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    Summary
    EudraCT Number:2020-003946-36
    Sponsor's Protocol Code Number:TAK-981-1501
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2021-06-09
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2020-003946-36
    A.3Full title of the trial
    Phase 1/2 Study of TAK-981 in Combination With Rituximab in Patients With Relapsed/Refractory CD20-Positive Non-Hodgkin Lymphoma
    Ensayo de fase 1/2 de TAK-981 en combinación con rituximab en pacientes con linfoma no Hodgkin positivo para CD20 en recaída o refractario
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Phase 1/2 Study of TAK-981 in Combination With Rituximab in Patients With Lymphoma
    Ensayo de fase 1/2 de TAK-981 en combinación con rituximab en pacientes con linfoma
    A.4.1Sponsor's protocol code numberTAK-981-1501
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04074330
    A.5.3WHO Universal Trial Reference Number (UTRN)U1111-1236-0243
    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 SponsorTakeda Development Center Americas, Inc.
    B.1.3.4CountryUnited States
    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 supportTakeda Development Center Americas, Inc. (TDC Americas)
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationTakeda Pharmaceuticals International, Co
    B.5.2Functional name of contact pointStudy Registration Call Center
    B.5.3 Address:
    B.5.3.1Street Address40 Landsowne Street
    B.5.3.2Town/ cityCambridge, MA
    B.5.3.3Post code02139
    B.5.3.4CountryUnited States
    B.5.4Telephone number900 834 223
    B.5.6E-mailRegistroEspanolDeEstudiosClinicos@druginfo.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 nameNA
    D.3.2Product code TAK-981
    D.3.4Pharmaceutical form 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 INNNot available
    D.3.9.1CAS number 1858276-04-6
    D.3.9.2Current sponsor codeTAK-981
    D.3.9.4EV Substance CodeSUB218403
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name MabThera
    D.2.1.1.2Name of the Marketing Authorisation holderRoche Registration GmbH
    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 nameRituximab
    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 INNRITUXIMAB
    D.3.9.1CAS number 174722-31-7
    D.3.9.2Current sponsor codeRITUXIMAB
    D.3.9.4EV Substance CodeSUB12570MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    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 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
    Relapsed/Refractory CD20-Positive Non-Hodgkin Lymphoma
    Ensayo de fase 1/2 de TAK-981 en combinación con rituximab en pacientes con linfoma no Hodgkin
    E.1.1.1Medical condition in easily understood language
    Lymphoma
    Linfoma
    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 HLGT
    E.1.2Classification code 10025320
    E.1.2Term Lymphomas non-Hodgkin's B-cell
    E.1.2System Organ Class 10005329 - Blood and lymphatic system disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Phase 1: To determine the safety and tolerability of TAK-981 in combination with rituximab in patients with r/r NHL.
    To establish the recommended Phase 2 dose (RP2D) of TAK-981 in combination with rituximab.
    Phase 2: To evaluate the efficacy of TAK-981 in combination with rituximab in select r/r NHL indications.
    Fase 1:
    •Determinar la seguridad y la tolerabilidad de TAK-981 en combinación con rituximab en pacientes con LNH positivo para CD20 r/r.
    •Establecer la DRF2 de TAK-981 en combinación con rituximab.
    Fase 2:
    •Evaluar la eficacia de TAK-981 en combinación con rituximab en determinadas indicaciones de LNH r/r.
    E.2.2Secondary objectives of the trial
    To characterize the PK profile of TAK-981 in combination with rituximab.
    Phase 1: To determine the MTD and/or pharmacologically active dose (PAD) of TAK-981 when administered in combination with rituximab.
    To assess the preliminary antitumor activity of TAK-981-rituximab combination.
    To assess target engagement of TAK-981 (SUMO-TAK-981 adduct formation) and SUMOylation pathway inhibition in blood and skin.
    Phase 2: To evaluate the efficacy of TAK-981 in combination with rituximab in select r/r NHL as measured by disease control rate (DCR), duration of response (DOR), time to progression (TTP), and progression-free survival (PFS).
    To evaluate the safety and tolerability of TAK-981 in combination with rituximab.
