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    Summary
    EudraCT Number:2020-004618-36
    Sponsor's Protocol Code Number:CTMX-2009-002
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2021-02-09
    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 ConcernedSpain - AEMPS
    A.2EudraCT number2020-004618-36
    A.3Full title of the trial
    A Phase 2, Open-Label Study to Evaluate the Safety and Antitumor Activity of CX-2009 in Advanced HR-Positive/HER2-Negative Breast Cancer and of CX-2009 as Monotherapy and in Combination with CX-072 in Advanced Triple-Negative Breast Cancer (CTMX-2009-002)
    Estudio de fase 2, abierto, para evaluar la seguridad y la actividad antitumoral de CX-2009 en el cáncer de mama avanzado positivo para receptores hormonales/negativo para el receptor HER2, y de CX-2009 como monoterapia y en combinación con CX-072 en el cáncer de mama avanzado triple negativo (CTMX-2009-002)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study to test CX-2009 in Advanced HR-Positive/HER2-Negative Breast Cancer and of CX-2009 as Monotherapy and in Combination with CX-072 in Advanced Triple-Negative Breast Cancer
    Estudio para evaluar CX-2009 en el cáncer de mama avanzado positivo para receptores hormonales/negativo para el receptor HER2, y de CX-2009 como monoterapia y en combinación con CX-072 en el cáncer de mama avanzado triple negativo (CTMX-2009-002)
    A.4.1Sponsor's protocol code numberCTMX-2009-002
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04596150
    A.5.4Other Identifiers
    Name:INDNumber:150962
    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 SponsorCytomX Therapeutics, 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 supportCytomX Therapeutics, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCytomX Therapeutics, Inc
    B.5.2Functional name of contact pointClinical Trial Information Desk
    B.5.3 Address:
    B.5.3.1Street Address151 Oyster Point, Suite 400
    B.5.3.2Town/ citySouth San Francisco, California
    B.5.3.3Post code94080-1913
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1650515 3185
    B.5.5Fax number+1650351 0353
    B.5.6E-mailclinicaltrials@cytomx.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 nameCX-2009
    D.3.2Product code CX-2009
    D.3.4Pharmaceutical form Powder 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 INNCX-2009
    D.3.9.2Current sponsor codeCX-2009
    D.3.9.3Other descriptive nameCX-2009
    D.3.9.4EV Substance CodeSUB186901
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    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) Yes
    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 Yes
    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 nameCX-072
    D.3.2Product code CX-072
    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 INNCX-072
    D.3.9.2Current sponsor codeCX-072
    D.3.9.3Other descriptive nameCX-072
    D.3.9.4EV Substance CodeSUB184393
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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 Yes
    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
    HR-positive/HER2-negative breast cancer
    Triple-negative breast cancer
    Cáncer de mama positivo para receptores hormonales/negativo para el
    receptor HER2
    Cáncer de mama avanzado triple negativo
    E.1.1.1Medical condition in easily understood language
    Breast Cancer
    Cáncer de mama
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10027475
    E.1.2Term Metastatic breast cancer
    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
    Arms A and B (CX-2009 Monotherapy)
    To evaluate the antitumor activity of CX-2009 based on ORR per the
    Central Radiology Review (CRR)

    Arm C (CX-2009 + CX-072 Combination Therapy)
    To evaluate the antitumor activity of CX-2009 in combination with CX-
    072 based on ORR per CRR
    Grupos A y B (CX-2009 en monoterapia)
    Evaluar la actividad antitumoral de CX-2009 en base a la tasa de
    respuesta objetiva (TRO) según la revisión central de radiología (RCR).

    Grupo C (tratamiento combinado de CX-2009 + CX-072)
    Evaluar la actividad antitumoral de CX-2009 en combinación con CX-072
    en base a la TRO según la RCR.
