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    Summary
    EudraCT Number:2020-004985-21
    Sponsor's Protocol Code Number:BGB-A317-A1217-302
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-10-05
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2020-004985-21
    A.3Full title of the trial
    A Phase 3, Randomized, Double-Blind Study of BGB A1217, an Anti TIGIT Antibody, in Combination With Tislelizumab Compared to Pembrolizumab in Patients With Previously Untreated, PD L1 Selected, and Locally Advanced, Unresectable, or Metastatic Non Small Cell Lung Cancer
    Studio di fase 3, randomizzato, in doppio cieco su BGB-A1217, un anticorpo anti TIGIT, in combinazione con tislelizumab rispetto a pembrolizumab in pazienti con cancro del polmone non a piccole cellule localmente avanzato, non resecabile o metastatico, selezionato per PD L1 e non precedentemente trattato.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 3, Randomized, Double-Blind Study of BGB A1217, an Anti TIGIT Antibody, in Combination With Tislelizumab Compared to Pembrolizumab in Patients With Previously Untreated, PD L1 Selected, and Locally Advanced, Unresectable, or Metastatic Non Small Cell Lung Cancer
    Studio di fase 3, randomizzato, in doppio cieco su BGB-A1217, un anticorpo anti TIGIT, in combinazione con tislelizumab rispetto a pembrolizumab in pazienti con cancro del polmone non a piccole cellule localmente avanzato, non resecabile o metastatico, selezionato per PD L1 e non precedentemente trattato.
    A.3.2Name or abbreviated title of the trial where available
    na
    na
    A.4.1Sponsor's protocol code numberBGB-A317-A1217-302
    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 SponsorBeiGene Ltd.
    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 supportBeiGene, Ltd.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationBeiGene, Inc.
    B.5.2Functional name of contact pointBeiGene Clinical Support
    B.5.3 Address:
    B.5.3.1Street Address2955 Campus Drive, Suite 200
    B.5.3.2Town/ citySan Mateo, California
    B.5.3.3Post code94403
    B.5.3.4CountryUnited States
    B.5.4Telephone number000000
    B.5.5Fax number000000
    B.5.6E-mailBeigeneClinicalSupportUS@beigene.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 nameOciperlimab
    D.3.2Product code [BGB-A1217]
    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 INNOciperlimab
    D.3.9.2Current sponsor codeBGB-A1217
    D.3.9.3Other descriptive nameHumanised IgG1 monoclonal antibody against TIGIT
    D.3.9.4EV Substance CodeSUB218294
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number18 to 22
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product 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 RoleComparator
    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 Yes
    D.2.1.1.1Trade name KEYTRUDA
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp & Dohme B.V.
    D.2.1.2Country which granted the Marketing AuthorisationNetherlands
    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 nameKeytruda
    D.3.2Product code [na]
    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 INNPembrolizumab
    D.3.9.2Current sponsor codena
    D.3.9.3Other descriptive namePembrolizumab
    D.3.9.4EV Substance CodeSUB167136
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product 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 nameTislelizumab
    D.3.2Product code [BGB-A317]
    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 INNTISLELIZUMAB
    D.3.9.1CAS number 1858168-59-8
    D.3.9.2Current sponsor codeBGB-A317
    D.3.9.3Other descriptive nameBGB-A317, BGN1, JHL2108
    D.3.9.4EV Substance CodeSUB193656
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number9 to 11
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product 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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolution for infusion
    D.8.4Route of administration of the placeboIntravenous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Previously Untreated, PD-L1-Selected, and Locally Advanced, Unresectable, or Metastatic Non-Small Cell Lung Cancer
    cancro del polmone non a piccole cellule localmente avanzato, non resecabile o metastatico, selezionato per PD L1 e non precedentemente trattato.
