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    Summary
    EudraCT Number:2020-003063-26
    Sponsor's Protocol Code Number:1634
    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:2021-11-18
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2020-003063-26
    A.3Full title of the trial
    Personalized Risk-Adapted Therapy in Post-Pubertal Patients with Newly Diagnosed Medulloblastoma (PersoMed-I)
    Terapia personalizzata adattata al rischio in pazienti post-puberali con nuova diagnosi di medulloblastoma (PersoMed-I)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Trial investigating a personalized treatment, based on age and tumor characteristics , of newly diagnosed medullablastoma in patients that are postpubertal and/or adult consisting of lowering RT,chemotherapy doses and adding an investigative drug.
    Trial che studia un trattamento personalizzato, in base all'età e alle caratteristiche del tumore, del medullablastoma di nuova diagnosi in pazienti postpuberali e/o adulti consistente nell'abbassamento della RT, delle dosi di chemioterapia e nell'aggiunta di un farmaco sperimentale.
    A.3.2Name or abbreviated title of the trial where available
    PersoMed-I
    PersoMed-I
    A.4.1Sponsor's protocol code number1634
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04402073
    A.5.4Other Identifiers
    Name:NOANumber:23
    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 SponsorEORTC AISBL/IVZW
    B.1.3.4CountryBelgium
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportEORTC-BTG
    B.4.2CountryBelgium
    B.4.1Name of organisation providing supportSunpharmaceuticals
    B.4.2CountryNetherlands
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationEuropean Organisation for Research and Treatment of
    B.5.2Functional name of contact pointRegulatory Affairs Department
    B.5.3 Address:
    B.5.3.1Street AddressAvenue E. Mounier 83/11
    B.5.3.2Town/ cityBrussels
    B.5.3.3Post code1200
    B.5.3.4CountryBelgium
    B.5.4Telephone number027741325
    B.5.5Fax number027727063
    B.5.6E-mailregulatory@eortc.org
    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 Odomzo
    D.2.1.1.2Name of the Marketing Authorisation holderSun Pharmaceutical Industries Europe B.V.
    D.2.1.2Country which granted the Marketing AuthorisationNetherlands
    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 nameSonidegib
    D.3.2Product code [L01XX48]
    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 INNSonidegib
    D.3.9.1CAS number 956697-53-3
    D.3.9.2Current sponsor codeSonidegib
    D.3.9.4EV Substance CodeSUB123432
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    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
    Newly Diagnosed Medulloblastoma
    Medulloblastoma di nuova diagnosi
    E.1.1.1Medical condition in easily understood language
    A malignant tumor originating from brain cells during embryo phase of life and grows in the area of brain stem.
    Un tumore maligno che origina dalle cellule cerebrali durante la fase embrionale della vita e cresce nell'area del tronco cerebrale.
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To compare progression-free survival (PFS) by central review of a personalized intensity-modulated therapy (experimental arm; sonidegib) vs. standard therapy in the SHH-activated subgroup in post-pubertal patients with newly diagnosed standard risk medulloblastoma.
    Confrontare la sopravvivenza libera da progressione (PFS) mediante revisione centrale di una terapia personalizzata a intensità modulata (braccio sperimentale; sonidegib) rispetto alla terapia standard nel sottogruppo attivato da SHH in pazienti post-puberali con medulloblastoma a rischio standard di nuova diagnosi.
