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    Summary
    EudraCT Number:2020-003973-23
    Sponsor's Protocol Code Number:213831
    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:2021-06-08
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2020-003973-23
    A.3Full title of the trial
    A Randomized Phase 3 Double-Blinded Study Comparing the Efficacy and Safety of Niraparib to Placebo in Participants with Either HER2-Negative BRCA--Mutated or Triple-Negative Breast Cancer with Molecular Disease Based on Presence of Circulating Tumor DNA After Definitive Therapy (ZEST)
    Studio di fase III, randomizzato, in doppio cieco, volto a confrontare l’efficacia e la sicurezza di niraparib rispetto al placebo in partecipanti con carcinoma mammario HER2-negativo e BRCA mutato oppure con carcinoma mammario triplo negativo con malattia molecolare confermata dalla presenza di DNA tumorale circolante dopo terapia definitiva (ZEST)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    The Efficacy and Safety of Niraparib vs Placebo to Treat Breast Cancer in Participants Who Have Tumour DNA in Their Blood After Completing Treatment (ZEST)
    Efficacia e sicurezza di niraparib rispetto a placebo per il trattamento del tumore mammario in partecipanti che hanno DNA tumorale nel sangue dopo il completamento del trattamento (ZEST)
    A.3.2Name or abbreviated title of the trial where available
    Niraparib vs Placebo in Participants with HER2- BRCAmut breast cancer or TNBC with Detectable ctDNA
    Niraparib vs Placebo in partecipanti con carcinoma mammario HR+/HER2- tBRCAmut oppure con TNBC con q
    A.4.1Sponsor's protocol code number213831
    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 SponsorGLAXOSMITHKLINE RESEARCH AND DEVELOPMENT
    B.1.3.4CountryUnited Kingdom
    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 supportGlaxoSmithKline Research & Development Ltd.
    B.4.2CountryUnited Kingdom
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGlaxoSmithKline Research & Development Ltd
    B.5.2Functional name of contact pointGSK Clinical Support Help Desk
    B.5.3 Address:
    B.5.3.1Street Address980 Great West Road
    B.5.3.2Town/ cityBrentford, Middlesex
    B.5.3.3Post codeTW8 9GS
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number004408007839733
    B.5.5Fax number00000000000000
    B.5.6E-mailGSKClinicalSupportHD@gsk.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 nameNiraparib
    D.3.2Product code [GSK3985771]
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNiraparib
    D.3.9.1CAS number 1038915-60-4
    D.3.9.2Current sponsor codeGSK3985771
    D.3.9.3Other descriptive nameNiraparib tosylate monohydrate
    D.3.9.4EV Substance CodeSUB177208
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Breast Cancer
    Carcinoma mammario
    E.1.1.1Medical condition in easily understood language
    Breast cancer that is either triple negative or hormone-positive. Participants with hormone-positive disease must also have a BRCA mutation in the tumour.
    Carcinoma mammario triplo negativo o ormone positivo. I partecipanti con malattia positiva agli ormoni devono anche avere una mutazione BRCA nel tumore.
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 23.0
    E.1.2Level PT
    E.1.2Classification code 10083232
    E.1.2Term HER2 negative breast cancer
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    -Evaluation of the efficacy of niraparib relative to placebo as measured by disease-free survival (DFS)
    Valutazione dell’efficacia di niraparib rispetto al placebo in termini di sopravvivenza libera da malattia (DFS)
    E.2.2Secondary objectives of the trial
    -Evaluation of overall survival (OS)
    -Evaluation of time to progression on next anticancer therapy
    -Evaluation of distant recurrence-free survival (DRFS)
    -Evaluation of the safety and tolerability of niraparib
    -Evaluation of disease-related symptoms that impact participant daily functioning
    -Evaluation of patient-reported treatment-related symptoms
    - Valutazione della sopravvivenza globale (OS)
    - Valutazione del tempo alla progressione durante la terapia antitumorale successiva
    - Valutazione della sopravvivenza libera da recidiva a distanza (DRFS)
    - Valutazione della sicurezza e della tollerabilità di niraparib
    - Valutazione dei sintomi correlati alla malattia aventi un impatto sul funzionamento quotidiano dei partecipanti
    - Valutazione dei sintomi correlati al trattamento riferiti dai pazienti
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives

    Other types of substudies
    Specify title, date and version of each substudy with relative objectives: Objective of PK sub-study is to assess the effect of niraparib on endocrine therapy (anastrozole, letrozole, exemestane, and tamoxifen) steady-state exposure

    Altre tipologie di sottostudi
    specificare il titolo, la data e la versione di ogni sottostudio con i relativi obiettivi: L'obiettivo del sottostudio di farmacocinetica (PK) è di valutare l'effetto di niraparib sull’esposizione allo stato stazionario della terapia endocrina (anastrozolo, letrozolo, exemestane e tamoxifene)
    E.3Principal inclusion criteria
    Participants are eligible to be included in the study
    if all following criteria are met:
    1.Stage I to III breast cancer per AJCC for breast cancer staging criteria
    8th edition with surgical resection of the primary tumor that is
    confirmed to be either:
    •TNBC,irrespective of BRCA status
    •HR+/HER2- BC with a known and documented tBRCA
    mutation
    2.Completed prior standard therapy for curative intent,including all the following,:neoadjuvant treatment,surgery,adjuvant radiotherapy,and adjuvant chemotherapy
    3.Participants with HR+ BC must be on a stable regimen of
    endocrine therapy,if indicated,for at least 3 months prior to enrollment.
