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    Summary
    EudraCT Number:2020-004918-35
    Sponsor's Protocol Code Number:CP-MGA271-06
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2021-07-19
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2020-004918-35
    A.3Full title of the trial
    A Phase 2 Open-Label Trial to Evaluate Enoblituzumab in Combination with Retifanlimab or Tebotelimab in the First-Line Treatment of Patients with Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck
    Ensayo de fase 2, abierto, para evaluar Enoblituzumab en combinación con Retifanlimab o Tebotelimab, como tratamiento de primera línea en pacientes con carcinoma de células escamosas de cabeza y cuello recurrente o metastásico
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study of Enoblituzumab in Combination with Retifanlimab or Tebotelimab in Patients with Head and Neck Cancer
    Estudio de Enoblituzumab en combinación con Retifanlimab o Tebotelimab, en pacientes con cáncer de cabeza y cuello
    A.4.1Sponsor's protocol code numberCP-MGA271-06
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04634825
    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 SponsorMacroGenics, 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 supportMacroGenics, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationSERMES PLANIFICACION S.L
    B.5.2Functional name of contact pointUnidad de Puesta en Marcha
    B.5.3 Address:
    B.5.3.1Street AddressCalle Rufino González, 14-2º D
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28037
    B.5.3.4CountrySpain
    B.5.4Telephone number+34913755025
    B.5.5Fax number+3491754 27 21
    B.5.6E-mailstart-up@sermescro.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 nameEnoblituzumab
    D.3.2Product code MGA271
    D.3.4Pharmaceutical form Concentrate for 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 INNENOBLITUZUMAB
    D.3.9.1CAS number 1353485-38-7
    D.3.9.2Current sponsor codeMGA271
    D.3.9.4EV Substance CodeSUB193459
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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.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 nameRetifanlimab
    D.3.2Product code MGA012 (INCMGA00012)
    D.3.4Pharmaceutical form Concentrate for 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 INNRETIFANLIMAB
    D.3.9.1CAS number 2079108-44-2
    D.3.9.2Current sponsor codeMGA012
    D.3.9.3Other descriptive nameINCMGA00012
    D.3.9.4EV Substance CodeSUB193740
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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.IMP: 3
    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 nameTebotelimab
    D.3.2Product code MGD013
    D.3.4Pharmaceutical form Concentrate for 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 INNTebotelimab
    D.3.9.1CAS number 2245725-04-4
    D.3.9.2Current sponsor codeMGD013
    D.3.9.4EV Substance CodeSUB216543
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    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
    Recurrent or Metastatic Squamous Cell Carcinoma of the Head and Neck
    carcinoma de células escamosas de cabeza y cuello recurrente o metastásico
    E.1.1.1Medical condition in easily understood language
    Advanced cancer disease
    Enfermedad cancerosa avanzada
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10067821
    E.1.2Term Head and neck 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
    Retifanlimab Cohort
    •To assess the efficacy of the combination of enoblituzumab + retifanlimab, based primarily upon evaluation of Investigator-assessed ORR in the response evaluable patient population, in patients with recurrent or metastatic SCCHN not curable by local therapy, with no prior systemic therapy for SCCHN in the recurrent or metastatic setting.

    Tebotelimab Cohort
    •To assess the safety, tolerability, and preliminary efficacy of the combination of enoblituzumab + tebotelimab, based primarily upon evaluation of Investigator-assessed ORR in the response evaluable patient population, in patients with recurrent or metastatic SCCHN not curable by local therapy, with no prior systemic therapy for SCCHN in the recurrent or metastatic setting.
    Cohorte de retifanlimab:
    • Evaluar la eficacia de la combinación de enoblituzumab + retifanlimab, basada principalmente en la evaluación de la tasa de respuesta objetiva (TRO) valorada por el investigador en la población de pacientes evaluables para respuesta, en pacientes con carcinoma de células escamosas de cabeza y cuello recurrente o metastásico (CECC) incurable mediante terapia local, sin terapia sistémica previa para CECC en el contexto recurrente o metastásico

    Cohorte de tebotelimab:
    • Evaluar la seguridad, tolerabilidad, y eficacia inicial de la combinación de enoblituzumab + retifanlimab, basadas principalmente en la evaluación de la TRO valorada por el investigador en la población de pacientes evaluables para respuesta, en pacientes con CECC incurable mediante terapia local, sin terapia sistémica previa para CECC en el contexto recurrente o metastásico
    E.2.2Secondary objectives of the trial
    Retifanlimab Cohort
    •To evaluate the Investigator-assessed PFS, disease control rate (DCR), DoR, and OS.
