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    Summary
    EudraCT Number:2020-003947-27
    Sponsor's Protocol Code Number:TAK-981-1002
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-08-05
    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 number2020-003947-27
    A.3Full title of the trial
    An Open Label, Dose-Escalation, Phase 1/2 Study to Evaluate the Safety, Tolerability, Preliminary Efficacy, and Pharmacokinetics of TAK-981 in Adult Patients With Advanced or Metastatic Solid Tumors or Relapsed/Refractory Hematologic Malignancies
    Estudio de fase 1/2, abierto, de aumento escalonado de la dosis para evaluar la seguridad, la tolerabilidad, la eficacia preliminar y la farmacocinética de TAK-981 en pacientes adultos con tumores sólidos avanzados o metastásicos o con neoplasias malignas hematológicas recidivantes/resistentes
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 1/2 Study to Evaluate the Safety, Tolerability, Preliminary Efficacy, and Pharmacokinetics of TAK-981 in Adult Patients With Solid Tumors or Hematologic Malignancies
    Estudio de fase 1/2 para evaluar la seguridad, la tolerabilidad, la eficacia preliminar y la farmacocinética de TAK-981 en pacientes adultos con tumores sólidos o con neoplasias malignas hematológicas
    A.4.1Sponsor's protocol code numberTAK-981-1002
    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 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 nameTAK-981
    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 INNTAK-981
    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.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
    Advanced or Metastatic Solid Tumors or Relapsed/Refractory Hematologic Malignancies
    Tumores sólidos avanzados o metastásicos o neoplasias malignas hematológicas recidivantes/resistentes
    E.1.1.1Medical condition in easily understood language
    Solid Tumors or Hematologic Malignancies
    Tumores sólidos o neoplasias malignas hematológicas
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10066481
    E.1.2Term Hematological malignancy
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Phase 1:To determine the safety and tolerability of TAK-981 as a single agent in patients with advanced or metastatic solid tumors and lymphomas. To establish the RP2D of TAK-981.
    Phase 2:To evaluate preliminary efficacy of TAK-981 in patients with select solid tumors or relapsed/refractory CD20+ NHL indications
    Fase 1:
    Determinar la seguridad y la tolerabilidad de TAK-981 en monoterapia en pacientes con tumores sólidos y linfomas avanzados o metastásicos.
    Determinar la DRF2 de TAK-981.
    Fase 2:
    Evaluar la eficacia preliminar de TAK-981 en pacientes con determinadas indicaciones de tumores sólidos o LNH CD20+ recidivante/resistente.
    E.2.2Secondary objectives of the trial
    Phase 1:To assess the preliminary antitumor activity of TAK-981. To assess target engagement of TAK-981 (SUMO-TAK-981 adduct formation) and SUMOylation pathway inhibition in skin and peripheral blood cells. To characterize the PK profile of TAK-981.
    Phase 2:To evaluate the efficacy of TAK-981 in select solid tumor and CD20+ NHL indications as measured by overall response rate (ORR), time to response (TTR), duration of the response (DOR), disease control rate (DCR), time to progression (TTP), and progression-free survival (PFS). To evaluate overall survival (OS). To evaluate the safety and tolerability of TAK-981.To collect plasma concentration-time data for TAK-981.
    Fase 1:
    •Evaluar la actividad antitumoral preliminar de TAK-981.
    •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 células de la piel y de sangre periférica.
    •Caracterizar el perfil FC de TAK-981.
    Fase 2:
    •Evaluar la eficacia de TAK-981 en determinadas indicaciones de tumores sólidos y LNH CD20+, determinada mediante la tasa de respuesta global (TRG), el tiempo hasta la respuesta (THR), la duración de la respuesta (DR), la tasa de control de la enfermedad (TCE), el tiempo hasta la progresión (THP) y la supervivencia sin progresión (SSP).
    •Evaluar la supervivencia global (SG).
    •Evaluar la seguridad y la tolerabilidad de TAK-981.
    •Obtener datos de concentración plasmática-tiempo de TAK-981.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Adult male or female patients ≥18 years old.