    E.2.2Secondary objectives of the trial
    In experimental versus standard arm and in the 3 molecular subgroups separately (except otherwise stated):
    • To compare PFS by central reviewer in the WNT & Group 4 subgroups
    • To compare PFS by local investigator in the 3 molecular subgroups
    • To compare overall survival (OS) in the 3 molecular subgroups
    • To evaluate safety and tolerability profile
    • To evaluate short- and long-term health-related quality of life (HRQoL) with a particular emphasis on the social functioning scale
    • To evaluate issues linked to survivorship (fear of recurrence, having problems with insurance/mortgage, work opportunities, life plans/goals and relationships with family or friends)
    • To evaluate short- and long-term neurocognitive function (NCF)
    • To evaluate short- and long-term endocrine function
    • To assess the incidence of second malignancies
    See protocol for the following:
    Exploratory objectives
    Fertility sub-study objectives (in selected centres)
    Translational research objectives
    Nel braccio sperimentale rispetto a quello standard e nei 3 sottogruppi molecolari separatamente:
    • Per confrontare PFS per revisore centrale nei sottogruppi WNT e Gruppo 4
    • Confrontare la PFS per ricercatore locale nei 3 sottogruppi molecolari
    • Confrontare la OS nei 3 sottogruppi molecolari
    • Valutare il profilo di sicurezza e tollerabilità
    • Valutare la qualità della vita correlata HRQoL a breve e lungo termine con particolare enfasi sulla scala del funzionamento sociale
    • Valutare problemi legati alla sopravvivenza (paura di recidive, problemi con assicurazioni/mutui, opportunità di lavoro, progetti/obiettivi di vita e relazioni con la famiglia o gli amici)
    • Valutare la NCF a breve e lungo termine
    • Per valutare la funzione endocrina a breve e lungo termine
    • Per valutare l'incidenza di secondi tumori maligni
    Vedere il protocollo per quanto segue:
    Obiettivi esplorativi
    Obiettivi del sottostudio sulla fertilità (in centri selezionati)
    Obiettivi della ricerca traslazionale
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Step 1: Registration
    • Before patient registration/randomization/enrollment, written informed consent must be given according to ICH/GCP, and national/local regulations. For patients under age of legal consent, consent has to be obtained from the parent(s) or legal representative according to ICH/GCP, and national/local regulations.
    • FFPE tumor tissue from surgical resection and whole blood for central pathology review
    Step 2: Enrollment/randomization
    • Newly diagnosed, histologically proven, genetically classified, centrally confirmed medulloblastoma (WNT M0-1, SHH (p53wt) M0-1, Group 4 M0-1)
    • Molecular subtype: medulloblastoma, SHH-activated and TP53-wildtype, M0-1; medulloblastoma, WNT-activated, M0-1; medulloblastoma, Group 4, M0-1
    • Histologic subtype: medulloblastoma, classic (CMB); medulloblastoma, desmoplastic/nodular (DNMB); medulloblastoma, with extensive nodularity (MBEN); medulloblastoma, large cell/anaplastic (LCA)
    • Adults (= 18 years) in WNT-activated and Group 4 medulloblastoma
    • Post-pubertal patients (<18y of age), or adults (18 y of age and above) in SHH-activated and TP53-wildtype medulloblastoma
    Non-SHH dependent patients under age 18 should be transferred to a paediatric site for inclusion in the PNET5 trial in countries where PNET5 is open. SHH-activated patients under age 18 with M1 disease or above should be transferred to a paediatric site for inclusion in the HRMB trial in countries where HRMB is open.
    • For patients with SHH activated tumours: exclusion of germline alteration of TP53, PTCH, SUFU, BRCA2 and PALB2 if known before randomization or enrollment
    • Clinical status within 2 weeks of randomization/enrollment: Karnofsky 50-100. NANO-score 0 to 9 (allowing full-blown cerebellar symptoms)
    • Clinically standard-risk (centrally assessed MRI review) defined as: total or near total surgical resection with less than or equal to 1.5 cm2 (measured in axial plane) of residual tumour on early post-operative MRI, without and with contrast; no CNS metastasis on MRI (cranial and spinal); Chang stage M0-1 with no clinical evidence of extra-CNS metastasis
    • Full recovery from surgery or any post-surgical complication (e.g. bleeding, infections etc.)
    • Post-surgery (within 72h) MRI available (pre-surgery MRI upload is encouraged if available)
    • Baseline brain MRI and spinal MRI for uploading available within 2 weeks of randomization/enrollment
    • Normal liver, renal and haematological function within 2 weeks of randomization/enrollment.
    • WBC = 3×10^9/L
    • ANC = 1.5×10^9/L
    • Platelet count of = 100×10^9/L independent of transfusion
    • Hemoglobin = 10 g/dl
    • Total Bilirubin = 1.5 × ULN
    • ALT (SGPT), AST (SGOT), alkaline phosphatase (ALP) = 2.5 × ULN
    • Serum creatinine < 1.5 × ULN or creatinine clearance (CrCl) > 30 mL/min (using the Cockcroft-Gault formula)
    • Negative serum or urine pregnancy test within 7 days before randomization/enrollment for WOCBP
    • Patients of childbearing / reproductive potential (WOCBP) must use two methods of adequate birth control, including a highly effective method and a barrier method during the study treatment period and for at least 20 months after the last study treatment is mandatory for the patients that received sonidegib, for all other patients this period is at least 6 months after the last study treatment. A highly effective method of birth control is defined as those which result in low failure rate (i.e. less than 1% per year) when used consistently and correctly. Male patients even those who have had a vasectomy must always use a condom during treatment and for 6 months after last treatment. Men should not donate semen during treatment and for at least 6 months after ending treatment (donation of semen for the semen analyses in the 1 b fertility project is allowed)
    • Female subjects who are breast feeding must discontinue nursing prior to the first dose of study treatment and until 20 months after the last study treatment
    Passaggio 1: registrazione
    • Prima della registrazione/randomizzazione/arruolamento del paziente, deve essere fornito il consenso informato scritto secondo ICH/GCP e le normative nazionali/locali. Per i pazienti di età inferiore al consenso legale, il consenso deve essere ottenuto dai genitori o dal rappresentante legale secondo ICH/GCP e le normative nazionali/locali.
