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    Summary
    EudraCT Number:2020-003999-40
    Sponsor's Protocol Code Number:EONHL1-20
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Trial now transitioned
    Date on which this record was first entered in the EudraCT database:2021-08-30
    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 number2020-003999-40
    A.3Full title of the trial
    A global multicenter phase 1/2 trial of EO2463, a novel microbial-derived
    peptide therapeutic vaccine, as monotherapy, and in combination with
    lenalidomide and rituximab, for treatment of patients with indolent NonHodgkin's Lymphoma.
    Sperimentazione multicentrica globale di FaSe 1/2 di EO2463, un nuovo vaccino terapeutico peptIdico di derivazione microbica, in monoterapia, e in combinazione con lenalidomide e rituximab, per il trattamento di pazienti con linfoma non Hodgkin indolente
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    An early phase clinical trial to investigate EO2463, a novel cancer vaccine
    therapy, in patients with indolent Non-Hodgkin's Lymphoma.
    Sperimentazione clinica di fase iniziale per studiare EO2463, una nuova terapia antitumorale a base di vaccino in pazienti con Linfoma non Hodgkin indolente.
    A.3.2Name or abbreviated title of the trial where available
    SIDNEY
    SIDNEY
    A.4.1Sponsor's protocol code numberEONHL1-20
    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 SponsorENTEROME
    B.1.3.4CountryFrance
    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 supportEnterome
    B.4.2CountryFrance
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationEnterome
    B.5.2Functional name of contact pointJan Fagerberg
    B.5.3 Address:
    B.5.3.1Street Address94/96 avenue Ledru-Rollin
    B.5.3.2Town/ cityParis
    B.5.3.3Post code75011
    B.5.3.4CountryFrance
    B.5.4Telephone number0033614310759
    B.5.5Fax number00000000
    B.5.6E-mailmedicalmonitoring-hem@enterome.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 nameEO2463
    D.3.2Product code [EO2463]
    D.3.4Pharmaceutical form Emulsion for injection/infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeOMP72
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeOMP64
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeOMP65
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeOMP66
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 190396-06-6
    D.3.9.2Current sponsor code-
    D.3.9.4EV Substance CodeSUB33722
    D.3.10 Strength
    D.3.10.1Concentration unit µl/ml microlitre(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeUCP2
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    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.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.2.5The 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 nameEO2463
    D.3.2Product code [EO2463]
    D.3.4Pharmaceutical form Emulsion for injection/infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeOMP72
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeOMP64
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeOMP65
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 190396-06-6
    D.3.9.2Current sponsor code-
    D.3.9.4EV Substance CodeSUB33722
    D.3.10 Strength
    D.3.10.1Concentration unit µl/ml microlitre(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeUCP2
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    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
    Indolent Non-Hodgkin's Lymphoma (Follicular Lymphoma; Marginal Zone Lymphoma)
    linfoma non Hodgkin indolente (Follicular Lymphoma; Marginal Zone Lymphoma)
    E.1.1.1Medical condition in easily understood language
    Indolent Non-Hodgkin's Lymphoma
    linfoma non Hodgkin indolente
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 22.0
    E.1.2Level PT
    E.1.2Classification code 10029547
    E.1.2Term Non-Hodgkin's lymphoma
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objectives are:
    Phase 1
    to define the recommended phase 2 dose (RP2D) for EO2463
    monotherapy, and to confirm the safety of EO2463 at the monotherapy
    RP2D in combination with lenalidomide (EL), rituximab (ER), and
    lenalidomide/rituximab (ER^2).
    Phase 2
    to estimate the objective response rate (ORR) according to the Lugano
    Classification 2014 during EO2463 monotherapy
    Gli obiettivi primari della Fase 1 della sperimentazione sono definire la dose raccomandata per la Fase 2 (RP2D) di EO2463 in monoterapia e confermare la sicurezza di EO2463 alla RP2D in monoterapia, in combinazione con lenalidomide (EL), rituximab (ER) e lenalidomide/rituximab (ER2).
    L’obiettivo primario della Fase 2 della sperimentazione è stimare il tasso di risposta obiettiva (ORR) secondo la Classificazione di Lugano 2014 durante la somministrazione di EO2463 in monoterapia.
    E.2.2Secondary objectives of the trial
    The secondary objectives include assessment of:
    1. safety and tolerability of EO2463 as monotherapy, and in combination
    with lenalidomide, rituximab, and lenalidomide/rituximab, for treatment
    of patients with FL and MZL,
    2. changes (depletion/expansion), including durations, of B and T cell,
    and immunoglobulin levels,
    3. immunogenicity in relation to T cells of OMP72, OMP64, OMP65,
    OMP66, and UCP2 that compose EO2463, including T cell cross-reactivity
    with the human B cell antigens CD20, CD22, CD37, and BAFF-receptor,
    4. ORR and duration of response (DOR) by the Lugano Classification
    2014, and the Lymphoma Response to Immunomodulatory Therapy
    Criteria (LyRIC) 2016 by trial cohort, and
    5. time to next anti-lymphoma therapy (TTT), progression-free survival
    (PFS) and overall survival (OS) by trial cohort.
    Gli obiettivi secondari comprendono la valutazione di
    1. sicurezza e tollerabilità di EO2463 in monoterapia, e in combinazione con lenalidomide, rituximab, e lenalidomide/rituximab, per il trattamento di pazienti con FL e MZL,
    2. variazioni (deplezione/espansione), incluse le durate, dei livelli di linfociti B e T e dell’immunoglobulina,
    3. immunogenicità in relazione ai linfociti T di OMP72, OMP64, OMP65, OMP66 e UCP2 che costituiscono EO2463, inclusa la reattività crociata dei linfociti T con gli antigeni umani dei linfociti B CD20, CD22, CD37 e del recettore BAFF,
    4. ORR e durata della risposta (DoR) mediante la Classificazione di Lugano 2014 e i Criteri di risposta del linfoma alla terapia immunomodulante (Lymphoma Response to Immunomodulatory Therapy Criteria, LyRIC) 2016 per coorte di sperimentazione, e
    5. tempo al successivo trattamento anti-linfoma (TTT), sopravvivenza libera da progressione (PFS) e sopravvivenza globale (OS) per coorte di sperimentazione.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Cohorts 1 and 4 patients should have relapsed/refractory, biopsyproven grade 1, 2 or 3A, FL or MZL, ECOG performance status 0 to 2, and