    E.2.2Secondary objectives of the trial
    Arms A and B (CX-2009 Monotherapy)
    • To evaluate the antitumor activity of CX-2009 based on ORR per
    Investigator assessment,
    • To evaluate progression-free survival (PFS), clinical benefit rate at 16
    weeks (CBR16), CBR24, duration of response (DoR), and OS
    • To characterize the safety profile of CX-2009
    • To characterize the PK of CX-2009
    • To assess the incidence of ADA formation to CX-2009

    Arm C (CX-2009 + CX-072 Combination Therapy)
    • To evaluate the antitumor activity of CX-2009 in combination with CX-072 based on ORR per Investigator assessment
    • To evaluate PFS, CBR16, CBR24, DoR, and OS
    • To characterize the safety profile of CX-2009 in combination with CX-
    072
    • To characterize the PK of CX-2009 in combination with CX-072
    • To characterize the PK of CX-072 in combination with CX-2009
    • To assess the incidence of ADA formation to CX-2009
    • To assess the incidence of ADA formation to CX-072
    Grupos A y B (CX-2009 en monoterapia)
    Evaluar la actividad antitumoral de CX-2009 en base a la TRO según la evaluación del investigador
    Evaluar la supervivencia sin progresión (SSP), la tasa de beneficio clínico
    a las 16 semanas (TBC16), la tasa de beneficio clínico a las 24 semanas (TBC24), la duración de la respuesta (DR) y la supervivencia general (SG)
    Caracterizar el perfil de seguridad de CX-2009
    Caracterizar la farmacocinética (FC) de CX-2009
    Evaluar la incidencia de la formación de anticuerpos antifármaco (AAF)
    contra CX-2009
    Grupo C (tratamiento combinado de CX-2009 + CX-072)
    Evaluar la actividad antitumoral de CX-2009 en combinación con CX-072 en base a la TRO según la evaluación del investigador.
    Evaluar la SSP, TBC16, TBC24, DR y SG
    Caracterizar el perfil de seguridad de CX-2009 en combinación con CX-072
    Caracterizar la FC de CX-2009 en combinación con CX-072

    Para un listado completo de los objetivos secundarios, por favor,refiéranse al Protocolo.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    HR-positive/HER2-negative breast cancer
    1. Must have inoperable, locally advanced or metastatic HR-positive/HER2-negative breast cancer
    2. Histologically confirmed HR-positive/HER2-negative breast cancer based on the most recent analyzed biopsy defined as
    3. ER/PgR > 10%
    4. HER2 negative: IHC 0 or 1+ or HER2/CEP17 ratio 2.0 and average
    HER2 copy number < 4.0 signals/cell by ISH
    5. Must have received at least 2 but no more than 4 prior systemic lines of treatment regimens for inoperable, locally advanced, or metastatic breast cancer (not including single-agent hormonal therapy).
    6. At least 1 cyclin-dependent kinase inhibitor 4/6 in any setting is
    required.
    7. 0 to 2 prior cytotoxic chemotherapy in the inoperable, locally
    advanced, or metastatic setting (eg, microtubulin-targeted agents,
    including taxanes, antimetabolites, anthracyclines, alkylating agents,
    topoisomerase 1 or 2 inhibitor)
    8. Patients with brain metastases that are ≤ 1 cm, are asymptomatic,
    and require treatment may be eligible after discussion with Medical
    Monitor.
    9. Patients with central nervous system lesions that are equivocal (ie,
    may or may not be brain metastases) as assessed by the Investigator
    may be enrolled without definitive local treatment.

    TNBC
    10. Must have inoperable, locally advanced, or metastatic TNBC
    11. Histologically confirmed TNBC based on the most recent analyzed biopsy as defined in the protocol.
    12. Archival or fresh tumor tissue must have high CD166 expression by
    IHC.
    13. Must have received at least 1 but no more than 3 prior systemic lines of treatment regimens for inoperable, locally advanced, or metastatic TNBC
    14. Prior receipt of a taxane (paclitaxel or docetaxel)-based regimen in
    any setting (neoadjuvant, adjuvant, localized, or advanced/metastatic
    disease) is required.
    15. If a patient has disease progression within 12 months following
    completion of adjuvant therapy, the adjuvant therapy will count toward the number of treatments required for eligibility.
    16. Patients with known germline BRCA 1 or 2 mutations must have
    received a platinum or poly ADP ribose polymerase (PARP) inhibitor.