    • Tessuto tumorale FFPE da resezione chirurgica e sangue intero per la revisione della patologia centrale
    Passaggio 2: randomizzazione
    • Medulloblastoma di nuova diagnosi, accertato istologicamente, classificato geneticamente, confermato centralmente (WNT M0-1, SHH (p53wt) M0-1, Gruppo 4 M0-1)
    • Sottotipo molecolare: medulloblastoma, SHH-attivato e TP53-wildtype, M0-1; medulloblastoma, attivato da WNT, M0-1; medulloblastoma, gruppo 4, M0-1
    • Sottotipo istologico: CMB; DNMB; MBEN; medulloblastoma, a LCA
    • Adulti (= 18 anni) in medulloblastoma attivato da WNT e di Gruppo 4
    • Pazienti post-puberali (<18 anni di età) o adulti (18 anni di età e oltre) con medulloblastoma attivato da SHH e di tipo selvatico TP53
    I pazienti non dipendenti da SHH di età inferiore ai 18 anni devono essere trasferiti in un centro pediatrico per l'inclusione nello studio PNET5 nei paesi in cui PNET5 è aperto. I pazienti attivati ¿¿da SHH di età inferiore a 18 anni con malattia M1 o superiore devono essere trasferiti in un sito pediatrico per l'inclusione nello studio HRMB nei paesi in cui è aperto l'HRMB.
    • Per i pazienti con tumori attivati ¿¿da SHH: esclusione dell'alterazione della linea germinale di TP53, PTCH, SUFU, BRCA2 e PALB2 se nota prima della randomizzazione o dell'arruolamento
    • Stato clinico entro 2 settimane dalla randomizzazione/arruolamento: Karnofsky 50-100. NANO-punteggio da 0 a 9 (consentendo sintomi cerebellari conclamati)
    • Rischio clinicamente standard (revisione RM valutata centralmente) definito come: resezione chirurgica totale o quasi totale con meno o uguale a 1,5 cm2 (misurati sul piano assiale) di tumore residuo alla RM post-operatoria precoce, senza e con mezzo di contrasto; nessuna metastasi al SNC alla risonanza magnetica (cranica e spinale); Stadio di Chang M0-1 senza evidenza clinica di metastasi extra-SNC
    • Recupero completo da un intervento chirurgico o da qualsiasi complicazione post-chirurgica (ad es. sanguinamento, infezioni, ecc.)
    • MRI post-operatorio (entro 72 ore) disponibile
    • RM cerebrale basale e RM spinale per il caricamento disponibili entro 2 settimane dalla randomizzazione/iscrizione
    • Normale funzionalità epatica, renale ed ematologica entro 2 settimane dalla randomizzazione/arruolamento.
    • GB = 3×10^9/L
    • ANC = 1,5×10^9/L
    • Conta piastrinica di = 100×10^9/L indipendente dalla trasfusione
    • Emoglobina = 10 g/dl
    • Bilirubina totale = 1,5 × ULN
    • ALT (SGPT), AST (SGOT), fosfatasi alcalina (ALP) = 2,5 × ULN
    • Creatinina sierica < 1,5 × ULN o clearance della creatinina (CrCl) > 30 ml/min
    • Test di gravidanza negativo su siero o urine entro 7 giorni prima della randomizzazione/arruolamento per WOCBP
    • I pazienti in età fertile/riproduttiva (WOCBP) devono utilizzare due metodi di controllo delle nascite adeguato, compreso un metodo altamente efficace e un metodo di barriera durante il periodo di trattamento in studio e per almeno 20 mesi dopo che l'ultimo trattamento in studio è obbligatorio per i pazienti che ricevuto sonidegib, per tutti gli altri pazienti questo periodo è di almeno 6 mesi dopo l'ultimo trattamento in studio.
