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    Summary
    EudraCT Number:2020-002620-36
    Sponsor's Protocol Code Number:17000139BLC3001
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2023-01-27
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2020-002620-36
    A.3Full title of the trial
    A Phase 3, Multi-center, Randomized Study Evaluating Efficacy of TAR-200 in Combination With Cetrelimab Versus Concurrent Chemoradiotherapy in Participants With Muscle-Invasive Urothelial Carcinoma (MIBC) of the Bladder who are not Receiving Radical Cystectomy
    Estudio de fase 3, aleatorizado y multicéntrico para evaluar la eficacia de TAR-200 en combinación con cetrelimab en comparación con
    quimiorradioterapia concomitante en participantes con carcinoma urotelial de vejiga músculo-invasivo (CVMI) que no se vayan a tratar con cistectomía radical
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 3, Multi-center, Randomized Study Evaluating Efficacy of TAR-200 in Combination With Cetrelimab Versus Concurrent Chemoradiotherapy in Participants With Muscle-Invasive Urothelial Carcinoma (MIBC) of the Bladder who are not Receiving Radical Cystectomy
    Estudio de fase 3, aleatorizado y multicéntrico para evaluar la eficacia de TAR-200 en combinación con cetrelimab en comparación con
    quimiorradioterapia concomitante en participantes con carcinoma urotelial de vejiga músculo-invasivo (CVMI) que no se vayan a tratar con cistectomía radical
    A.3.2Name or abbreviated title of the trial where available
    SunRISe-2
    A.4.1Sponsor's protocol code number17000139BLC3001
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04658862
    A.5.4Other Identifiers
    Name:INDNumber:149505
    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 SponsorJanssen-Cilag International NV
    B.1.3.4CountryBelgium
    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 supportJanssen Research & Development LLC
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationJanssen-Cilag International NV
    B.5.2Functional name of contact pointClinical Registry Group
    B.5.3 Address:
    B.5.3.1Street AddressArchimedesweg 29
    B.5.3.2Town/ cityLeiden
    B.5.3.3Post code2333 AG
    B.5.3.4CountryNetherlands
    B.5.4Telephone number+3171524 21 66
    B.5.5Fax number+3171524 21 10
    B.5.6E-mailClinicalTrialsEU@its.jnj.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 nameTAR-200
    D.3.2Product code JNJ-17000139
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravesical use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNgemcitabine hydrochloride
    D.3.9.1CAS number 122111-03-9
    D.3.9.2Current sponsor codeJNJ-17000139-AAC
    D.3.9.3Other descriptive nameGEMCITABINE HYDROCHLORIDE
    D.3.9.4EV Substance CodeSUB02324MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number225
    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 Yes
    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 nameCetrelimab
    D.3.2Product code JNJ-63723283
    D.3.4Pharmaceutical form Lyophilisate 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 INNCetrelimab
    D.3.9.2Current sponsor codeJNJ-63723283
    D.3.9.3Other descriptive nameCNTO 8470, anti-PD-1
    D.3.9.4EV Substance CodeSUB193853
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number240
    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 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 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 Yes
    D.3.11.13.1Other medicinal product typemonoclonal antibody
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleComparator
    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 Gemcitabine
    D.2.1.1.2Name of the Marketing Authorisation holderAccord Healthcare Limited
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    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 nameGemcitabine 100 mg/ml Concentrate for Solution for Infusion
    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 INNGEMCITABINE
    D.3.9.1CAS number 95058-81-4
    D.3.9.4EV Substance CodeSUB07892MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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.IMP: 4
    D.1.2 and D.1.3IMP RoleComparator
    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 Cisplatin
    D.2.1.1.2Name of the Marketing Authorisation holderAccord Healthcare Limited
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    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 nameCisplatin 1 mg/ml Concentrate for Solution for Infusion
    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 INNCisplatin
    D.3.9.1CAS number 15663-27-1
    D.3.9.4EV Substance CodeSUB07483MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1
    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: 5
    D.1.2 and D.1.3IMP RoleComparator
    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 Cisplatin
    D.2.1.1.2Name of the Marketing Authorisation holderAccord Healthcare Polska Sp. z o.o.