    To assess target engagement of TAK-981 (SUMO-TAK-981 adduct formation) and SUMOylation pathway inhibition in tumor.
    •Caracterizar el perfil FC de TAK-981 en combinación con rituximab.
    Fase 1:
    •Determinar la DMT o la DFA de TAK-981 cuando se administra en combinación con rituximab.
    •Evaluar la actividad antitumoral preliminar de la combinación de TAK-981 y rituximab.
    •Evaluar la actuación sobre la diana de TAK-981 (formación de aductos de SUMO-TAK-981) y la inhibición de la vía de SUMOilación en la sangre y la piel.
    Fase 2:
    •Evaluar la eficacia de TAK-981 en combinación con rituximab en determinados LNH r/r, determinada mediante la tasa de control de la enfermedad (TCE), la duración de la respuesta (DR), el tiempo hasta la progresión (THP) y la SSP.
    •Evaluar la seguridad y la tolerabilidad de TAK-981 en combinación con rituximab.
    •Evaluar la actuación sobre la diana de TAK-981 (formación de aductos en SUMO-TAK-981) y la inhibición de la vía de SUMOilación en el tumor.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Adults ≥18 years old.
    2. For Phase 1 Dose Escalation:aNHL including mantle cell lymphoma and DLBCL histologies such as transformed DLBCL from low-grade lymphoma (follicular or others), DLBCL associated with small-cell infiltration in bone marrow, B-cell lymphoma with intermediate features between DLBCL and Burkitt’s lymphoma or with intermediate features between DLBCL and Hodgkin lymphoma, FL grade 3B, and aggressive B-cell lymphoma unclassifiable who must have previously received rituximab, cyclophosphamide, doxorubicin (hydroxydaunorubicin), vincristine, (Oncovin) and prednisone (R-CHOP) (or equivalent anti-CD20 containing therapy) and 1 additional line of therapy in the r/r setting; iNHL (including FL of grades 1–3A and marginal zone lymphoma) refractory to rituximab or to any other anti-CD20 monoclonal antibodies, who have received at least 1 prior systemic therapy for r/r iNHL:Rituximab or anti-CD20 refractoriness is defined as failure to respond to, or progression during, any previous rituximab/anti-CD20-containing regimen (monotherapy or combined with chemotherapy), or progression within 6 months of the last rituximab or anti-CD20 dose.
    For Phase 2, the following CD20 positive: r/r DLBCL progressed or relapsed after a prior chimeric antigen receptor (CAR) T-cells therapy that has received approval by a health authority for the treatment of DLBCL (Cohort A); r/r DLBCL that has progressed or relapsed after at least 2 but no more than 3 prior lines of systemic therapy and has not received prior cellular therapy. At least one prior line of therapy must have included a CD20-targeted therapy (Cohort B); r/r FL that has progressed or relapsed after at least 2 but no more than 3 prior lines of
    systemic therapy. At least one prior line of therapy must have included a CD20-targeted therapy (Cohort C).
    3. Patients must be considered ineligible for, in the opinion of the investigator, or must have refused autologous stem cell transplantation.
    4.Eastern Cooperative Oncology Group (ECOG) performance score of ≤2.
    5. Adequate bone marrow function per local laboratory reference range at screening
    6. Adequate renal and hepatic function, per local laboratory reference range at screening
    7. Left ventricular ejection fraction (LVEF) ≥40%; as measured by echocardiogram or multiple gated acquisition scan (MUGA).
    8. Suitable venous access for safe drug administration and the study-required PK and pharmacodynamic sampling.
    9. Have at least 1 bidimensionally measurable lesion per Lugano Classification (>1.5 cm in its largest dimension) by computed tomography (CT). Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions. In the Phase 2, Stage 1 portion of the study >1 measurable lesions are required, 1 for biopsy, and 1 for response.
    10. Willing to consent to 1 mandatory pretreatment and 1 on-treatment skin biopsy during Phase 1. The skin biopsy entry requirement may be discontinued by the sponsor once there is enough pharmacodynamic evidence of target engagement.