    Ovarian suppression,if indicated,must also have been started at least 3
    months prior to enrollment.
    4.Detectable ctDNA as measured by central Signatera testing.
    5.An archival tumour tissue specimen of the primary tumor sufficient in
    quality and quantity
    ( minimum fifteen 5µm sections or 1 FFPE tumur block for ctDNA
    assay design and tBRCA testing and minimum 1 FFPE tumur block
    for HRD testing)is required.
    6.An Eastern Cooperative Oncology Group performance status of
    0 or 1.
    7.Must be =18 years of age.
    8.Must have adequate organ and bone marrow function, as defined
    below.If these criteria are not met, randomization and treatment may
    be delayed up to 3 weeks.
    Absolute neutrophil count:=1,500/µL
    Platelets:=100,000/µL
    Hemoglobin:=9g/dL or 5.6mmol/L
    Serum creatinine:<2×ULN
    Total bilirubin:=3×ULN
    ALT:=2.5×ULN
    Note:complete blood count should be obtained without
    transfusion or receipt of colony stimulating factors within 4 weeks prior
    to obtaining the sample.Participants with current active liver or biliary
    disease are excluded(with the exception of Gilbert's syndrome or
    asymptomatic gallstones or otherwise stable chronic liver disease per
    Investigator assessment).
    9.Participants with toxicity from prior cancer therapy must have
    recovered to Grade 1(A participant with Grade 2 neuropathy or Grade 2
    alopecia is an exception to this criterion and may qualify for this study.).
    Randomization and treatment may be delayed up to 3 weeks to allow for
    this criterion to be met.
    10.Must be able to swallow and retain orally administered study
    treatment.
    11.A female participant is eligible if she is not pregnant or breastfeeding,
    and at least 1 of the following conditions applies:
    •Is not a woman of childbearing potential(WOCBP), as defined in
    Appendix 4.
    OR
    •Is a WOCBP and using a contraceptive method that is highly effective
    ,as defined in Appendix 4,during the Treatment Period and for at least
    180 days after the last dose and agrees not to donate
    Eggs for the purpose of reproduction during this period.
    The Investigator should evaluate the effectiveness of the contraceptive
    method in relationship to the first dose of study treatment.
    •A WOCBP must have a negative pregnancy test within 72 hours
    before the first dose of study treatment.
    •Additional requirements for pregnancy testing are described in Section 8.4.6.
    •The Investigator is responsible for review of medical history,menstrual
    history,and recent sexual activity to decrease the risk for inclusion of woman with an early undetected pregnancy.
    12.Male participants are eligible if they agree to the following during the
    Treatment Period and for at least 180 days after the last dose:
    •Be abstinent from heterosexual intercourse as their preferred and usual
    Life style and agree to
    remain abstinent
    OR
    •Must Agree to use a male condom when having sexual intercourse with a WOCBP who
    is not currently pregnant
    PLUS
    •Male participants must refrain from donating sperm for at least 90 days
    after the last dose
    Please refer protocol for detailed inclusion criteria
    I partecipanti sono idonei all’inclusione nello studio se soddisfano i seguenti criteri:
    1.Carcinoma mammario di stadio da I a III,in base ai criteri di stadiazione definiti dall’AJCC,8a edizione,con res. chirurgica del tumore primitivo,che sia stato confermato essere:
    •TNBC,con o senza mutazione BRCA,oppure
    •HR+/HER2- con mutazione tBRCA nota e docum.