    D.2.1.2Country which granted the Marketing AuthorisationPoland
    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 nameCisplatin 1mg/ml Concentrate for
    D.3.2Product code L01XA01
    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 INNCisplatin
    D.3.9.1CAS number 15663-27-1
    D.3.9.4EV Substance CodeSUB07483MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1
    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
    Muscle-Invasive Urothelial Carcinoma (MIBC) of the Bladder
    Carcinoma urotelial de vejiga músculo-invasivo (CVMI)
    E.1.1.1Medical condition in easily understood language
    Bladder cancer
    Cáncer de vejiga
    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 LLT
    E.1.2Classification code 10046714
    E.1.2Term Urothelial carcinoma bladder
    E.1.2System Organ Class 100000004864
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10046720
    E.1.2Term Urothelial carcinoma bladder stage II
    E.1.2System Organ Class 100000004864
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10046721
    E.1.2Term Urothelial carcinoma bladder stage III
    E.1.2System Organ Class 100000004864
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10046722
    E.1.2Term Urothelial carcinoma bladder stage IV
    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
    To compare bladder intact event-free survival (BI-EFS) in participants receiving TAR-200 in combination with cetrelimab versus concurrent chemoradiotherapy.
    Comparar la supervivencia sin acontecimientos con vejiga intacta (SSA-VI) en participantes que reciben TAR-200 en combinación con cetrelimab frente a la quimiorradioterapia concomitante
    E.2.2Secondary objectives of the trial
    - To compare metastasis-free survival (MFS) in participants receiving TAR-200 in combination with cetrelimab versus concurrent chemoradiotherapy
    - To compare the Overall Survival (OS) in participants receiving TAR-200 in combination with cetrelimab versus concurrent chemoradiotherapy
    - To compare the Overall Response Rate (ORR)
    (Complete Response [CR] or Partial Response [PR]) in both treatment arms at Week 18, in participants who have pathologic stage T1 at baseline (screening TURBT)
    - To assess the safety and tolerability of participants receiving TAR-200 in combination with cetrelimab versus concurrent chemoradiotherapy
    -Comparar la supervivencia sin metástasis (SSM) en participantes que reciben TAR-200 en combinación con cetrelimab en comparación con la quimiorradioterapia concomitante
    -Comparar la supervivencia general (SG) en participantes que reciben TAR-200 en combinación con cetrelimab en comparación con quimiorradioterapia concomitante
    -Comparar la tasa de respuesta global (TRG) (respuesta completa [RC] o respuesta parcial [RP]) en ambos grupos de tratamiento en la semana 18, en participantes con enfermedad en estadio patológico ≥T1
    -Evaluar la seguridad y tolerabilidad de los participantes que reciben TAR-200 en combinación con cetrelimab en comparación con quimiorradioterapia concomitante
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. ≥18 years (or the legal age of consent in the jurisdiction in which the study is taking place) at the time of informed consent
    2. Histologically proven, cT2-T4a N0, M0 infiltrating urothelial carcinoma of the bladder. Initial diagnosis must have been within 90 days of randomization date. Participants with variant histologic subtypes (e.g. squamous cell carcinoma) are allowed if urothelial (transitional cell) differentiation is predominant (e.g. <20% variant histologic subtype). However, the presence of any neuroendocrine, micropapillary, signet ring cell, plasmacytoid, or sarcomatoid features will make a participant ineligible
    3. Ineligible for or have elected not to undergo radical cystectomy.
    4. All adverse events associated with any prior surgery and/or intravesical therapy must have resolved to CTCAE version 5.0 Grade ≤ 2 prior to randomization
    5. Eastern Cooperative Oncology Group (ECOG) performance status Grade 0, 1, or 2
    6. Thyroid function tests within normal range or stable on hormone supplementation per investigator assessment.
    7. Adequate bone marrow, liver, and renal function:
    a. Bone marrow function (without the support of cytokines or erythropoiesis-stimulating agent in preceding two weeks):
    i. Absolute neutrophil count (ANC) ≥ 1,500/mm^3
    ii. Platelet count ≥80,000/mm^3
    iii. Hemoglobin ≥9.0 g/dL
    b. Liver function:
    i. Total bilirubin ≤1.5 x ULN OR direct bilirubin ≤ULN for participants
    with total bilirubin levels >1.5xULN (except participants with Gilbert’s Syndrome, who must have a total bilirubin < 3.0 mg/dL),
    ii. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5x institutional ULN
    c. Renal function:
    - Creatinine clearance >40 mL/min using the Cockcroft-Gault formula.