    11. For patients enrolled in Phase 2, Stage 1, willing to consent to one mandatory pretreatment and 1 on-treatment tumor biopsy. For fresh tumor biopsies, the lesion must be accessible for a low-risk biopsy procedure (those occurring outside the brain, lung/mediastinum, and intra-abdominal, or obtained with endoscopic procedures beyond the stomach or bowel). Outside of Phase 2, Stage 1, paired tumor biopsies are optional.
    12. Recovered to Grade 1, baseline or established as sequela, from all toxic effects of previous therapy (except alopecia, neuropathy, autoimmune endocrinopathies with stable endocrine replacement therapy, neurotoxicity [Grade 1 or 2 permitted], or bone marrow parameters [any of Grade 1, 2, permitted if directly related to bone marrow involvement]).
    13. Women of childbearing potential participating in this study should avoid becoming pregnant, and male patients should avoid impregnating a female partner. Nonsterilized female patients of reproductive age and male patients should use effective methods of contraception through defined periods during and after study treatment.
    14. Male patients, even if surgically sterilized (ie, status postvasectomy) must agree to 1 of the following:Agree to practice effective barrier contraception during the entire study treatment period and through 12 months after the last dose of study drug, or Agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods], withdrawal, spermicides only, and lactational amenorrhea are not acceptable methods of contraception. Female and male condoms should not be used together.)
    15. Subject has provided informed consent.
    16. Must be willing and able to comply with clinic visits and procedures outlined in the study protocol.
    1. Adultos ≥18 años.2. Poblaciones de pacientes: En fase 1 de aumento escalonado de la dosis a LNHa con histologías de linfoma de cél. del manto y LDLBG, como LDLBG transformado a partir de linfoma de bajo grado (folicular u otros), LDLBG asociado a infiltración de cél. pequeñas en la méd. ósea, linfoma de linfocitos B con caract. intermedias entre LDLBG y linfoma de Burkitt o con caract. intermedias entre LDLBG y linfoma de Hodgkin, LF de grado 3B y linfoma de linfocitos B agresivo inclasificable que deben haber recibido previamente rituximab, ciclofosfamida, doxorrubicina (hidroxidaunorrubicina), vincristina (Oncovin®) y prednisona (R-CHOP) (o un tto. con anti-CD20 equivalente) y 1 línea adicional de tto. en el contexto r/r; LNHi (incluido LF de grado 1–3A y linfoma de la zona marginal) resist. a rituximab o a cualquier otro anticuerpo monoclonal anti-CD20 que hayan recibido al menos 1 tto. sistémico previo para el LNHi r/r: La res. a rituximab o anti-CD20 definida como la falta de respuesta o la prog. durante cualquier régimen previo con rituximab/anti-CD20 (en monoterapia o combinado con quimio), o la prog. en los 6 meses sig. a la última dosis de rituximab o anti CD20. En la fase 2, los sig. res. positivos para CD20: *El LDLBG r/r progresó o recidivó después de un tto. previo con linfocitos T con CAR que ha recibido la aprob. de una aut. sanitaria para el tto. del LDLBG (cohorte A). *LDLBG r/r que ha prog. o recidivado después de un min. de 2 pero no más de 3 líneas previas de tto. sistémico y que no ha recibido tto. celular previo. Al menos una lín. previa de tto. debe haber incl. un tto. contra CD20 (cohorte B). *LF r/r que ha progresado o recidivado después de un min. de 2 pero no más de 3 lín. previas de tto. sistémico. Al menos una lín. previa de tto. debe haber incluido un tto. contra CD20 (cohorte C). 3. Los pacientes no podrán, en opinión del invest., optar por el autotrasplante de cél. madre. 4. Estado funcional del Eastern Cooperative Oncology Group ≤2. 5. Func. adecuada de la méd. ósea según el int. de ref. del lab.local en la selección. 6. Func. renal y hepática adecuada, conforme al int. de ref. del lab.local en la selección. 7. Fracción de eyección del ventrículo izquierdo ≥40 %, medida mediante ecocardiograma o ventriculografía isotópica. 