
    - Hemoglobina >/= 9 g/dl
    - Cifra de plaquetas >/= 100 x 109/l
    - Alanina-aminotransferasa (ALT) y aspartato-aminotransferasa (AST) </=3 × límite superior de la normalidad (ULN) o </=5 × ULN ante evidencia de metástasis hepáticas
    - Bilirrubina sérica dentro de los límites de la normalidad o </=1,5 x ULN en pacientes con metástasis hepáticas; o bilirrubina total </=3,0 x ULN con bilirrubina directa dentro de los limites de la normalidad en pacientes con síndrome de Gilbert documentado
    -Creatinina sérica </=1,5 x ULN, o aclaramiento de creatinina medido (CrCl) >/=45 ml/min estimado con el método de Cockcroft-Gault, un análisis de orina de 24 horas u otro método validado según la práctica local (solo se requiere confirmación del aclaramiento de creatinina en caso de creatinina >1,5 x ULN del centro)
    10. Consentimiento para enviar y entregar una muestra de tumor fijada en formol e incluida en parafina, de carácter imprescindible. El centro debe confirmar la disponibilidad de dicha muestra antes de la administración del tratamiento.
    11. Mujeres sin capacidad de gestación o mujeres potencialmente fértiles que acepten emplear medidas anticonceptivas adecuadas desde el momento de firmar el documento de consentimiento informado hasta un (1) mes después de suspender el tratamiento del estudio, que no den el pecho y que presenten una prueba de embarazo en suero o en orina negativa en la selección, con confirmación el Día 1 del Ciclo 1 (antes de iniciar el tratamiento del estudio).
    E.4Principal exclusion criteria
    1. Any underlying medical condition that would impair the ability of the participant to receive study treatment, as judged by the investigator.
    2. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
    3. Common Terminology Criteria for Adverse Events (CTCAE) v5.0 Grade >1 toxicity from prior therapy (except alopecia, anorexia or CTCAE grade 2 peripheral neuropathy).
    4. Unable to swallow oral medications
    5. History of another primary malignancy; exceptions include malignancy treated with curative intent and with no known active disease >= 5 years prior to first dose, basal cell and squamous cell carcinoma of skin that has undergone potentially curative therapy, and adequately treated carcinoma in situ without evidence of disease.
    6. Spinal cord compression or metastases unless asymptomatic, stable, and not requiring steroids for at least 4 weeks prior to start of study intervention.
    7. Patients with current (or within 28 days prior to Cycle 1, Day 1) signs or symptoms of bowel obstruction, including sub-occlusive disease, related to underlying disease.
    8. Any of the following cardiac diseases currently or within the last 6 months:
    - Unstable angina pectoris
    - Acute myocardial infarction
    - Congestive heart failure >/= Class 2 (as defined by New York Heart Association)
    - Conduction abnormality not controlled with pacemaker or medication
    - Significant ventricular or supraventricular arrhythmias (patients with chronic rate-controlled atrial fibrillation in the absence of other cardiac abnormalities are eligible)
    9. History of Torsades de pointes unless all risk factors that contributed to Torsades have been corrected.
    10.a) Resting corrected QTc interval using the Fridericia formula (QTcF) > 480 msec (as calculated per institutional standards) obtained from an electrocardiogram (ECG) (NOTE: if one ECG demonstrates a QTcF > 480 msec, then a mean QTcF of </= 480 msec obtained from 3 ECGs 2-5 minutes apart, is required at study entry), or
    b) congenital long QT syndrome
    11. Immunocompromised patients, eg, patients who are known to be serologically positive for human immunodeficiency virus (HIV).
    12. Patients with known active hepatitis (ie, hepatitis B or C):
    - Active hepatitis B virus (HBV) is defined by a known positive HBV surface antigen (HBsAg) result. Patients with a past or resolved HBV infection (defined as the presence of hepatitis B core antibody and absence of HBsAg) are eligible
    - Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction is negative for HCV RNA
    13. Use of anticancer treatment drug </= 21 days (</= 6 weeks for nitrosoureas or mitomycin C) or use of an investigational product within 5 half-lives prior to the first dose of adavosertib. For PD-1/PD-L1 inhibitors, a minimum of 28 days since last dose is required.
    Patients on luteinising-hormone releasing hormone analogue treatment for more than 6 months are allowed entry into the study and may continue at the discretion of the investigator.
    14. Palliative radiotherapy with a limited field of radiation within 2 weeks or with wide field of radiation or to more than 30% of bone marrow within 4 weeks prior to the first dose of study intervention
    15. Major surgical procedures </=28 days, or minor surgical procedures </=7 days, prior to beginning study treatment. No waiting period required following port-a-cath or other central venous access placement.
