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    Summary
    EudraCT Number:2020-000209-10
    Sponsor's Protocol Code Number:D8731C00002
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-01-21
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2020-000209-10
    A.3Full title of the trial
    A Phase II, Open-label, Study to Assess the Efficacy, Safety, and Tolerability of AZD4635 in Combination with Durvalumab and in Combination with Cabazitaxel and Durvalumab in Patients Who Have Progressive Metastatic Castrate-Resistant Prostate Cancer (AARDVARC)
    Studio in aperto di fase II volto a valutare l’efficacia, la sicurezza e la tollerabilità di AZD4635 in combinazione con durvalumab e in combinazione con cabazitaxel e durvalumab in pazienti con carcinoma prostatico metastatico resistente alla castrazione in fase progressiva (AARDVARC)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Phase II two-arm study of AZD4635 in combination with durvalumab and in combination with cabazitaxel and durvalumab in patients with mCRPC
    Studio di fase II a due bracci per valutare AZD4635 in combinazione con durvalumab e in combinazione con cabazitaxel e durvalumab in pazienti affetti da mCRPC
    A.3.2Name or abbreviated title of the trial where available
    AARDVARC
    AARDVARC
    A.4.1Sponsor's protocol code numberD8731C00002
    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 AddressUSA
    B.5.3.2Town/ cityUSA
    B.5.3.3Post codeUSA
    B.5.3.4CountryUnited States
    B.5.4Telephone number000000
    B.5.5Fax number000000
    B.5.6E-mailinformation.centre@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 Yes
    D.2.1.1.1Trade name SANDOZ MYCOPHENOLATE MOFETIL
    D.2.1.1.2Name of the Marketing Authorisation holderSandoz Canada Inc.
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameSANDOZ MYCOPHENOLATE MOFETIL
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Capsule, hard
    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 INNMICOFENOLATO MOFETILE
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number250
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.1.1.1Trade name NA
    D.2.1.1.2Name of the Marketing Authorisation holderNA
    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 nameDurvalumab
    D.3.2Product code [MEDI4736]
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDurvalumab
    D.3.9.1CAS number 1428935-60-7
    D.3.9.2Current sponsor codeMEDI4736
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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 No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Inflectra
    D.2.1.1.2Name of the Marketing Authorisation holderPfizer Europe MA EEIG
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameInflectra
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Concentrate for solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNINFLIXIMAB
    D.3.9.2Current sponsor code-
    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 No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    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: 4
    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 Jevtana
    D.2.1.1.2Name of the Marketing Authorisation holderSanofi-aventis groupe
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameCabazitaxel
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCABAZITAXEL
    D.3.9.1CAS number 183133-96-2
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 5
    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 name-
    D.3.2Product code [AZD4635]
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 1321514-06-0
    D.3.9.2Current sponsor codeAZD4635
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Progressive Metastatic Castrate-Resistant Prostate Cancer
    Carcinoma prostatico metastatico resistente alla castrazione in fase progressiva
    E.1.1.1Medical condition in easily understood language
    Prostate Cancer
    Carcinoma alla prostata
    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.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To determine the efficacy (as assessed by radiographic progression free survival [rPFS]) of AZD4635 plus durvalumab and separately of AZD4635
    plus durvalumab plus cabazitaxel in participants with mCRPC.
    Determinare l’efficacia (valutata in base alla sopravvivenza libera da progressione radiografica [rPFS]) di AZD4635 più durvalumab e separatamente di AZD4635 più durvalumab e cabazitaxel in partecipanti affetti da mCRPC.
    E.2.2Secondary objectives of the trial
    - To determine the efficacy of AZD4635 plus durvalumab and separately of AZD4635 plus durvalumab plus cabazitaxel by assessment of overall
    survival (OS), objective response rate (ORR), duration of response (DoR), prostate-specific antigen (PSA) response in participants with
    mCRPC.
    - Investigate the PK of AZD4635 when given in combination with durvalumab, and when given in combination with durvalumab plus
    cabazitaxel.
    - To determine the efficacy of AZD4635 plus durvalumab and AZD4635 plus durvalumab plus cabazitaxel in participants with mCRPC, by
    adenosine (ADO) gene expression in high and low subgroups in each arm separately.
    - To determine the efficacy of AZD4635 plus durvalumab and AZD4635 plus durvalumab plus cabazitaxel in participants with mCRPC, by
    adenosine deaminase (ADA) gene expression in high and low subgroups in each arm separately.
    - To explore the effects of AZD4635 on pain and other prostate cancerrelated symptoms.