    have received at least one prior line of treatment (no limitation in

    number of prior treatments; radiotherapy by itself is not considered a

    line of
    treatment).
    2. Cohort 2 patients should have newly diagnosed, previously untreated

    (non-definitive radiotherapy as only prior treatment is allowed),
    biopsyproven grade 1, 2 or 3A, FL or MZL, Ann Arbor stage III or IV, or Ann

    Arbor stage I or II when the patient is not eligible for definitive

    radiotherapy, ECOG performance status 0 or 1, and not be in need of

    standard of care therapy according to the assessment of the treating

    physician.
    3. Cohort 3 patients should have newly diagnosed, previously untreated

    (radiotherapy as only prior treatment is allowed), biopsy-proven grade

    1, 2 or 3A, FL or MZL, Ann Arbor stage III or IV, ECOG performance

    status 0 or 1, low tumor burden by GELF criteria (low tumor burden

    defined as: no mass > 7 cm, < three masses >3 cm, no systemic or
    Bsymptoms, no splenomegaly > 16 cm by PET/CT or CT scan, no risk of

    vital organ compression, no leukemic phase > 5,000/µL circulating

    lymphocytes, and no cytopenia [defined as platelets < 100,000/µL,

    hemoglobin < 10 g/dL, or absolute neutrophil count <1,500/µL]), and

    be in need of therapy according to the assessment of the treating

    physician.
    * MZL includes the entities extranodal MZL (EMZL, i.e. MALT lymphoma),

    splenic MZL (SMZL), and nodal MZL
    (NMZL).
    4. Patients with an age = 18 years
    old.
    5. Patients who are human leukocyte antigen (HLA)-A2
    positive.
    6. Patients should have radiologically measurable disease with a lymph

    node or tumor mass greater than or equal to 1.5 cm in at least one

    dimension.