    2. Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
    3. Patient population for Phase 1 dose escalation:
    a. Have a histologically or cytologically confirmed advanced or metastatic solid tumors who have no standard therapeutic option with a proven clinical benefit, are intolerant, or have refused them.
    b. Have a relapsed/refractory lymphoma not amenable to therapies with proven clinical benefit or who are intolerant or who refuse them. Patients with low-grade lymphomas such as FL, small lymphocytic lymphoma, lymphoplasmacytoid lymphoma, and marginal zone lymphomas may not need to exhaust all available therapy. These patients can be enrolled after failure of at least 2 prior systemic therapies, provided that there is not an immediate need for cytoreduction. In these cases, patients who need immediate therapy for tumor bulk are not eligible for this trial.
    4. Patient population for Phase 2 dose expansion cohorts:
    Have a histologically or cytologically documented, advanced (metastatic and/or unresectable) cancer as listed below, which is incurable and for which prior standard first-line treatment has failed:
    a.Nonsquamous NSCLC that has progressed to 1 prior systemic immune checkpoint inhibitor (CPI)/anti-PD-(1/L1)-containing therapy and no more than 2 lines of therapy. Patients must have not shown evidence of tumor progression during the first 5 months of treatment with first-line CPI/anti-PD-(1/L1)-containing therapy (cohort A).
    b. CPI-naïve cervical cancer (squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the cervix) patients who have received no more than 1 prior systemic line of therapy for recurrent or Stage IVB cervical cancer (cohort B).
    c. CPI-naïve MSS-CRC patients who have progressed on no more than 3 chemotherapy regimens (cohort C).
    d. Relapsed/refractory 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 D).
    e. Relapsed/refractory 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 E).
    f. Relapsed/refractory 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 F).
    5. In Phase 2 only, have at least 1 radiologically measurable lesion based on Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) for patients with solid tumors or Lugano criteria for lymphoma. Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.
    6. In Phase 2 stage 1, willing to consent to mandatory pretreatment and on-treatment tumor biopsy.
    7. Is willing to provide archival tumor tissue sample, if available.
    8. Adequate bone marrow reserve and renal and hepatic function based on the following laboratory parameters:
    a. Absolute neutrophil count (ANC) ≥1.0 × 109/L, hemoglobin ≥85 g/L (red blood cell transfusion allowed ≥14 days before assessment), and platelet count ≥75.0 × 109/L(platelet count ≥50.0 × 109/L is allowed for patients with lymphoma if it is clearly due to marrow involvement with no evidence of myelodysplastic syndrome or hypoplastic bone marrow, if found).
    b. Total bilirubin ≤1.5 times the institutional upper limit of normal (ULN); or total bilirubin <3.0 times the ULN with direct bilirubin within normal range in patients with well documented Gilbert’s syndrome.
    c. Serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≤3.0 times the ULN (<5 times the ULN if liver enzyme elevations are due to liver metastases).
    d. Estimated creatinine clearance using the Cockcroft-Gault formula ≥45 mL/min.
    9. Recovered to Grade 1 or baseline or established as sequelae from all toxic effects of previous therapy (except alopecia, neuropathy, or autoimmune endocrinopathies with stable endocrine replacement therapy, or bone marrow parameters [any of Grade 1/2 permitted if directly related to bone marrow involvement]).
    10. Consented to undergo serial skin punch biopsies .
    11. Voluntary written consent must be given before performance of any study-related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to future medical care.
    12. Suitable venous access for safe drug administration and the study-required PK and pharmacodynamic sampling.
    13. Women of childbearing potential participating in this study should avoid becoming pregnant
    See 14. Male patients contraception more details set out in protocol
    1.Adultos ambos sexos ≥18 años.
    2.Estado func. Eastern Cooperative Oncology Group (ECOG) de 0 a 1.
    3. Fase 1
    a.Tener tumores sólidos avanzados (con recidiva locorregional no susceptible de tto. curativo) o metastásicos, conf. histol. o citol. que no dispongan de una opción terap. estándar con beneficios clínicos demostrados, sean intolerantes a ellos o los hayan rechazado o
    b.Tener un linfoma recidivante/resistente no susceptible de recibir ttos. con benef. clín. demostrados o que sean intolerantes o que los rechacen. Los pacientes con linfomas de bajo grado, como LF, linfoma linfocítico de células pequeñas, linfoma linfoplasmocitoide y linfomas de la zona marginal, pueden no tener que agotar todo el tto. disp.. Estos ptes. podrán participar tras el fracaso de al menos 2 ttos. sistémicos previos, siempre que no exista una necesidad inmed. de citorreducción. En estos casos, los ptes. que necesiten tto. inmediato por tener tumores voluminosos no podrán participar en este ensayo.