    17. Arm B only: Patients whose tumors test positive for PD-L1 by an
    approved test may enroll to Arm B only if they cannot be (re)treated
    with a checkpoint inhibitor (CPI) for safety reasons (e.g., underlying
    autoimmune disease, prior CPI treatment caused Grade 3 or 4 irAE
    requiring permanent discontinuation)
    18. Arm C only: For patients who have received prior checkpoint
    inhibitors (CPI) therapy: if the CPI was the most recent treatment given prior to enrollment into this study, the patient must not have progressed within 120 days of the first dose of the CPI.
    19. Patients must have tumor tissue known to be positive for PD-L1
    expression.
    20. Patients with brain metastases that are ≤ 1 cm, are asymptomatic, and require treatment may be eligible after discussion with Medical Monitor.
    21. Arms B and C: Patients with brain and/or leptomeningeal metastases are eligible if they have received standard-of-care treatment and are determined to be radiologically and clinically stable (ie, 2 scans at least 28 days apart, including the scan obtained during the screening period) and must not require radiation therapy or corticosteroids within 2 weeks prior to C1D1.
    22. Patients with central nervous system lesions that are equivocal (ie, may or may not be brain metastases) as assessed by the Investigator may be enrolled without definitive local treatment.
    Cáncer de mama positivo para RH/negativo para HER2
    1. Deben tener cáncer de mama inoperable, localmente avanzado o
    metastásico.
    2. Cáncer de mama positivo para RH/negativo para HER2 confirmadohistológicamente en base a la biopsia analizada más reciente, definido como
    Receptor de estrógenos (RE)/receptor de progesterona (RPg) >10 %
    4. Negativo para HER2: IHQ 0 o 1+ o cociente HER2/CEP17 2,0 y número
    medio de copias HER2 <4,0 señales/célula) por ISH
    5. Deben haber recibido al menos 2 pero no más de 4 líneas sistémicas
    previas de pautas de tratamiento para el cáncer de mama inoperable,
    localmente avanzado o metastásico (sin incluir tratamiento hormonal en
    monoterapia).
    6. Se requiere al menos 1 inhibidor de la cinasa dependiente de ciclinas
    4/6 en cualquier contexto.
    7. De 0 a 2 quimioterapias citotóxicas previas en el contexto inoperable,
    localmente avanzado o metastásico (p. ej., agentes dirigidos a la
    microtubulina, incluidos taxanos, antimetabolitos, antraciclinas, agentes
    alquilantes, inhibidor de la topoisomerasa 1 o 2)
    8. Las pacientes con metástasis cerebrales ≤1 cm, que son asintomáticas
    y requieren tratamiento pueden ser aptas tras comentarlo con el supervisor médico.
    9. Las pacientes con lesiones del sistema nervioso central que sean
    dudosas (es decir, pueden ser o no metástasis cerebrales), según la
    evaluación del investigador, podrán ser incluidas sin tratamiento local
    definitive
    CMTN
    10. Deben tener CMTN inoperable, localmente avanzado o metastásico.
    11. CMTN confirmado histológicamente en base a la biopsia analizada
    más reciente, como está definido en el protocolo
    12. El tejido tumoral de archivo o reciento debe tener sobreexpresión de
    CD166 mediante IHQ .
    13. Deben haber recibido al menos 1 pero no más de 3 líneas sistémicas
    previas de pautas de tratamiento para el CMTN inoperable, localmente
    avanzado o metastásico.

    14. Se requiere la recepción previa de una pauta basada en taxanos
    (paclitaxel o docetaxel) en cualquier contexto (enfermedad
    neoadyuvante, adyuvante, localizada o avanzada/metastásica).
    15. Si una paciente presenta progresión de la enfermedad en los 12
    meses posteriores a la finalización del tratamiento adyuvante, el
    tratamiento adyuvante contará para el número de tratamientos
    necesarios para la determinar elegibilidad. El tratamiento adyuvante
    incluye cualquier tratamiento administrado para el cáncer de mama
    localmente avanzado operable.
    16. Las pacientes con mutaciones conocidas de la estirpe germinal BRCA
    1 o 2 deben haber recibido un inhibidor de la poli ADP-ribosa polimerasa
    (PARP).
