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    Summary
    EudraCT Number:2020-003946-36
    Sponsor's Protocol Code Number:TAK-981-1501
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2021-06-17
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    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
    Studio di fase 1/2 su TAK-981 in associazione con rituximab in pazienti con linfoma non Hodgkin CD20-positivo recidivante/refrattario
    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
    Studio di fase 1/2 di TAK-981 in combinazione con rituximab in pazienti con linfoma
    A.3.2Name or abbreviated title of the trial where available
    --
    --
    A.4.1Sponsor's protocol code numberTAK-981-1501
    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 pointTakeda Pharmaceuticals Internationa
    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 number0018778253327
    B.5.5Fax number0000000000
    B.5.6E-mailmedinfoUS@takeda.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name 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.3.2Product code [--]
    D.3.4Pharmaceutical form Concentrate for solution for injection/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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.1.1.1Trade name --
    D.2.1.1.2Name of the Marketing Authorisation holder--
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product name--
    D.3.2Product code [TAK-981]
    D.3.4Pharmaceutical form Concentrate for solution for injection/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 INN--
    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 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
    Relapsed/Refractory CD20-Positive Non-Hodgkin Lymphoma
    Linfoma non Hodgkin recidivante/refrattario positivo a CD20
    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 CD20+ 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:
    • Determinare la sicurezza e la tollerabilità di TAK-981 in associazione con rituximab in pazienti con NHL r/r CD20+.
    • Stabilire la dose raccomandata per la Fase 2 (RP2D) di TAK-981 in associazione con rituximab.
    Fase 2:
    • Valutare l'efficacia di TAK-981 in associazione con rituximab in indicazioni selezionate per il NHL 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 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 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.
    • Caratterizzare il profilo PK di TAK-981 in associazione con rituximab.
    Fase 1:
    • Determinare la MTD e/o la PAD di TAK-981 quando somministrato in associazione con rituximab.
    • Valutare l'attività antitumorale preliminare dell'associazione TAK-981-rituximab.
    • Valutare il coinvolgimento del target di TAK-981 (formazione di addotti SUMO-TAK-981) e l'inibizione del percorso di SUMOilazione nel sangue e nella pelle.
    Fase 2:
    • Valutare l'efficacia di TAK-981 in associazione con rituximab nel NHL r/r misurata in base a tasso di controllo della malattia (DCR), durata della risposta (DOR), tempo alla progressione (TTP) e PFS.
    • Valutare la sicurezza e la tollerabilità di TAK-981 in associazione con rituximab.
    • Valutare il coinvolgimento del target di TAK-981 (formazione di addotti SUMO-TAK-981) e l'inibizione della via di SUMOilazione nel tumore.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    REFER TO PROTOCOL FOR FULL LIST
    1. Adults =18 years old.
    2. Patient populations:
    a) 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 antibody, who have received at least 1 prior systemic therapy for r/r iNHL:
    o 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.
    NOTE: The minimum qualifying rituximab/anti-CD20 dose is 1 full cycle (ie, weekly x 4 doses monotherapy or 1 complete dose if combined with chemotherapy). Prior anti-CD20 antibody or cytotoxic drugs may have been administered as single agents or as components of combination therapies. Each repeated course of the same single agent or combination is considered an independent regimen.
    b) For Phase 2, the following CD20 positive:
    • r/r DLBCL progressed or relapsed after a prior CAR T-cell 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 performance score of =2.
    5. Adequate bone marrow function per local laboratory reference range at screening as follows:
    o Platelet count =75.0 x 109/L, Grade 2 thrombocytopenia (platelet count =50.0 x 109/L) is allowed if it is clearly due to marrow involvement with no evidence of myelodysplastic syndrome or hypoplastic bone marrow if found. ANC =1.0 x 109/L. Hemoglobin =85 g/L (red blood cell transfusion allowed =14 days before assessment).
    6. Adequate renal and hepatic function, per local laboratory reference range at screening as follows:
    o Calculated creatinine clearance = 30 mL/min calculated with Cockcroft – Gault formula.
    o Aspartate aminotransferase and alanine aminotransferase =3.0× the upper limit of normal (ULN) of the institution’s normal range; bilirubin =1.5× ULN. Patients with Gilbert’s syndrome may have a bilirubin level >1.5× ULN, per discussion between the investigator and the Medical Monitor.