    •To evaluate safety and tolerability.
    •To assess the PK of enoblituzumab + retifanlimab.
    •To evaluate the immunogenicity of enoblituzumab + retifanlimab.

    Tebotelimab Cohort
    •To evaluate the Investigator-assessed PFS, DCR, DoR, and OS.
    •To assess the PK of enoblituzumab + tebotelimab.
    •To evaluate the immunogenicity of enoblituzumab + tebotelimab.
    Cohorte de retifanlimab:
    • Evaluar la supervivencia sin progresión (SLP), la tasa de control de la enfermedad (TCE), la duración de la respuesta (DR) y la supervivencia general (SG) valoradas por el investigador.
    • Evaluar la seguridad y la tolerabilidad.
    • Evaluar la farmacocinética (FC) de enoblituzumab + retifanlimab.
    • Evaluar la inmunogenicidad de enoblituzumab + retifanlimab

    Cohorte de tebotelimab:
    • Evaluar la SLP, TCE, DR y SG valoradas por el investigador.
    • Evaluar la FC de enoblituzumab + tebotelimab.
    • Evaluar la inmunogenicidad de enoblituzumab + tebotelimab
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1.Ability to provide informed consent and documentation of informed consent prior to initiation of any study-related tests or procedures that are not part of standard of care for the patient’s disease.
    2.Age ≥ 18 years old.
    3.Histologically proven, recurrent or metastatic SCCHN not curable by local therapy.
    4.No prior systemic therapy for SCCHN in the recurrent or metastatic setting (with the exception of systemic therapy completed > 6 months prior if given as part of multimodal treatment for locally advanced disease).
    5.Primary tumor locations of oropharynx, oral cavity, hypopharynx, or larynx. Patients may not have a primary tumor site of upper esophagus, salivary gland, or nasopharynx (any histology).
    6.All patients enrolled in this study must have an identified formalin-fixed, paraffin embedded (FFPE) tumor specimen for immunohistochemical evaluation of pharmacodynamic markers of interest. If no archival specimen is available, tissue from a contemporaneous core or excisional biopsy is acceptable.
    Patients must also be willing to provide consent for a baseline and on treatment tumor biopsy, if tumor lesions are accessible for biopsy with acceptable risk in the judgment of the Investigator and after discussion with the Sponsor. This requirement will expire after an adequate number of samples have been collected, as determined by the Sponsor.
    7.Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, verified within 3 days before Day 1.
    8.Life expectancy ≥ 6 months.
    9.Has adequate end organ function as determined by the site Investigator.
    10.Has at least one radiographically measurable lesion (target lesion), as defined in RECIST v1.1 and documented by computed tomography (CT) or magnetic resonance imaging (MRI), suitable for response monitoring.
    11.Has PD-L1 expression level that is either:
    a.Positive (CPS ≥ 1) for the Retifanlimab Cohort, or
    b.Negative (CPS < 1) for the Tebotelimab Cohort
    12.Has results from testing of HPV p16 status for oropharyngeal cancer.
    13.Acceptable laboratory parameters as follows:
    a.Platelet count ≥ 100 × 103/µL without transfusion within 28 days prior to the initiation of study drug.
    b.Absolute neutrophil count ≥ 1.5 × 103/µL in the absence of any growth factor support within 28 days prior to the initiation of study drug.
    c.ALT/AST ≤ 2.5 × ULN; for patients with hepatic metastases, ALT and AST ≤ 5 × ULN.
    d.Total bilirubin < 1.5 × ULN, except patients with Gilbert’s syndrome, who may enroll if the conjugated bilirubin is within normal limits.
    e.Creatinine < 2 mg/dL, or a calculated or measured creatinine clearance > 50 mL/min.
    f.Negative serum pregnancy test, if applicable.