    17. Solo Grupo B: Las pacientes cuyos tumores den positivo para PD-L1
    mediante una prueba aprobada podrán inscribirse en el grupo B solo si
    no pueden (volver a) tratarse con un inhibidor del punto de control (IPC)
    por motivos de seguridad (p. ej., enfermedad autoinmunitaria
    subyacente, el tratamiento previo con IPC causó un AAri de grado 3 o 4
    que requirió la interrupción permanente)
    18. Solo Grupo C: Para las pacientes que han recibido tratamiento previo
    con inhibidores del punto de control (IPC): si el IPC fue el tratamiento
    más reciente administrado antes de la inscripción en este estudio, la
    paciente no debe haber progresado en el plazo de 120 días desde la
    primera dosis del IPC
    19. Las pacientes deben presentar tejido tumoral positivo para la
    expresión de PD-L1
    20. Las pacientes con metástasis cerebrales ≤1 cm, que son
    asintomáticas y requieren tratamiento pueden ser aptas tras comentarlo
    con el supervisor medico.
    21. Grupos B y C: Las pacientes con metástasis cerebrales y/o
    leptomeníngeas son aptas si han recibido tratamiento de referencia y se
    determina que están radiológicamente y clínicamente estables (es decir,
    2 exploraciones por lo menos con 28 días de diferencia, incluida la
    exploración obtenida durante la fase de selección) y no deben requerir
    radioterapia ni corticoesteroides en las 2 semanas previas al D1C1.
    22. Las pacientes con lesiones del sistema nervioso central que sean
    dudosas (es decir, pueden ser o no metástasis cerebrales), según la
    evaluación del investigador, podrán ser incluidas sin tratamiento local.
    E.4Principal exclusion criteria
    1. History of malignancy that is active within the previous 2 years.
    Exceptions include localized cancers that are not related to the current
    cancer being treated, that are considered to have been cured, and in the opinion of the Investigator present a low risk for recurrence.
    2. Symptomatic or untreated brain and/or leptomeningeal metastases
    3. Unresolved prior therapy-related acute toxicity Grade > 1, including
    neuropathy. Alopecia and other nonacute toxicities are not exclusionary.
    4. Active or chronic corneal disorder, including but not limited to the
    following: Fuchs corneal dystrophy (requiring treatment), history of
    corneal transplantation, active herpetic keratitis, and active ocular
    conditions requiring ongoing treatment/monitoring such as wet agerelated macular degeneration requiring intravitreal injections, active diabetic retinopathy with macular edema, presence of papilledema, and acquired monocular vision.
    5. Serious concurrent illness
    6. History of allogeneic tissue/solid organ transplant, stem cell
    transplant, or bone marrow transplant

    Arm C only
    7. History of or current active autoimmune diseases, which is not a
    sequela of prior immune CPI therapy, including but not limited to
    inflammatory bowel diseases, rheumatoid arthritis, autoimmune
    thyroiditis, autoimmune hepatitis, autoimmune dermatologic diseases, systemic sclerosis, systemic lupus erythematosus, autoimmune vasculitis, autoimmune neuropathies, labile type 1 insulin-dependent diabetes mellitus, vascular thrombosis associated with antiphospholipid syndrome, myositis, Sjogren's syndrome, Guillain-Barre syndrome, glomerulonephritis, or myasthenia gravis unless otherwise approved by the Medical Monitor
    8. History of myocarditis regardless of the cause
    9. History of intolerance to prior immune CPI therapy defined as the
    need to discontinue treatment due to an immune-related AE
    Prior or concomitant therapies
    10. Current use of a known sensitive CYP3A substrate or CYP3A
    substrate with a narrow therapeutic index (see Protocol Appendix 4)
    11. Receipt of systemic anticancer treatment (including investigational
    treatment) within 14 days prior to C1D1 for an oral medication or within 21 days prior to C1D1 for an IV medication
    12. Arm C only: Immunosuppressive therapy including chronic systemic steroid (≥ 10 mg daily prednisone equivalents) within 14 days of C1D1. However, patients who require brief courses of steroids (eg, as prophylaxis for IV contrast or for treatment of an allergic reaction) may be eligible with Medical Monitor approval. Inhaled or topical steroids are permitted.
    13. History of severe allergic or anaphylactic reactions to previous mAb therapy or known hypersensitivity to any component of Probody therapeutic
    14. Prior treatment with maytansinoid-containing drug conjugates (eg, DM4 antibody drug conjugate)
    15. Major surgery (requiring general anesthesia) within 3 months prior to dosing. Patients who have undergone major surgery within this time period may be enrolled after consultation with the Medical Monitor.