8. Acceso venoso adecuado para la admon. segura del fármaco y la obt. de muestras para farmacocin. y farmacodin. exigidas por el estudio. 9. Presencia de al menos una lesión mensurable en dos dim. según clasif. Lugano (>1,5 cm en su dim. mayor) med. tomografía comput.. Las lesiones tumorales sitas en zona irradiada prev. se considerarán mensurables si se ha demostrado prog. en dichas lesiones. En la etapa 1 fase 2 del estudio se precisan más de una lesión mensurable, una para biopsia y otra para respuesta. 10. Disposición a otorgar consent. para una biopsia cutánea obligatoria previa al tto. y otra durante el tto. en la fase 1. El promotor podrá suspender el requisito de introducción de biopsias cutáneas una vez que haya indicios farmacodin. suf. de actuación sobre la diana. 11. En los pac. incl. en la etapa 1 fase 2, disposición a otorgar su consent. para una biopsia tumoral obligatoria previa al tto. y otra durante el tto.. En caso de biopsias tumorales recientes, la lesión deberá ser accesible para se pueda llevar a cabo un proc. de biopsia de bajo riesgo (sitas fuera del cerebro, pulmón/mediastino y intraabdominales, u obtenidas mediante proc. endoscópicos más allá del estómago o intestino). Aparte de la etapa 1 fase 2, las biopsias tumorales emparejadas son opcionales. 12. Recuperado a un grado 1, basal o establecido como secuela, de todos los ef. tóxicos del tto. previo (exc. alopecia, neuropatía, endocrinopatías autoinmunitarias con tto. de reposición endocrina estable, neurotoxicidad [grado 1 o 2 permitido] o parám. de la méd. ósea [cualquiera de los gr. 1 o 2 permitidos si está direct. relac. con la afectación de la méd. ósea]). 13. Las mujeres en edad fértil que participen deberán evitar quedarse embarazadas y los varones no deberán dejar emb. a sus parejas. Las muj. en edad fértil no ester. y los varones deberán usar métodos anticonc. eficaces durante períodos definidos durante y después del tto. del estudio. 14. Los pac. varones, aunque se hayan sometido a vasectomía, deberán comprometerse a utilizar un método anticonc. de barrera eficaz durante todo el período de tto. del estudio y hasta 12m tras la última dosis del fármaco del estudio o a practicar abstinencia real acorde con su modo de vida pref. y habitual, la abst. periódica [ej. mét. del calendario, ovulación, sintotérmico o postovulatorio], el coito interr., el uso excl. de espermicidas y la amenorrea por lactancia no son métodos anticonc. aceptables. No deberán usarse preservativos fem. y masc. conjuntamente. 15. El pac. ha otorgado su consentimiento inf.. 16. Debe estar dispuesto y ser capaz de cumplir con las visitas al centro y los proced. descritos en el protocolo del estudio
    E.4Principal exclusion criteria
    1. CNS lymphoma; active brain or leptomeningeal metastases, as indicated by positive cytology from lumbar puncture or CT scan/magnetic resonance imaging (MRI).
    2. Hypersensitivity to TAK-981, rituximab, or any component of the drug product.
    3. History of Grade ≥3 IRR that lead to permanent discontinuation of previous rituximab treatment.
    4. Previous participation in the TAK-981-1002 clinical study.
    5. Posttransplantation lymphoproliferative disease except relapsed NHL after autologous stem-cell transplantation.
    6. Undergone ASCT or treatment with cellular therapy including CAR T within ≤ 3 months of TAK-981 dosing.
    7. Prior allogeneic hematopoietic stem-cell transplantation.
    8. Lymphomas with leukemic expression.
    9. Prior anticancer therapy including chemotherapy, hormonal therapy, or investigational agents within 2 weeks or within at least 5 half-lives before TAK-981 dosing, whichever is shorter. Low dose steroids (oral prednisone or equivalent ≤20 mg per day), hormonal therapy for prostate cancer or breast cancer (in adjuvant situation), and treatment with bisphosphonates and RANKL (receptor activator of nuclear factor kappa-B ligand) inhibitors are allowed.
    10. Major surgery within 14 days before the first dose of study drug and not recovered fully from any complications from surgery.