    16. Prior receipt of a cell cycle checkpoint inhibitor (eg, CHK1, WEE1, or ATR inhibition)
    17. Has had prescription or non-prescription drugs or other products known to be moderate to strong inhibitors/inducers of CYP3A4. If the drug could be discontinued, then a wash out of >/=2 weeks prior to Day 1 of dosing is required and the drug will be withheld throughout the study until 2 weeks after the last dose of study drug.
    18. Use of herbal medications 7 days prior to first dose of study treatment.
    19. Participants with a known hypersensitivity or contraindication to adavosertib or any of the excipients of the product.
    20. Involvement in the planning and/or conduct of the study (applies to both AstraZeneca
    staff and/or staff at the study site).
    21. Judgment by the investigator that the participant should not participate in the study if the
    participant is unlikely to comply with study procedures, restrictions and requirements
    22. Previous enrolment in the present study.
    23. Currently pregnant (confirmed with positive pregnancy test) or breast-feeding.
    1. Cualquier proceso médico subyacente que perjudique la capacidad de la participante para recibir el tratamiento del estudio, a juicio del investigador.
    2. Enfermedad intercurrente no controlada, como, entre otras, infección en curso o activa, insuficiencia cardiaca congestiva sintomática, angina de pecho inestable, arritmia cardiaca o trastornos psiquiátricos o situaciones sociales que dificulten el cumplimiento de los requisitos del estudio.
    3. Toxicidad de grado >1 según los Criterios terminológicos comunes para acontecimientos adversos (Common Terminology Criteria for Adverse Events, CTCAE) v5.0 del tratamiento anterior (excepto alopecia, anorexia o neuropatía periférica de grado 2 según los CTCAE).
    4. Incapacidad para deglutir medicamentos orales.
    5. Antecedentes de otra neoplasia maligna primaria.
    6. Metástasis o ompresión de la médula espinal, salvo que sean asintomáticas, estables y que no requieran corticosteroides desde como mínimo 4 semanas antes del inicio de la intervención del estudio.
    7. Pacientes con signos o síntomas actuales (o en el plazo de los 28 días anteriores al Día 1 del Ciclo 1) de obstrucción intestinal (incluida la subcoclusión) debida a la enfermedad subyacente.
    8. Cualquiera de las siguientes cardiopatías en la actualidad o en los últimos 6 meses:
    - Angina de pecho inestable
    - Infarto agudo de miocardio
    - Insuficiencia cardiaca congestiva de clase >/=2 (según la clasificación de la New York Heart Association)
    - Trastorno de la conducción no controlado con marcapasos o farmacológicamente
    - Arritmias ventriculares o supraventriculares importantes (podrán participar las pacientes con fibrilación auricular crónica con la frecuencia controlada en ausencia de otros trastornos cardiacos)
    9. Antecedentes de Torsades de pointes, salvo que se hayan corregido todos los factores de riesgo contribuyentes.
    10.a) Intervalo QTc corregido con la fórmula de Fridericia (QTcF) >480 ms (calculado según las normas del centro) en reposo obtenido de un electrocardiograma (ECG) (NOTA: si un ECG muestra un QTcF >480 ms, para entrar en el estudio se precisará un valor medio del QTcF </=480 ms obtenido de 3 ECG con 2 a 5 minutos de diferencia), o b) síndrome del QT largo congénito.
    11. Pacientes inmunocomprometidas, por ejemplo, con resultado positivo en la prueba serológica del virus de la inmunodeficiencia humana.
    12. Pacientes con diagnóstico de hepatitis activa (hepatitis B o C):
    - Se define como hepatitis B activa un resultado positivo del antígeno de superficie del virus de la hepatitis B (HBsAg). Podrán participar en el estudio las pacientes con hepatitis B pasada o resuelta (definida como la presencia del anticuerpo frente al antígeno central del virus de la hepatitis B y ausencia de HBsAg).
    - Las pacientes con anticuerpos frente al virus de la hepatitis C solo podrán participar si la prueba de la reacción en cadena de la polimerasa del ARN del virus es negativa.
    13. Tratamiento farmacológico antitumoral recibido </=21 días (</=6 semanas en caso de nitrosoureas o mitomicina C) o producto en investigación recibido en el plazo de 5 semividas antes de la primera dosis de adavosertib. En el caso de los inhibidores de PD-1/PD-L1 se precisa un mínimo de 28 días desde la última dosis.