    2.Devono aver completato una precedente terapia standard con finalità curativa,comprese trattamento neoadiuvante,intervento chirurgico,radioterapia adiuvante e chemioterapia adiuvante.
    3.I soggetti HR+ dovranno essere in terapia endocrina in regime stabile da almeno 3 mesi prima dell’arruolamento,se indicato. Anche la soppressione ovarica, se indicata,dovrà essere stata avviata almeno 3 mesi prima dell’arruolamento.
    4.ctDNA rilevabile,misurato con test Signatera dal laboratorio centrale.
    5.Campione archiviato di tessuto del tumore primitivo di qualità e quantità sufficienti(almeno quindici sezioni da 5µm o 1 blocchetto FFPE per il saggio del ctDNA e il test tBRCA,e almeno 1 blocchetto FFPE per il test HRD).
    6. ECOG pari a 0 o 1.
    7.Devono avere un’età=18 anni.
    8.Devono avere un’adeguata funzionalità d’organo e del midollo osseo,come definita di seguito.Se non soddisfatti tali criteri,la randomizzazione e il trattamento possono essere ritardati per un massimo 3 settimane.
    Conta assoluta dei neutrofili: =1.500/µL
    Piastrine: =100.000/µL
    Emoglobina: =9g/dL o 5,6mmol/L
    Creatinina sierica: <2×ULN
    Bilirubina totale: =3×ULN
    ALT: =2,5×ULN
    Nota:l’esame CBC completo deve essere ottenuto senza trasfusione o ricezione di fattori stimolanti le colonie nelle 4 settimane precedenti il prelievo.I partecipanti con malattia del fegato o delle vie biliari in corso sono esclusi(ad eccezione della sindrome di Gilbert o calcoli biliari asintomatici o epatopatia cronica stabile in base alla valutazione dello sperimentatore).
    9.I partecipanti con tossicità da terapia antitumorale precedente devono essersi ripresi fino al grado 1.(Un soggetto con neuropatia di grado 2 o alopecia di grado 2 rappresenta un’eccezione a questo criterio e può partecipare a questo studio).La randomizzazione e il trattamento possono essere ritardati per un massimo 3 settimane per soddisfare tale criterio.
    10.Devono essere in grado di deglutire e trattenere il trattamento in studio somministrato per via orale.
    11.Le pazienti di sesso femminile sono eleggibili se non sono in gravidanza o in allattamento e se almeno una delle condizioni indicate di seguito risulta applicabile:
    •Non è una donna in età fertile, come definito nell’Appendice 4 del protocollo
    O
    •È una donna in età fertile e sta utilizzando un metodo contraccettivo altamente efficace come descritto nell’Appendice 4 del protocollo, durante il periodo di trattamento e per almeno 180 giorni dopo l’ultima dose e che acconsente a non donare ovuli a scopo riproduttivo durante questo periodo. Lo sperimentatore deve valutare l’efficacia del metodo contraccettivo in relazione alla prima dose.
    •Una donna in età fertile deve avere un esito negativo al test di gravidanza eseguito nelle 72 ore precedenti alla prima dose.
    •Ulteriori requisiti per il test di gravidanza sono descritti al paragrafo 8.4.6 del protocollo.
    •Lo sperimentatore è responsabile della raccolta di anamnesi, anamnesi mestruale e attività sessuale recente per ridurre il rischio di inclusione di donne in gravidanza in fase iniziale non rilevata.
    12.I soggetti di sesso maschile sono eleggibili se acconsentono a quanto segue per il periodo di trattamento e per almeno 180 giorni dopo l’ultima dose:
    •Astenersi da rapporti eterosessuali come stile di vita preferito e abituale e accettare di rimanere astinenti
    O
    •Acconsentire a utilizzare un preservativo durante il rapporto sessuale con una donna in età fertile non in stato di gravidanza
    E INOLTRE
    •I partecipanti di sesso maschile devono astenersi dal donare sperma per almeno 90 giorni dopo l’ultima dose.
    Fare riferimento al protocollo per criteri d’inclusione dettagliati
    E.4Principal exclusion criteria
    Participants are excluded from the study if any of
    following criteria are met:
    1.Prior treatment with a PARP inhibitor.
    2.Current treatment with a CDK4/6 inhibitor or endocrine therapy other
    than anastrozole,letrozole,exemestane,and tamoxifen.
    3.Participants have any sign of metastasis or local recurrence after
    comprehensive assessment conducted per protocol.