    11. Significant medical diseases or conditions, as assessed by the Investigators and Sponsor that would substantially increase the risk-benefit ratio of participating in the study. This includes but is not limited to acute myocardial infarction or unstable angina within the last 6 months; uncontrolled diabetes mellitus; significant active bacterial, viral or fungal infections; severely immunocompromised state; severe non-compensated hypertension and congestive heart failure New York Heart Association Class III or IV; ongoing symptomatic cardiac arrhythmias of >Grade 2, pulmonary embolism, or symptomatic cerebrovascular events; or any other serious cardiac condition (eg, pericardial effusion or restrictive cardiomyopathy). Chronic atrial fibrillation on stable anticoagulant therapy is allowed.
    12. Known chronic hepatitis C and/or positive serology (unless due to vaccination or passive immunization due to Ig therapy) for chronic hepatitis B. Known HIV infection.
    13. Second malignancy within the previous 3 years, except treated basal cell or localized squamous skin carcinomas, localized prostate cancer, cervical carcinoma in situ, resected colorectal adenomatous polyps, breast cancer in situ, or other malignancy for which the patient is not on active anticancer therapy as defined in Exclusion Criterion 9.
    14. Receipt of any live vaccine within 4 weeks of initiation of study treatment.
    15. Active, uncontrolled autoimmune disease requiring >20 mg of prednisone or equivalent, cytotoxics, or biologicals.
    16. Corticosteroid use within 1 week before the first dose of study drug, except as indicated for other medical conditions such as inhaled steroid for asthma, topical steroid use, or as premedication for administration of study drug or contrast. Patients requiring steroids at daily doses >20 mg prednisone equivalent systemic exposure daily, or those who are administered steroids for lymphoma control or white blood cell count lowering are not eligible.
    17. History of medical or psychiatric illness likely to interfere with the ability to comply with protocol requirements or give informed consent.
    18. Patients with baseline prolongation of the Fridericia-corrected QT interval (QTcF) (eg, repeated demonstration of corrected QT interval (QTcT)>480 ms, history of congenital long QT syndrome, or torsades de pointes).
    19. Receiving or requiring the continued use of medications that are known to be strong or moderate inhibitors and inducers of CYP3A4/5 and strong Pgp inhibitors. To participate in this study, such patients should discontinue use of such agents for at least 2 weeks (1 week forCYP3A4/5 and Pgp inhibitors) before receiving a dose of TAK-981.
    20. Female patients who are lactating and breastfeeding or have a positive urine or serum pregnancy test during the screening period or on Day 1 before first dose of study drug.
    Criterios de exclusión principales:
    1.Linfoma del sistema nervioso central; metástasis cerebrales o leptomeníngeas activas, según lo indicado por una citología positiva en una punción lumbar o una TC o resonancia magnética.
    2.Hipersensibilidad a TAK-981, rituximab o a cualquiera de los componentes del medicamento.
    3.Antecedentes de RRI de grado ≥3 que motiven la suspensión permanente del tratamiento previo con rituximab.
    4.Participación previa en el estudio clínico TAK-981-1002.
    5.Enfermedad linfoproliferativa postrasplante, excepto el LNH recidivante después de un autotrasplante de células madre.
    6.Haberse sometido a ATCM o a tratamiento celular como linfocitos T con CAR en los ≤3 meses previos a la administración de TAK-981.
    7.Alotrasplante de células madre hematopoyéticas previo.
    8. Linfomas con expresión leucémica.
    9. Tratamiento antineoplásico previo con quimioterapia, hormonoterapia o fármacos en investigación en las 2 semanas o al menos 5 semividas previas a la administración de TAK-981, lo que suponga menos tiempo. Se permite el uso de corticoesteroides en dosis bajas (prednisona oral o equivalente ≤20 mg al día), tratamiento hormonal para el cáncer de próstata o el cáncer de mama (en situación adyuvante) y tratamiento con bisfosfonatos e inhibidores de RANKL (ligando del receptor activador del factor nuclear kappa-B).