    Las pacientes en tratamiento con análogos de la hormona liberadora de gonadotropinas desde hace más de 6 meses podrán entrar en el estudio y continuar con dicho tratamiento, a criterio del investigador.
    14. Radioterapia paliativa con un campo de radiación limitado en el plazo de las 2 semanas anteriores a la primera dosis de la intervención estudio o con un campo de radiación amplio o en más del 30% de la médula ósea en el plazo de las 4 semanas anteriores.
    15. Intervención quirúrgica de carácter mayor </=28 días antes de comenzar el tratamiento del estudio o de carácter menor </=7 días antes. No se requiere ningún periodo de espera tras la colocación de un catéter implantable u otro acceso venoso central.
    16. Tratamiento previo con un inhibidor de los puntos de control del ciclo celular (por ejemplo, inhibición de CHK1, WEE1 o ATR).
    17. Pacientes que reciban medicamentos de venta con o sin receta u otros productos inhibidores/inductores moderados o potentes de CYP3A4. Si se puede suspender dicho producto, se requiere un lavado >/=2 semanas antes del Día 1 del tratamiento del estudio y no deberá administrarse durante todo el estudio y hasta 2 semanas después de la última dosis del medicamento del estudio.
    18. Administración de plantas medicinales en los 7 días anteriores a la primera dosis del tratamiento del estudio.
    19. Pacientes con hipersensibilidad o contraindicación conocidas al adavosertib o cualquiera de los excipientes del producto.


    Texto incompleto por falta de espacio. Referir al Protocolo.
    E.5 End points
    E.5.1Primary end point(s)
    Overall Response Rate (ORR) is defined as the proportion of participants with measurable disease at baseline who have a confirmed complete response (CR) or partial response (PR), as determined by Blinded Independent Central Review (BICR) per RECIST v1.1.
    Tasa de respuesta global, que se define como el porcentaje de participantes con enfermedad medible en el momento basal que presenten una respuesta completa o parcial confirmada, en su determinación mediante revisión central independiente sin conocimiento del tratamiento (Blinded Independent Central Review, BICR) según los criterios RECIST v1.1.
    E.5.1.1Timepoint(s) of evaluation of this end point
    After start of treatment (Cycle 1, Day 1), scans will be repeated every 6 weeks (±7 days) for the first 48 weeks and every 9 weeks (±7 days) thereafter, until objective radiological disease progression by investigator assessment using RECIST v1.1.
    Tras el comienzo del tratamiento (Día 1 del Ciclo 1), se repetirán las pruebas de diagnóstico por imagen cada 6 semanas (±7 días) durante las primeras 48 semanas y, a continuación, cada 9 semanas (±7 días) hasta la progresión radiológica objetiva de la enfermedad en su evaluación por el investigador según los criterios RECIST v1.1.
    E.5.2Secondary end point(s)
    1. Duration of Response (DoR) is defined as the time from the date of first documented response until date of documented progression per RECIST v1.1 as assessed by Blinded Independent Central Review (BICR), or death in the absence of disease progression.
    2. Depth of response is defined as the best percentage change from baseline in Target Lesions.
    3. Progression-free survival (PFS) is defined as time from date of first dose until progression per RECIST v1.1 as assessed by BICR, or death due to any cause.
    4. Disease control rate (DCR) is defined as the percentage of participants who have a best overall response of CR (complete response) or PR (partial response) or who have stable disease for at least 5 weeks after start of treatment (to allow for an early assessment within the assessment window).
    5. Overall survival (OS) is defined as time from date of first dose until the date of death due to any cause
    6. Progression free at 6 months (PFS6) is defined as the proportion of participants alive and progression free at 6 months, and will be reported as the Kaplan-Meier estimate of PFS per RECIST v1.1 as assessed by BICR at 6 months
    7. Plasma concentration of adavosertib
    8. Safety will be evaluated in terms of AEs, vital signs, clinical laboratory assessments, ECGs, and AEs leading to dose interruptions, dose reductions, and dose discontinuations.
    Vital signs parameters include systolic and diastolic blood pressure, and pulse as well as heart rate, body temperature, body weight, height, and BMI.
    Laboratory parameters include clinical chemistry and haematology parameters as well as urinalysis.
    1. Duración de la respuesta, que se define como el tiempo desde la fecha de la primera respuesta documentada hasta la fecha de la progresión documentada según los criterios de evaluación de la respuesta en tumores sólidos (RECIST) v1.1 en su evaluación mediante revisión central independiente sin conocimiento del tratamiento (BICR) o, en ausencia de progresión de la enfermedad, hasta la muerte.