    4. Fase 2:
    Tener un cáncer avanzado (metastásico y/o irresecable) doc. histológ. o citológ., según se indica, incurable y en el que haya fracasado un tto. de ref. de primera línea previo:
    a.CPNM no epidermoide que ha progres. con un tto. previo que contenía un inhibidor del punto de control inmunitario (IPC)/anti-PD-(1/L1) y no más de 2 líneas de tto. No deben haber mostrado signos de progres. tumoral durante los primeros 5 meses de tto. de prim. línea con IPC/anti-PD-(1/L1) (cohorte A).
    b.Ptes. con cáncer de cuello uterino (carcinoma epidermoide, carcinoma adenoepidermoide o adenocarcinoma de cuello uterino) no trat. prev. con CPI que no hayan recib. más de 1 línea sist. previa de tto. para el cáncer de cuello uterino recurrente o en estadio IVB (cohorte B).
    c.Ptes. con CCR-MSS no ttdos. previ. con IPC que hayan presentado prog. con no más de 3 pautas de quimio (cohorte C).
    d.El LDCBG recid./resis. tuvo prog. o recidiva después de un tto.previo con linf. T CAR que había recibido la aprob. de las aut. sanit. para el tto. del LDCBG (cohorte D).
    e.LDCBG recid./resis. que haya prog. o recidi.o después de al menos 2 pero no más de 3 lín. previas de tto. sist. y que no haya recib. tto. celular previo. Al menos una lín. previa de tto.o debe haber incluido un tto. dirig. contra CD20 (cohorte E).
    f.LF recidi./resis. que ha prog. o recid. después de al menos 2 pero no más de 3 lín. previas de tto. sistémico. Al menos una lín. previa de tto. debe haber incluido un tto. dirig. contra CD20 (cohorte F).
    5.Solo en la fase 2, tener al menos una lesión radiológ. mens. según los Crit. de eval. de la resp. en tumores sólidos, v. 1.1 (RECIST v1.1), en los ptes. con tumores sólidos o los crit. de Lugano para el linfoma. las lesiones tum. sitas en una zona irradiada prev. se consideran mens. si se ha dem. prog. en dichas lesiones.
    6.En la etapa 1 de la fase 2, disposición a dar su consentimiento para la biopsia tumoral oblig. previa al tto. y durante el tto.
    7.Disposición a prop. una muestra de tejido tumoral de archivo, si disponible.
    8.Reserva de méd. ósea y fun. renal y hep. adecuadas basadas en los sig. parám. an.:
    a.Rto. absoluto de neutrófilos (RAN) ≥1,0 × 109/l, hemoglobina ≥85 g/l (se permite una transf. de eritrocitos ≥14 días antes de la eval.) y rcto. de plaquetas ≥75,0 × 109/l (se permite un rcto. de plaquetas ≥50,0 × 109/l en los ptes. con linfoma si se debe claramente a afectación med. sin signos de síndrome mielodisplásico o médula ósea hipoplásica, si se detecta).
    b.Bilirrubina total ≤1,5 veces el lím. sup. de la norm. (LSN) del centro; o bilirrubina total <3,0 veces el LSN con bilirr. directa dentro del int. norm. en ptes. con síndrome de Gilbert bien doc..
    c.Alanina aminotransferasa (ALT) o aspartato aminotransferasa (AST) en suero ≤3,0 veces el LSN (< 5 veces el LSN si las elev. de las enzimas hep. se deben a metástasis hep.)
    d.Estimación del aclar. de creatinina con la f. de Cockcroft-Gault ≥45 ml/min.
    9.Recup. a un grado 1 o a la sit. basal o confirmación como secuelas de todos los efectos tóxicos del tto. previo (excepto alopecia, neuropatía o endocrinopatías autoinmunitarias con tto. de reposición endocrina estable o parám. de la méd. ósea [se permite clquier. grado 1/2 si está dir. rel. con la afect. de la méd. ósea]).
    10.Consentim. para someterse a biopsias cutáneas seriadas en sacabocados (solo en el aumento de la dosis).