    10. Intervención de cirugía mayor en los 14 días previos a la primera dosis del fármaco del estudio y ausencia de recuperación plena de cualquier complicación de la intervención quirúrgica.
    11. Enfermedades o trastornos médicos importantes, según la evaluación de los investigadores y el promotor, que podrían aumentar considerablemente la relación entre riesgos y beneficios de la participación en el estudio. Por ejemplo, infarto agudo de miocardio o angina inestable en los 6 últimos meses,diabetes mellitus no controlada; infecciones bacterianas, víricas o micóticas activas importantes; estado de inmunodepresión grave; hipertensión no compensada grave e insuficiencia cardíaca congestiva de clase III o IV de la New York Heart Association; arritmias cardíacas sintomáticas en curso de grado >2, embolia pulmonar o acontecimientos cerebrovasculares sintomáticos; o cualquier otra cardiopatía grave (p. ej., derrame pericárdico o miocardiopatía restrictiva). Se permite la fibrilación auricular crónica en tratamiento anticoagulante estable.
    12. Hepatitis C crónica conocida o serología positiva (a menos que se deba a vacunación o inmunización pasiva debido al tratamiento con inmunoglobulinas) para hepatitis B crónica. Infección conocida por el VIH.
    13. Segunda neoplasia maligna en los 3 años anteriores, excepto carcinomas basocelulares o espinocelulares localizados tratados, cáncer de próstata localizado, carcinoma cervicouterino in situ, pólipos adenomatosos colorrectales resecados, cáncer de mama in situ u otra neoplasia maligna para la que el paciente no esté recibiendo tratamiento antineoplásico activo según se define en el criterio de exclusión 9.
    14. Recepción de una vacuna de microorganismos vivos en las 4 semanas previas al comienzo del tratamiento del estudio.
    15. Enfermedad autoinmunitaria activa no controlada que precise >20 mg de prednisona o equivalente, citotóxicos o productos biológicos.
    16. Uso de corticoesteroides en la semana previa a la primera dosis del fármaco del estudio, excepto los indicados para otras enfermedades, como corticoesteroides inhalados para el asma, uso de esteroides tópicos o premedicación para la administración del fármaco del estudio o contraste. No podrán participar los pacientes que precisen corticoesteroides en dosis diarias >20 mg de exposición sistémica equivalente a prednisona al día ni los que reciban esteroides para controlar el linfoma o reducir el recuento de leucocitos.
    17. Antecedentes de enfermedad física o psiquiátrica que probablemente interfiera en la capacidad de cumplir los requisitos del protocolo o de otorgar el consentimiento informado.
    18. Pacientes con prolongación basal del intervalo QT corregido con la fórmula de Fridericia (QTcF) (p. ej., demostración repetida de un intervalo QT corregido QTcT >480 ms, antecedentes de síndrome de QT largo congénito o torsades de pointes).
    19. Recepción o necesidad de uso continuado de medicamentos que sean inhibidores o inductores potentes o moderados del citocromo P-450 (CYP)3A4/5 e inhibidores potentes de la glucoproteína P (Pgp). Para participar en este estudio, estos pacientes deberán suspender el uso de estos fármacos durante al menos 2 semanas (1 semana para los inhibidores de la CYP3A4/5 y la Pgp) antes de recibir una dosis de TAK-981.
    20.Mujeres que estén dando el pecho o tengan una prueba de embarazo en orina o suero positiva durante el período de selección o una prueba de embarazo en orina positiva el día 1 antes de recibir la primera dosis del fármaco del estudio.
    E.5 End points
    E.5.1Primary end point(s)
    Phase 1:
    Frequency, severity, and duration of TEAEs and laboratory abnormalities for all dose groups according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Version 5.0; except CRS which will be graded according to American Society for Transplantation and Cellular Therapy (ASTCT) Consensus Grading forCRS.
    Occurrence of DLTs within the first 21 days of treatment in Cycle 1.
    Phase 2:
    ORR (CR + PR) as defined by the investigator according to Lugano Classification for lymphomas.