    14.Women patients of child bearing potential (WOCBP), defined as not surgically sterilized (hysterectomy, bilateral salpingectomy, and bilateral oophorectomy) and between menarche and 1-year post menopause, must have a negative serum pregnancy test performed within 72 hours prior to the initiation of study drug administration. Female patients must agree to abstain from egg donation during the course of the study.
    15.WOCBP and male patients with partners of WOCBP must agree to use highly effective methods of contraception from the time of consent through 120 days after discontinuation of study drug administration. Male patients must agree to abstain from sperm donation during the course of the study.
    16.WOCBP is not pregnant or breastfeeding or male patient is not expecting to father children within the projected duration of the study, starting with screening visit through 120 days after the last dose of study drug.
    1.Capacidad de proporcionar consentimiento informado y documentación del consentimiento informado antes de iniciar cualquier prueba o procedimiento relacionado con el estudio que no forman parte del estándar de atención para la enfermedad del paciente.
    2.Edad ≥ 18 años.
    3. SCCHN recurrente o metastásico probado histológicamente no curable por terapia local.
    4.No hay terapia sistémica previa para CECC en el contexto recurrente o metastásico (con la excepción de la terapia sistémica completada> 6 meses antes si se administra como parte de un tratamiento multimodal para la enfermedad localmente avanzada).
    5.Localizaciones tumorales primarias de orofaringe, cavidad oral, hipofaringe o laringe. Es posible que los pacientes no tengan un sitio de tumor primario en la parte superior del esófago, glándula salival o nasofaringe (cualquier histología).
    6.Todos los pacientes inscritos en este estudio deben tener una etiqueta fijada con formalina identificada, espécimen de tumor incluido en parafina (FFPE) para evaluación inmunohistoquímica de marcadores farmacodinámicos de interés. Si no hay una muestra de archivo disponible, el tejido de un núcleo contemporáneo o una biopsia por escisión es aceptable. Los pacientes también deben estar dispuestos a dar su consentimiento para una línea de base y de tratamiento de la biopsia tumoral, si las lesiones tumorales son accesibles para biopsia con riesgo aceptable a juicio del investigador y después de la discusión con el promotor. Este requisito expirará después de que un número adecuado de muestras hayan sido recolectadas, según lo determine el Promotor.
    7.Estado funcional del Grupo de Oncología Cooperativa del Este (ECOG) de 0 o 1, verificado dentro de los 3 días anteriores al Día 1.
    8. Esperanza de vida ≥ 6 meses.
    9.Tiene una función de órgano terminal adecuada según lo determinado por el Investigador del centro.
    10.Tiene al menos una lesión medible radiográficamente (lesión diana), como se define en RECIST v1.1 y documentado por tomografía computarizada (TC) o imágenes por resonancia magnética (RM), adecuadas para el seguimiento de la respuesta.
    11.Tiene un nivel de expresión PD-L1 que es:
    a) Positivo (CPS ≥ 1) para la cohorte de Retifanlimab, o
    b) Negativo (CPS <1) para la cohorte de Tebotelimab
    12.Tiene los resultados de las pruebas del estado p16 del VPH para el cáncer de orofaringe.
    13.Parámetros de laboratorio aceptables como sigue:
    a) Recuento de plaquetas ≥ 100 × 103 / μLsegún se india a sin transfusión en 28 días antes del inicio del fármaco del estudio.
    b) Recuento absoluto de neutrófilos ≥ 1,5 × 103 / μL en ausencia de soporte del factor de crecimiento dentro de los 28 días anteriores al inicio del fármaco del estudio.
    c) ALT / AST ≤ 2,5 × LSN; para pacientes con metástasis hepáticas, ALT y AST ≤ 5 × LSN.
    d) Bilirrubina total <1,5 × LSN, excepto pacientes con síndrome de Gilbert, quién puede inscribirse si la bilirrubina conjugada está dentro de los límites normales.
    e) Creatinina <2 mg / dL, o un aclaramiento de creatinina calculado o medido > 50 ml / min.
    f) Prueba de embarazo en suero negativa, si corresponde.
    14.Mujeres pacientes en edad fértil (WOCBP), definidas como no esterilizadas quirúrgicamente (histerectomía, salpingectomía bilateral y bilateral ooforectomía) y entre la menarquia y 1 año después de la menopausia, debe tener una prueba de embarazo en suero negativa realizada dentro de las 72 horas antes del inicio de la administración del fármaco del estudio. Las pacientes deben estar de aceptar abstenerse de la donación de óvulos durante el transcurso del estudio.