    Insufficient space, refer to the Protocol.
    Italiano 1. I pazienti delle Coorti 1 e 4 devono presentare FL o MZL recidivante/refrattario, di grado 1, 2 o 3A accertato mediante biopsia, performance status ECOG da 0 a 2 e aver ricevuto almeno una precedente linea di trattamento (senza limite sul numero di trattamenti precedenti, la sola radioterapia non è considerata una linea di trattamento).
    2. I pazienti della Coorte 2 devono presentare FL o MZL di nuova diagnosi, non trattato in precedenza (la radioterapia non definitiva come unico trattamento previo è consentita), di grado 1, 2 o 3A accertato mediante biopsia, di stadio Ann Arbor III o IV, oppure di stadio Ann Arbor I o II quando il paziente non è eleggibile per la radioterapia definitiva, con performance status ECOG da 0 a 1, e senza necessità di terapia dello standard di cura in base al parere del medico curante.
    3. I pazienti della Coorte 3 devono presentare FL o MZL di nuova diagnosi, non trattato in precedenza (la radioterapia come unico trattamento previo è consentita), di grado 1, 2 o 3A accertato mediante biopsia, di stadio Ann Arbor III o IV, con performance status ECOG 0 o 1, basso carico tumorale in base ai criteri GELF (basso carico tumorale definito come: nessuna massa >7 cm, <tre masse >3 cm, assenza di sintomi sistemici o sintomi B, assenza di splenomegalia >16 cm in base a scansione (PET/TC o TC), assenza di rischio di compressione di organi vitali, assenza di fase leucemica >5.000/µl linfociti circolanti e assenza di citopenia [definita come piastrine <100.000/µl, emoglobina <10 g/dl, oppure conta assoluta dei neutrofili <1.500/µl]) e con necessità di terapia in base al parere del medico curante.
    * MZL include MZL extranodale (EMZL, ovvero linfoma MALT), MZL splenico (SMZL) e MZL nodale (NMZL).
    4. Pazienti di età =18 anni.
    5. Pazienti positivi all’antigene leucocitario umano (HLA)-A2.
    6. I pazienti devono presentare una malattia misurabile radiologicamente con un linfonodo o una massa tumorale maggiore o uguale a 1,5 cm in almeno una dimensione.

    Spazio insufficente, fare riferimento al Protocollo.
    E.4Principal exclusion criteria
    1. Patients treated with dexamethasone > 2 mg/day or equivalent (ie 13
    mg/day of prednisone or 53 mg/day of hydrocortisone) within 14 days
    before the first EO2463 administration.
    2. Patients with grade 3B FL or transformation to an aggressive
    lymphoma subtype.
    3. Patients with only one prior treatment and a high-risk profile as
    defined by first progression of disease within 24 months of diagnosis
    (the exclusion is not applicable for patients with more than one prior line
    treatment).
    4. Patients with prior exposure to EO2463.
    5. Patients treated with immunotherapy (meaning immunostimulatory or
    immunosuppressive therapy; beside excluded, or allowed, compounds
    per other inclusion/exclusion criteria specifications), radionuclide
    therapy, radiotherapy, cytoreductive therapy, or received treatment with
    any other investigational agent within 28 days before the first EO2463
    administration.
    6. Patients to be included in Cohorts 1 and 4, and who have received
    rituximab or other B cell ablation therapy within 8 weeks of start of
    study treatment.
    7. Patients to be included in Cohorts 1 and 4, and who have already
    progressed during prior treatment with the R^2-regimen, i.e. an
    adequate combination of lenalidomide and rituximab.
    8. Patients with abnormal laboratory values according to the following
    list (note, lab ranges according to the performing laboratory's reference
    ranges):
    a. hemoglobin < 8 g/dL (sample should be taken = 7 days after any red
    blood cell transfusion),
    b. absolute neutrophil count decrease (< 1.0 ×10^9 /L) (sample should
    be taken = 7 days after any growth factor administration),
    c. platelet count decrease (< 75 ×10^9 /L) (sample should be taken = 7
    days after any platelet transfusion),
    d. bilirubin > 1.5 x upper limit of normal (ULN) (benign hereditary
    hyperbilirubinemia, e.g. Gilbert's syndrome is permitted),
    e. alanine aminotransferase (ALT) > 3 x ULN; if disease affecting the
    liver > 5 x ULN,
    f. aspartate aminotransferase (AST) > 3 x ULN; if disease affecting the
    liver > 5 x ULN, and
    g. serum creatinine increase (> 1.5 x ULN).