    E.1.1.1Medical condition in easily understood language
    Non-Small Cell Lung Cancer
    cancro del polmone non a piccole cellule l
    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 10061873
    E.1.2Term Non-small cell lung 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
    • To compare progression-free survival (PFS) between Arm A (BGBA1217 in combination with tislelizumab) and Arm B (pembrolizumab followed by placebo) in the Intent-to-Treat (ITT) Analysis Set as assessed by investigators according to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
    • To compare overall survival (OS) between Arm A (BGB-A1217 in combination with tislelizumab) and Arm B (pembrolizumab followed by placebo) in the ITT Analysis Set
    • Confrontare la sopravvivenza libera da progressione (PFS) tra il Braccio A (BGB-A1217 in combinazione con tislelizumab) e il Braccio B (pembrolizumab seguito da placebo) nel set di analisi Intent-to-Treat (ITT) come valutato dagli sperimentatori in base ai Criteri di valutazione della risposta nei tumori solidi versione 1.1 (RECIST v1.1)
    • Confrontare la sopravvivenza complessiva (OS) tra il Braccio A (BGB-A1217 in combinazione con tislelizumab) e il Braccio B (pembrolizumab seguito da placebo) nel set di analisi ITT
    E.2.2Secondary objectives of the trial
    •To compare PFS between Arm A (BGB-A1217 in combination with tislelizumab) and Arm B (pembrolizumab followed by placebo) in the ITT
    Analysis Set as assessed by the Blinded Independent Review Committee (BIRC) according to RECIST v1.1
    •To compare the overall response rate (ORR) and duration of response (DOR) between Arm A (BGB-A1217 in combination with tislelizumab) and Arm B (pembrolizumab followed by placebo) in the ITT Analysis Set as assessed by investigators according to RECIST v1.1
    •To compare health-related quality of life (HRQoL) and time to deterioration (TTD) between Arm A (BGB-A1217 in combination with
    tislelizumab) and Arm B (pembrolizumab followed by placebo) in the ITT Analysis Set
    •To further investigate the safety and tolerability of BGB-A1217 in combination with tislelizumab
    • Confrontare la PFS tra il Braccio A (BGB-A1217 in combinazione con tislelizumab) e il Braccio B (pembrolizumab seguito da placebo) nel set di analisi ITT come valutato dal Comitato di verifica indipendente in cieco (BIRC) secondo RECIST v1.1
    • Confrontare il tasso di risposta globale (ORR) e la durata della risposta (DOR) tra il Braccio A (BGB-A1217 in combinazione con tislelizumab) e il Braccio B (pembrolizumab seguito da placebo) nel set di analisi ITT come valutato dagli sperimentatori secondo RECIST v1.1
    • Confrontare la qualità della vita correlata alla salute (HRQoL) e il tempo al deterioramento (TTD) tra il Braccio A (BGB-A1217 in combinazione con tislelizumab) e il Braccio B (pembrolizumab seguito da placebo) nel set di analisi ITT
    • Analizzare ulteriormente la sicurezza e la tollerabilità di BGB-A1217 in combinazione con tislelizumab
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1.Able to provide written informed consent and can understand and agree to comply with the requirements of the study and the schedule of
    assessments.
    2.Age = 18 years on the day of signing the informed consent form (or the legal age of consent in the jurisdiction in which the study is taking
    place).
    3.Histologically or cytologically documented locally advanced or recurrent NSCLC that is not eligible for curative surgery and/or definitive
    radiotherapy with or without chemoradiotherapy, or metastatic nonsquamous or squamous NSCLC.
    4.No prior systemic treatment for metastatic NSCLC.
    5.Agreement to provide archival tissue (formalin-fixed paraffinembedded block containing tumor [preferred] or 6 to 15 freshly cut unstained slides) or fresh biopsy (if archival tissue is not available) for prospective central evaluation of PD-L1 levels and retrospective analysis
    of other biomarkers.
    6.Tumors with PD-L1 TC = 50% expression as centrally determined.
    7.At least 1 measurable lesion as defined per RECIST v1.1.
    8.ECOG Performance Status = 1.
    9.Adequate organ function as indicated by the following laboratory values during screening:
    a.Patients must not have required blood transfusion or growth factor support = 14 days before sample collection at screening for the
    following:
    -Absolute neutrophil count (ANC) = 1.5 x 109/L
    -Platelets = 75 x 109/L or 100 x 109/L in chemotherapy combination studies
    -Hemoglobin = 90 g/L
    b.Serum creatinine = 1.5 x upper limit of normal (ULN) or estimated Glomerular Filtration Rate = 60 mL/min/1.73 m2 by Chronic Kidney
    Disease Epidemiology Collaboration equation (Appendix 8).
    c.Serum total bilirubin = 1.5 x ULN (total bilirubin must be < 3 x ULN for patients with Gilberts syndrome).
    d.AST and ALT = 2.5 x ULN or < 5 x ULN if hepatic metastases present.
