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    Summary
    EudraCT Number:2020-005173-28
    Sponsor's Protocol Code Number:BLU-263-1201
    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:2021-10-18
    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 number2020-005173-28
    A.3Full title of the trial
    A Randomized, Double-Blind, Placebo-Controlled Phase 2/3 Study of BLU263 in Indolent Systemic Mastocytosis
    Studio di fase 2/3 randomizzato, in doppio cieco, controllato con placebo su BLU-263 nella mastocitosi sistemica indolente
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Study of BLU-263 in patients with Indolent Systemic Mastocytosis
    Studio su BLU-263 in pazienti con mastocitosi sistemica indolente
    A.3.2Name or abbreviated title of the trial where available
    HARBOR
    HARBOR
    A.4.1Sponsor's protocol code numberBLU-263-1201
    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 SponsorBLUEPRINT MEDICINES CORPORATION
    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 supportBlueprint Medicines Cororation
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPPD
    B.5.2Functional name of contact pointPatsy Folio
    B.5.3 Address:
    B.5.3.1Street AddressMetro Center Dr 200
    B.5.3.2Town/ cityAustin
    B.5.3.3Post code78744
    B.5.3.4CountryUnited States
    B.5.4Telephone number+19105583604
    B.5.5Fax number000000
    B.5.6E-mailpatsy.folio@ppd.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 nameBLU-263
    D.3.2Product code [BLU-263]
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNBLU-263
    D.3.9.1CAS number 2505078-08-8
    D.3.9.2Current sponsor codeBLU-263
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    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 Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameBLU-263
    D.3.2Product code [BLU-263]
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNBLU-263
    D.3.9.1CAS number 2505078-08-8
    D.3.9.2Current sponsor codeBLU-263
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboTablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Indolent Systemic Mastocytosis (ISM) and monoclonal Mast Cell Activation Syndrome (mMCAS)
    Mastocitosi Sistemica Indolente (ISM) e Sindrome da Attivazione dei Mastociti Monoclonali (mMCAS)
    E.1.1.1Medical condition in easily understood language
    Indolent Systemic Mastocytosis
    Mastocitosi Sistemica Indolente
    E.1.1.2Therapeutic area Diseases [C] - Blood and lymphatic diseases [C15]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level LLT
    E.1.2Classification code 10056452
    E.1.2Term Indolent systemic mastocytosis
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Part 1: To determine RD of BLU-263.
    Part 2: To assess if treatment with BLU-263 improves outcomes compared to placebo + BSC, as assessed using the ISM-SAF.
    Part 3:
    - To assess the long-term safety and tolerability of treatment with BLU263.
    - To assess the long-term efficacy of treatment with BLU-263.
    Parte 1: Determinare la RD di BLU-263
    Parte 2: Valutare se il trattamento con BLU-263 migliora i risultati rispetto al placebo + BSC, come valutato utilizzando ISM-SAF
    Parte 3:
    - Valutare la sicurezza e la tollerabilità a lungo termine del trattamento con BLU-263.
    - Valutare l'efficacia a lungo termine del trattamento con BLU-263.