    Insufficient space, refer to the Protocol.
    1. Pazienti trattati con desametasone >2 mg/die o equivalente (ossia 13 mg/die di prednisone oppure 53 mg/die di idrocortisone) entro 14 giorni precedenti la prima somministrazione di EO2463. Nota, la somministrazione di steroidi per una via per cui è nota la minima esposizione sistemica (topica, intranasale, intraoculare o inalazione) è accettabile.
    2. Pazienti con FL di grado 3B o trasformazione verso un sottotipo di linfoma aggressivo.
    3. Pazienti con un solo trattamento precedente e un profilo di alto rischio definito dalla prima progressione di malattia entro 24 mesi dalla diagnosi (l’esclusione non è applicabile ai pazienti sottoposti a più di una linea di trattamento precedente).
    4. Paziente previamente esposti a EO2463.
    5. Pazienti trattati con immunoterapia (si intende terapia immunostimolante o immunosoppressiva; oltre a composti esclusi o consentiti per altre specifiche dei criteri di inclusione/esclusione), terapia radionuclidica, radioterapia, terapia citoriduttiva, o che hanno ricevuto un trattamento con qualsiasi altro agente sperimentale entro 28 giorni precedenti la prima somministrazione di EO2463.
    6. Pazienti da includere nelle Coorti 1 e 4 e che hanno ricevuto rituximab o altra terapia di ablazione dei linfociti B entro 8 settimane dall’inizio del trattamento in studio.
    7..Pazienti da includere nelle Coorti 1 e 4 e che hanno già manifestato una progressione durante il trattamento precedente con il regime R2, ossia una combinazione adeguata di lenalidomide e rituximab.
    8. Pazienti con valori di laboratorio anomali in base al seguente elenco (nota, intervalli di laboratorio in base agli intervalli di riferimento del laboratorio utilizzato):
    a. emoglobina <8 g/dl (i campioni si devono prelevare =7 giorni dopo qualsiasi trasfusione di globuli rossi),
    b. diminuzione della conta assoluta dei neutrofili (<1,0 × 109/l) (i campioni si devono prelevare =7 giorni dopo qualsiasi somministrazione di fattore di crescita),
    c. diminuzione della conta piastrinica (<75 × 109/l) (i campioni si devono prelevare =7 giorni dopo qualsiasi trasfusione di piastrine),
    d. bilirubina >1,5 x limite superiore della norma (ULN) (iperbilirubinemia ereditaria benigna, ad es. la Sindrome di Gilbert è permessa),
    e. alanina aminotransferasi (ALT) >3 x ULN; se la malattia interessa il fegato >5 x ULN,
    f. aspartato aminotransferasi (AST) >3 x ULN; se la malattia interessa il fegato >5 x ULN, e
    g. aumento della creatinina sierica (>1,5 x ULN).

    Spazio insufficente, fare riferimento al Protocollo.
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoints of the phase 1 part of the trial are to define the
    recommended phase 2 dose (RP2D) for EO2463 monotherapy by
    applying a 3-by-3 trial design and defined acceptability levels for safety
    concern events (Cohort 1), and to confirm the safety of EO2463 at the
    monotherapy RP2D in combination with lenalidomide (EL; Cohort 4),
    rituximab (ER; Cohort 2), and lenalidomide/rituximab (ER^2; Cohorts 1
    and 4).
    The primary endpoint of the phase 2 part of the trial is to estimate the
    ORR according to the Lugano Classification, during EO2463 monotherapy (Cohort 1 weeks 1-6, Cohort 2 whole treatment period, and Cohort 3
    weeks 1-6), among patients evaluable for efficacy (i.e. patients having
    at least one tumor assessment post treatment start during EO2463
    monotherapy).
    Gli endpoint primari della Fase 1 della sperimentazione sono definire la dose raccomandata per la Fase 2 (RP2D) di EO2463 in monoterapia, applicando un disegno della sperimentazione 3 per 3 e livelli di accettabilità definiti per eventi relativi alla sicurezza (Coorte 1), e confermare la sicurezza di EO2463 alla RP2D in monoterapia, in combinazione con lenalidomide (EL; Coorte 4), rituximab (ER; Coorte 2) e lenalidomide/rituximab (ER2; Coorti 1 e 4).
    L’endpoint primario della Fase 2 della sperimentazione è stimare l’ORR secondo la Classificazione di Lugano durante la somministrazione di EO2463 in monoterapia (Coorte 1 settimane 1-6, Coorte 2 intero periodo di trattamento e Coorte 3 settimane 1-6) dei pazienti valutabili in termini di efficacia (ossia pazienti sottoposti ad almeno una valutazione del tumore dopo l’avvio del trattamento durante l’assunzione di EO2463 in monoterapia).
    E.5.1.1Timepoint(s) of evaluation of this end point
    Phase 1:
    Safety assessment will be performed during each study visit from ICF
    signature.
    recommended phase 2 dose (RP2D) for EO2463 monotherapy- Initial 6
    weeks
    Phase 2:
    Screening2; W6-7 (before W7 treatment); W18-19 (before W19
    treatment); W42-43 (before W43 treatment); 30 days (-0/+4) after last
    treatment; every 6 months (+/- 14 days) before PD
    Fase 1:
    La valutazione della sicurezza sarà eseguita ad ogni vista dello studio a partire dalla firma dell’ICF.
    dose raccomandata della fase 2 (RP2D) per EO2463 in monoterapia - Prime 6 settimane