    4.Participants have shown no definitive response to preoperative
    chemotherapy by pathologic or radiological evaluation,in cases where
    preoperative chemotherapy was administered(see Appendix 1).
    5.Participants have systolic BP>140mmHg or diastolic BP>90mmHg.
    6.Participants have any clinically significant gastrointestinal
    abnormalities that may alter absorption such as malabsorption
    syndrome or major resection of the stomach and/or bowels.
    7.Participants have received colony-stimulating factors(eg, granulocyte
    macrophage colony-stimulating factor or recombinant erythropoietin)
    within 4 weeks prior to the first dose of study treatment.
    8.Participants have previously or are currently participating in a
    treatment study of an investigational agent within 4 weeks of the first
    dose of therapy preceding the study.
    9.Participants have received live vaccine within 30 days of planned start
    of study randomization.The use of live
    COVID-19adenoviral vaccines within 30 days of randomization must
    be discussed with the Medical Monitor.
    10.Participants have known hypersensitivity to the components of
    niraparib,placebo,or their formulation excipients.
    11.Participants have undergone major surgery within 4 weeks of starting
    the first dose of study treatment or have not recovered from any effects
    of any major surgery.
    12.Participants have a second primary malignancy.Exceptions are the
    following:
    •Adequately treated nonmelanoma skin cancer,curatively treated in situ
    cancer of the cervix,ductal carcinoma in situ of the breast,Stage
    I Grade 1 endometrial carcinoma
    •Other solid tumors and lymphomas(without bone marrow involvement) diagnosed =5 years prior to randomization and treated
    with no evidence of disease recurrence and for whom no more than 1 line of chemotherapy was applied
    13.Participants have current active pneumonitis or any history of
    pneumonitis requiring steroids(any dose)or immunomodulatory
    treatment within 90 days of planned start of the study.
    14.Participants have any clinically significant concomitant disease or
    condition(such as transfusion-dependent anemia or thrombocytopenia)
    that could interfere with,or for which the treatment might interfere
    with,the conduct of the study or that would,in the opinion of the
    Investigator,pose an unacceptable risk to the participants in this study.
    15.Participants have any psychological,familial,sociological,or
    geographical condition potentially hampering compliance with the study
    requirements and/or follow up procedures.Those conditions should be
    discussed with the participants before study entry.
    16.Participants have high medical risk due to a serious,uncontrolled
    medical disorder;nonmalignant systemic disease;or active,uncontrolled
    infection(including COVID-19).
    17.Participant is pregnant,breastfeeding,or expecting to conceive
    children while receiving study treatment and/or for up to 180 days after
    the last dose of study treatment.
    18.Participants have presence of hepatitis B surface antigen or a positive
    hepatitis C antibody test result at Screening or within 3 months prior to
    first dose of study treatment.For potent immunosuppressive agents,
    participants with presence of hepatitis B core antibody should also be
    excluded.
    19.Participants have a history of HIV
    disease.
    20.Participants have a known history of myelodysplastic syndrome
    or acute myeloid leukemia.
    Saranno esclusi dallo studio i soggetti che rispondono ad uno qualsiasi dei seguenti criteri:
    1.Precedente trattam. con un inibitore di PARP.
    2.Sono in trattam. con un inibitore di CDK4/6,oppure con una terapia end. diversa da anastrozolo,letrozolo,exemestane e tamoxifene.
    3.Presentano segni di metastasi o di recidiva locale in seguito a un’approfondita valutazione condotta come da protocollo.
    4.Non hanno dimostrato, in seguito a valutazione patologica o radiologica,una risposta definitiva alla chemioterapia neoadiuvante,nei casi in cui sia stata somministrata chemioterapia neoadiuvante (si veda Appendice 1 protocollo).
    5.Presentano PA sistolica>140 mmHg o PA diastolica>90 mmHg
    6.Hanno una qualsiasi anomalia gastroint. clinicamente significativa che potrebbe alterare l’assorbimento,come la sindrome da malassorbimento,o hanno subito una resezione maggiore dello stomaco e/o dell’intestino.
    7.Hanno ricevuto fattori stimolanti le colonie(ad es. il fattore di stimolazione delle colonie di granulociti e macrofagi o l’eritropoietina ricombinante) nelle 4 settimane precedenti la prima dose.
    8.Hanno partecipato o stanno partecipando a uno studio di trattamento su un agente sperimentale nelle 4 settimane che precedono la prima dose.