    16. Receipt of live vaccine within 28 days prior to the planned first dose, including but not limited to measles, mumps, rubella, chicken pox/zoster, yellow fever, rabies, Bacillus Calmette-Guérin, and typhoid vaccines. Intranasal influenza vaccines contain live attenuated virus and are therefore prohibited.
    17. Current participation in an ongoing clinical study involving treatment with medications, radiation, or surgery within the past 30 days prior to C1D1
    18. Pregnant or breastfeeding
    1. Antecedentes de neoplasia maligna activa en los 2 años anteriores,
    excepto cánceres localizados que no estén relacionados con el cáncer
    actual que se está tratando, que se consideren curados y que, en opinión
    del investigador, presenten un riesgo bajo de recidiva.
    2. Metástasis cerebrales y/o leptomeníngeas sintomáticas no tratadas.
    3. Toxicidad aguda previa no resuelta relacionada con el tratamiento de grado >1, incluida la neuropatía. La alopecia y otras toxicidades no agudas no son motivo de exclusión.
    4. Trastorno corneal activo o crónico, incluyendo pero no limitado a:
    distrofia corneal Fuchs (que requiera tratamiento), historia de
    transplante de córnea, queratitis herpética activa y condiciones oculares
    activas que requieran tratamiento/monitorización tales como la degeneración
    macular relacionada con la edada que requiera injecciones intravítreas,
    retinopatia diabetica activa con edema macular , presencia de
    papiledema, y vision monocular adquirida.
    5. Enfermedad concomitante grave.
    6. Antecedentes de alotrasplante de tejido/órgano sólido, trasplante de
    células madre o trasplante de médula ósea.
    Solo Grupo C
    7. Antecedentes o enfermedades autoinmunes activas actuales, que no
    es una
    secuela de la terapia inmunitaria CPI previa, que incluye, entre otros,
    enfermedades inflamatorias del intestino, artritis reumatoide,
    tiroiditis autoinmune, hepatitis autoinmune, enfermedades
    dermatológicas autoinmunes, esclerosis sistémica, lupus eritematoso
    sistémico, vasculitis autoimmune, neuropatías autoinmunes, diabetes
    mellitus dependiente de insulina de tipo 1 lábil, trombosis vascular
    asociada con el síndrome de antifosfolípidos, miositis, síndrome de
    Sjogren, síndrome de Guillain-Barré,
    glomerulonefritis o miastenia gravis a menos que lo apruebe el monitor
    medico.
    8. Antecedentes de miocarditis, independientemente de la causa.
    9. Antecedentes de intolerancia al tratamiento previo con IPC, definida
    como una necesidad de interrumpir el tratamiento debido a un AA
    inmunitario relacinado con terapias anteriores o concomitantes.
    10. Uso actual de un sustrato sensible de CYP3A o sustrato de CYP3A con
    un índice terapéutico estrecho ( ver protocolo apéndice 4)
    11. Recepción de un tratamiento antineoplásico sistémico, incluso en un
    entorno en investigación en el plazo de 14 días de un medicamento por
    vía oral (21 días de un medicamento por vía i.v.) antes del D1C1.
    12. Solo Grupo C: Tratamiento inmunodepresor, incluidos los
    corticoesteroides sistémicos crónicos (≥10 mg diarios de equivalentes
    de prednisona) en los 14 días previos al D1C1. Sin embargo, las
    pacientes que requieran ciclos breves de corticoesteroides (p. ej., como
    profilaxis para el contraste i.v. o para el tratamiento de una reacción
    alérgica) pueden ser aptas con la aprobación del monitor médico. Se permiten
    los corticoesteroides inhalados o tópicos.
    13. Antecedentes de reacciones alérgicas o anafilácticas graves al
    tratamiento previo con anticuerpos monoclonales (Acm) o
    hipersensibilidad conocida a algún componente de Probody®.
    14. Tratamiento previo con conjugados de fármacos que contengan
    maitansinoide (p. ej., conjugado anticuerpo-fármaco DM4).
