E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Low Grade Upper Tract Urothelial Cancer |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10077840 |
E.1.2 | Term | Urothelial cancer of renal pelvis |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10046375 |
E.1.2 | Term | Ureter cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To demonstrate the efficacy and durability of effect following TOOKAD (padeliporfin) VTP on low grade UTUC tumors in the calyces, renal pelvis and ureter |
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E.2.2 | Secondary objectives of the trial |
-To evaluate TOOKAD (padeliporfin) VTP related safety and tolerability in the treatment of low grade UTUC tumors in the calyces, renal pelvis and ureter -To explore a potential link between UTUC cancer genomic markers and treatment related clinical outcomes and disease progression
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
-To evaluate the pharmacokinetic profile in UTUC patients with moderate hepatic impairment. |
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E.3 | Principal inclusion criteria |
1.Male and female patients 18 years or older 2.Able to understand and provide written informed consent and willing to comply with all tests and procedures associated with the study 3.New or recurrent low-grade, non-invasive UTUC disease 4.Biopsy-proven disease. A concurrence of the central pathology reader will be required for eligibility. 5.Up to 2 biopsy-proven sites of low-grade involvement with the largest tumor (index tumor) between 5 mm and 15 mm in diameter (as measured by endoscopy), both located in the calyces, renal pelvis or in the ureter of ipsilateral kidney, with an absence of high-grade cells on cytology. (Ureter involvement should be in one anatomical location with no more than 20 mm of contiguous ureteral length). 6.Karnofsky Performance Status ≥ 50% 7.Adequate organ function defined at baseline as: ▪ANC ≥1,000/ μl, ▪Platelets ≥75,000/ μl, Hb ≥9 g/dl, ▪INR ≤2 ▪Estimated glomerular filtration rate eGFR ≥30 ml/min using CKD-EPI Method ▪Total serum bilirubin <3 mg/dL, AST/ALT ≤5× upper limit of normal
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E.4 | Principal exclusion criteria |
1.Current high-grade or muscle invasive (>pT1) urothelial carcinoma of the bladder 2.Carcinoma in situ (CIS) current or previous in the upper urinary tract 3.History of invasive T2 or higher urothelial cancer in past 2 years 4.Participation in another clinical study involving an investigational product within 1 month before study entry 5.BCG or local chemotherapy treatment (including VEGF-targeted therapy) in the upper urinary tract within 2 months prior to inclusion 6.Systemic chemotherapy treatment (including VEGF-targeted therapy) within 2 months prior to enrollment 7.Prohibited medication that could not be adjusted or discontinued prior to study treatment 8. Patients with photosensitive skin diseases or porphyria 9.Any other medical or psychiatric co-morbidities, including decompensated heart failure, unstable angina or coronary artery disease, severe pulmonary or liver disease or current heavy smoker that, in the opinion of the study investigator, would make the patient a poor candidate for the study 10.Pregnant or breast-feeding women Women of childbearing potential (WOCBP) must undergo a negative serum pregnancy test prior to study entry. 11.Men and women of reproductive potential not willing to observe conventional and effective birth control for the duration of treatment and for 90 days following the last TOOKAD VTP treatment
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy outcome is the absence of UTUC tumors in the entire ipsilateral calyces, renal pelvis and ureter on endoscopic evaluation. This outcome will be determined dichotomously as either failure or success in achieving complete response.
Complete Response will be defined as absence of disease based on: •absence of visual tumor on endoscopy •no evidence of tumor on biopsy (if feasible) •negative urinary cytology by instrumented collection
Additional information are part of the protocol (section Primary Endpoint/Estimand) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
This endpoint will be evaluated at the time of Primary Response Evaluation (PRE) (28 +/- 3 days post last treatment) during the TOOKAD (padeliporfin) VTP induction treatment phase. |
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E.5.2 | Secondary end point(s) |
1.The duration of response at the entire ipsilateral kidney will be defined as absence of disease in the entire ipsilateral calyces, renal pelvis and ureter 2.The duration of response at the Treatment Area of the ipsilateral kidney will be defined as absence of disease in the ipsilateral Treatment Area 3.Overall renal functional outcome 4.Kidney organ loss or preservation 5.Pathological evaluation of response performed in kidney tissue of patient that will undergo kidney surgical removal following at least one TOOKAD VTP treatment 6.Safety follow up based and recording of adverse events
Additional information are part of the protocol (section secondary Endpoint/Estimands) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1.Measured at the 3, 6, 9, 12, 18, 24, 36, 48 and 60 months postPRE 2.Measured at the 3, 6, 9, 12, 18, 24, 36, 48 and 60 months postPRE 3.Measured at the 6, 12, 18, 24, 36, 48 and 60 months postPRE 4.Measured at the 3, 6, 9, 12, 18, 24, 36, 48 and 60months postPRE 5.Whenever possible for patients that will undergo kidney surgical removal postPRE 6.Measured at 3, 6, 9, 12, 18, 24, 36, 48 and 60months postPRE Timepoints at 18 ,24 36, 48 and 60 month postPRE for patients who have a CR at the end of maintenance treatment phase or 6 and 12 months postPRE if the patient has not participated to maintenance treatment phase or 6 and 12 months post last VTP for patient discontinued from the treatment phases Additional information are part of the protocol (section secondary Endpoint/Estimands) |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 15 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Israel |
United States |
Austria |
France |
Germany |
Italy |
Spain |
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E.8.7 | Trial 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
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 7 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 7 |
E.8.9.2 | In all countries concerned by the trial months | 10 |
E.8.9.2 | In all countries concerned by the trial days | 0 |