    E.2.2Secondary objectives of the trial
    Part 1:
    -To assess the change in measures of mast cell burden from treatment with BLU-263 or placebo
    -To assess the change in ISM-SAF individual symptom scores from treatment with BLU-263 or placebo
    -To assess the time to achieve a 30% reduction in ISM-SAF TSS, ISM-SAF Gastrointestinal Symptom Score (GSS), ISM-SAF Skin Symptom Score (SSS), and ISM-SAF Neurocognitive Symptom Cluster Score
    Part 2:
    -To assess if treatment with BLU-263 improves outcomes compared to placebo, as assessed using serum tryptase
    -To assess if treatment with BLU-263 improves outcomes compared to placebo, as assessed using peripheral blood KIT D816V allele fraction
    -To assess if treatment with BLU-263 improves outcomes compared to placebo + BSC, as assessed using the mean change in ISM-SAF TSS from Baseline
    Part 3:
    -To assess the change in measures of mast cell burden
    -To assess the change in BSC usage for SM symptoms
    -To assess the change in ISM-SAF Individual Symptom Scores
    Parte 1:
    - Valutare la variazione nelle misure del carico di mastociti dal trattamento con BLU-263 o placebo
    - Valutare il cambiamento nei punteggi dei sintomi individuali ISM-SAF dal trattamento con BLU-263 o placebo
    - Valutare il tempo al raggiungimento di riduzione del 30% in TSS ISM-SAF, GSS ISM-SAF, SSS ISM-SAF, e punteggio del cluster di sintomi neurocognitivi ISM-SAF
    Parte 2:
    - Valutare se BLU-263 migliora i risultati rispetto al placebo, come valutato utilizzando la triptasi sierica
    - Valutare se BLU-263 migliora i risultati rispetto al placebo, come valutato utilizzando la frazione allelica di KIT D816V nel sangue periferico
    - Valutare se BLU-263 migliora i risultati rispetto al placebo+BSC, come valutato utilizzando la variazione media in TSS ISM-SAF dal basale
    Parte 3:
    - Valutare la variazione nelle misure del carico di mastociti
    - Valutare la variazione nell'uso di BSC per i sintomi della SM
    - Valutare la variazione nei punteggi dei sintomi individuali ISM-SAF
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    All Patients
    1. Patient must have an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 to 2.
    Part 1 only
    2. Patient must have moderate-to-severe symptoms based on minimum mean total symptom score (TSS) of the ISM Symptom Assessment Form (ISM-SAF) over the 14-day eligibility screening period.
    Part 1 and Part 2
    3. Patient has confirmed diagnosis of ISM, confirmed by Central Pathology Review of BM biopsy and central review of B- and C-findings by WHO diagnostic criteria. Archival biopsy may be used if completed within the past 12 months.
    4. Patient must have failed to achieve adequate symptom control for 1 or more Baseline symptoms, as determined by the Investigator, with at least 2 of the following symptomatic therapies administered: H1 blockers, H2 blockers, proton-pump inhibitors, leukotriene inhibitors, cromolyn sodium, corticosteroids, or omalizumab.
    5. Patients must have BSC for ISM symptom management stabilized for at least 14 days prior to starting screening procedures.
    6. For patients receiving corticosteroids, the dose must be = 20 mg/d prednisone or equivalent, and the dose must be stable for = 14 days.
    Part M
    7. Patients must have mMCAS, confirmed by Central Pathology Review of BM biopsy. An archival biopsy may be used if completed within the past 12 months.
    8. Patients must have tryptase < 20 ng/mL.
    9. Patients must have KIT D816V in peripheral blood (PB) or BM and/or CD25+ Mast cells in BM.
    10. Patients must have symptoms consistent with mast cell activation (despite BSC) in at least two organ systems characterized by cutaneous flushing, tachycardia, syncope, hypotension, diarrhea, nausea, vomiting and gastro-intestinal cramping) and serum blood tryptase (sBT) levels above 8 ng/mL OR Severe (Ring and Messmer grading = II, recurrent anaphylaxis, including but not limited to hymenoptera venom, drug or food, regardless of sBT levels.
    Optional PK Group
    11. See inclusion criteria for All patients and Part 1/Part 2
    12. Accrual may be limited to patients who have specific disease manifestations (ie, GI involvement) or are taking acid-reducing agents to better explore the impact of these features on PK.
    Tutti i pazienti
    1. Il paziente deve presentare uno stato di validità secondo l’Eastern Cooperative Oncology Group (ECOG PS) da 0 a 2.
    Solo Parte 1
    2. Il paziente deve avere sintomi da moderati a gravi in base al punteggio medio minimo dei sintomi totali (TSS) del modulo di valutazione dei sintomi ISM (ISM-SAF) nel periodo di screening di 14 giorni.
    Parte 1 e Parte 2
    3. Il paziente ha una diagnosi confermata di ISM, confermata dall'esame della biopsia midollare da parte della Patologia Centrale e dall'esame centrale dei reperti B e C secondo i criteri diagnostici dell'OMS. La biopsia d'archivio può essere utilizzata se completata negli ultimi 12 mesi.