    15. Cirugía mayor (que requiere anestesia general) en los 3 meses
    anteriores a la administración de la dosis. Las pacientes que se hayan
    sometido a cirugía mayor dentro de este periodo de tiempo podrán
    inscribirse tras consultarlo con el supervisor médico.
    16. Recepción de vacunas con microbios vivos en los 28 días anteriores a
    la primera dosis prevista, incluidas, entre otras, sarampión, paperas,
    rubéola, varicela/herpes zóster, fiebre amarilla, rabia, bacilo Calmette-
    Guérin y vacuna tifoidea. Las vacunas intranasales contra la gripe
    contienen virus vivos atenuados y, por lo tanto, están prohibidas
    17. Participación actual en un estudio clínico en curso que implica
    tratamiento con medicamentos, radiación o cirugía en los 30 días
    anteriores a la primera dosis.
    18. Mujeres embarazadas o en periodo de lactancia.
    E.5 End points
    E.5.1Primary end point(s)
    Arms A and B (CX-2009 Monotherapy)
    ORR is the proportion of patients in the modified efficacy-evaluable
    population with a best response of complete response (CR) or partial response (PR) based on Response Evaluation Criteria in Solid Tumors
    (RECIST) v1.1 by CRR

    Arms C (CX-2009 + CX-072 Combination Therapy)
    ORR is the proportion of patients in the modified efficacy-evaluable
    population with a best response of CR or PR based on RECIST v1.1 by
    CRR.
    Grupos A y B (CX-2009 en monoterapia)
    La TRO es la proporción de pacientes en la población evaluable para la
    eficacia modificada con una mejor respuesta de respuesta completa (RC)
    o respuesta parcial (RP) según los Criterios de evaluación de la
    respuesta en tumores sólidos (RECIST) v1.1 según la RCR.
    Grupo C (tratamiento combinado de CX-2009 + CX-072)
    La TRO es la proporción de pacientes en la población evaluable para la
    eficacia modificada con una mejor respuesta de respuesta completa (RC)
    o respuesta parcial (RP) según los Criterios de evaluación de la
    respuesta en tumores sólidos (RECIST) v1.1 según la RCR.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Best response according to RECIST 1.1 per CRR will be described with the estimate of ORR and its associated 90% CI.
    La mejor respuesta según RECIST 1.1 por RRC se describirá con la estimación de la TRO y su IC del 90% asociado.
    E.5.2Secondary end point(s)
    Arms A and B (CX-2009 Monotherapy)
    • ORR is the proportion of patients in the modified efficacy-evaluable
    population with a best response of CR or PR based on RECIST v1.1 by
    Investigator assessment.
    • PFS is the time from the date of the first dose of study treatment until documentation of objective tumor progression (based on RECIST v1.1) or death due to any cause, whichever occurs first, evaluated using the CRR and Investigator's datasets.
    • CBR16 and CBR24 are the proportions of patients in the modified
    efficacy-evaluable population with a best response of CR, PR, or stable
    disease at 16 and 24 weeks, respectively, based on RECIST v1.1,
    evaluated using the CRR and Investigator's datasets.
    • DoR is the time from the first documentation of CR or PR (based on
    RECIST v1.1) to documentation of objective disease progression or death due to any cause, whichever occurs first, evaluated using the CRR and Investigator's datasets.
    • OS is the time from the date of the first dose of study treatment to the date of death due to any cause.
    • The safety profile of CX-2009 will be evaluated based on the frequency and severity of adverse events considered related to CX-2009.
    • The PK of CX-2009 will be characterized with respect to the following
    analytes:
    • Intact CX-2009 (referring to the prodrug form of CX-2009 ± DM4)
    • Total CX-2009 (intact and activated forms of CX-2009 ± DM4)
    • Total CX-2009-conjugated DM4 (antibody conjugated-DM4)
    • Free DM4
    • S-methyl DM4 (DM4-Me), a DM4 metabolite with potent cytotoxic activity
    • The following PK parameters will be derived from the concentration–time data of CX-2009 analytes when appropriate and when applicable:
    • Maximum plasma concentration (Cmax)
    • Cmin
    • Incidence of ADA formation to CX-2009

    Arms C (CX-2009 + CX-072 Combination Therapy)
    • ORR is the proportion of patients in the modified efficacy-evaluable
    population with a best response of CR or PR based on RECIST v1.1 by
    Investigator assessment.