    Fase 2:
    Screening2; S6-7 (prima del trattamento della S7); S18-19 (prima del trattamento della S19); S42-43 (prima del trattamento della S43 ); 30 giorni (-0/+4) dopo l’ultimo trattamento; ogni 6 mesi (+/- 14 giorni) prima di PD
    E.5.2Secondary end point(s)
    The Secondary endpoints are:
    1. Incidences of adverse events (AEs), treatment-emergent AEs (TEAEs),
    serious AEs (SAEs), deaths, treatment discontinuations/delays, and
    laboratory abnormalities using the NCI-CTCAE v5.0 grading system. For
    EO2463 administered as monotherapy, and in combination with
    lenalidomide, rituximab, and lenalidomide/rituximab.
    2. Level of changes (depletion/expansion), including durations, of B and
    T cells, and immunoglobulins, as measured in peripheral blood (FACS)
    and serum (electrophoresis or equivalent method), respectively.
    3. Percentage of patients with shown immunogenicity (expansion of
    specific T cells comparing samples taken at baseline versus on treatment
    in an individual patient determining if the patient has a positive response
    to the immunization, or not) in relation to OMP72, OMP64, OMP65,
    OMP66, and UCP2 that compose EO2463 by interferon-gamma (IFN-¿)
    enzyme-linked immunospot (ELISpot), and by intracellular cytokines
    staining, and multimers staining assays. Cross reactivities with the
    human B cell antigens CD20, CD22, CD37, and BAFF-receptor will also be
    evaluated by the same methods.
    4. ORR and DOR as described by the Lugano Classification 2014, and by
    the Lymphoma Response to Immunomodulatory Therapy Criteria
    (LyRIC) 2016 by trial cohort.
    5. TTT, PFS and OS:
    a. TTT by trial cohort, defined as the time interval from the date of first
    study treatment administration to the date of start of the next (nonstudy treatment) systemic anti-lymphoma therapy. Patients who has
    not
    started a next (non-study treatment) systemic anti-lymphoma therapy

    will be censored at the date of the last documented
    follow-up.
    b. PFS as described by the Lugano Classification and LyRIC by trial

    cohort, defined as the time interval from the date of first study

    treatment administration to the date of progression, or death due to any

    cause, whichever is earlier. Patients without progression or death are to

    be censored at the time of the last tumor assessment.

    c. OS by trial cohort, defined as the time interval from the date of first

    study treatment administration to the date of death due to any cause.