    - Determinare l’efficacia di AZD4635 più durvalumab e separatamente di AZD4635 più durvalumab e cabazitaxel in base alla valutazione della sopravvivenza complessiva (OS) in partecipanti affetti da mCRPC.
    - Studiare la farmacocinetica (PK) di AZD4635 quando somministrato in combinazione con durvalumab e quando somministrato in combinazione con durvalumab più cabazitaxel.
    - Determinare l’efficacia di AZD4635 più durvalumab e AZD4635 più durvalumab e cabazitaxel in partecipanti affetti da mCRPC in base alla firma di espressione genica dell’adenosina (ADO) in sottogruppi
    - Determinare l’efficacia di AZD4635 più durvalumab e AZD4635 più durvalumab e cabazitaxel in partecipanti affetti da mCRPC in base all’espressione genica dell’adenosina deaminasi (ADA) in sottogruppi con espressione elevata e bassa in ciascun braccio separatamente.
    - Esplorare gli effetti di AZD4635 sul dolore e altri sintomi correlati al carcinoma prostatico.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1 Participant must be 18 years of age inclusive at the time of signing the informed consent.
    2 Histologically confirmed adenocarcinoma of the prostate
    - Disease must be metastatic and inoperable and for which there is no curative intervention available. Participants may have bone-only disease.
    - Participants presenting with treatment-emergent neuroendocrine differentiation, but not primary small-cell features, are eligible.
    3 Known castrate-resistant disease, defined as:
    - Testosterone level in the castration range (levels <50 ng/dl) because of a previous, and ongoing, androgen-deprivation with luteinizing hormone-releasing hormone (LHRH) agonists or antagonists or bilateral orchiectomy. Participants must have developed progression of metastases following surgical castration or during medical androgen ablation therapy. Participants receiving medical castration therapy with gonadotropin-releasing hormone (GnRH) analogues should continue this treatment during this study.
    4 Evidence of disease progression =6 months defined by one or more of the following:
    - Progression as defined by RECIST v1.1 criteria for assessment of malignant soft tissue disease and lymph nodes
    - Progression of bone lesions on bone scan from a previous or baseline assessment per PCWG3
    - Rising PSA
    5 Must have measurable disease:
    - At least 1 documented lesion on either a bone scan or a computed tomography (CT)/magnetic resonance imaging (MRI) scan that can be followed for response is suitable for repeated measurement
    Or
    - Non-measurable disease must have measurable PSA > =1.0 ng/mL as the minimum starting level for trial entry if the confirmed rise is the only indication of progression (excluding small cell carcinoma)
    6 Body weight >30 kg at screening.
    7 Willingness to adhere to the study treatment-specific contraception requirements: Participants must be surgically sterile or using an acceptable method of contraception (defined as barrier methods in conjunction with spermicides) for the duration of the study (from the time they sign ICF) and for 3 months after the last dose of AZD4635 and/or durvalumab and/or cabazitaxel to prevent pregnancy in a female partner. Participants must not donate or bank sperm for 24 weeks after treatment.
    8 Adequate bone marrow reserve and organ function as demonstrated by all of the following laboratory values:
    - Absolute neutrophil count (ANC) >=1.5 × 10^9/L
    - Platelet count >= 100 × 10^9/L
    - Haemoglobin >= 9.0 g/dL
    - Creatinine < =1.5 × ULN concurrent with creatinine clearance >50 mL/min (measured or calculated by Cockcroft and Gault equation); confirmation of creatinine clearance is only required when creatinine is >1.5 × ULN.
    Additional Inclusion Criteria Specific for Arm A
    9 Adequate organ function for Arm A as demonstrated by all of the following laboratory values:
    - Alanine aminotransferase (ALT) < = 2.5 × the upper limit of normal (ULN) if no demonstrable liver metastases or =5 × ULN in the presence of liver metastases.
    - Aspartate aminotransferase (AST) >= 2.5 × ULN if no demonstrable liver metastases or =5 × ULN in the presence of liver metastases
    - Total bilirubin (TBL) < = 1.5 × ULN
    - TBL < = 2.0 × ULN in the case of known Gilbert syndrome with normal direct bilirubin
    1 I partecipanti devono avere compiuto 18 anni di età al momento della firma del consenso informato.
    2 Conferma istologica di adenocarcinoma della prostata
    - La malattia deve essere metastatica e non operabile e non esistono trattamenti curativi disponibili per la malattia. I partecipanti possono avere metastasi solo ossee.