    • PFS is the time from the date of the first dose of study treatment until documentation of objective tumor progression (based on RECIST v1.1) or death due to any cause, whichever occurs first, evaluated using the CRR and Investigator's datasets.
    • CBR16 and CBR24 are the proportions of patients in the modified
    efficacy-evaluable population with a best response of CR, PR, or stable
    disease at 16 and 24 weeks, respectively, based on RECIST v1.1,
    evaluated using the CRR and Investigator's datasets.
    • DoR is the time from the first documentation of CR or PR (based on
    RECIST v1.1) to documentation of objective disease progression or death due to any cause, whichever occurs first, evaluated using the CRR and Investigator's datasets.
    • OS is the time from the date of the first dose of study treatment to the date of death due to any cause.
    • The safety profile of CX-2009 in combination with CX-072 will be
    evaluated based on the frequency and severity of adverse events
    considered related to CX-2009 and/or CX-072.
    • The PK of CX-2009 (Cmax and Cmin) will be characterized with respect to the following analytes:
    • Intact CX-2009
    • Total CX-2009
    • Total CX-2009-conjugated DM4
    • Free DM4
    • DM4-Me
    • The PK of CX-072 (Cmax and Cmin) will be characterized with respect
    to the following analytes:
    • Intact CX-072 (referring to the prodrug form of CX-072)
    • Total CX-072 (intact and activated forms of CX-072)
    • Incidence of ADA formation to CX-2009
    • Incidence of ADA formation to CX-072
    Grupos A y B (CX-2009 en monoterapia)
    •La TRO es la proporción de pacientes en la población evaluable para la
    eficacia modificada con una mejor respuesta de respuesta completa (RC)
    o respuesta parcial (RP) según los Criterios de evaluación de la
    respuesta en tumores sólidos (RECIST) v1.1 según la RCR o la
    evaluación del investigador.
    • La SSP es el tiempo transcurrido desde la fecha de la primera dosis del
    tratamiento del estudio hasta la documentación de la progresión objetiva
    del tumor (según los criterios RECIST v1.1) o la muerte por cualquier
    causa, lo que ocurra primero, evaluado usando el RCR y las bases de datos de los investigadores.
    • TBC16 y TBC24 son las proporciones de pacientes en la población
    evaluable para la eficacia modificada con una mejor respuesta de RC, RP
    o enfermedad estable a las 16 y 24 semanas, respectivamente, según los
    criterios RECIST v1.1 usando el RCR y las bases de datos de los investigadores..
    • La DR es el tiempo transcurrido desde la primera documentación de RC
    o RP (según RECIST v1.1) hasta la documentación de la progresión de la
    enfermedad objetiva o la muerte por cualquier causa, lo que ocurra
    primero.¡, evaluado usando RRC y las bases de datos del Investigador.
    •La SG es el tiempo transcurrido desde la fecha de la primera dosis deltratamiento del estudio hasta la fecha de la muerte por cualquier causa.
    • El perfil de seguridad de CX-2009 en combinación con CX-072 sera
    evaluado en función de la frecuencia y severidad de los efectos adversos
    considerados relacionados con CX-2009
    • Se caracterizará la PK de CX-2009 se caracterizará con respecto a las
    siguientes analitos:
    • CX-2009 intacto (referido a la forma de profármaco de CX-2009 ± DM4)
    • Total CX-2009 ( formas intactas e incativadas de CX-2009 ± DM4)
    •CX-2009 total conjugado con DM4 (anticuerpo conjugado DM4)
    • DM4 libre
    • S metil DM4 (DM4-Me), un metabolite de DM4 con potente actividad citotóxica.
    Los siguientes parámetros PK serán derivados de los datos de concentración tiempo de los analitos de CX-2009 cuando sea apropiado y applicable:
    •Cmáxima
    •Cmínima
    •Incidencia de la formación AAF contra CX-2009
    Grupo C (tratamiento combinado de CX-2009 + CX-072)
    •La TRO es la proporción de pacientes en la población evaluable para la
    eficacia modificada con una mejor respuesta de respuesta completa (RC)
    o respuesta parcial (RP) según los Criterios de evaluación de la
    respuesta en tumores sólidos (RECIST) v1.1 según la RCR o la
    evaluación del investigador.