    8. Contraceptive use by men or women should be consistent with local regulations regarding the use of contraceptive methods for participants participating in clinical studies. Investigators will advise both male and female participants on the options for banking of sperm and ova, respectively for reproductive conservation.
    a. A female participant must be either of the following:
    i. Not of childbearing potential
    ii. Of childbearing potential and practicing true abstinence, or have a sole partner who is vasectomized, or practicing at least 1 highly effective user independent method of contraception
    Participant must agree to continue the above throughout the study and for 6 months after the last dose of study treatment.
    Note: If a women becomes of childbearing potential after start of the study, the woman must comply with point (ii), as described above.
    A female participant must also agree to not donate eggs (ova, oocytes) for the purposes of assisted reproduction during the study and for at least 6 months after the last dose of study drug, and not be
    breastfeeding and not planning to become pregnant during the study and for at least 6 months after the last dose of study drug.
    b. A male participant must wear a condom (with or without spermicidal foam/gel/film/cream/suppository) when engaging in any activity that allows for passage of ejaculate to another person during the study and
    for a minimum of 6 months after receiving the last dose of study treatment. His female partner, if of childbearing potential, must also be practicing a highly effective method of contraception.
    If the male participant is vasectomized, he still must wear a condom (with or without spermicidal foam/gel/film/cream/suppository), but his female partner is not required to use contraception.
    A male participant must also agree to not donate sperm for the purpose of reproduction during the
    study and for at least 6 months after the last dose of study drug, and not plan to father a child while enrolled in the study or within 6 months after the last dose of study drug.
    9. A female participant of childbearing potential must have a negative serum test at screening and a negative urine test wtihin 72hrs of the first dose of study treatment and must agree to further serum or urine pregnancy tests during the study, that may exceed those listed in the Schedule of Activities.
    10. Must sign an Informed Consent Form indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study and agree to store samples when applicable
    1. ≥18 años (o la edad legal de consentimiento en la jurisdicción en la que se realiza el estudio) en el momento del consentimiento informado
    2. Carcinoma urotelial infiltrante de vejiga, histológicamente probado, cT2-T4a N0, M0. El diagnóstico inicial debe haberse producido en los 90 días anteriores a la fecha de aleatorización. Se permiten participantes con subtipos histológicos variantes (por ejemplo, carcinoma de células escamosas) si la diferenciación urotelial (de células de transición) es predominante (por ejemplo, <20% de subtipo histológico variante). Sin embargo, la presencia de cualquier característica neuroendocrina, micropapilar, de células en anillo de sello, plasmocitoide o sarcomatoide hará que el participante no sea elegible
    3. No ser elegible o haber elegido no someterse a una cistectomía radical.
    4. Todos los acontecimientos adversos asociados a cualquier cirugía y/o terapia intravesical previa deben haberse resuelto hasta el grado ≤ 2 de la versión 5.0 de CTCAE antes de la aleatorización
    5. Estado de rendimiento del Eastern Cooperative Oncology Group (ECOG) Grado 0, 1 o 2
    6. Pruebas de función tiroidea dentro de los límites normales o estables con suplementos hormonales según la evaluación del investigador.
    7. Función adecuada de la médula ósea, el hígado y los riñones:
    a. Función de la médula ósea (sin el apoyo de citoquinas o agente estimulante de la eritropoyesis en las dos semanas anteriores):
    i. Recuento absoluto de neutrófilos (ANC) ≥ 1.500/mm^3
    ii. Recuento de plaquetas ≥80.000/mm^3
    iii. Hemoglobina ≥9,0 g/dL
    b. Función hepática:
    i. Bilirrubina total ≤1,5 x ULN O bilirrubina directa ≤ULN para los participantes
    con niveles de bilirrubina total >1,5xULN (excepto los participantes con síndrome de Gilbert, que deben tener una bilirrubina total < 3,0 mg/dL),
    ii. Alanina aminotransferasa (ALT) y aspartato aminotransferasa (AST) ≤2,5x ULN institucional
    c. Función renal:
    - Aclaramiento de creatinina >40 mL/min utilizando la fórmula de Cockcroft-Gault.