    15. Mujeres pacientes en edad fértil y los pacientes masculinos con parejas en edad fértil (WOCBP) deben aceptar usar métodos anticonceptivos altamente efectivos desde el momento del consentimiento hasta 120 días después de la interrupción de la administración del fármaco del estudio. Los pacientes varones deben aceptar abstenerse de la donación de esperma durante el transcurso del estudio.
    16. Mujeres pacientes en edad fértil (WOCBP)no embarazadas o amamantando o el paciente masculino que no prevé tener hijos dentro de la duración prevista del estudio, comenzando con la visita de selección hasta 120 días después de la última dosis de fármaco de estudio.
    E.4Principal exclusion criteria
    1.Disease suitable for local therapy administered with curative intent.
    2.Has progressive disease within 6 months of completion of curatively intended systemic treatment for locoregionally advanced SCCHN.
    3.Radiation therapy (or other non-systemic therapy) within 2 weeks prior to the first dose of study drug.
    4.Toxicity of prior therapy that has not recovered to ≤ Grade 1 or baseline, with the exception of any grade of alopecia and anemia not requiring transfusion support.
    5.Diagnosis of immunodeficiency or receiving systemic steroid therapy corticosteroids or any other form of immunosuppressive therapy within 14 days prior to the first dose of study medication.
    6.Currently participating in a study of an investigational agent and receiving study therapy, participated in a study of an investigational agent and received study therapy, or used an investigational drug or device within 4 weeks of the first dose of study drug administration.
    7.Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, including:
    a.Participants who are known to be HIV-positive, unless all the following criteria are met:
    - CD4+ count ≥ 300/μL,
    -Undetectable viral load, and
    -Receiving highly active antiretroviral therapy.
    b.Known history of or current acute or chronic hepatitis B virus (HBV) infection.
    c.Patients with a history of hepatitis C virus (HCV) infection, unless the infection has been treated and cured.
    d.Has had an allogeneic stem cell or tissue/solid organ transplant.
    e.Patients with central nervous system metastases and/or carcinomatous meningitis.
    f.Patients with a history of psoriatic arthritis.
    g.Patients with any history of known or suspected autoimmune disease with the specific exceptions of vitiligo, resolved childhood atopic dermatitis, psoriasis not requiring systemic treatment within the past 2 years and patients with a history of autoimmune disease who are now clinically stable with replacement therapy and by laboratory testing.
    h.Evidence of active viral, bacterial, or systemic fungal infection requiring systemic treatment within 7 days prior to the initiation of study treatment.
    i.Known hypersensitivity to recombinant proteins, polysorbate 80, or any excipient contained in the enoblituzumab, retifanlimab, or tebotelimab drug formulation.
    j.Any serious underlying medical or psychiatric condition that would impair the ability of the patient to receive or tolerate the planned treatment at the investigational site.
    k.History of uncontrolled seizures within 6 months prior to the first dose of study drug.
    l.Active or history of alcohol or other substance abuse within 1 year prior to the first dose of study drug.
    8.Clinically significant cardiovascular disease including but not limited to:
    a.Myocardial infarction or unstable angina within the 6 months prior to the initiation of study drug.
    b.Stroke or transient ischemic attack within 6 months prior to the initiation of study drug.
    c.Clinically significant cardiac arrhythmias.
    d.Uncontrolled hypertension.
    e.Congestive heart failure.
    f.Pericarditis or clinically significant pericardial effusion.
    g.Myocarditis.
    h.QTcF > 480 milliseconds as the average of 3 repeat examinations.
    9.Clinically significant gastrointestinal disorders including but not limited to:
    a.Any history of gastrointestinal perforation unless the affected area has been deemed by the Investigator to no longer be a risk for perforation.
    b.History of clinically significant gastrointestinal bleeding within 4 weeks prior to the initiation of study drug.
    c.History of acute pancreatitis within 4 weeks prior to the initiation of study drug.
    d.Diverticulitis that is clinically significant in the opinion of the Investigator
    10.Vaccination with any live virus vaccine within 4 weeks prior to the initiation of study drug administration. Inactivated annual influenza vaccination is allowed.
    a.If an immunization strategy for SARS-CoV-2 was available prior to enrollment, potential exclusion from the study based on history of receipt of SARS-CoV-2 prophylaxis will be discussed with the Sponsor.