    10.Females of childbearing potential must be willing to use a highly effective method of birth control for the duration of the study, and for =
    120 days after the last dose of study drug, and must have a negative urine or serum pregnancy test = 7 days before randomization.
    11.Nonsterile males must be willing to use a highly effective method of birth control for the duration of the study and for = 120 days after the
    last dose of study drug.
    •A sterile male is defined as one for whom azoospermia has been previously demonstrated in a semen sample examination as definitive
    evidence of infertility.
    •Males with known "low sperm counts" (consistent with "subfertility") are not to be considered sterile for purposes of this study.
    1. Capacità di fornire il consenso informato per iscritto e di comprendere e accettare di rispettare i requisiti dello studio e il programma delle valutazioni.
    2. Età = 18 anni il giorno della firma del modulo di consenso informato (o l'età legale del consenso prevista nella giurisdizione in cui si svolge lo studio).
    3. NSCLC localmente avanzato o recidivante documentato istologicamente o citologicamente che non può essere sottoposto a chirurgia curativa e/o radioterapia definitiva con o senza chemio-radioterapia, o NSCLC non squamoso o squamoso metastatico.
    4. Nessun trattamento sistemico precedente per NSCLC metastatico.
    5. Accordo di fornire tessuto d'archivio (blocco fissato in formalina e incluso in paraffina contenente tumore [preferito] o da 6 a 15 vetrini non colorati appena tagliati) o biopsia fresca (se il tessuto d'archivio non è disponibile) per una valutazione centrale prospettica dei livelli di PD-L1 e analisi retrospettiva di altri biomarcatori.
    6. Tumori con espressione di PD-L1 TC = 50% come determinato centralmente.
    7. Almeno 1 lesione misurabile come definita da RECIST v1.1.
    Nota: una lesione in un'area sottoposta a precedente terapia locoregionale, inclusa la precedente radioterapia, non è considerata misurabile a meno che non sia stata dimostrata una progressione della lesione dopo la terapia come definito da RECIST v1.1.
    8. Performance status secondo l'ECOG = 1.
    9. Funzionalità adeguata degli organi definita dai seguenti valori di laboratorio durante lo screening:
    a. I pazienti non devono aver richiesto trasfusioni di sangue o supporto del fattore di crescita = 14 giorni prima della raccolta del campione allo screening per quanto segue:
    - Conta assoluta dei neutrofili (ANC) = 1,5 x 109/L
    - Piastrine = 75 x 109/L
    - Emoglobina = 90 g/L
    b. Creatinina sierica = 1,5 x limite superiore della norma (ULN) o velocità di filtrazione glomerulare stimata = 60 mL/min/1,73 m2 mediante equazione sviluppata dalla Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). (Appendice 8).
    c. Bilirubina sierica totale = 1,5 x ULN (la bilirubina totale deve essere < 3 x ULN per pazienti con sindrome di Gilbert).
    d. Aspartato aminotransferasi (AST) e alanina aminotransferasi (ALT) = 2,5 x ULN o < 5 x ULN se sono presenti metastasi epatiche.
    10. Le donne in età fertile devono essere disposte a utilizzare un metodo contraccettivo altamente efficace per la durata dello studio e per = 120 giorni dopo l'ultima dose del farmaco dello studio e devono avere un test di gravidanza negativo su urine o siero = 7 giorni prima della randomizzazione. Vedere Appendice 9.
    11. I maschi non sterili devono essere disposti a utilizzare un metodo contraccettivo altamente efficace per la durata dello studio e per = 120 giorni dopo l'ultima dose del farmaco dello studio.
    • Un uomo sterile è definito come un individuo per il quale è stata precedentemente dimostrata una condizione di azoospermia mediante un esame del campione di sperma come prova definitiva di infertilità.
    • Gli uomini che presentano una "bassa conta spermatica" (compatibile con la condizione di "subfertilità") non sono considerati sterili ai fini di questo studio.
    E.4Principal exclusion criteria
    1.Known sensitizing mutation in the EGFR gene or an ALK fusion oncogene.
    Note: Patients with nonsquamous NSCLC whose EGFR mutational status is unknown will be required to have a tissue-based EGFR test either locally or centrally at prescreening. Patients found to have EGFRsensitizing mutations will be excluded.
    2.Prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-TIGIT, or any other antibody or drug specifically targeting T-cell costimulation or checkpoint pathways.3.Active leptomeningeal disease or uncontrolled, untreated brain metastasis.