    8. El uso de anticonceptivos por parte de los hombres o las mujeres debe ser coherente con la normativa local relativa al uso de métodos anticonceptivos para los participantes en los estudios clínicos. Los investigadores asesorarán a los participantes masculinos y femeninos sobre las opciones de almacenamiento de esperma y óvulos, respectivamente, para la conservación reproductiva.
    a. Una participante femenina debe ser una de las siguientes:
    i. No estar en edad de procrear
    ii. En edad fértil y practicar la abstinencia verdadera, o tener una única pareja vasectomizada, o practicar al menos un método anticonceptivo altamente eficaz e independiente del usuario.
    La participante debe aceptar continuar con lo anterior durante todo el estudio y durante 6 meses después de la última dosis del tratamiento del estudio.
    Nota: Si una mujer entra en edad fértil después del inicio del estudio, debe cumplir con el punto (ii), como se describe anteriormente.
    Una participante femenina también debe aceptar no donar óvulos (óvulos, oocitos) con fines de reproducción asistida durante el estudio y durante al menos 6 meses después de la última dosis del fármaco del estudio, y no estar
    amamantar y no planear quedar embarazada durante el estudio y durante al menos 6 meses después de la última dosis del fármaco del estudio.
    b. Los participantes masculinos deben utilizar un preservativo (con o sin espuma/gel/película/crema/supositorio espermicida) cuando realicen cualquier actividad que permita el paso de la eyaculación a otra persona durante el estudio y
    durante un mínimo de 6 meses después de recibir la última dosis del tratamiento del estudio. Su pareja femenina, si está en edad fértil, también debe practicar un método anticonceptivo altamente eficaz.
    Si el participante masculino está vasectomizado, deberá seguir utilizando un preservativo (con o sin espuma/gel/película/crema/supositorio espermicida), pero su pareja femenina no está obligada a utilizar métodos anticonceptivos.
    El participante masculino también debe aceptar no donar esperma con fines de reproducción durante el
    estudio y durante al menos 6 meses después de la última dosis del fármaco del estudio, y no planear engendrar un hijo mientras esté inscrito en el estudio o dentro de los 6 meses siguientes a la última dosis del fármaco del estudio.
    9. Una participante con potencial reproductivo debe tener una prueba de suero negativa en el momento de la selección y una prueba de orina negativa dentro de las 72 horas siguientes a la primera dosis del tratamiento del estudio, y debe aceptar que se realicen más pruebas de embarazo en suero u orina durante el estudio, que pueden exceder las enumeradas en el programa de actividades.
    10. Debe firmar un formulario de consentimiento informado que indique que entiende el propósito y los procedimientos requeridos para el estudio y que está dispuesto a participar en el estudio y acepta almacenar las muestras cuando corresponda
    E.4Principal exclusion criteria
    1. Active malignancies other than the disease being treated under study.
    2. Must not have had urothelial carcinoma or histological variant at any site outside of the urinary bladder.
    3. Must not have diffuse carcinoma in situ based on cystoscopy and biopsy. Diffuse, or multi-focal, CIS is defined as the presence of at least 4 distinct CIS lesions in the bladder
    at the time of the Screening re-TURBT.
    4. Participants must not have evidence of cT4b, or N1-3, or M1 disease based on local radiology staging within 42 days prior to randomization.
    5. Presence of any bladder or urethral anatomic feature that, in the opinion of the investigator, may prevent the safe placement, indwelling use, or removal of TAR-200.
    6. Evidence of bladder perforation during diagnostic cystoscopy.
    7. Bladder post-void residual volume >350 mL at screening after second voided urine.
    8. History of clinically significant polyuria with recorded 24-hour urine volumes greater than 4,000-mL.
    9. Currently participating or has participated in a study of an investigational agent and received study therapy or investigational device within 4 weeks prior to randomization.