    Fase 1:
    •Frecuencia, intensidad y duración de los AAST y las anomalías analíticas en todos los grupos de dosis según los criterios del National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE del NCI), versión 5.0, excepto el SLC, que se graduará con arreglo a la clasificación de consenso para el SLC de la ASTCT.
    •Aparición de TLD en los primeros 21 días de tratamiento del ciclo 1
    Fase 2:
    •Tasa de respuesta global (TRG) (RC + RP), definida por el investigador conforme a la clasificación de Lugano para linfomas
    E.5.1.1Timepoint(s) of evaluation of this end point
    Phase 1 and Phase 2
    Fase 1 y Fase 2
    E.5.2Secondary end point(s)
    PK parameters after the first dose of TAK-981 on C1D1 and C1D8;
    Phase 1:ORR, DCR, DOR, TTP, and PFS as assessed by the investigator according to Lugano Classification for lymphomas;
    TAK-981-SUMO adduct formation and SUMO pathway inhibition in skin/blood.
    Phase 2:Frequency, severity, and duration of TEAEs and laboratory abnormalities for all dose groups according to the NCI CTCAE, Version 5.0; except CRS which will be graded according to ASTCT Consensus Grading for CRS; DCR, DOR, TTP, and PFS as assessed by the investigator according to Lugano Classification for lymphomas; TAK-981-SUMO adduct formation and SUMO pathway inhibition in tumor tissues.
    •Parámetros FC después de la primera dosis de TAK-981 el D1C1 y el día 8 del ciclo 1.
    Fase 1:
    •TRG, TCE, DR, THP y SSP evaluados por el investigador conforme a la clasificación de Lugano para linfomas.
    •Formación de aductos de TAK-981-SUMO e inhibición de la vía de SUMO en la piel y la sangre.
    Fase 2:
    •Frecuencia, intensidad y duración de los AAST y las anomalías analíticas en todos los grupos de dosis según los CTCAE del NCI, versión 5.0, excepto el SLC, que se graduará con arreglo a la clasificación de consenso para el SLC de la ASTCT.
    •TCE, DR, THP y SSP evaluados por el investigador conforme a la clasificación de Lugano para linfomas.
    •Formación de aductos de TAK-981-SUMO e inhibición de la vía del pequeño modificador de tipo ubiquitina (SUMO) en los tejidos tumorales.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Phase 1 and Phase 2
    Fase 1 y Fase 2
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other Yes
    E.7.1.3.1Other trial type description
    Phase 1 occurs only in Japan and NA
    La fase 1 solo se ha realizado en Japón y Estados Unidos
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.3 The trial involves single site in the Member State concerned 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 concerned7
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA26
    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
    Canada
    China
    Japan
    United States
    France
    Germany
    Italy
    Spain
    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
    The final data cutoff for the clinical study report will be conducted after all patients have been discontinued from treatment or transferred to a long-term safety study, a single-patient investigational new drug application, or a similar program.
    El corte de datos final para el informe del estudio clínico se realizará después de que todos los pacientes hayan discontinuado del tratamiento o hayan sido transferidos al estudio de seguridad a largo plazo, a una nueva solicitud de farmaco en investigación o a un programa similar
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years
    E.8.9.1In the Member State concerned months48
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial months48
    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: 65
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 65
    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 state15
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 50
    F.4.2.2In the whole clinical trial 130
    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)
    Subjects who have met the primary/ secondary endpoints, in the opinion of the investigator and confirmed by the sponsor, experienced a clinically important benefit from TAK-981 in combination with rituximab may continue to receive TAK-981 or the combination in an extension phase of this study or will be given the opportunity to enroll in a separate open-label rollover study or have the possibility of using an individual patient investigational new drug to continue receiving both study drugs.
    Los pacientes que hayan alcanzado los objetivos primarios y secundarios, en opinión del investigador y del promotor, y hayan experimententado beneficio clínico importante con la combinación del TAK-981 con rituximab pueden continuar recibiendo TAK-981 o la combinación en una fase de extensión del estudio o se les dará la oportunidad de participar en otro estudio abierto de traspaso o de usar un nuevo fármaco en investigación de paciente individual para continuar recibiendo ambos fármacos
    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 Decision2021-09-15
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-05-27
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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