    7. Left ventricular ejection fraction =40%; as measured by echocardiogram or multiple gated acquisition scan.
    8. Suitable venous access for safe drug administration and the study-required PK and pharmacodynamic sampling.
    FARE RIFERIMENTO AL PROTOCOLLO PER LA LISTA COMPLETA
    1. Adulti di età =18 anni.
    2. Popolazioni di pazienti:
    • a) Per l'aumento progressivo della dose nella Fase 1:
    • aNHL, incluso linfoma a cellule mantellari e istologie di DLBCL, come DLBCL trasformato da linfoma di basso grado (follicolare o altri), DLBCL associato a infiltrazione di piccole cellule nel midollo osseo, linfoma a cellule B con caratteristiche intermedie tra DLBCL e linfoma di Burkitt o con caratteristiche intermedie tra DLBCL e linfoma di Hodgkin, FL di grado 3B e linfoma aggressivo a cellule B non classificabile, che abbia precedentemente ricevuto rituximab, ciclofosfamide, doxorubicina (idrossiaunorubicina), vincristina (Oncovin®) e prednisone (R-CHOP) (o terapia contenente anti-CD20 equivalente) e 1 linea di terapia aggiuntiva nel contesto r/r.
    • iNHL (incluso FL di grado 1-3A e linfoma della zona marginale) refrattario a rituximab o a qualsiasi altro anticorpo monoclonale anti-CD20, che abbia ricevuto almeno 1 precedente terapia sistemica per iNHL r/r:
    o La refrattarietà a rituximab o ad anti-CD20 è definita come la mancata risposta o la progressione durante qualsiasi regime precedente contenente rituximab/anti-CD20 (in monoterapia o in associazione con chemioterapia), o progressione entro 6 mesi dall'ultima dose di rituximab o anti-CD20.
    NOTA: la dose minima qualificante di rituximab/anti-CD20 è 1 ciclo completo (ovvero, 4 dosi settimanali in monoterapia o 1 dose completa se associata con chemioterapia). Precedenti anticorpi anti-CD20 o farmaci citotossici possono essere stati somministrati come agenti singoli o come componenti di terapie in associazione. Ogni ciclo ripetuto dello stesso agente in monoterapia o in associazione è considerato un regime indipendente.
    • b) Per la Fase 2, positività a CD20:
    • DLBCL r/r progredito o recidivato dopo una precedente terapia CAR-T che ha ricevuto l'approvazione da un'autorità sanitaria per il trattamento del DLBCL (Coorte A).
    • DLBCL r/r che è progredito o recidivato dopo almeno 2 ma non più di 3 linee precedenti di terapia sistemica e non ha ricevuto una precedente terapia cellulare. Almeno una precedente linea di terapia deve aver incluso una terapia mirata al CD20 (Coorte B).
    • FL r/r che è progredito o recidivato dopo almeno 2 ma non più di 3 precedenti linee di terapia sistemica. Almeno una precedente linea di terapia deve aver incluso una terapia mirata al CD20 (Coorte C).
    3. I pazienti devono essere considerati non idonei secondo il parere dello sperimentatore o devono aver rifiutato il trapianto autologo di cellule staminali.
    4. Performance status secondo l'Eastern Cooperative Oncology Group pari a =2.
    5. Adeguata funzionalità del midollo osseo, secondo l'intervallo di riferimento del laboratorio locale allo screening come segue:
    o Conta delle piastrine =75,0 x 109/l, trombocitopenia di grado 2 (conta delle piastrine =50,0 x 109/l) consentita se chiaramente dovuta al coinvolgimento del midollo senza evidenza di sindrome mielodisplastica o di midollo osseo ipoplastico, se rilevati. ANC =1,0 x 109/l. Emoglobina =85 g/l (trasfusione di globuli rossi consentita =14 giorni prima della valutazione).
    6. Adeguata funzionalità renale ed epatica, secondo l'intervallo di riferimento del laboratorio locale allo screening come segue:
    o Clearance della creatinina calcolata =30 ml/min calcolata usando la formula di Cockcroft Gault.
    o Aspartato aminotransferasi e alanina aminotransferasi =3,0 × il limite superiore della norma (ULN) dell'intervallo di normalità dell'istituto; bilirubina =1,5 × ULN. I pazienti con sindrome di Gilbert possono avere un livello di bilirubina >1,5 × ULN, secondo quanto discusso dallo sperimentatore e il Monitor medico.