    • I soggetti di sesso femminile che stanno allattando devono interrompere l'allattamento prima della prima dose del trattamento in studio e fino a 20 mesi dopo l'ultimo trattamento in studio
    E.4Principal exclusion criteria
    Exclusion criteria
    Step 2: Enrollment/randomization
    • Prior treatment for medulloblastoma
    • Unavailability of central review pathology results
    • Known prognostic markers (MYC/MYCN amplification, MYC/MYCN mutation)
    • Inability to start radiotherapy within 43 days after surgery
    • Significant sensorineural hearing deficit as defined by pure tone audiometry with bone conduction or air conduction and normal tympanogram showing impairment = 20 dB at 1-3 kHz
    • Any medical contraindication to radiotherapy or chemotherapy
    • Hypersensitivity to contrast medium for MRI
    • Hypersensitivity towards the active substance of any of study drugs or their excipients
    • Prior or current use of mitoxantrone, methotrexate, topotecan, imatinib, irinotecan or statins
    • Concurrent severe or uncontrolled medical disease (e.g., active systemic infection, diabetes, psychiatric disorder) that, in the opinion of the investigator, would compromise the safety of the patient or compromise the ability of the patient to complete the study
    • Prior or second invasive malignancy, except non-melanoma skin cancer, completely resected cervical carcinoma in situ, low risk prostate cancer (cT1-2a N0 and Gleason score = 6 and PSA < 10 ng/mL), either totally resected or irradiated with curative intent (with PSA of less than or equal to 0.1 ng/mL) or under active surveillance as per ESMO guidelines. Other cancers for which the subject has completed potentially curative treatment more than 5 years prior to diagnosis of medulloblastoma study entry are allowed
    • Known history or current evidence of active Hepatitis B (e.g., positive HBV surface antigen) or C (e.g., HCV RNA [qualitative] is detected)
    • Known or current evidence of Human Immunodeficiency Virus (HIV) infection (positive HIV-1/2 antibodies)
    • Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial.
    All eligibility criteria must be adhered to. A deviation of 5% for hematological and 10% for biochemistry values will be acceptable.
    The randomization/enrollment process can start after central pathology results are available.
    Treatment must start within 14 days of randomization/enrollment BUT the latest on day 43 after surgery.
    Criteri di esclusione
    Passaggio 2: iscrizione/randomizzazione
    • Trattamento precedente per medulloblastoma
    • Indisponibilità dei risultati della revisione centrale della patologia
    • Marcatori prognostici noti (amplificazione MYC/MYCN, mutazione MYC/MYCN)
    • Impossibilità di iniziare la radioterapia entro 43 giorni dall'intervento
    • Deficit uditivo neurosensoriale significativo come definito dall'audiometria a tono puro con conduzione ossea o aerea e timpanogramma normale che mostra una compromissione = 20 dB a 1-3 kHz
    • Qualsiasi controindicazione medica alla radioterapia o alla chemioterapia
    • Ipersensibilità al mezzo di contrasto per la risonanza magnetica
    • Ipersensibilità verso il principio attivo di uno qualsiasi dei farmaci in studio o dei loro eccipienti
    • Uso precedente o attuale di mitoxantrone, metotrexato, topotecan, imatinib, irinotecan o statine
    • Malattia medica grave o non controllata concomitante (ad es. infezione sistemica attiva, diabete, disturbo psichiatrico) che, a parere dello sperimentatore, comprometterebbe la sicurezza del paziente o comprometterebbe la capacità del paziente di completare lo studio
    • Precedenti o secondi tumori maligni invasivi, eccetto carcinoma cutaneo non melanoma, carcinoma cervicale in situ completamente resecato, carcinoma prostatico a basso rischio (cT1-2a N0 e punteggio di Gleason = 6 e PSA < 10 ng/mL), totalmente resecato o irradiato con intento curativo (con PSA inferiore o uguale a 0,1 ng/mL) o sotto sorveglianza attiva secondo le linee guida ESMO. Sono consentiti altri tumori per i quali il soggetto ha completato un trattamento potenzialmente curativo più di 5 anni prima della diagnosi di accesso allo studio sul medulloblastoma
    • Storia nota o evidenza attuale di epatite B attiva (ad es. antigene di superficie HBV positivo) o C (ad es. HCV RNA [qualitativo] rilevato)
    • Evidenza nota o attuale di infezione da virus dell'immunodeficienza umana (HIV) (anticorpi HIV-1/2 positivi)
    • Presenza di qualsiasi condizione psicologica, familiare, sociologica o geografica che possa ostacolare il rispetto del protocollo di studio e del programma di follow-up; tali condizioni dovrebbero essere discusse con il paziente prima della registrazione allo studio.