    10. Received intervening serial intravesical chemotherapy or immunotherapy from the time of pre-screening (diagnostic) or screening (completion) cystoscopy/Transurethral Resection of Bladder Tumor to starting study treatment. Peri-operative intravesical chemotherapy prior to study treatment is
    allowed per institutional guidelines.
    11. Prior therapy with an anti-programmed cell death 1, anti-PD-ligand 2 agent, or with an agent directed to another co-inhibitory T-cell receptor.
    12. Participants with a history of Grade ≥3 toxic effects when using anti-TNF or anti-IL-6 agents.
    13. Received prior systemic chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to starting study treatment or not recovered from adverse events due to a previously administered agent.
    14. An active, known or suspected autoimmune disease.
    15. Received a live virus vaccine within 30 days prior to planned start of study treatment. Inactivated (non-live) vaccines approved or authorized for emergency use (eg, COVID 19) by local health authorities are allowed.
    16. Active infection requiring systemic IV therapy within 14 days prior to randomization.
    17. Has had an allogeneic tissue/solid organ transplant.
    18. A pyeloureteral tube externalized to the skin is exclusionary. Unilateral nephrostomy tube or ureteral stent is permitted if it does not interfere with placement or retention of TAR-200 in the bladder. Participants with unilateral hydronephrosis are permitted; however, participants with bilateral hydronephrosis are excluded.
    19. Indwelling urinary catheters are not permitted; however, intermittent catheterization is acceptable.
    20. Participants who require immunosuppressive medications including but not limited to systemic corticosteroid at doses >10 mg/day of prednisone or its equivalence, methotrexate, cyclosporine, azathioprine, and TNF-alpha blockers. Use of immunosuppressive medications for the management of immune related adverse events, infusion related reactions, or in participants with contrast allergies is acceptable. Use of inhaled, topical, and intranasal corticosteroids are permitted.
    21. Must not have clinically significant liver disease that precludes participant treatment regimens prescribed on the study
    22. Human immunodeficiency virus (HIV) infection, unless the participant has been on a stable anti-retroviral therapy regimen for the last 6 months or more and has had no opportunistic infections and a CD4 count of >350 in the last 6 months.
    23. Active hepatitis B or C infection
    24. Concurrent urinary tract infection
    25. History of allergy to protein-based therapies and participants with a history of any significant drug allergy.
    26. Known hypersensitivity to any component of the drug formulation for cetrelimab, gemcitabine (or other drug excipients) or chemically-related drugs.
    27. Known hypersensitivity to gemcitabine (or other drug excipients) or chemically-related drugs.
    28. Known hypersensitivity to TAR-200 device constituent or the (TAR-200) Urinary Placement Catheter materials.
    29. Evidence of interstitial lung disease or active non-infectious pneumonitis.
    30. Must not have active tuberculosis.
    31. History of uncontrolled cardiovascular disease including any of the following in the preceding 3 months: unstable angina, myocardial infarction, ventricular fibrillation, Torsades de Pointes, cardiac arrest, or known congestive New York Heart Association Class III-IV heart failure, cerebrovascular accident, or transient ischemic attack; pulmonary embolism or other venous thromboembolism within the preceding 2 months.

    For the full list of exclusion criteria please refer to the protocol.
    1 Enfermedades malignas activas distintas de la enfermedad en estudio
    2 No debe haber tenido carcinoma urotelial o variante histológica en ningún sitio fuera de la vejiga urinaria
    3 No debe tener carcinoma difuso in situ según cistoscopia y biopsia
    4 Participantes no deben tener evidencia de enfermedad cT4b, o N1-3, o M1 basada en la estadificación radiológica local dentro de los 42d anteriores a la aleatorización.