    Patients alive will be censored at the date of the last documented
    followup.
    Gli endpoint secondari comprendono
    1. Incidenze di eventi avversi (AE), AE emergenti dal trattamento (TEAE), AE seri (SAE), decessi, interruzioni/ritardi del trattamento e anomalie di laboratorio utilizzando il sistema di classificazione NCI-CTCAE v5.0. Per EO2463 somministrato in monoterapia, e in combinazione con lenalidomide, rituximab, e lenalidomide/rituximab.
    2. Livello di variazioni (deplezione/espansione), incluse le durate, dei linfociti B e T e delle immunoglobuline, misurati rispettivamente nel sangue (FACS) e nel siero (elettroforesi o metodo equivalente) periferici.
    3. Percentuale di pazienti con immunogenicità dimostrata (espansione di linfociti T specifici confrontando i campioni prelevati al basale rispetto a durante il trattamento nel singolo paziente per stabilire se il paziente presenta, o meno, una risposta positiva all’immunizzazione) in relazione a OMP72, OMP64, OMP65, OMP66 e UCP2 che costituiscono EO2463, mediante analisi enzima-collegata immunospot (ELISpot) di interferone gamma (IFN-¿) e da test di colorazione delle citochine intracellulari e dei multimeri. Le reattività crociate con gli antigeni umani dei linfociti B CD20, CD22, CD37 e recettore BAFF saranno valutate utilizzando gli stessi metodi.
    4. ORR e DoR descritte dalla Classificazione di Lugano 2014 e dai Criteri di risposta del linfoma alla terapia immunomodulante (Lymphoma Response to Immunomodulatory Therapy Criteria, LyRIC) 2016 per coorte di sperimentazione.
    5. PFS e OS:
    a. TTT per coorte di sperimentazione, definito come l’intervallo di tempo dalla data della prima somministrazione del trattamento in studio alla data di inizio della successiva terapia sistemica anti-linfoma (non trattamento in studio). I pazienti che non hanno iniziato una successiva terapia sistemica anti-linfoma (non trattamento in studio) saranno censurati alla data dell’ultimo follow-up documentato.
    b. PFS descritta dalla Classificazione di Lugano e dal criterio LyRIC per coorte di sperimentazione, definita come l’intervallo di tempo dalla data della prima somministrazione del trattamento in studio alla data di progressione o morte per qualsiasi causa, a seconda dell’evento che si verifica prima. I pazienti che non presentano progressione o non decedono devono essere censurati al momento dell’ultima valutazione del tumore.
    c. OS per coorte di sperimentazione, definita come l’intervallo di tempo dalla data della prima somministrazione del trattamento in studio alla data di morte per qualsiasi causa. I pazienti vivi saranno censurati alla data dell’ultimo follow-up documentato.
    E.5.2.1Timepoint(s) of evaluation of this end point
    1. Safety assessment will be performed during each study visit from ICF
    signature.
    2. Screening2; W7; W19; W31; W43; 30 days (-0/+4) after last
    treatment; every 6 months (+/- 14 days) before PD
    3. Screening2; W1; W5; W7; W11; W15; W19; W23; W27; W31; W35;
    W39; W43; W47; W51; every 6 months (+/- 14 days) before PD
    4. Screening2; W6-7 (before W7 treatment); W18-19 (before W19
    treatment); W42-43 (before W43 treatment); 30 days (-0/+4) after last
    treatment; every 6 months (+/- 14 days) before PD
    5. TTT & OS - time interval from Visit 1 (week 1) first study treatment
    administration to the date of start of the next (non study treatment)
    systemic anti-lymphoma therapy.
    PFS - Time interval from time interval from Visit 1 (week 1) to the date
    of progression or death
    1. Valutazione sicurezza eseguita ad ogni vista dello studio a partire da firma ICF.
    2. Screening2; S7; S19; S31; S43; 30 giorni (-0/+4) dopo ultimo trattamento; ogni 6 mesi (+/- 14 giorni) prima di PD
    3. Screening2; S1; S5; S7; S11; S15; S19; S23; S27; S31; S35; S39; S43; S47; S51; ogni 6 mesi (+/- 14 giorni) prima di PD
    4. Screening2; S6-7 (prima trattamento S7); S18-19 (prima trattamento S19); S42-43 (prima trattamento S43 ); 30 giorni (-0/+4) dopo ultimo trattamento; ogni 6 mesi (+/- 14 giorni) prima di PD
    5. TTT & OS - Intervallo temporale da prima somministrazione della Visita 1 (settimana 1), alla data di inizio della successiva terapia sistemica anti-linfoma (non trattamento in studio).
    PFS - Intervallo temporale dalla Visita 1 (settimana 1) a data di progressione o decesso
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Immunogenicity
    Immunogenicità
    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 I/II
    Fase I/II
    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
    Studio a 4 coorti
    4-cohort trial
    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 trial4
    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 concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA9
    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
    United States
    France
    Italy
    Spain
    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
    LVLS
    LVLS
    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 months5
    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 months5
    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: 24
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 30
    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 state11
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 43
    F.4.2.2In the whole clinical trial 54
    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)
    The investigator will ensure that patients receive appropriate standard
    of care to treat the condition under the study.
    Lo sperimentatore si assicurerà che i pazienti ricevano uno standard di cura appropriato per trattare la patologia oggetto 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 Decision2021-01-08
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-12-16
    P. End of Trial
    P.End of Trial StatusTrial now transitioned
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