    4. Il paziente non deve aver raggiunto un adeguato controllo dei sintomi per 1 o più sintomi al basale, come determinato dallo Sperimentatore, con almeno 2 delle seguenti terapie sintomatiche somministrate: Bloccanti H1, bloccanti H2, inibitori della pompa protonica, inibitori dei leucotrieni, sodio cromoglicato, corticosteroidi o omalizumab.
    5. I pazienti devono ricevere BSC per la gestione dei sintomi ISM stabilizzata da almeno 14 giorni prima di iniziare le procedure di screening.
    6. Per i pazienti che ricevono corticosteroidi, la dose deve essere = 20 mg/d prednisone o equivalente, e la dose deve essere stabile per = 14 giorni.
    Parte M
    7. I pazienti devono essere affetti da mMCAS, confermata dall'esame della biopsia midollare da parte della Patologia Centrale. Una biopsia d'archivio può essere utilizzata se completata negli ultimi 12 mesi.
    8. I pazienti devono presentare triptasi < 20 ng/mL.
    9. I pazienti devono presentare KIT D816V nel sangue periferico (PB) o nel midollo osseo e/o mastociti CD25+ nel midollo osseo.
    10. I pazienti devono avere sintomi coerenti con l'attivazione dei mastociti (nonostante la BSC) in almeno due sistemi d'organo caratterizzati da vampate cutanee, tachicardia, sincope, ipotensione, diarrea, nausea, vomito e crampi gastrointestinali) e livelli di triptasi sierica nel sangue (sBT) superiori a 8 ng/mL O grave (classificazione di Ring e Messmer = II, anafilassi ricorrente, a titolo esemplificativo e non esaustivo, a veleno di imenotteri, farmaci o cibo, indipendentemente dai livelli di sBT.
    Gruppo/i PK facoltativo/i
    11. Vedere i criteri di inclusione per Tutti i pazienti e Parte 1/Parte 2
    12. L'arruolamento può essere limitato ai pazienti che hanno manifestazioni specifiche della malattia (per es., coinvolgimento gastrointestinale) o stanno assumendo agenti riducenti l'acido per esplorare meglio l'impatto di queste caratteristiche sulla PK.
    E.4Principal exclusion criteria
    1. Patient has been diagnosed with any of the following WHO systemic mastocytosis (SM) sub-classifications: cutaneous mastocytosis only, smoldering SM, SM with associated hematologic neoplasm, aggressive SM, mast cell leukemia, or mast cell sarcoma.
    2. Patient has been diagnosed with another myeloproliferative disorder.
    3. Patient has organ damage C-findings attributable to SM.
    4. Patient has clinically significant, uncontrolled, cardiovascular disease
    5. Patient has a QT interval corrected using Fridericia's formula (QTcF)> 480 msec.
    6. Patient has previously received treatment with any targeted KIT inhibitors.
    7. Patient has a history of a primary malignancy that has been diagnosed or required therapy within 3 years. The following prior malignancies are not exclusionary: completely resected basal cell and squamous cell skin cancer, curatively treated localized prostate cancer, and completely resected carcinoma in situ of any site.
    8. Time since any cytoreductive therapy including mastinib and midostaurin should be at least 5 half-lives or 14 days (whichever is longer), and for cladribine, interferon alpha, pegylated interferon, or antibody therapy <28 days or 5 half-lives of the drug (whichever is longer), before beginning the screening period.
    9.Patient has received radiotherapy or psoralen and ultraviolet A (PUVA) therapy < 14 days before beginning the screening period.
    1. Al paziente è stata diagnosticata una delle seguenti sotto-classificazioni di mastocitosi sistemica (SM) dell'OMS: solo mastocitosi cutanea, SM smoldering, SM con neoplasia ematologica associata, SM aggressiva, leucemia a mastociti o sarcoma a mastociti.
    2. Al paziente è stato diagnosticato un altro disturbo mieloproliferativo.
    3. Il paziente presenta reperti C di danno d'organo attribuibili alla SM
    4. Il paziente ha una malattia cardiovascolare clinicamente significativa e non controllata - 5. Il paziente ha un intervallo QT corretto con la formula di Fridericia (QTcF) > 480 msec.