    5 Presencia de cualquier característica anatómica de la vejiga o la uretra que pueda impedir la colocación segura, el uso permanente o la extracción del TAR-200
    6 Evidencia de perforación de la vejiga durante la cistoscopia diagnóstica
    7 Vol residual posmiccional de la vejiga >350mL en el momento de la selección tras la 2da micción
    8 Antecedentes de poliuria clínicamente significativa con vol de orina de 24h registrados superiores a 4.000mL
    9 Participa actualmente o ha participado en un estudio de un agente en investigación y ha recibido la terapia del estudio o el dispositivo en investigación dentro de las 4sem anteriores a la aleatorización
    10 Ha recibido quimioterapia intravesical en serie o inmunoterapia desde el momento de la cistoscopia previa (diagnóstico) o de selección (finalización)/resección transuretral del tumor de vejiga hasta el inicio del tto del estudio. Quimioterapia intravesical perioperatoria antes del tto del estudio está permitida según directrices institucionales
    11 Terapia previa con un agente anti-muerte celular programada 1, anti-PD-ligando 2, o con agente dirigido a otro receptor co-inhibidor de células T
    12 Participantes con antecedentes de efectos tóxicos grado≥3 al utilizar agentes anti-TNF o anti-IL-6
    13 Haber recibido quimioterapia sistémica previa, terapia de moléculas pequeñas dirigidas o radioterapia dentro de las 2sem anteriores al inicio del tto del estudio o no haberse recuperado de los efectos adversos debidos a un agente administrado previamente.
    14 Enfermedad autoinmune activa, conocida o sospechada.
    15 Haber recibido vacuna de virus vivos en los 30d anteriores al inicio previsto del tto del estudio. Se permiten vacunas no vivas autorizadas para uso de emergencia (ej, COVID 19) por las autoridades sanitarias locales
    16 Infección activa que requiera terapia sistémica intravenosa dentro de los 14d anteriores a la aleatorización.
    17 Ha sido sometido a un trasplante alogénico de tejido/órgano sólido.
    18 Sonda pieloureteral exteriorizada a la piel es excluyente. Se permite una sonda de nefrostomía unilateral o un stent ureteral si no interfiere con la colocación o retención del TAR-200 en la vejiga. Se permiten participantes con hidronefrosis unilateral. Se excluyen participantes con hidronefrosis bilateral
    19 No se permite el uso de catéteres urinarios permanentes. Se acepta el cateterismo intermitente
    20 Participantes que requieran medicamentos inmunosupresores, incluyendo pero no limitándose a corticosteroides sistémicos en dosis >10 mg/d de prednisona o su equivalente, metotrexato, ciclosporina, azatioprina y bloqueadores del TNF-alfa. Se acepta uso de medicamentos inmunosupresores para el manejo de eventos adversos relacionados con la inmunidad, reacciones relacionadas con la infusión o en participantes con alergias al contraste. Se permite uso de corticosteroides inhalados, tópicos e intranasales
    21 No debe tener una enfermedad hepática clínicamente significativa que impida los regímenes de tratamiento de los participantes prescritos en el estudio
    22 Infección por VIH, a menos que el participante haya estado en un régimen de terapia antirretroviral estable durante los últimos 6m o más y no haya tenido infecciones oportunistas y un recuento de CD4>350 en los últimos 6m
    23 Infección activa por hepatitis B o C
    24 Infección concurrente del tracto urinario
    25 Antecedentes de alergia a terapias basadas en proteínas y participantes con antecedentes de cualquier alergia significativa a medicamentos
    26 Hipersensibilidad conocida a cualquier componente de la formulación del fármaco para cetrelimab, gemcitabina (u otros excipientes del fármaco) o fármacos relacionados químicamente
    27 Hipersensibilidad conocida a la gemcitabina (u otros excipientes del fármaco) o a fármacos relacionados químicamente.
    28 Hipersensibilidad conocida al componente del dispositivo TAR-200 o a los materiales del catéter de colocación urinaria (TAR-200)
    29 Evidencia de enfermedad pulmonar intersticial o neumonitis activa no infecciosa
    30 No debe tener tuberculosis activa
    31 Antecedentes de enfermedades cardiovasculares no controladas, incluyendo cualquiera de las siguientes en los 3m anteriores: angina inestable, infarto de miocardio, fibrilación ventricular, Torsades de Pointes, paro cardíaco, o insuficiencia cardíaca congestiva conocida de la NYHA Clase III-IV, accidente cerebrovascular o ataque isquémico transitorio; embolia pulmonar u otra tromboembolia venosa en los 2m anteriores

    Lista completa de criterios de exclusión, consulte el protocolo
    E.5 End points
    E.5.1Primary end point(s)
    Time from randomization to the first BI-EFS event, including histologically proven presence of muscle-invasive bladder cancer (MIBC), clinical evidence of nodal or metastatic disease (as assessed by RECIST 1.1 criteria), radical cystectomy (RC), or death due to any cause.