    •Patients with a history of treated and, at the time of screening, stable central nervous system (CNS) metastases are eligible, provided they
    meet all the following:
    -Brain imaging at screening shows no evidence of interim progression, patient is clinically stable for at least 2 weeks and without evidence of new brain metastases.
    -Measurable and/or evaluable disease outside the CNS.
    -No ongoing requirement for corticosteroids as therapy for CNS disease; off steroids 3 days before randomization; anticonvulsants at a stable dose are allowed.
    -No stereotactic radiation or whole-brain radiation within 14 days before randomization.
    4.Active autoimmune diseases or history of autoimmune diseases that may relapse.
    5.Any active malignancy = 2 years before randomization except for the specific cancer under investigation in this study and any locally recurring cancer that has been treated curatively (eg, resected basal or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of the cervix or breast).
    6.Any condition that required systemic treatment with either corticosteroids (> 10 mg daily of prednisone or equivalent) or other
    immunosuppressive medication = 14 days before randomization.
    b.Topical, ocular, intra-articular, intranasal, or inhaled corticosteroid with minimal systemic absorption.c.Short course (= 7 days) of
    corticosteroid prescribed prophylactically (eg, for contrast dye allergy) or for the treatment of a non-autoimmune condition (eg, delayed-type
    hypersensitivity reaction caused by contact allergen.
    7.Uncontrolled diabetes or > Grade 1 laboratory test abnormalities in potassium, sodium, or corrected calcium despite standard medical
    management or = Grade 3 hypoalbuminemia = 14 days before randomization.
    8.Uncontrollable pleural effusion, pericardial effusion, or ascites requiring frequent drainage (recurrence within 2 weeks of intervention).
    Patients with symptomatic pleural effusion are excluded unless the patient undergoes a therapeutic thoracentesis or has had pleurodesis
    (more than 2 weeks prior) and has subsequently stable effusions.
    9.History of interstitial lung disease, noninfectious pneumonitis or uncontrolled lung diseases including pulmonary fibrosis, acute lung diseases, etc. Patients with significantly impaired pulmonary function, or who require supplemental oxygen at baseline must undergo an
    assessment of pulmonary function at screening
    10.Infection (including tuberculosis infection, etc) requiring systemic antibacterial, antifungal, or antiviral therapy within 14 days before
    randomization.
    11.Untreated chronic hepatitis B or chronic HBV carriers with HBV DNA > 500 IU/mL (or>2500 copies/mL) at screening.
    12.Patients with active hepatitis C.
    13.Known history of HIV infection.
    14.Any major surgical procedure = 28 days before randomization. Patients must have recovered adequately from the toxicity and/or
    complications from the intervention before randomization.
    15.Prior allogeneic stem cell transplantation or organ transplantation.
    (please see protocol)
    1. Mutazione sensibilizzante nota nel gene EGFR o un oncogene di fusione ALK.
    Nota: i pazienti con NSCLC non squamoso la cui mutazione di EGFR presenta uno stato sconosciuto dovranno essere sottoposti a un test di EGFR basato sul tessuto localmente o centralmente allo screening preliminare. I pazienti nei quali si riscontrano mutazioni sensibilizzanti di EGFR saranno esclusi.
    2. Precedente terapia con un anti-PD-1, anti-PD-L1, ligando 2 di morte cellulare programmata (PD-L2), TIGIT o qualsiasi altro anticorpo o farmaco mirato specificamente alla costimolazione dei linfociti T o ai percorsi di checkpoint.
    3. Malattia leptomeningea attiva o metastasi cerebrali incontrollate e non trattate.
    • Sono idonei i pazienti con anamnesi di metastasi del sistema nervoso centrale (SNC) trattate e, al momento dello screening, stabili, a condizione che soddisfino tutte le seguenti condizioni:
    - L'imaging cerebrale allo screening non mostra evidenza di progressione ad interim, il paziente è clinicamente stabile per almeno 2 settimane e senza evidenza di nuove metastasi cerebrali.
    - Malattia misurabile e/o valutabile al di fuori del SNC.
    - Nessun requisito in corso per i corticosteroidi come terapia per la malattia del SNC; sospensione degli steroidi 3 giorni prima della randomizzazione; sono ammessi anticonvulsivanti a dose stabile.
    - Nessuna radiazione stereotassica o radiazione cerebrale intera entro i 14 giorni prima della randomizzazione.