    -I partecipanti che presentano differenziazione neuroendocrina emergente dal trattamento, ma senza caratteristiche primarie a piccole cellule, sono idonei.
    3 Nota malattia resistente alla castrazione, definita come:
    - Livello di testosterone nel range della castrazione (livelli <50 ng/dl) a causa di una precedente deprivazione di androgeni con agonisti o antagonisti dell’ormone di rilascio dell’ormone luteinizzante (LHRH), tuttora in corso o orchiectomia bilaterale. I partecipanti devono avere sviluppato progressione delle metastasi dopo castrazione chirurgica o durante la terapia medica di ablazione androgenica. I partecipanti sottoposti a castrazione farmacologica con analoghi dell’ormone di rilascio delle gonadotropine (GnRH), devono continuare questo trattamento nel corso di questo studio.
    4 Evidenza di progressione della malattia =6 mesi, definita da una o più delle seguenti circostanze:
    - Progressione secondo la definizione dei criteri RECIST v1.1 per la valutazione dei tumori maligni dei tessuti molli e dei linfonodi
    - Progressione delle lesioni ossee alla scintigrafia ossea rispetto a una valutazione precedente o al basale secondo il Gruppo di lavoro sul carcinoma della prostata 3 (PCWG3)
    - Un aumento dei livelli dell’antigene prostatico specifico (PSA)
    5 I soggetti devono avere una malattia misurabile:
    - Almeno una lesione documentata mediante scintigrafia ossea o tomografia computerizzata (TAC)/risonanza magnetica per immagini (RMI) che possa essere seguita per la risposta è idonea per misure ripetute
    Oppure
    - Malattia non misurabile che deve presentare un livello di PSA > =1.0 ng/ml come livello minimo iniziale per l’ingresso nella sperimentazione se la conferma dell’aumento è l’unica indicazione di progressione (escluso il carcinoma a piccole cellule)
    6 Peso corporeo >30 kg allo screening.
    7 Disponibilità a rispettare i requisiti di contraccezione specifici del trattamento dello studio: I partecipanti devono avere subito sterilizzazione chirurgica o usare un metodo contraccettivo accettabile (definito come metodo barriera in associazione con spermicidi) per tutta la durata dello studio (dal momento in cui firmano il modulo di consenso informato) e per 3 mesi dopo l’ultima dose di AZD4635 e/o durvalumab e/o cabazitaxel per evitare una gravidanza della compagna. I partecipanti non devono donare o conservare sperma per 24 settimane dopo il trattamento.
    8 Adeguata funzione del midollo osseo e funzionalità degli organi comprovate da tutti i seguenti valori di laboratorio:
    - Conta assoluta dei neutrofili (ANC) >= 1,5 × 10^9/L
    - Conta piastrinica >= 100 × 10^9/L
    - Emoglobina >= 9,0 g/dl
    -Creatinina < = 1,5 × ULN concomitante con clearance della creatinina >50 ml/min (misurata o calcolata mediante equazione di Cockcroft-Gault); la conferma della clearance della creatinina è necessaria solo quando la creatinina è >1,5 × ULN.
    Criteri di inclusione aggiuntivi specifici per il Braccio A
    9 Adeguata funzionalità degli organi per il Braccio A comprovata da tutti i seguenti valori di laboratorio:
    -Alanina aminotransferasi (ALT) < = 2,5 x limite superiore della norma (ULN) in assenza di metastasi epatiche dimostrabili o =5 × ULN in presenza di metastasi epatiche.
    - Aspartato aminotransferasi (AST) >= 2,5 × ULN in assenza di metastasi epatiche dimostrabili o < = 5 × ULN in presenza di metastasi epatiche
    - Bilirubina totale (TBL) < = 1,5 × ULN
    - TBL< = 2,0 × ULN in caso di sindrome di Gilbert nota con bilirubina normale diretta

    Per ulteriori dettagli fare riferimento al protocollo.
    E.4Principal exclusion criteria
    1 Active brain metastases or leptomeningeal metastases. Participants with brain metastases are eligible if treated and there is no evidence of progression for at least 8 weeks after treatment is completed and within 28 days prior to the first dose of study intervention.
    2 There must be no requirement for immunosuppressive doses of systemic corticosteroids (>10 mg/day prednisone/equivalent) for at least 2 weeks prior to study enrollment.
    3 Participant with a history of pneumonitis requiring corticosteroids.
    4 History of a second malignancy that is progressing and/or received active treatment < = 3 years before the first dose of study intervention.