    mpo desde la aleatorización hasta el primer suceso SSA-VI, incluyendo presencia probada histológicamente de cáncer de vejiga
    músculo-invasivo (CVMI), evidencia clínica de enfermedad nodal o metastática (según los criterios RECIST 1.1), cistectomía radical (CR) o muerte por cualquier motivo.
    E.5.1.1Timepoint(s) of evaluation of this end point
    18 weeks
    18 semanas
    E.5.2Secondary end point(s)
    - Time from randomization to first radiologic (as assessed by RECIST 1.1 criteria) or histologic evidence of metastatic disease or death due to any cause.
    - Time from randomization to death.
    - Biopsy Response at Week 18
    - Frequency and grade of adverse events (AEs) (according to Common Terminology Criteria for Adverse Events [CTCAE] version 5.0) and according to Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (NCI PRO-CTCAE). NCI PROCTCAE assessments will be done for all urinary and all
    gastrointestinal items in the NCI PRO-CTCAE item library.
    Laboratory abnormalities: CTCAE grades and NCI PRO-CTCAE grades comparing baseline to the worst post-baseline value.
    - Tiempo desde la aleatorización hasta la primera evidencia radiológica (según los criterios RECIST 1.1) o histológica de enfermedad metastática o muerte por cualquier motivo.
    - Tiempo desde la aleatorización hasta la muerte.
    - Respuesta de la biospia en la semana 18
    - Frecuencia y grado de los acontecimientos adversos (AAs) (según la versión 5.0 de los Criterios Terminológicos Para Acontecimientos Adversos -Common Terminology Criteria for Adverse Events [CTCAE]-) y de acuerdo con la versión de resultados informados por el paciente de la Criterios terminológicos para acontecimientos adversos (NCI PROCTCAE). Se realizarán evaluaciones de NCI PRO-CTCAE para todas las vías urinarias y zonas gastrointestinales en la biblioteca de artículos NCI PRO-CTCAE. Anormalidades de laboratorio: los grados de CTCAE y de NCI PRO-CTCAE comparando el valor inicial con el peor valor posterior a la del inicio.
    E.5.2.1Timepoint(s) of evaluation of this end point
    - Duration of trial
    - Biopsy Response at Week 18
    -Duración del ensayo
    -Respuesta de la biospia en la semana 18
    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 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) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    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) Yes
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Concurrente con quimiorradioterapia
    Concurrent with chemoradiotherapy
    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 concerned12
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA103
    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
    Argentina
    Australia
    Brazil
    Canada
    China
    India
    Israel
    Japan
    Korea, Republic of
    Mexico
    South Africa
    Taiwan
    United States
    European Union
    Russian Federation
    Turkey
    Ukraine
    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
    The study is considered completed with the last follow-up overall survival assessment for the last participant participating in the study, or 5 years after the last participant is randomized. The final data from the study site will be sent to the sponsor (or designee) after completion of the final participant's survival assessment at that study site, in the time frame specified in the Clinical Trial Agreement
    Se considera que el estudio se ha completado con la última evaluación del seguimiento global de supervivencia del último participante que participó en el estudio, o 5 años después de que se aleatorizase al último participante. Los datos finales del centro en el estudio se enviarán al promotor (o su delegado) tras completar la evaluación final de supervivencia del participante en ese centro del estudio, en el plazo especificado en el contrato del ensayo clínico.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years8
    E.8.9.1In the Member State concerned months
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years8
    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: 165
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 385
    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 state27
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 206
    F.4.2.2In the whole clinical trial 550
    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
    Ninguno
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2023-01-26
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-12-20
    P. End of Trial
    P.End of Trial StatusOngoing
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