E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
RET-mutated Medullary Thyroid Cancer (MTC) |
Cáncer de tiroides medular con mutación en RET (MTC) |
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E.1.1.1 | Medical condition in easily understood language |
RET-Mutated Medullary Thyroid Cancer (MTC) is a form of thyroid carcinoma which originates from parafollicular cells and which produce the hormone calcitonin. |
El cáncer de tiroides medular mutado con RET (MTC) es una forma de carcinoma de tiroides que se origina a partir de células parafoliculares y que produce la hormona calcitonina. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10027105 |
E.1.2 | Term | Medullary thyroid cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
• To evaluate the efficacy of pralsetinib compared with investigator’s choice of standard of care (SOC) multikinase inhibitor (MKI) therapy for patients with RET-mutated MTC |
• Evaluar la eficacia de pralsetinib en comparación con el tratamiento de referencia con MKI elegido por el investigador en pacientes con CMT con mutación RET. |
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E.2.2 | Secondary objectives of the trial |
• To evaluate the efficacy of pralsetinib compared with investigator’s choice of SOC MKI therapy • To evaluate objective response rate • To evaluate overall survival • To further characterize the safety and tolerability profile of pralsetinib • To evaluate additional measures of anticancer activity, including duration of response, disease control rate, and clinical benefit rate • To evaluate the efficacy of pralsetinib versus SOC treatment through patient-reported endpoints • To evaluate the acceptability and palatability of pralsetinib capsules |
- Evaluar la eficacia de pralsetinib en comparación con el tratamiento de referencia con MKI elegido por el investigador - Evaluar la TRO - Evaluar la SG - Caracterizar mejor el perfil de seguridad y tolerabilidad de pralsetinib. - Evaluar otras medidas de la actividad antineoplásica, como DR, TCE y TBC. - Evaluar la eficacia de pralsetinib en comparación con el tratamiento de referencia mediante los criterios de valoración comunicados por los pacientes. - Evaluar la aceptabilidad y la palatabilidad de pralsetinib en cápsulas. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Age >= 18 years (participants as young as 12 years of age will be allowed if permitted by local regulatory authorities) • Histologically confirmed unresectable locally advanced or metastatic MTC and candidate for systemic therapy with SOC MKI • No prior systemic anticancer treatment with MKI therapies for advanced or metastatic MTC • Radiologically confirmed progressive disease within the last 14 months • Confirmed RET mutation • Able to swallow an oral medication • Eastern Cooperative Oncology Group (ECOG)Performance Status of 0-2 • Men and women of childbearing potential must agree to use a highly effective contraceptive method during treatment period and for 14 days after the final dose of pralsetinib and for 120 days after the final dose of cabozantinib or vandetanib |
- Edad mínima de 18 años en el momento de firmar el consentimiento informado o asentimiento. - Deben tener CMT metastásico o localmente avanzado irresecable confirmado histológicamente y ser tributarios de tratamiento sistémico con un MKI de referencia. - Ausencia de tratamiento antineoplásico sistémico previo con MKI para el CMT avanzado o metastásico. - Progresión de la enfermedad confirmada radiológicamente en los últimos 14 meses - Mutación confirmada de RET determinada localmente - Capacidad de tragar un medicamento oral. - Estado funcional del ECOG de 0-2 - Los hombres y mujeres en edad fértil deben aceptar utilizar un método anticonceptivo altamente eficaz durante el período de tratamiento y durante 14 días después de la dosis final de pralsetinib y durante 120 días después de la dosis final de cabozantinib o vandetanib. |
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E.4 | Principal exclusion criteria |
• Previously treated with any systemic kinase inhibitor therapy regimens, including a selective RET inhibitor, given for recurrent and/or metastatic disease • Any additional known primary driver alterations other than RET • History of pneumonitis within last 12 months • Ongoing treatment with chronic immunosuppressants or systemic steroids >10 mg/day of prednisone • Symptomatic CNS metastases or untreated spinal cord compression • Clinically significant, uncontrolled, cardiovascular disease • Other malignancy diagnosed or treated within the past 2 years • Active, uncontrolled infection • Have received organ or allogenic bone marrow or peripheral blood stem cell transplant |