    5 As judged by the Investigator, any evidence of severe or uncontrolled systemic diseases, including uncontrolled hypertension, active bleeding diatheses, or active infection including hepatitis B, hepatitis C, and human immunodeficiency virus. Screening for chronic conditions is not required.
    6 Creatinine clearance <50 mL/min (calculated by Cockcroft-Gault equation).
    7 Prior exposure to immune-mediated therapy including, but not limited to anti-CTLA-4, anti-PD-1, anti-PD-L1 and anti-PD-L2 antibodies, excluding therapeutic anti-cancer vaccines.
    Additional Exclusion Criteria Specific for Arm B: Medical Conditions
    8 Participant with active grade > = 2 peripheral neuropathy
    9 Participant with active grade > = 2 stomatitis
    10 Any small-molecule, biologic, or hormonal agent from a previous treatment regimen or clinical study within 21 days or 5 half-lives (whichever is shorter) prior to the first dose of study intervention. At least 7 days must have elapsed between the last dose of such agent and the first dose of study intervention. Exception: androgen-deprivation therapy is permitted.
    11 History of hypersensitivity to polysorbate-80 if allocated to cabazitaxel.
    12 Nitrosourea or mitomycin C within 6 weeks of the first dose of study intervention.
    13 Prescription or non-prescription drugs or other products known to be sensitive BCRP or OAT1 substrates or to be strong inhibitors/inducers of CYP1A2, which cannot be discontinued 2 weeks prior to Day 1 of dosing and withheld throughout the study, until 2 weeks after the last dose of
    study intervention.
    14 Exclusion Criteria for Arm B: Concurrent or planned treatment with strong inhibitors or strong inducers of cytochrome P450 3A4/5 (CYP3A4/5) are excluded (a 2-week washout period is required for participants already on these treatments).
    15 Herbal preparations/medications are not allowed throughout the study. These herbal medications include but are not limited to St. John's wort, kava, ephedra (ma huang), gingko biloba, dehydroepiandrosterone, yohimbe, saw palmetto, and ginseng.
    Participants should stop using these herbal medications 7 days prior to the first dose of study intervention. Exceptions may be agreed, but the circumstances must be reviewed by the Medical Monitor/AZ Study Physician in advance.
    16 Ongoing treatment with warfarin (Coumadin).
    17 Receipt of live attenuated vaccine within 30 days prior to the first dose of study intervention.
    18 Major surgery (excluding placement of vascular access) within 4 weeks of the first dose of study intervention.
    19 Radiotherapy with a wide field of radiation within 4 weeks or radiotherapy with a limited field of radiation for palliation within 2 weeks of the first dose of study intervention.

    Please refer to the protocol for further details.
    1 Metastasi cerebrali o metastasi leptomeningee attive. I partecipanti con metastasi cerebrali sono idonei se trattati e non presentano evidenza di progressione per almeno 8 settimane dopo la fine del trattamento e nei 28 giorni precedenti la prima dose di trattamento dello studio.
    2 Non deve esserci alcun requisito per dosi immunosoppressive di corticosteroidi sistemici (>10 mg/die di prednisone/equivalente) per almeno 2 settimane prima dell’arruolamento nello studio.
    3 Partecipante con anamnesi di polmonite che richieda corticosteroidi.
    4 Anamnesi di un secondo tumore maligno in fase di progressione e/o partecipante che abbia ricevuto un trattamento attivo < = 3 anni prima della prima dose di trattamento dello studio.
    5 A giudizio dello sperimentatore, qualsiasi evidenza di malattie sistemiche gravi o non controllate, tra cui ipertensione non controllata, diatesi emorragica attiva, o di infezione attiva tra cui l’epatite B, l’epatite C e il virus dell’immunodeficienza umana. Lo screening per le malattie croniche non è richiesto.
    6 Clearance della creatinina <50 ml/min (calcolata con l’equazione di Cockcroft-Gault).
    7 Precedente esposizione a terapia immunomediata, tra cui, a titolo non esaustivo, anticorpi anti-CTLA-4, anti-PD-1, anti-PD-L1 e anti-PD-L2, esclusi i vaccini antitumorali terapeutici.
    Criteri di esclusione aggiuntivi specifici per il Braccio B: Condizioni mediche
    8 Partecipante con neuropatia periferica attiva di grado > = 2
    9 Partecipante con stomatite attiva di grado> = 2
    10 Qualsiasi agente a molecole piccole, biologico, o ormonale di un precedente regime di trattamento o di studio clinico entro 21 giorni o 5 emivite (a seconda di quale sia più breve) precedente la prima dose di trattamento dello studio. Devono essere trascorsi almeno 7 giorni tra la somministrazione dell’ultima dose di tale agente e la prima dose di trattamento dello studio. Eccezione: la terapia di deprivazione androgenica è consentita.