    11.Deberá obtenerse el consent. voluntario por escrito antes de llevar a cabo ningún proced. rel. con el estudio que no forme parte de la asis. méd. hab. y el pte. ha de saber que podrá retirar su consent. sin perjuicio alguno de la asis. méd. que reciba en el futuro.
    12.Acceso venoso adecuado para la admon. segura del fármaco y la ob. de muestras para FC y farmacodinamia exigidas por el estudio.
    13.Las mujeres con capacidad de procrear que participen deberán evitar quedarse embarazadas y los pte. no deberán dejar embarazadas a sus parejas. Ver detalles en el protocolo
    E.4Principal exclusion criteria
    1. Phase 1 dose escalation and Phase 2 cancer treatment expansion cohorts:
    a. Have received treatment with systemic anticancer treatments or investigational products within 14 days before the first dose of study drug or 5 half-lives, whichever is shorter.
    b. Have received extended field radiotherapy ≤4 weeks before the start of treatment (≤2 weeks for limited field radiation for palliation) and have not recovered to Grade 1 or baseline from related side effects of such therapy (except for alopecia).
    2. Have a history of uncontrolled brain metastasis. Patients with brain metastases are allowed if they are previously treated with surgery, whole-brain radiation, or stereotactic radiosurgery and the patients are receiving a corticosteroid dose ≤10 mg/day of prednisone equivalent at the time of receiving the first dose of TAK-981. For asymptomatic patients, screening brain imaging is not required.
    3. Patient is receiving any live vaccine (eg, varicella, pneumococcus) within 4 weeks of initiation of study treatment.
    4. History of any of the following ≤6 months before first dose: congestive heart failure New York Heart Association Grade III or IV, unstable angina, myocardial infarction, unstable symptomatic ischemic heart disease, severe noncompensated hypertension despite appropriate medical therapy, 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.
    5. Baseline prolongation of the QT interval with Fridericia correction method (QTcF) (eg, repeated demonstration of QTcF interval >480 ms, history of congenital long QT syndrome, or torsades de pointes).
    6. Psychiatric illness/social circumstances that would limit compliance with study requirements and substantially increase the risk of AEs or has compromised ability to provide written informed consent.
    7. Admission or evidence of illicit drug use, drug abuse, or alcohol abuse.
    8. History of autoimmune disease requiring systemic immunosuppressive therapy with daily doses of prednisone >10 mg/day or equivalent doses, or any other form of immunosuppressive therapy. Hormone therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered an excluded form of systemic treatment of an autoimmune disease
    9. History of immune-related AEs related to treatment with immune checkpoint inhibitors that required treatment discontinuation.
    10. History of noninfectious pneumonitis that required steroids or a history of interstitial lung disease.
    11. Has evidence of active, noninfectious pneumonitis.
    12. Have a significant active infection.
    13. Known history of human immunodeficiency virus infection or any other relevant congenital or acquired immunodeficiency.
    14. Known hepatitis B virus (HBV) surface antigen seropositive or detectable hepatitis C infection viral load.
    15. Receiving or requiring the continued use of medications that are known to be strong or moderate inhibitors and inducers of CYP3A4/5 or are strong P-gp inhibitors at screening. To participate in this study, such patients should discontinue use of such agents for at least 2 weeks or 5 times the half-life
    (whichever is shorter) before receiving a dose of TAK-981.
    16. Patient requires the use of drugs known to prolong QTc interval (during Phase 1 only).
    17. History of allogeneic tissue or solid organ transplant.
    18. 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.
    19. Female patients who are lactating and breastfeeding or have a positive serum pregnancy test during the screening period or a positive urine pregnancy test on Day 1 before first dose of study drug.
    1.Fase 1 y de ampliación del tratamiento oncológico de la fase 2:
    a.Haber recibido tratamiento oncológico sistémico o productos en investigación en los 14 días previos a la primera dosis del fármaco del estudio o el equivalente a 5 semividas, lo que suponga menos tiempo.
    b.Haber recibido radioterapia de campo amplio ≤4 semanas antes del inicio del tratamiento (≤2 semanas en caso de radioterapia de campo limitado con fines paliativos) y no haberse recuperado hasta un grado 1 o la situación basal de los efectos secundarios relacionados de dicho tratamiento (excepto alopecia).