    Tutti i criteri di ammissibilità devono essere rispettati. Sarà accettabile una deviazione del 5% per i valori ematologici e del 10% per i valori biochimici.
    Il processo di randomizzazione/arruolamento può iniziare dopo che sono disponibili i risultati della patologia centrale.
    Il trattamento deve iniziare entro 14 giorni dalla randomizzazione/arruolamento, MA l'ultima il giorno 43 dopo l'intervento.
    E.5 End points
    E.5.1Primary end point(s)
    Progression-Free Survival (PFS) according to RAPNO assessed by central reviewer of a personalized intensity-modulated therapy (experimental arm; sonidegib) in SHH-activated patients.
    Sopravvivenza libera da progressione (PFS) secondo RAPNO valutata da un revisore centrale di una terapia personalizzata a intensità modulata (braccio sperimentale; sonidegib) in pazienti attivati da SHH.
    E.5.1.1Timepoint(s) of evaluation of this end point
    [ Time Frame: 91 months after the date of recruitment of the first patient ]
    Compare progression-free survival (PFS) by central review of a personalized intensity-modulated therapy (experimental arm; sonidegib) vs. standard therapy in the SHH-activated subgroup in post-pubertal patients with newly diagnosed standard risk medulloblastoma

    [ Time Frame: 91 mesi dalla data di reclutamento del primo paziente ]
    Confrontare la sopravvivenza libera da progressione (PFS) mediante revisione centrale di una terapia personalizzata a intensità modulata (braccio sperimentale; sonidegib) rispetto alla terapia standard nel sottogruppo attivato da SHH in pazienti post-puberali con medulloblastoma a rischio standard di nuova diagnosi
    E.5.2Secondary end point(s)
    • PFS by central reviewer in WNT and Group 4 patients.
    • PFS by local investigator in the 3 molecular subgroups
    • OS
    • Frequencies and percentages of worst adverse events (AEs) or laboratory event; grades according to CTCAE v.5 (with neurological, kidney, auditory, endocrine and radiotherapy associated as AE of special interest)
    • Patient reported outcomes:
    • Health-related Quality of life (HRQol): EORTC QLQ-C30 + BN20, social functioning as scale of special interest
    • Survivorship outcomes (five items from EORTC QLQ-SURV111)
    • Neurocognitive function (NCF): Hopkins Verbal Learning Test, Controlled Oral Word Association Trail Making Test Part A, Trail Making Test Part B, cerebellar cognitive affective/Schmahmann syndrome scale
    • Clinical endocrine function parameters: adynamia, tiredness, reduced concentration, depression, intolerance against cold, muscle weakness, obesity, oligomenorrhea, intermenstrual bleeding, sexual dysfunction, decline in libido, pain during intercourse, infertility, constipation, polydipsia, polyuria, hair loss, dry skin, osteoporosis, skin edema, decreased weight, and thyroid function parameters: TSH, if abnormal FT3 and FT4
    • Frequencies and percentages of second malignancies
    PFS da parte del revisore centrale nei pazienti WNT e del gruppo 4.