    11 Anamnesi di ipersensibilità al polisorbato 80, se assegnato a cabazitaxel.
    12 Nitrosuree o mitomicina C entro 6 settimane dalla prima dose di trattamento dello studio.
    13 Farmaci su prescrizione o da banco o altri prodotti noti per essere substrati sensibili della proteina di resistenza del cancro al seno (BCRP) o del trasportatore di anioni organici 1 (OAT1), o per essere forti inibitori/induttori del CYP1A2 che non possono essere interrotti nelle 2 settimane precedenti al Giorno 1 di somministrazione e sospesi per tutta la durata dello studio, fino a 2 settimane dopo l’ultima dose di trattamento dello studio.
    14 Criteri di esclusione per il Braccio B: Il trattamento concomitante o programmato con forti inibitori o induttori del citocromo P450 3A4/5 (CYP3A4/5) è escluso (un periodo di washout di 2 settimane è necessario per i partecipanti che già ricevono questi trattamenti).
    15 I preparati/medicinali fitoterapici non sono consentiti per l’intera durata dello studio. Tali medicinali fitoterapici includono, ma non sono limitati a, iperico, kava, efedra (ma huang), ginkgo biloba, deidroepiandrosterone, yohimbe, palmetta della Florida e ginseng.
    I partecipanti devono interrompere l’uso di questi medicinali fitoterapici 7 giorni prima della prima dose di trattamento dello studio. Le eccezioni possono essere concordate, ma le circostanze devono essere esaminate in anticipo dal Monitor/Medico dello studio di AZ.
    16 Trattamento in corso con warfarin (Coumadin).
    17 Somministrazione di vaccino vivo attenuato nei 30 giorni precedenti la prima dose di trattamento dello studio.
    18 Intervento di chirurgia maggiore (escluso il posizionamento di accesso vascolare) nelle 4 settimane precedenti la prima dose di trattamento dello studio.
    19 Radioterapia ad ampio campo di radiazioni entro 4 settimane o radioterapia con radiazioni a campo ristretto a fini palliativi entro 2 settimane dalla prima dose di trattamento dello studio.

    Per ulteriori dettagli fare riferimento al protocollo.
    E.5 End points
    E.5.1Primary end point(s)
    rPFS, defined as the time from first dose to radiographic progression as assessed by the Investigator per Response Evaluation Criteria in Solid
    Tumours (RECIST v1.1) (soft tissue) and Prostate Cancer Working Group 3 criteria (PCWG3) (bone) or death from any cause, whichever occurs
    first.
    rPFS, definita come l’intervallo di tempo che va dalla prima dose alla progressione radiografica valutata dallo sperimentatore secondo i Criteri di valutazione della risposta nei tumori solidi (RECIST v1.1) (tessuto molle) e i criteri del Gruppo di lavoro 3 sul carcinoma prostatico (PCWG3) (ossa), o al decesso per qualsiasi causa, a seconda di quale evento si verifichi prima.
    E.5.1.1Timepoint(s) of evaluation of this end point
    - Arm A: RECIST and PCWG3 measurements will be made every 8 weeks (±1 week) for the first 24 weeks relative to the start of study treatment
    (Cycle 1, Day 1) and every 12 weeks (±1 week) thereafter until RECIST 1.1 defined disease progression or cessation of study treatment (if
    treating beyond disease progression)."
    - Arm B: RECIST and PCWG3 measurements will be made every 9 weeks (±1 week) for the first 27 weeks relative to the start of study treatment
    (Cycle 1, Day 1) and every 12 weeks (±1 week) thereafter until RECIST 1.1 defined disease progression or cessation of study treatment (if treating beyond disease progression)."
    - Braccio A: le misurazioni RECIST e PCWG3 verranno eseguite ogni 8 settimane (+/- 1 set) per le prime 24 set rispetto all'inizio del trattamento in studio (Ciclo 1, Giorno 1) e successivamente ogni 12 set (+/- 1 set) fino a quando RECIST 1.1 non ha definito la progressione della malattia o l'interruzione del trattamento in studio (se trattamento va oltre la progressione della malattia).