    • La SSP es el tiempo transcurrido desde la fecha de la primera dosis del
    tratamiento del estudio hasta la documentación de la progresión objetiva
    del tumor (según los criterios RECIST v1.1) o la muerte por cualquier
    causa, lo que ocurra primero, evaluado usando el RCR y las bases de datos de los investigadores.
    • TBC16 y TBC24 son las proporciones de pacientes en la población
    evaluable para la eficacia modificada con una mejor respuesta de RC, RP
    o enfermedad estable a las 16 y 24 semanas, respectivamente, según los
    criterios RECIST v1.1 usando el RCR y las bases de datos de los investigadores..
    • La DR es el tiempo transcurrido desde la primera documentación de RC
    o RP (según RECIST v1.1) hasta la documentación de la progresión de la
    enfermedad objetiva o la muerte por cualquier causa, lo que ocurra
    primero.¡, evaluado usando RRC y las bases de datos del Investigador.
    •La SG es el tiempo transcurrido desde la fecha de la primera dosis deltratamiento del estudio hasta la fecha de la muerte por cualquier causa.

    • El perfil de seguridad de CX-2009 en combinación con CX-072 sera
    evaluado en función de la frecuencia y severidad de los efectos adversos
    considerados relacionados con CX-2009 y o CX-072 .
    • Se caracterizará la PK de CX-2009 (Cmax y Cmin) se caracterizará con respecto a las
    siguientes analitos:
    CX-2009 intacto
    Total CX-2009
    CX-2009 total conjugado con DM4
    DM4 libre
    DM4-Me
    • La PK de CX-072 (Cmax y Cmin) se caracterizará con respect a los siguientes analitos:
    •CX-072 intacto (en referencia a la forma de profármaco de CX-072(
    •Total CX-072 (formas intactas y activadas de CX-072 )
    •Incidencia de la formación AAF contra CX-2009
    •Incidencia de la formación AAF contra CX-072
    E.5.2.1Timepoint(s) of evaluation of this end point
    Best response according to RECIST 1.1 per CRR will be described with
    the estimate of Investigator-assessed ORR and its associated 90% CI.
    Investigator-Assessed PFS: Time from the date of the first dose of study treatment until documentation of objective tumor progression based on RECIST v1.1 or until death due to any cause
    OS: Time from treatment initiation until death as a result of any cause
    CBR16: Sum of confirmed Complete plus Partial Responses plus stable disease at 16 weeks on treatment
    CBR24: Sum of confirmed Complete plus Partial Responses plus stable disease at 24 weeks on treatment
    La mejor respuesta según RECIST 1.1 por RRC se describirá con
    la estimación de la TRO valorada por el Investigador y su IC del 90%
    asociado.
    SSP evaluada por el investigador: es el tiempo transcurrido desde la
    fecha de la primera dosis del tratamiento del estudio hasta la
    documentación de la progresión objetiva del tumor (según los criterios
    RECIST v1.1) o la muerte por cualquier causa, lo que ocurra primero.
    SG: tiempo desde el inicio del tratamiento hasta la muerte por cualquier
    causa
    TBC16: Suma de respuestas completas y parciales confirmadas y de la enfermedad estable a las 16 semanas de tratamiento
    TBC24:Suma de respuestas completas y parciales confirmadas y de la enfermedad estable a las 16 semanas de tratamiento


    Para una lista completa, refieranse al protocol.
    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 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) 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 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 No
    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 trial3
    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 EEA8
    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
    Australia
    Korea, Republic of
    United States
    Spain
    United Kingdom
    E.8.7Trial has a data monitoring committee No
    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
    When the last patient completes the last study-related visit, withdraws consent, dies, or is lost to follow-up, whichever occurs first
    Cuando el último paciente complete la última visita relacionada con el estudio, retire su consentimiento, fallezca, o se pierda su seguimiento; lo que ocurra primero.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months2
    E.8.9.1In the Member State concerned days23
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months2
    E.8.9.2In all countries concerned by the trial days23
    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: 112
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 38
    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 state9
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 23
    F.4.2.2In the whole clinical trial 150
    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)
    None
    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 Decision2021-03-15
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-03-08
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2023-06-02
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