    6. Il paziente ha ricevuto in precedenza trattamento con un qualsiasi inibitore mirato di KIT.
    7. Il paziente presenta un’anamnesi di un tumore maligno primario che è stato diagnosticato o ha richiesto terapia entro 3 anni. I seguenti tumori maligni precedenti non sono motivo di esclusione: carcinoma cutaneo a cellule basali e squamose con resezione completa, cancro alla prostata localizzato trattato in maniera curativa e carcinoma in situ con resezione completa in qualsiasi sito.
    8. Il tempo trascorso da qualsiasi terapia citoriduttiva, compresi masitinib e midostaurin, deve essere di almeno 5 emivite o 14 giorni (a seconda di qual è il periodo più lungo), e per cladribina, interferone alfa, interferone pegilato o terapia con anticorpi < 28 giorni o 5 emivite del farmaco (a seconda di qual è il periodo più lungo), prima di iniziare il periodo di screening.
    9. Il paziente ha ricevuto radioterapia o terapia con psoraleni e raggi ultravioletti A (PUVA) < 14 giorni prima di iniziare il periodo di screening.
    E.5 End points
    E.5.1Primary end point(s)
    Part 1
    - Safety and tolerability as determined by AEs, serious adverse events (SAEs), and changes in safety laboratory parameters, vital signs, and ECG evaluations
    - PK and PD data
    - The mean change in Indolent Systemic Mastocytosis-Symptom Assessment Form (ISM-SAF) Total Symptom Score (TSS) from Baseline at Week 13.
    Part 2
    - Proportion of patients with moderate to severe ISM who achieve at least a 30% reduction in ISM-SAF TSS from Baseline at Week 25"
    Part 3
    - Safety and tolerability determined by AEs, SAEs, and changes in safety laboratory parameters, vital signs, and ECG evaluations
    - The mean change in ISM-SAF TSS from BLU-263 Baseline (the last available observation prior to the first dose of BLU-263)
    Parte 1
    - Sicurezza e tollerabilità come determinate da AE, eventi avversi seri (SAE), e variazioni nei parametri di laboratorio per la sicurezza, segni vitali, e valutazioni ECG
    - Dati di PK e PD
    - Il cambiamento medio nel Punteggio totale dei sintomi (TSS) del Modulo di valutazione dei sintomi della mastocitosi sistemica indolente (ISM-SAF) dal Basale alla Settimana 13.
    Parte 2
    - Percentuale di pazienti con ISM da moderata a grave che raggiungono almeno una riduzione del 30% nel TSS ISM-SAF dal Basale alla Settimana 25.
    Parte 3
    - Sicurezza e tollerabilità determinate da AE, SAE, e variazioni nei parametri di laboratorio di sicurezza, segni vitali, e valutazioni ECG
    - La variazione media nel TSS ISM-SAF dal basale di BLU-263 (l'ultima osservazione disponibile prima della prima dose di BLU-263)
    E.5.1.1Timepoint(s) of evaluation of this end point
    Part 1: At Week 13
    Part 2: At Week 25
    Part 3: Ongoing basis
    Parte 1: alla settimana 13
    Parte 2: alla settimana 25
    Parte 3: su base continua
    E.5.2Secondary end point(s)
    Part 1:
    - The mean change in the following measures from Baseline at Week 13: Serum tryptase, KIT D816V allele fraction in blood, Bone marrow mast cells
    - The mean change in ISM-SAF individual symptom scores from Baseline at Week 13
    - The time to achieve a 30% reduction in ISM-SAF TSS, ISM-SAF GSS, ISM-SAF SSS, and ISM-SAF Neurocognitive Symptom Cluster Score from randomization among patients who achieve such a reduction on or before Week 13
    - The mean change in the following measures from Baseline at Week 13: Mastocytosis Quality of Life Questionnaire (MC-QoL) score, Patient Global Impression of Severity (PGI-S) score, Patient Global Impression of Change (PGI-C) score, Twelve-item Short Form Health Survey (SF-12) score, Five-level EuroQual 5D (EQ-5D-5L) score.