    - Braccio B: le misurazioni RECIST e PCWG3 verranno eseguite ogni 9 settimane (+/- 1 set) per le prime 27 settimane rispetto all'inizio del trattamento in studio (Ciclo 1, Giorno 1) e successivamente ogni 12 settimane (+/- 1 set) fino a quando RECIST 1.1 non ha definito la progressione della malattia o la cessazione del trattamento in studio (se il trattamento va oltre la progressione della malattia).
    E.5.2Secondary end point(s)
    - Overall survival (also within the gene expression subgroups)
    - Objective response rate (also within the gene expression subgroups)
    - Duration of response (also within the gene expression subgroups)
    - Prostate-specific antigen response (also within the gene expression subgroups)
    - AZD4635, durvalumab and cabazitaxel plasma concentration and derived PK parameters.
    - Radiographic progression free survival within the gene expression subgroups
    - Change from baseline in worst pain, general pain and pain interference in the daily activities scales of the BPI-SF and in the worst bone pain item.
    - Time to pain progression based on BPI-SF Item 3 "worse pain in 24-hours".
    - Change from baseline in the FAPSI-8, as derived from 8 items within the FACT-P and the PCS, as derived from the 12 items in the prostrate specific module of the FACT-P.
    - OS (anche all'interno dei sottogruppi di espressione genica)
    - Tasso di risposta obiettiva (anche all'interno dei sottogruppi di espressione genica)
    - Durata della risposta (anche all'interno dei sottogruppi di espressione genica)
    - Risposta specifica all'antigene prostatico (anche all'interno dei sottogruppi di espressione genica)
    - Concentrazione plasmatica di AZD4635, durvalumab e cabazitaxel e parametri PK derivati.
    - Sopravvivenza libera da progressione radiografica all'interno dei sottogruppi di espressione genica
    - Variazione rispetto al basale nelle scale relative a dolore peggiore, dolore generalizzato e interferenza del dolore nelle attività quotidiane dell’Inventario breve sul dolore-Modulo abbreviato (BPI-SF) e nella voce relativa al peggiore dolore osseo.
    - Tempo alla progressione del dolore in base alla voce 3 del BPI-SF “dolore peggiore in 24 ore”.
    - Variazione rispetto al basale nel FAPSI-8, come derivata da 8 voci della FACT-P e dell PCS, derivate dalle 12 voci del modulo specifico per il carcinoma prostatico della FACT-P.
    E.5.2.1Timepoint(s) of evaluation of this end point
    - RECIST and PCWG3 measurements will be made every 8 ± 1 weeks (Arm A) or 9 ±1 weeks (Arm B) for the first 24 weeks (Arm A) or 27 weeks (Arm B) relative to the start of study treatment and every 12 ±1 weeks thereafter until RECIST 1.1 defined disease progression or cessation of study treatment
    - OS: will be determined every 3 months from disease progression until data cut-off or death
    - PK: will be measured at limited time points during treatment and up to follow up
    - PSA assessment at baseline and at the start of each new treatment cycle (every 4 weeks for arm A and every 3 weeks for first 10 cycles and then every 4 weeks arm B), at end of treatment, and at progression
    - BPI-SF and FACT-P assessments will be measured at limited time points during treatment and up to follow up
    - Le misurazioni RECIST e PCWG3 verranno effettuate ogni 8 +/- 1 set (braccio A) o 9 +/- 1 set (braccio B) per le prime 24 set (braccio A) o 27 settimane (braccio B) rispetto all'inizio del trattamento in studio e ogni 12 +/- 1 set in seguito fino a quando RECIST 1.1 ha definito la progressione della malattia o l'interruzione del trattamento in studio
    - OS: sarà determinato ogni 3 mesi dalla progressione della malattia fino al cut-off o alla morte
    - PK: sarà misurato in time-point limitati durante il trattamento e fino al follow-up
    Fare riferimento al protocollo per ulteriori dettagli.
    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 Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Biomarker assessment
    Valutazione biomarker
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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 EEA35
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Korea, Republic of
    United States
    Belgium
    Denmark
    France
    Germany
    Italy
    Netherlands
    Spain
    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
    Last visit of the last patient
    Ultima visita dell'ultimo paziente
    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 months6
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 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: 32
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 128
    F.2 Gender
    F.2.1Female No
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    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 state46
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 120
    F.4.2.2In the whole clinical trial 160
    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)
    Intervention after the end of the study will be at the discretion of the Investigator.
    L'intervento dopo la fine dello studio sarà a discrezione dello sperimentatore.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2020-09-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-07-30
    P. End of Trial
    P.End of Trial StatusOngoing
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