    11.Major surgical procedure or trauma within the 4 weeks prior to the initiation of study treatment.
    12.A history of (non-infectious) pneumonitis or interstitial lung disease that required steroids, or current pneumonitis or interstitial lung disease.
    13.Prior therapy with an anti-B7-H3, anti-PD-1, anti-PD-L1, anti-PD-L2, or anti-LAG-3 agent.
    14.Severe dyspnea at rest due to complications of advanced malignancy or requiring supplemental oxygen therapy.
    15.Clinically significant pulmonary compromise.
    16.Second primary invasive malignancy that has not been in remission for greater than 2 years.
    17.Known psychiatric or substance abuse disorders.
    18.Prisoners or other individuals who are involuntarily detained.
    1.Enfermedad adecuada para terapia local administrada con fines curativos.
    2. Tiene una enfermedad progresiva dentro de los 6 meses posteriores a la finalización del tratamiento sistémico con fines curativos para el CECC locorregionalmente avanzado.
    3.Terapia de radiación (u otra terapia no sistémica) dentro de las 2 semanas antes de la primera dosis del fármaco del estudio.
    4.Toxicidad de la terapia previa que no se ha recuperado a ≤ Grado 1 o línea de base, con la excepción de cualquier grado de alopecia y anemia que no requiera apoyo transfusional.
    5.Diagnóstico de inmunodeficiencia o recibir terapia con esteroides sistémicos corticosteroides o cualquier otra forma de terapia inmunosupresora dentro de los 14 días anteriores a la primera dosis del medicamento del estudio.
    6. Participa actualmente en un estudio de un agente en investigación y recibe la terapia del estudio, participó en un estudio de un agente de investigación y recibió la terapia del estudio, o usó un fármaco en investigación o dispositivo dentro de las 4 semanas posteriores a la primera dosis de administración del fármaco del estudio.
    7.Tiene antecedentes o evidencia actual de alguna condición, terapia o anomalía de laboratorio que podría confundir los resultados del ensayo, incluyendo:
    a) Participantes que se sabe que son VIH positivos, a menos que se cumplan todos los siguientes criterios :
    - Recuento de CD4 + ≥ 300 / μL,
    -Carga viral indetectable, y
    -Recibir terapia antirretroviral de gran actividad.
    b) Historia conocida o actual del virus de la hepatitis B aguda o crónica (VHB) infección.
    c) Pacientes con antecedentes de infección por el virus de la hepatitis C (VHC), a menos que la infección haya sido tratada y curada.
    d)Ha tenido un trasplante alogénico de células madre o de tejido / órgano sólido.
    e) Pacientes con metástasis del sistema nervioso central y / o meningitis carcinomatosa.
    f) Pacientes con antecedentes de artritis psoriásica.
    g) Pacientes con antecedentes de enfermedad autoinmune conocida o sospechada con las excepciones específicas del vitiligo, dermatitis atópica infantil resuelta, psoriasis que no requirió tratamiento sistémico en los últimos 2 años y pacientes con antecedentes de enfermedad autoinmune que están ahora clínicamente estables con terapia de reemplazo y pruebas de laboratorio.
    h) Evidencia de infección fúngica viral, bacteriana o sistémica activa que requieran tratamiento sistémico dentro de los 7 días anteriores al inicio de estudio de tratamiento.
    i)Hipersensibilidad conocida a proteínas recombinantes, polisorbato 80 o cualquier excipiente contenido en la formulación de los fármacos enoblituzumab, retifanlimab o tebotelimab.
    j) Cualquier afección médica o psiquiátrica subyacente grave que perjudique la capacidad del paciente para recibir o tolerar el plan de tratamiento en el centro de investigación.
    k) Historial de convulsiones no controladas en los 6 meses anteriores a la primera dosis del fármaco en estudio.
    l) Activo o antecedentes de abuso de alcohol u otras sustancias dentro del año anterior a la primera dosis del fármaco del estudio.