    • PFS da investigatore locale nei 3 sottogruppi molecolari
    • Sistema operativo
    • Frequenze e percentuali dei peggiori eventi avversi (AE) o eventi di laboratorio; gradi secondo CTCAE v.5 (con neurologici, renali, uditivi, endocrini e radioterapia associati come AE di particolare interesse)
    • Risultati riportati dai pazienti:
    • Qualità della vita correlata alla salute (HRQol): EORTC QLQ-C30 + BN20, funzionamento sociale come scala di interesse speciale
    • Risultati di sopravvivenza (cinque elementi da EORTC QLQ-SURV111)
    • Funzione neurocognitiva (NCF): Hopkins Verbal Learning Test, Controlled Oral Word Association Trail Making Test Parte A, Trail Making Test Parte B, scala cognitivo affettiva cerebellare/sindrome di Schmahmann
    • Parametri clinici della funzione endocrina: adinamia, stanchezza, riduzione della concentrazione, depressione, intolleranza al freddo, debolezza muscolare, obesità, oligomenorrea, sanguinamento intermestruale, disfunzione sessuale, calo della libido, dolore durante i rapporti, infertilità, stitichezza, polidipsia, poliuria, perdita di capelli , pelle secca, osteoporosi, edema cutaneo, diminuzione del peso e parametri di funzionalità tiroidea: TSH, se FT3 e FT4 anormali
    • Frequenze e percentuali di secondi tumori
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    E.5.2.1Timepoint(s) of evaluation of this end point
    1. (PFS) [ when 43 PFS events are observed estimated to occur 91 months after the date of recruitment of 1st patient]
    2. (OS) [ when 43 PFS events are observed estimated to occur 91 m after the date of recruitment of 1st patient]
    3.safety and tolerability profile: CTCAE v5 [ when 43 PFS events are observed estimated to occur 91 months after the date of recruitment of 1st patient]
    4. (HRQoL) [ when 43 PFS events are observed estimated to occur 91 m after the date of recruitment of 1st patient]
    The primary HRQoL endpoint that is considered relevant for this study is social functioning. The other scales from the QLQ-C30 and BN20 considered as exploratory in nature.
    5.OS[when 43 PFS events are observed estimated to occur 91 M after the date of recruitment of 1st patient
    1. (PFS) [quando si osservano 43 eventi di PFS stimati a 91 mesi dopo la data di reclutamento del 1° paziente]
    2. (OS) [quando si osservano 43 eventi di PFS stimati a 91 m dopo la data di reclutamento del 1° paziente]
    3.profilo di sicurezza e tollerabilità: CTCAE v5 [quando si osservano 43 eventi di PFS stimati a 91 mesi dopo la data di reclutamento del 1° paziente]
    4. (HRQoL) [quando si osservano 43 eventi di PFS stimati a 91 m dopo la data di reclutamento del 1° paziente]
    L'endpoint primario HRQoL considerato rilevante per questo studio è il funzionamento sociale. Le altre scale della QLQ-C30 e della BN20 sono considerate di natura esplorativa.
    5.OS[quando si osservano 43 eventi di PFS stimati 91 M dopo la data di reclutamento del 1° paziente
    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 No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Radiotherapy, QOL, radiogenomics, neurocognitive function, long term effects, impact on fertility, biobanking
    Radioterapia, QOL, radiogenomica, funzione neurocognitiva, effetti a lungo termine, impatto sulla fertilità, biobanche
    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 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 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 concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA36
    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
    Australia
    Austria
    Denmark
    France
    Germany
    Italy
    Netherlands
    Spain
    Switzerland
    United Kingdom
    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
    End of study occurs when all of the following criteria have been satisfied:
    • 5 months after all patients have stopped protocol treatment.
    • The trial is mature for the analysis of the primary endpoint as defined in the protocol.
    • The database has been fully cleaned and frozen for this analysis.
    La fine dello studio si verifica quando tutti i seguenti criteri sono stati soddisfatti:
    • 5 mesi dopo che tutti i pazienti hanno interrotto il trattamento del protocollo.
    • Lo studio è maturo per l'analisi dell'endpoint primario come definito nel protocollo.
    • Il database è stato completamente pulito e bloccato per questa analisi.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years7
    E.8.9.1In the Member State concerned months5
    E.8.9.1In the Member State concerned days83
    E.8.9.2In all countries concerned by the trial years7
    E.8.9.2In all countries concerned by the trial months5
    E.8.9.2In all countries concerned by the trial days83
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    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) Yes
    F.1.1.6.1Number of subjects for this age range: 37
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 164
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 4
    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 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 Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    Minor patients will give assent and one or both parents will sign the consent . The legal age is defined according to each country local legislation
    I pazienti minorenni daranno il consenso e uno o entrambi i genitori firmeranno il consenso. L'età legale è definita in base alla legislazione locale di ciascun paese
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state23
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 163
    F.4.2.2In the whole clinical trial 205
    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)
    According to the discretion of the treating physician
    A discrezione del medico curante
    G. Investigator Networks to be involved in the Trial
    G.4 Investigator Network to be involved in the Trial: 1
    G.4.1Name of Organisation University of Munich
    G.4.3.4Network Country Germany
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2022-03-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-06-27
    P. End of Trial
    P.End of Trial StatusOngoing
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