    7. Frazione di eiezione ventricolare sinistra =40%, misurata mediante ecocardiogramma o scansione con acquisizione a gate multipli.
    8. Accesso venoso idoneo per la somministrazione sicura del farmaco e per il prelievo di campioni per PK e farmacodinamica richiesti dallo studio.
    E.4Principal exclusion criteria
    REFER TO PROTOCOL FOR FULL LIST
    Main Criteria for Exclusion:
    1. Central nervous system lymphoma; active brain or leptomeningeal metastases, as indicated by positive cytology from lumbar puncture or CT scan/magnetic resonance imaging.
    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 immunoglobulin 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 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 ability to comply with protocol requirements or give informed consent.
    FARE RIFERIMENTO AL PROTOCOLLO PER LA LISTA COMPLETA
    1. Linfoma del sistema nervoso centrale, metastasi cerebrali attive o leptomeningee, come indicato dalla citologia positiva da puntura lombare o TC/risonanza magnetica.
    2. Ipersensibilità a TAK-981, rituximab o qualsiasi componente del farmaco.
    3. Storia di IRR di grado =3 che ha portato alla sospensione permanente del precedente trattamento con rituximab.
    4. Precedente partecipazione allo studio clinico TAK-981-1002.
    5. Malattia linfoproliferativa post-trapianto, eccetto NHL recidivante dopo trapianto autologo di cellule staminali.
    6. Sottoposti a ASCT o trattamento con terapia cellulare, inclusa CAR-T, entro =3 mesi dalla somministrazione di TAK-981.
    7. Trapianto allogenico precedente di cellule staminali ematopoietiche.
    8. Linfomi con espressione leucemica.
    9. Precedente terapia antitumorale, inclusa chemioterapia, terapia ormonale o agenti sperimentali entro 2 settimane o entro almeno 5 emivite prima della somministrazione di TAK-981, a seconda di quale periodo sia più breve. Sono consentiti steroidi a basso dosaggio (prednisone orale o equivalente =20 mg al giorno), terapia ormonale per cancro alla prostata o cancro della mammella (in situazione adiuvante) e trattamento con bisfosfonati e inibitori del RANKL (attivatore del recettore del fattore nucleare kappa-B ligando).
    10. Intervento chirurgico importante entro 14 giorni prima della prima dose del farmaco dello studio e ancora in fase di ripresa da eventuali complicazioni dovute all'intervento.
    11. Malattie o condizioni mediche significative, valutate dagli sperimentatori e dallo sponsor, che aumenterebbero sostanzialmente il rapporto rischio-beneficio della partecipazione allo studio. Ciò include, ma non si limita a, infarto miocardico acuto o angina instabile negli ultimi 6 mesi, diabete mellito non controllato, infezioni batteriche, virali o micotiche attive significative, stato gravemente immunocompromesso, ipertensione grave non compensata e insufficienza cardiaca congestizia di classe III o IV secondo la New York Heart Association, aritmie cardiache sintomatiche in corso di grado >2, embolia polmonare o eventi cerebrovascolari sintomatici o qualsiasi altra condizione cardiaca grave (ad es. versamento pericardico o cardiomiopatia restrittiva). È consentita la fibrillazione atriale cronica con terapia anticoagulante stabile.
    12. Epatite cronica C nota e/o sierologia positiva (a meno che non sia dovuta a vaccinazione o immunizzazione passiva causata da terapia immunoglobulinica) per epatite B cronica. Infezione da HIV nota.
    13. Seconda neoplasia nei 3 anni precedenti, a eccezione del carcinoma cutaneo a cellule basali o squamoso localizzato trattato, carcinoma prostatico localizzato, carcinoma cervicale in situ, polipi adenomatosi del colon-retto resecati, carcinoma mammario in situ o altre neoplasie per le quali il paziente non è in terapia antitumorale attiva come definito nel Criterio di esclusione 9.
    14. Ricezione di qualsiasi vaccino vivo entro 4 settimane dall'inizio del trattamento in studio.
    15. Malattia autoimmune attiva, non controllata che richiede >20 mg di prednisone o equivalente, farmaci citotossici o biologici.
    16. Uso di corticosteroidi entro 1 settimana prima della prima dose del farmaco dello studio, a eccezione di quanto indicato per altre condizioni mediche come steroidi per inalazione per l'asma, uso di steroidi topici o come premedicazione per la somministrazione del farmaco dello studio o del mezzo di contrasto. Non sono idonei i pazienti che richiedono steroidi a dosi giornaliere pari a >20 mg, esposizione sistemica giornaliera equivalente a prednisone o quelli a cui vengono somministrati steroidi per il controllo del linfoma o per la riduzione della conta leucocitaria.