    Additional exploratory endpoints shared across Part 1, Part 2, and Part 3 are detailed in Section 3.4
    Part 2 - Key secondary endpoints:
    - The proportion of patients who achieve at least a 50% reduction in serum tryptase from Baseline at Week 25, among patients with Baseline moderate to severe ISM and Baseline tryptase = 20 ng/mL.
    - The proportion of patients who achieve at least a 50% reduction in peripheral blood KIT D816V allele fraction, or a reduction to undetectable levels, from Baseline at Week 25, among patients with Baseline moderate to severe ISM and detectable mutation at Baseline.
    - The mean change in ISM-SAF from Baseline at Week 25, among patients with Baseline moderate to severe ISM
    - The proportion of patients who achieve at least a 50% reduction in bone marrow MCs, or a reduction to no aggregates, from Baseline at Week 25, among patients with Baseline moderate to severe ISM and aggregates at Baseline.
    Part 2 - Secondary Endpoint(s):
    - ORR, among all patients regardless of Baseline ISM-SAF TSS.
    - Part 2 Key Secondary Endpoints, among all patients regardless of Baseline ISM-SAF TSS.
    - The mean change in the following measures of MC burden from Baseline at Week 25, among patients with Baseline severe to moderate ISM: Serum tryptase, KIT D816V allele fraction in blood, Bone marrow MCs.
    - The change in the number of concomitant medications identified as BSC from Baseline.
    - The mean change in ISM-SAF Individual Symptom Scores from Baseline
    - The mean change in ISM-SAF LSS from Baseline.
    - The time to achieve a 30% reduction in ISM-SAF TSS, ISM-SAF GSS, ISM-SAF SSS, and ISM-SAF Neurocognitive Symptom Cluster Score from randomization among patients who achieve such a reduction on or before Week 25.
    - The mean change in the following measures from Baseline at Week 25: MC-QoL score, PGI-S score, SF-12 score, EQ-5D-5L score.
    - The mean and individual patient predicted BLU-263 exposure parameters (Cmax, AUC0-24, and Ctrough).
    - Safety and tolerability determined by AEs, SAEs, and changes in safety laboratory parameters, vital signs, and ECG evaluations.
    Part 3:
    - The mean change in the following measures of mast cell burden from BLU-263 Baseline: Serum tryptase, KIT D816V allele fraction in blood, the change in the number of concomitant medications identified as BSC from Baseline.
    - The mean change in ISM-SAF Individual Symptom Scores from Baseline
    - The mean change in ISM-SAF Lead Symptom Score from Baseline
    - The time to achieve a 30% reduction in ISM-SAF TSS, ISM-SAF GSS, ISM-SAF SSS, and ISM-SAF Neurocognitive Symptom Cluster Score from the first dose of BLU-263 among patients who achieve such a reduction on or before 1 year of BLU-263 therapy
    - The mean change in the following measures from Baseline at Week 25: MC-QoL score, PGI-S score, SF-12 score, EQ-5D-5L score
    Parte 1:
    - La variazione media nelle seguenti misure dal basale alla Settimana 13: Triptasi sierica, Frazione allelica di KIT D816V nel sangue, Mastociti del midollo osseo
    - La variazione media nei punteggi dei sintomi individuali ISM-SAF dal basale alla Settimana 13
    - Il tempo al raggiungimento di una riduzione del 30% in TSS ISM-SAF, GSS ISM-SAF, SSS ISM-SAF, e punteggio del cluster di sintomi neurocognitivi ISM-SAF dalla randomizzazione tra i pazienti che raggiungono tale riduzione alla Settimana 13 o prima
    - La variazione media nelle seguenti misure dal basale alla Settimana 13: Punteggio del questionario MC-QoL, Punteggio PGI-S, Punteggio PGI-C, Punteggio del questionario SF-12, Punteggio EQ-5D-5L.
    Ulteriori endpoint esplorativi condivisi nella Parte 1, Parte 2 e Parte 3 sono dettagliati nella Sezione 3.

    Parte 2 – Principali Endpoint secondari:
    - La percentuale di pazienti che raggiunge almeno una riduzione del 50% della triptasi sierica dal basale alla Settimana 25, tra i pazienti con ISM da moderata a grave al basale e triptasi = 20 ng/mL al basale.