    8.Enfermedad cardiovascular clínicamente significativa que incluye, pero no se limita a :
    a) Infarto de miocardio o angina inestable en los 6 meses anteriores al inicio del fármaco de estudio.
    b) Accidente cerebrovascular o ataque isquémico transitorio en los 6 meses anteriores al inicio del fármaco del estudio.
    c) Arritmias cardíacas clínicamente significativas.
    d) Hipertensión no controlada.
    e) Insuficiencia cardíaca congestiva.
    f) Pericarditis o derrame pericárdico clínicamente significativo.
    g) Miocarditis.
    h) QTcF> 480 milisegundos como promedio de 3 exámenes repetidos.
    9.Trastornos gastrointestinales clínicamente significativos que incluyen, pero no limitado a:
    a) Cualquier historial de perforación gastrointestinal a menos que el investigador haya considerado que el área afectada ya no representa un riesgo de perforación.
    b) Historial de hemorragia gastrointestinal clínicamente significativa en 4 semanas antes del inicio del fármaco del estudio.
    c) antecedentes de pancreatitis aguda en las 4 semanas anteriores al inicio de fármaco de estudio.
    d) Diverticulitis que sea clínicamente significativa en opinión del Investigador
    10. Vacunación con cualquier virus vivo dentro de las 4 semanas previas al inicio de la administración del fármaco del estudio. Se permite la vacuna antigripal anual inactivada.
    a) Si se dispuso de una estrategia de inmunización para el SRAS-CoV-2 antes de inscripción, posible exclusión del estudio basada en el historial de la recepción de la profilaxis del SARS-CoV-2 se discutirá con el Promotor.
    11.Procedimiento quirúrgico mayor o trauma dentro de las 4 semanas previas al inicio del tratamiento del estudio.
    12.Un historial de neumonitis (no infecciosa) o enfermedad pulmonar intersticial que requirieron esteroides.. (ver el resto de criterios en el protocolo)
    E.5 End points
    E.5.1Primary end point(s)
    1. Efficacy of enoblituzumab plus retifanlimab
    Investigator-assessed objective response rate (complete response [CR] or partial response [PR])
    2. Safety of enoblituzumab plus tebotelimab
    Incidence of treatment-emergent adverse events
    3. Efficacy of enoblituzumab plus tebotelimab
    Investigator-assessed objective response rate
    1.Eficacia de enoblituzumab más retifanlimab Tasa de respuesta objetiva evaluada por el investigador (respuesta completa [RC] o respuesta parcial [RP])
    2. Seguridad de enoblituzumab más tebotelimab Incidencia de eventos adversos emergentes del tratamiento
    3. Eficacia de enoblituzumab más tebotelimab Tasa de respuesta objetiva evaluada por el investigador
    E.5.1.1Timepoint(s) of evaluation of this end point
    Ad. 1 - Efficacy of enoblituzumab plus retifanlimab - 28 months
    Ad. 2 - Safety of enoblituzumab plus tebotelimab - 30 days after last dose
    Ad. 3 - Efficacy of enoblituzumab plus tebotelimab - 28 months
    Anuncio. 1 - Eficacia de enoblituzumab más retifanlimab - 28 meses
    Anuncio. 2 - Seguridad de enoblituzumab más tebotelimab - 30 días después de la última dosis
    Anuncio. 3 - Eficacia de enoblituzumab más tebotelimab - 28 meses
    E.5.2Secondary end point(s)
    4. Progression-free survival
    Time from the first dose date to the date of first documented progression or death from any cause, whichever occurs first, evaluated by cohort
    5. Disease-control rate
    Percentage of response-evaluable patients with CR, PR, or stable disease (SD) for at least 3 months, evaluated by cohort
    6. Duration of response
    Time from the date of initial response (CR or PR) to the date of first documented progression or death from any cause, whichever occurs first, evaluated by cohort
    7. Overall survival
    Time from the first dose date to the date of death from any cause, evaluated by cohort
    8. Safety of enoblituzumab plus retifanlimab
    Incidence of treatment-emergent adverse events
    9. Pharmacokinetics of enoblituzumab plus retifanlimab
    Serum concentration of enoblituzumab and retifanlimab
    10. Pharmacokinetics of enoblituzumab plus tebotelimab
    Serum concentration of enoblituzumab and tebotelimab
    11. Immunogenicity of enoblituzumab plus retifanlimab
    Proportion of patients who develop anti-drug antibodies
    12. Immunogenicity of enoblituzumab plus tebotelimab
    Proportion of patients who develop anti-drug antibodies
    4. Supervivencia libre de progresión