    4. Malattie autoimmuni attive o anamnesi di malattie autoimmuni che possono recidivare.
    i pazienti con le seguenti malattie non sono esclusi e possono procedere a ulteriori screening:
    a. Diabete di tipo I controllato.
    b. Ipotiroidismo (a condizione che sia gestito solo con terapia ormonale sostitutiva).
    c. Celiachia controllata.
    d. Malattie cutanee che non richiedono un trattamento sistemico (ad es. vitiligine, psoriasi, alopecia).
    e. Qualsiasi altra malattia che non si prevede si ripresenti in assenza di fattori scatenanti esterni.
    5. Qualsiasi neoplasia attiva = 2 anni prima della randomizzazione a eccezione del tumore specifico oggetto di indagine in questo studio e di qualsiasi tumore recidivante a livello locale che sia stato trattato in maniera curativa (ad es. cancro della cute a cellule basali o squamose resecato, cancro della vescica superficiale, carcinoma in situ della cervice o della mammella).
    6. Qualsiasi condizione che richieda trattamento sistemico con corticosteroidi (> 10 mg al giorno di prednisone o equivalente) o altri farmaci immunosoppressori nei 14 giorni precedenti alla randomizzazione.
    Nota: i pazienti che sono attualmente o sono stati precedentemente sottoposti a uno dei seguenti regimi steroidei non sono esclusi:
    a. Trattamento sostitutivo con steroidi per insufficienza surrenalica (dose = 10 mg al giorno di prednisone o equivalente).
    b. Corticosteroidi topici, oculari, intra-articolari, intranasali o inalatori con assorbimento sistemico minimo.
    c. Ciclo breve (= 7 giorni) di corticosteroidi prescritti a scopo profilattico (ad es. per allergia al colorante di contrasto) o per il trattamento di una patologia non autoimmune (ad es. reazione di ipersensibilità di tipo ritardato causata da allergene da contatto).
    7. Diabete non controllato o anomalie delle analisi di laboratorio anormali di Grado > 1 per potassio, sodio o calcio corretto nonostante la gestione medica standard, o ipoalbuminemia Grado = 3 = 14 giorni prima della randomizzazione.
    8. Versamento della pleura incontrollabile, versamento pericardico o ascite che richiedono un drenaggio frequente (recidiva entro 2 settimane dall'intervento). I pazienti con versamento della pleura sintomatico sono esclusi a meno che il paziente non si sottoponga a toracentesi terapeutica o si sia sottoposto a pleurodesi (più di 2 settimane prima) e successivamente abbia versamenti stabili.
    (fare riferimento al protocollo)
    E.5 End points
    E.5.1Primary end point(s)
    PFS as assessed by investigators (time from the date of randomization to the date of the first objectively documented tumor progression per
    RECIST v1.1, or death, whichever occurs first) in the ITT Analysis Set of Arm A (BGB-A1217 in combination with tislelizumab) and Arm B
    (pembrolizumab followed by placebo)
    • OS (time from the date of randomization to the date of death due to any cause) in the ITT Analysis Set of Arm A (BGB-A1217 in combination
    with tislelizumab) and Arm B (pembrolizumab followed by placebo)
    • PFS come valutata dagli sperimentatori (tempo dalla data di randomizzazione alla data della prima progressione tumorale oggettivamente documentata secondo RECIST v1.1 o morte, a seconda di quale si verifica per prima) nel set di analisi ITT del Braccio A (BGB-A1217 in combinazione con tislelizumab) e del Braccio B (pembrolizumab seguito da placebo)
    • OS (tempo dalla data di randomizzazione alla data di morte per qualsiasi causa) nel set di analisi ITT del Braccio A (BGB-A1217 in combinazione con tislelizumab) e del Braccio B (pembrolizumab seguito da placebo)
    E.5.1.1Timepoint(s) of evaluation of this end point
    approximately 4 years
    circa 4 anni
    E.5.2Secondary end point(s)
    PFS as assessed by the BIRC in Arm A (BGB-A1217 in combination with tislelizumab) and Arm B (pembrolizumab followed by placebo)
    • ORR as assessed by investigators (proportion of patients with a documented, confirmed complete response [CR] or partial response [PR] per RECIST v1.1) and DOR as assessed by investigators (time from the first determination of an objective response per RECIST v1.1 until the first documentation of progression or death, whichever occurs first) in Arm A (BGB-A1217 in combination with tislelizumab) and Arm B (pembrolizumab followed by placebo)
    • HRQoL as assessed via patient-reported outcomes (PRO) using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), its lung cancer module Quality of Life Questionnaire Lung Cancer 13 (QLQ-LC13), and the 5- Level EuroQol 5-Dimension (EQ-5D-5L) questionnaire