    17. Anamnesi di malattia medica o psichiatrica che possa interferire con la capacità di rispettare i requisiti del protocollo o di fornire il consenso informato.
    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 for CRS.
    - 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:
    • Frequenza, gravità e durata dei TEAE e anomalie di laboratorio per tutti i gruppi di dosaggio secondo NCI CTCAE, versione 5.0, eccetto la CRS che sarà classificata secondo ASTCT Consensus Grading per CRS.
    • Presenza di DLT entro i primi 21 giorni di trattamento nel Ciclo 1.
    Fase 2:
    • Tasso di risposta complessivo (ORR) (CR + PR) come definito dallo sperimentatore secondo la classificazione di Lugano per i linfomi.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Phase 1 and Phase 2
    Fase 1 e Fase 2
    E.5.2Secondary end point(s)
    • PK parameters after the first dose of TAK-981 on C1D1 and Cycle 1, Day 8 (data permitting):
    - Maximum observed plasma concentration (Cmax).
    - Time of first occurrence of Cmax (tmax).
    - Area under the plasma concentration-time curve from time 0 to time t.
    - Area under the plasma concentration-time curve from time 0 to infinity.
    - Terminal disposition phase half-life.
    - Total clearance after IV administration.
    - Volume of distribution at steady state after IV administration.
    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 small ubiquitin-like modifier (SUMO) pathway inhibition in tumor tissues.
    Fase 2:
    • Tasso di risposta complessivo (ORR) (CR + PR) come definito dallo sperimentatore secondo la classificazione di Lugano per i linfomi.

    Gli endpoint secondari per questo studio sono:
    • Parametri PK dopo la prima dose di TAK-981 al C1G1 e Ciclo 1, Giorno 8 (dati permettendo):
    - Concentrazione plasmatica massima (Cmax) osservata.
    - Tempo della prima occorrenza di Cmax (tmax).
    - Area sotto la curva della concentrazione plasmatica-tempo dal tempo 0 al tempo t.
    - Area sotto la curva della concentrazione plasmatica-tempo dal tempo 0 all'infinito.
    - Emivita della fase di disposizione terminale.
    - Clearance totale dopo somministrazione EV.
    - Volume di distribuzione allo stato stazionario dopo somministrazione EV.
    Fase 1:
    • ORR, DCR, DOR, TTP e PFS valutati dallo sperimentatore secondo la classificazione di Lugano per i linfomi.
    • Formazione di addotti TAK-981-SUMO e inibizione del percorso dei SUMO nella pelle/nel sangue.
    Fase 2:
    • Frequenza, gravità e durata dei TEAE e anomalie di laboratorio per tutti i gruppi di dosaggio secondo NCI CTCAE, versione 5.0, eccetto la CRS che sarà classificata secondo ASTCT Consensus Grading per CRS.
    • DCR, DOR, TTP e PFS valutati dallo sperimentatore secondo la classificazione di Lugano per i linfomi.
    • Formazione di addotti TAK-981-SUMO e inibizione del percorso dei piccoli modificatori del tipo ubiquitina (SUMO) nei tessuti tumorali.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Phase 1 and Phase 2
    Fase 1 e 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
    Fase 1 condotta solo in Giappone e Nord America
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    in aperto
    open
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial1
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned6
    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 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
    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.
    Il cut-off finale dei dati per la relazione dello studio clinico sarà condotto dopo che tutti i pazienti avranno interrotto il trattamento o saranno stati trasferiti a uno studio sulla sicurezza a lungo termine, dopo una domanda di un nuovo farmaco sperimentale per un singolo paziente o un programma simile.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 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 state12
    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.
    I soggetti che hanno soddisfatto endpoint primari/secondari, a giudizio dello sperimentatore e sponsor, hanno manifestato un beneficio clinicamente importante derivante da TAK-981 in combinazione con rituximab, possono continuare a ricevere TAK-981 o la combinazione in una estensione di questo studio o avranno la possibilità di arruolarsi in uno studio di rollover in aperto separato o di utilizzare un nuovo farmaco sperimentale per continuare a ricevere entrambi i farmaci dello studio
    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 Decision2021-10-06
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-07-20
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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