    Tiempo desde la fecha de la primera dosis hasta la fecha de la primera documentada o fallecimiento por cualquier causa, lo que ocurra primero, evaluado por cohorte
    5. Tasa de control de enfermedades
    Porcentaje de pacientes con respuesta evaluable con RC, RP o enfermedad (estable SD) durante al menos 3 meses, evaluada por cohorte
    6. Duración de la respuesta
    Tiempo desde la fecha de la respuesta inicial (CR o PR) hasta la fecha de la primera progresión documentada o fallecimiento por cualquier causa, lo que ocurra primero, evaluado por cohorte
    7. Supervivencia general
    Tiempo desde la fecha de la primera dosis hasta la fecha del fallecimiento por cualquier causa, evaluado por cohorte
    8. Seguridad de enoblituzumab más retifanlimab
    Incidencia de eventos adversos emergentes del tratamiento
    9. Farmacocinética de enoblituzumab más retifanlimab
    Concentración sérica de enoblituzumab y retifanlimab
    10. Farmacocinética de enoblituzumab más tebotelimab Concentración sérica de enoblituzumab y tebotelimab
    11. Inmunogenicidad de enoblituzumab más retifanlimab
    Proporción de pacientes que desarrollan anticuerpos antidrogas
    12. Inmunogenicidad de enoblituzumab más tebotelimab
    Proporción de pacientes que desarrollan anticuerpos antidrogas
    E.5.2.1Timepoint(s) of evaluation of this end point
    Ad. 4 - Progression-free survival - 28 months
    Ad. 5 - Disease-control rate - 28 months
    Ad. 6 - Duration of response - 28 months
    Ad. 7 - Overall survival - 28 months
    Ad. 8 - Safety of enoblituzumab plus retifanlimab - 30 days after last dose
    Ad. 9 - Pharmacokinetics of enoblituzumab plus retifanlimab - up to 42 weeks
    Ad. 10 - Pharmacokinetics of enoblituzumab plus tebotelimab - up to 42 weeks
    Ad. 11 - Immunogenicity of enoblituzumab plus retifanlimab - 28 months
    Ad. 12 - Immunogenicity of enoblituzumab plus tebotelimab - 28 months
    Anuncio. 4 - Supervivencia libre de progresión - 28 meses
    Anuncio. 5 - Tasa de control de la enfermedad - 28 meses
    Anuncio. 6 - Duración de la respuesta - 28 meses
    Anuncio. 7 - Supervivencia global - 28 meses
    Anuncio. 8 - Seguridad de enoblituzumab más retifanlimab - 30 días después de la última dosis
    Anuncio. 9 - Farmacocinética de enoblituzumab más retifanlimab - hasta 42 semanas
    Anuncio. 10 - Farmacocinética de enoblituzumab más tebotelimab - hasta 42 semanas
    Anuncio. 11 - Inmunogenicidad de enoblituzumab más retifanlimab - 28 meses
    Anuncio. 12 - Inmunogenicidad de enoblituzumab más tebotelimab - 28 meses
    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 Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Immunogenicity
    Inmunogenicidad
    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 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 concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA21
    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
    Ukraine
    United States
    Bulgaria
    Hungary
    Poland
    Spain
    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
    The end of study will occur after the last patient has met off-study criteria and the data collection process is completed (time of study database lock).
    End of study for each patient is defined as follows: Patient is LTFU or discontinues from the study due to any reason.
    El final del estudio se producirá después de que el último paciente haya cumplido con los criterios por fuera del estudio y el proceso de recopilación de datos se haya completado (tiempo de bloqueo de la base de datos del estudio).
    El final del estudio para cada paciente se define de la siguiente manera: El paciente se perdió durante el estudio (LTFU Lost to folow-up) o abandona el estudio por cualquier motivo.
    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 months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    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: 40
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 40
    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 state10
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 40
    F.4.2.2In the whole clinical trial 80
    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
    ninguno
    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 Decision2021-07-15
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-05-26
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
    P.Date of the global end of the trial2022-07-07
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