    9. Hanno ricevuto un vaccino vivo nei 30 giorni precedenti la randomizzazione.L’uso di vaccini vivi basati sui vettori adenovirali contro la malattia da Coronavirus 2019 nei 30 giorni precedenti la randomizzazione deve essere discusso con il Medical Monitor.
    10.Hanno un’ipersensibilità nota ai componenti di niraparib, placebo, o agli eccipienti contenuti nelle loro formulazioni.
    11.Sono stati sottoposti a un intervento chirurgico maggiore nelle 4 settimane precedenti l’inizio della prima dose o non si sono ripresi da uno o più effetti di un qualsiasi intervento chirurgico maggiore.
    12.Hanno una neoplasia maligna primitiva secondaria, a eccezione delle seguenti:
    •Tumore cutaneo non-melanoma adeguatamente trattato,carcinoma in situ della cervice sottoposto a terapia curativa,carcinoma duttale in situ della mammella,carcinoma endometriale di stadio I e grado 1.
    •Altri tumori solidi e linfomi (senza interessamento del midollo osseo) diagnosticati =5 anni prima della randomizzazione e trattati senza evidenza di recidiva della malattia,per i quali non sia stata applicata più di una linea di chemioterapia.
    13.Hanno polmonite attiva o anamnesi di polmonite che abbia richiesto il trattamento con steroidi (a qualsiasi dose) o immunomodulatori nei 90 giorni precedenti l’inizio programmato dello studio.
    14.Hanno una qualsiasi malattia o condizione concomitante clinicamente significativa (come l’anemia trasfusione-dipendente o la trombocitopenia) che potrebbe interferire (la malattia o la sua terapia) con lo svolgimento dello studio o che, a giudizio dello sperimentatore, determinerebbe un rischio inaccettabile per i partecipanti a questo studio.
    15.Hanno una qualsiasi condizione psicologica,familiare,sociologica o geografica che potrebbe ostacolare il rispetto dei requisiti dello studio e/o delle procedure di follow-up.Tali condizioni devono essere discusse con i partecipanti prima dell’ingresso nello studio.
    16.Presentano un rischio elevato dovuto a un disturbo medico serio e non controllato; malattia sistemica non maligna; un’infezione non controllata in atto (tra cui COVID-19).
    17.Sono in gravidanza, in allattamento o intendono concepire durante l’assunzione del trattamento sperimentale e/o nei 180 giorni successivi all’ultima dose.
    18.Presentano l’antigene di superficie dell’epatite B o un risultato positivo al test per la ricerca degli anticorpi diretti contro il virus dell’epatite C al momento dello screening o nei 3 mesi precedenti la prima dose del trattamento sperimentale. Per gli agenti immunosoppressori potenti, devono essere esclusi anche i partecipanti con anticorpi contro l’antigene “core” del virus dell’epatite B.
    19.Hanno un’anamnesi di malattia da virus HIV.
    20.Hanno un’anamnesi nota di SMD o LMA.
    E.5 End points
    E.5.1Primary end point(s)
    -DFS is defined as the time until disease recurrence, measured from the time of randomization to the earliest date of assessment of disease recurrence or death by any cause, as assessed by Investigator using RECIST v1.1.
    - La DFS è definita come il tempo alla recidiva di malattia, misurato a partire dal momento della randomizzazione alla data di prima evidenza di recidiva di malattia o decesso per qualsiasi causa, sulla base del giudizio dello sperimentatore tramite i criteri RECIST versione1.1.
    E.5.1.1Timepoint(s) of evaluation of this end point
    -Median DFS for the placebo arm is expected to be ~9 months from randomization.
    -La mediana della DFS per il braccio con placebo è attesa essere all'incirca 9 mesi dalla randomizzazione.
    E.5.2Secondary end point(s)
    -OS is defined as the time of randomization to the date of death by any cause
    -Evaluation of time to progression on next anticancer therapy is defined as
    The time from randomization to the earliest progression event subsequent to that used for the primary variable DFS or death by any cause. The date of progression will be based on Investigator assessment during or after the next anticancer therapy and will be defined according to local standard clinical practice. Progression may involve any of the following: objective radiological, histopathological, or symptomatic progression or death.
    -DRFS is defined as the time from randomization to the first detection of distant metastasis or death by any cause as assessed by Investigator either using RECIST v1.1.
    -Safety and tolerability as measured by the incidence of TEAEs, SAEs, TEAEs leading to death, and AEs leading to discontinuation will be assessed. Clinical laboratory parameters, vital signs, ECOG performance status, physical examinations, and use of concomitant medications will be collected.