    2. Profundidad de la respuesta, que se define como el mejor cambio porcentual de las Lesiones Diana desde el momento basal.
    3. Supervivencia sin progresión, que se define como el tiempo desde la fecha de la primera dosis hasta la progresión según los criterios RECIST v1.1 en su evaluación mediante BICR o hasta la muerte por cualquier causa.
    4. Tasa de control de la enfermedad, que se define como el porcentaje de participantes con respuesta completa (completa) o respuesta parcial como mejor de respuesta global o con enfermedad estable durante como mínimo 5 semanas después del comienzo del tratamiento (que posibilite una evaluación temprana dentro del margen de evaluación).
    5. Supervivencia global, que se define como el tiempo desde la fecha de la primera dosis hasta la fecha de muerte por cualquier causa.
    6. Supervivencia sin progresión a los 6 meses, que se define como el porcentaje de participantes con vida y sin progresión al cabo de 6 meses, y que se comunicará en forma de la supervivencia sin progresión estimada con el método de Kaplan-Meier según los criterios RECIST v1.1 en su evaluación mediante BICR a los 6 meses.
    7. Concentración plasmática de adavosertib.
    8. Evaluación de la seguridad mediante los acontecimientos adversos, constantes vitales, determinaciones de laboratorio, ECG y acontecimientos adversos que lleven a interrumpir la administración, reducir la dosis y suspender permanentemente el tratamiento.
    Las constantes vitales comprenden presión arterial sistólica y diastólica, pulso, frecuencia cardiaca, temperatura, peso, altura e índice de masa corporal.
    Las determinaciones de laboratorio comprenden bioquímica sérica, parámetros hematológicos y análisis de orina.
    E.5.2.1Timepoint(s) of evaluation of this end point
    1-6: After start of treatment (Cycle 1, Day 1), scans will be repeated every 6 weeks (±7 days) for the first 48 weeks and every 9 weeks (±7 days) thereafter, until objective radiological disease progression by investigator assessment using RECIST v1.1.
    7: Pre dose and 2 hours post dose on Day 5 of Cycles 1 and 2
    8: From baseline to post treatment follow-up (30 days after last dose)
    1-6: Tras el comienzo del tratamiento (Día 1 del Ciclo 1), se repetirán las pruebas de diagnóstico por imagen cada 6 semanas (±7 días) durante las primeras 48 semanas y, a continuación, cada 9 semanas (±7 días) hasta la progresión radiológica objetiva de la enfermedad en su evaluación por el investigador según los criterios RECIST v1.1.
    7: Antes de la dosis y 2 horas después de la dosis el Día 5 de los Ciclos 1 y 2.
    8: Desde el momento basal hasta el seguimiento posterior al tratamiento (30 días después de la última dosis).
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    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 Yes
    E.6.13.1Other scope of the trial description
    Samples collected for the Genomic initiative are considered primary use and will be whole exome or whole genome sequenced. Analysis will be performed for both known and novel health related genes
    and this broad genetic research will not restrict to disease or drug. Sequencing data generated is for research purposes only and cannot be used for clinical decision making and there will not be any clinical endpoints delivered to the study, as a result of testing performed
    Las muestras recogidas para la Iniciativa Genómica se consideran de uso principal y en ellas se efectuará una secuenciación del exoma completo o del genoma completo.Se realizarán análisis de genes relacionados con la salud tanto nuevos como conocidos y esta amplia investigación genética no se limitará en cuanto a enfermedad o medicamento.Los datos obtenidos en la secuenciación son solo para fines de investigación (...)

    Texto incompleto por falta de espacio.
    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.8.2.4Number 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 concerned4
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA23
    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
    France
    Germany
    Italy
    Spain
    E.8.7Trial has a data monitoring committee Yes
    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
    Last subject's last visit
    Última visita del último paciente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months11
    E.8.9.1In the Member State concerned days14
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months1
    E.8.9.2In all countries concerned by the trial days19
    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: 60
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 60
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male No
    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 state40
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 60
    F.4.2.2In the whole clinical trial 120
    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)
    Participants are permitted to continue to receive adavosertib treatment beyond the end of study if, in the opinion of the investigator, they are continuing to receive clinical benefit. Treatment of participants with adavosertib beyond progression is not allowed.
    Las participantes podrán continuar el tratamiento con adavosertib después del fin del estudio si, en opinión del investigador, siguen obteniendo un beneficio clínico. No se permite el tratamiento de las participantes con adavosertib después de la progresión.
    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 Decision2020-11-06
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-10-01
    P. End of Trial
    P.End of Trial StatusTemporarily Halted
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