    - La percentuale di pazienti che raggiunge almeno una riduzione del 50% della frazione allelica di KIT D816V nel sangue periferico, o una riduzione a livelli non rilevabili, dal basale alla Settimana 25, tra i pazienti con ISM da moderata a grave al basale e mutazione rilevabile al basale.
    - La variazione media in ISM-SAF dal basale alla Settimana 25, tra i pazienti con ISM da moderata a grave al basale.
    - La percentuale di pazienti che raggiunge almeno una riduzione del 50% nei MC del midollo osseo, o una riduzione fino a nessun aggregato, dal basale alla Settimana 25, tra i pazienti con ISM da moderata a graveal basale e aggregati al basale
    Parte 2 - Endpoint secondari:
    - ORR, tra tutti i pazienti indipendentemente dalla TSS ISM-SAF al basale.
    - Parte 2 Endpoint secondari principale, tra tutti i pazienti indipendentemente dalla ISM-SAF TSS al basale.
    - La variazione media delle seguenti misure del carico di MC dal basale alla Settimana 25, tra i pazienti con ISM da moderata a grave al basale: Triptasi sierica, Frazione allelica di KIT D816V nel sangue, Mastociti del midollo osseo
    - La variazione nel numero di farmaci concomitanti identificati come BSC dal basale
    - La variazione media nei punteggi dei sintomi individuali ISM-SAF dal basale
    - La variazione media nel LSS ISM-SAF dal basale
    - Il tempo al raggiungimento di una riduzione del 30% in TSS ISM-SAF, GSS ISM-SAF, SSS ISM-SAF, e punteggio del cluster di sintomi neurocognitivi ISM-SAF dalla randomizzazione tra i pazienti che raggiungono tale riduzione alla Settimana 25 o prima
    • La variazione media nelle seguenti misure dal basale alla Settimana 25: Punteggio MC-QoL, Punteggio PGI-S, Punteggio SF-12, Punteggio EQ-5D-5L
    - La media e i parametri di esposizione previsti dai singoli pazienti per il BLU-263 (Cmax, AUC0-24 e Ctrough).
    - Sicurezza e tollerabilità determinate da AE, SAE, e variazioni nei parametri di laboratorio di sicurezza, segni vitali, e valutazioni ECG.

    Parte 3:
    - La variazione media delle seguenti misure del carico di mastociti dal basale di BLU-263: Triptasi sierica, Frazione allelica di KIT D816V nel sangue
    - La variazione nel numero di farmaci concomitanti identificati come BSC dal basale
    - La variazione media nei punteggi dei sintomi individuali ISM-SAF dal basale
    - La variazione media nei punteggi dei sintomi principali ISM-SAF dal basale
    - Il tempo al raggiungimento di una riduzione del 30% in TSS ISM-SAF, GSS ISM-SAF, SSS ISM-SAF e punteggio del cluster di sintomi neurocognitivi ISM-SAF dalla prima dose di BLU-263 tra i pazienti che raggiungono tale riduzione ad 1 anno di terapia con BLU-263 o prima
    - La variazione media nelle seguenti misure dal basale alla Settimana 25: Punteggio MC-QoL, Punteggio PGI-S, Punteggio SF-12, Punteggio EQ-5D-5L
    E.5.2.1Timepoint(s) of evaluation of this end point
    Part 1 - baseline to week 13
    Part 2 - baseline to week 25
    Part 3 - ongoing basis
    Parte 1 - dal basale alla settimana 13
    Parte 2 - dal basale alla settimana 25
    Parte 3 - su base continua
    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 Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    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) 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 trial4
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA45
    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
    United States
    Austria
    Belgium
    France
    Germany
    Italy
    Netherlands
    Portugal
    Spain
    Switzerland
    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
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years7
    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 years7
    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 Yes
    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) Yes
    F.1.1.6.1Number of subjects for this age range: 3
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 383
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 17
    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 state25
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 320
    F.4.2.2In the whole clinical trial 403
    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
    Nessuno
    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 Decision2021-09-16
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-09-06
    P. End of Trial
    P.End of Trial StatusOngoing
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