    -Evaluation of disease- and treatment-related symptoms that impact participant daily functioning measured by change from baseline as assessed using the following instruments: EORTC-QLQ-C30
    -Evaluation of patient-reported treatment-related symptoms measured by descriptive data presented using items from the PRO-CTCAE and FACT-GP5
    -La OS è definita come il tempo dalla randomizzazione alla data del decesso per qualsiasi causa.
    -La valutazione del tempo alla progressione durante la terapia antitumorale successiva è definita come
    Il tempo intercorso dalla randomizzazione al primo evento di progressione di malattia successivo a quello utilizzato per la variabile primaria (DFS) oppure al decesso per qualsiasi causa. La data di progressione della malattia sarà stabilita in base alla valutazione dello sperimentatore durante o dopo la terapia antitumorale successiva, e sarà definita in base agli standard di pratica clinica locali. Per progressione si può intendere uno qualsiasi degli eventi seguenti: progressione radiologica, istopatologica o sintomatica obiettiva, oppure decesso.
    -Valutazione della sicurezza e della tollerabilità di niraparib. Sarà valutata l’incidenza di TEAE, SAE, TEAE fatali e di AE che portano all’interruzione dello studio. Saranno raccolti parametri clinici di laboratorio, segni vitali, performance status ECOG, esami obiettivi e utilizzo di farmaci concomitanti.
    -Valutazione dei sintomi correlati alla malattia aventi un impatto sul funzionamento quotidiano dei partecipanti misurata tramite la variazione rispetto al basale, valutata utilizzando il questionario EORTC-QLQ-C30.
    - Valutazione dei sintomi correlati al trattamento riferiti dai pazienti misurati tramite la presentazione dei dati descrittivi tramite gli item dei questionari PRO-CTCAE e FACT-GP5.
    E.5.2.1Timepoint(s) of evaluation of this end point
    -Median overall survival for the placebo arm is expected to be ~30 months from randomization; final OS analysis will be ~8 years after the date on which the first participant was randomized. Patient-reported outcomes to assess quality of life will be measured monthly during the trial, at end of treatment, and then post-dose at +30, +90, and +180 days
    - La sopravvivenza globale mediana per il braccio con placebo dovrebbe essere di circa 30 mesi dalla randomizzazione; l'analisi finale della OS avverrà all'incirca 8 anni dopo la data in cui il primo partecipante è stato randomizzato. Gli esiti riportati dai pazienti per valutare la qualità della vita saranno misurati mensilmente durante lo studio, alla fine del trattamento e quindi a +30, +90 e +180 giorni post-dose.
    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 No
    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 Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    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 Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned15
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA107
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Brazil
    Canada
    Chile
    Colombia
    Israel
    Mexico
    New Zealand
    Russian Federation
    South Africa
    United States
    Austria
    Belgium
    Finland
    France
    Germany
    Hungary
    Ireland
    Italy
    Netherlands
    Norway
    Poland
    Portugal
    Romania
    Spain
    Sweden
    Switzerland
    United Kingdom
    Argentina
    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 end of the study is defined as the date of the last scheduled procedure shown in the Schedule of Activities for the last participant in the study.
    La conclusione dello studio è definita come data dell'ultima procedura programmata mostrata nel Programma delle Attività per l'ultimo partecipante nello studio.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years8
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years8
    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: 560
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 240
    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 state45
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 390
    F.4.2.2In the whole clinical trial 800
    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 are expected to discontinue study treatment upon disease recurrence, death, or unacceptable toxicity but will continue long-term follow-up visits/phone calls until discontinued from the study, which occurs upon death, loss to follow-up, withdrawal of consent, or investigator’s decision. After discontinuation from study drug, patients should receive treatment and care at the discretion of their treating physician.
    Ci si aspetta che i soggetti interrompino il trattamento in studio in caso di recidiva della malattia, morte o tossicità inaccettabile, ma continueranno le visite / telefonate di follow-up a lungo termine fino all'uscita dallo studio, che si verifica in caso di morte, perdita del follow-up, revoca del consenso, o su decisione dell'investigatore. Dopo l'interruzione del farmaco in studio, i pazienti devono ricevere i trattamenti e le cure a discrezione del proprio medico curante.
    G. Investigator Networks to be involved in the Trial
    G.4 Investigator Network to be involved in the Trial: 1
    G.4.1Name of Organisation Frontage Laboratories, Inc.
    G.4.3.4Network Country United States
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2021-06-01
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-04-08
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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