    • TTD, defined as worsening scores (10-point change, to be defined in the Statistical Analysis Plan [SAP] if otherwise) for 2 consecutive assessments or 1 assessment followed by death from any cause before the next scheduled data collection
    • The incidence and severity of adverse events (AEs) according to National Cancer Institute Common Terminology Criteria for Adverse Events Version 5.0 (NCI CTCAE v5.0) in Arm A (BGB-A1217 in combination with tislelizumab)
    • PFS come valutata dal BIRC nel Braccio A (BGB-A1217 in combinazione con tislelizumab) e nel Braccio B (pembrolizumab seguito da placebo)
    • ORR come valutata dagli sperimentatori (percentuale di pazienti con una risposta completa [CR] o parziale [PR] secondo RECIST v1.1) e DOR come valutata dagli sperimentatori (tempo dalla prima determinazione di una risposta obiettiva secondo RECIST v1.1 fino alla prima documentazione di progressione o morte, a seconda dell'evento che si verifica per primo) nel Braccio A (BGB A1217 in combinazione con tislelizumab) e nel Braccio B (pembrolizumab seguito da placebo)
    • HRQoL come valutata tramite i risultati riportati dai pazienti (PRO) utilizzando il questionario sulla qualità della vita Core 30 (EORTC QLQ-C30) dell'Organizzazione europea per la ricerca e il trattamento del cancro, il suo modulo sul cancro del polmone Questionario sulla qualità della vita cancro del polmone 13 (QLQ-LC13) e il questionario 5 Level EuroQol 5 Dimension (EQ-5D-5L)
    • TTD, definito come peggioramento dei punteggi (variazione di 10 punti, da definire nel Piano di analisi statistica [SAP] in caso contrario) per 2 valutazioni consecutive o 1 valutazione seguita da morte per qualsiasi causa prima della successiva raccolta dati programmata
    • L'incidenza e la gravità degli eventi avversi (AE) secondo i Common Terminology Criteria for Adverse Events Versione 5.0 del National Cancer Institute (NCI CTCAE v5.0) nel Braccio A (BGB A1217 in combinazione con tislelizumab)
    E.5.2.1Timepoint(s) of evaluation of this end point
    approximately 4 years
    circa 4 anni
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic 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) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the 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 concerned7
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA35
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    China
    Georgia
    Japan
    Korea, Republic of
    Russian Federation
    Turkey
    Ukraine
    United States
    France
    Germany
    Netherlands
    Spain
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    The end of study is defined as the timepoint when the final data point is collected from the last patient in the study. This is when the last
    patient dies, withdraws consent, completes all study assessments, or is lost to follow-up. Alternatively, the end of study is when the sponsor
    decides to terminate the study
    La fine dello studio è definita come il momento in cui i dati finali vengono raccolti dall'ultimo paziente nello studio.
    Quando l'ultimo paziente muore, revoca il consenso, completa tutte le valutazioni dello studio o è perso al follow up.
    In alternativa, la fine dello studio è quando lo sponsor decide di interrompere lo studio
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months1
    E.8.9.1In the Member State concerned days21
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months1
    E.8.9.2In all countries concerned by the trial days21
    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: 450
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 155
    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 state12
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 73
    F.4.2.2In the whole clinical trial 605
    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)
    Patients who, in the opinion of the investigator, continue to benefit from tislelizumab alone or in combination with BGB-A1217 at study
    termination, will be offered the option to continue treatment in a company-sponsored clinical trial until treatment is commercially
    available in the country of the patient's residence
    Ai pazienti che, secondo lo sperimentatore, continuano a beneficiarne di tislelizumab da solo o in combinazione con BGB-A1217 al termine dello studio, verrà offerta la possibilità di continuare il trattamento all'interno di una sperimentazione clinica sponsorizzata dall'azienda fino a quando il trattamento non sarà commercializzato e disponibile nel paese di residenza del paziente
    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 Decision2022-01-13
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-12-16
    P. End of Trial
    P.End of Trial StatusOngoing
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