    2.Tener antecedentes de metástasis cerebrales no controladas. Se permite la participación de pacientes con metástasis cerebrales si han sido tratados previamente con cirugía, radioterapia holocraneal o radiocirugía estereotáctica y si están recibiendo una dosis de corticosteroides ≤10 mg/día de equivalente de prednisona en el momento de recibir la primera dosis de TAK-981. En los pacientes asintomáticos no será necesario realizar estudios de imagen cerebral en la selección.
    3.El paciente está recibiendo cualquier vacuna de microorganismos vivos (p. ej., varicela, neumococo) en las 4 semanas previas al inicio del tratamiento del estudio.
    4.Antecedentes de cualquiera de las siguientes circunstancias ≤6 meses antes de la primera dosis: insuficiencia cardíaca congestiva de grado III o IV de la New York Heart Association, angina inestable, infarto de miocardio, cardiopatía isquémica sintomática inestable, hipertensión grave no compensada a pesar del tratamiento médico adecuado, arritmias cardíacas sintomáticas persistentes de grado >2, embolia pulmonar o episodios cerebrovasculares sintomáticos, o cualquier otra cardiopatía grave (p. ej., derrame pericárdico o miocardiopatía restrictiva). Se permite la fibrilación auricular crónica en tratamiento anticoagulante estable.
    5.Prolongación basal del intervalo QT con el método de corrección de Fridericia (QTcF) (por ejemplo, demostración repetida de un intervalo QTcF >480 ms, antecedentes de síndrome de QT largo congénito o torsades de pointes).
    6.Enfermedad psiquiátrica o circunstancias sociales que limitarían el cumplimiento de los requisitos del estudio y aumentarían considerablemente el riesgo de AA o afectarían a la capacidad de otorgar el consentimiento informado por escrito.
    7.Reconocimiento o pruebas de uso de drogas, toxicomanía o alcoholismo.
    8.Antecedentes de enfermedad autoinmunitaria con necesidad de tratamiento inmunodepresor sistémico con dosis diarias de prednisona >10 mg/día o dosis equivalentes, o cualquier otra forma de tratamiento inmunodepresor. El tratamiento hormonal (por ejemplo, tiroxina, insulina o corticoides en dosis fisiológicas por insuficiencia suprarrenal o hipofisaria) no se considera una forma excluida de tratamiento sistémico de una enfermedad autoinmunitaria.
    9.Antecedentes de AA relacionados con la inmunidad relacionados con el tratamiento con inhibidores de puntos de control inmunológico que precisaron la suspensión del tratamiento.
    10.Antecedentes de neumonitis no infecciosa con necesidad de esteroides o antecedentes de neumopatía intersticial.
    11.Signos de neumonitis no infecciosa activa.
    12.Tener una infección activa importante.
    13.Antecedentes conocidos de infección por el virus de la inmunodeficiencia humana o cualquier otra inmunodeficiencia congénita o adquirida relevante.
    14.Seropositividad del antígeno de superficie del virus de la hepatitis B (VHB) o carga viral detectable de infección por el hepatitis C.
    15.Recepción o necesidad de uso continuado de medicamentos que sean inhibidores o inductores potentes o moderados de la enzima CYP3A4/5) o que sean inhibidores potentes de la gp-P en la fase de selección. Para participar en este estudio, estos pacientes deberán suspender el uso de estos fármacos durante al menos 2 semanas o 5 veces la semivida (lo que sea más breve) antes de recibir una dosis de TAK-981.
    16.El paciente requiere el uso de fármacos que prolongan el intervalo QTc (solo durante la fase 1).
    17.Antecedentes de alotrasplante de tejidos u órganos sólidos.
    18.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.
    19.Mujeres que estén dando el pecho o tengan una prueba de embarazo en 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 for CRS.
    DLTs within the first 21 days of treatment in Cycle 1.
    Phase 2:
    ORR (complete response [CR] + partial response [PR]) as defined by the investigator according to RECIST v1.1 criteria for solid tumors or 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 terminológicos comunes para acontecimientos adversos del National Cancer Institute (CTCAE del NCI), versión 5.0, excepto el SLC, que se clasificarán por grados con arreglo a la Clasificación de consenso del SLC de la American Society for Transplantation and Cellular Therapy (ASTCT) [1].
    •TLD en los primeros 21 días de tratamiento del ciclo 1.