- Tratamiento previo con cualquier régimen sistémico con inhibidores de cinasas, incluido un inhibidor selectivo de RET, administrado por enfermedad recurrente o metastásica. -Cualquier alteración adicional conocida del controlador principal que no sea RET - Historia de neumonitis en los últimos 12 meses - Tratamiento en curso con inmunodepresores crónicos o esteroides sistémicos que superen los 10 mg/día de prednisona - Presencia de metástasis en el SNC o compresión de la médula espinal no tratada - Enfermedad cardiovascular no controlada y de importancia clínica - Antecedentes de otra neoplasia maligna primaria diagnosticada o que haya precisado tratamiento en los 2 años previos a la aleatorización - Presencia de infección activa no controlada - Recepción de un trasplante de órgano o alotrasplante de médula ósea o de células madre de sangre periférica. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression free survival by Blinded Independent Central Review (BICR) |
Supervivencia libre de progresión según la revisión central independiente ciega (BICR) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Up to 13 years |
Hasta 13 años |
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E.5.2 | Secondary end point(s) |
1. Time-to-treatment failure 2. Objective response rate 3. Overall survival 4. Incidence and severity of adverse events, with severity, as determined according to the National Cancer Institute Common Toxicity Criteria for Adverse Events version 5.0 5. Change from baseline in targeted clinical laboratory test results 6. Change from baseline in ECG results 7. Change from baseline in ECOG Performance Status 8. Duration of response 9. Disease control rate 10. Clinical benefit rate 11. Time to deterioration of function and quality of life 12. Acceptability Survey scores on Day 1 of Cycle 1 and Crossover Cycle 1 |
1. Fracaso en el tiempo transcurrido hasta el tratamiento 2. Tasa de respuesta objetiva 3. Supervivencia general 4. Incidencia y gravedad de los eventos adversos, con gravedad, según lo determinado de acuerdo con los Criterios de toxicidad comunes para eventos adversos del Instituto Nacional del Cáncer versión 5.0 5. Cambio con respecto al valor inicial en los resultados de las pruebas de laboratorio clínico específicas 6. Cambio con respecto al valor inicial en los resultados de ECG 7. Cambio con respecto a la línea de base en el estado de desempeño ECOG 8. Duración de la respuesta 9. Tasa de control de enfermedades 10. Tasa de beneficio clínico 11. Tiempo hasta el deterioro de la función y la calidad de vida. 12. Puntuaciones de la encuesta de aceptabilidad en el día 1 del ciclo 1 y el ciclo cruzado 1 |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1-4. Up to 13 years 5-6. From baseline (Day -28 to -1) to 13 years 7. From baseline to Day 1 of Cycle 1-5, and end of treatment 8-11. Up to 13 years 12. Day 1 of Cycle 1 and Crossover Cycle 1 |
1-4. Hasta 13 años 5-6. Desde el inicio (día -28 a -1) hasta los 13 años 7. Desde el inicio hasta el día 1 del ciclo 1-5 y el final del tratamiento 8-11. Hasta 13 años 12. Día 1 del ciclo 1 y ciclo cruzado 1 |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | Yes |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 61 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Mexico |
Philippines |
Thailand |
Argentina |
Austria |
Belgium |
Brazil |
Bulgaria |
Canada |
Croatia |
Denmark |
Germany |
Greece |
Hungary |
India |
Israel |
Italy |
Korea, Republic of |
Netherlands |
Poland |
Portugal |
Romania |
Russian Federation |
Spain |
Sweden |
Ukraine |
United Kingdom |
United States |
France |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The end of this study is defined as the date when the last patient, last visit occurs or when the required number of deaths for the final analysis of overall survival has been observed, whichever occurs last. The expected duration of the study is approximately, but not limited to 13 years. |
El final de este estudio se define como la fecha en que se produce el último paciente, la última visita o cuando se ha observado el número requerido de muertes para el análisis final de supervivencia global, lo que ocurra en último lugar. La duración esperada del estudio es aproximadamente, pero no se limita a 13 años. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 13 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 13 |