    Fase 2:
    •TRG (respuesta completa [RC] + respuesta parcial [RP]) definida por el investigador conforme a los criterios RECIST v1.1 para tumores sólidos o la clasificación de Lugano para linfomas.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Phase 1 and 2
    Fase 1 y 2
    E.5.2Secondary end point(s)
    PK parameters after the first dose of TAK-981 on C1D1 and C1D8 (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 the last measurable concentration (AUClast).
    – Area under the plasma concentration-time curve from time 0 to infinity (AUC∞).
    – Terminal disposition phase half-life (t1/2z).
    – Total clearance (CL) after IV administration.
    – Vss.
    Phase 1:
    ORR, DCR, DOR, TTP, and PFS as assessed by the investigator according to RECIST v1.1 criteria for solid tumors or 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, TTR, TTP, PFS, and OS as assessed by the investigator according to RECIST v1.1 criteria for solid tumors or Lugano classification for lymphomas.
    •Parámetros FC después de la primera dosis de TAK-981 el D1C1 y el D8C1 (si lo permiten los datos):
    –Concentración plasmática máxima observada (Cmáx)
    –Tiempo hasta la Cmáx (tmáx) por primera vez.
    –Área bajo la curva de la concentración plasmática frente al tiempo desde el momento 0 hasta la última concentración medible (AUCúlt).
    –Área bajo la curva de concentración plasmática-tiempo desde el momento 0 hasta el infinito (AUC∞)
    –Semivida de la fase de eliminación terminal (t1/2z).
    –Aclaramiento total (Acl) tras la administración IV.
    –Vss
    Fase 1:
    •TRG, TCE, DR, THP y SSP evaluados por el investigador conforme a los criterios RECIST v1.1 para tumores sólidos o 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 clasificarán por grados con arreglo a la Clasificación de consenso del SLC de la ASTCT .
    •TCE, DR, THR, THP, SSP y SG evaluados por el investigador conforme a los criterios RECIST v1.1 para tumores sólidos o la clasificación de Lugano para linfomas.
    E.5.2.1Timepoint(s) of evaluation of this end point
    After the first dose of TAK-981, phase 1 and 2
    Después de la primera dosis de TAK-981, fases 1 y 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 No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    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 Yes
    E.7.1.2Bioequivalence study No
    E.7.1.3Other Yes
    E.7.1.3.1Other trial type description
    Phase 1 occurs only in USA
    La fase 1 solo se llevará a cabo en 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 Yes
    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 Yes
    E.8.1.7.1Other trial design description
    Fase 1: aumento escalonado de dosis de TAK-981 con diseño adaptativo. Fase 2: 6 cohortes de tto.
    Ph1: cohort-based dose escalation with an adaptive design. Phase 2: 6 treatment cohorts of patients
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Fase 1 aumento escalondo de dosis, fase 2 amplicación de dosis de tto. con 6 brazos de tratamiento
    Phase 1 (dose escalation), Phase 2 is a cancer treatment dose expansion with 6 treatment arms
    E.8.2.4Number of treatment arms in the trial7
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned4
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA60
    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
    China
    Ukraine
    United States
    Belgium
    Poland
    Romania
    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 primary analyses for the primary endpoint will be conducted after all patients enrolled in the study have had the opportunity to complete 9 cycles of treatment with TAK-981. 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 primer análisis para el primer criterio de evaluación se llevará acabo después de que todos los pacientes participantes en el estudio hayan tenido oportunidad de completar 9 ciclos de tratamiento con TAK-981. El punto de corte de datos final para el informe del estudio clínico se producirá cuanto todos los pacientes hayan discontinuado del tratamiento o hayan sido transferidos a un estudio de seguridad a largo plazo, a una nueva solicitud de fármaco 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 years4
    E.8.9.1In the Member State concerned months
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years4
    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: 75
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 57
    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 62
    F.4.2.2In the whole clinical trial 132
    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)
    Participants may continue to receive TAK-981 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 TAK-981. Additionally, these patients should have no alternative therapeutic option, and would be harmed without continued access.
    Los pacientes pueden continuar recibiendo TAK-981 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 TAK-981. Además, estos pacientes no tienen una opción terapéutica alternativa y se verían perjudicados si no tuvieran acceso.
    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 Decision2021-11-15
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-10-27
    P. End of Trial
    P.End of Trial StatusOngoing
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