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Clinical trials

The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
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  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   43873   clinical trials with a EudraCT protocol, of which   7293   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
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    Summary
    EudraCT Number:2020-005407-38
    Sponsor's Protocol Code Number:MK-3475-B49
    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:2021-08-02
    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 number2020-005407-38
    A.3Full title of the trial
    A Randomized, Double-blind, Placebo-controlled, Phase 3 Study of Pembrolizumab Plus Chemotherapy Versus Placebo Plus Chemotherapy for the Treatment of Chemotherapy-Candidate Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative (HR+/HER2-) Locally Recurrent Inoperable or Metastatic Breast Cancer (KEYNOTE-B49)
    Studio di fase 3, controllato con placebo, in doppio cieco, randomizzato, con Pembrolizumab associato a chemioterapia verso placebo associato a chemioterapia, per il trattamento del carcinoma mammario metastatico o localmente ricorrente non operabile, in candidati a chemioterapia, positivi al recettore ormonale, negativi al recettore 2 del fattore di crescita epidermico umano (HR+/HER2-) (Keynote-B49)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    This trial is testing pembrolizumab (pembro) + chemotherapy (chemo) in people with certain types of breast cancer called hormone receptor positive/ human epidermal growth factor receptor 2-negative (HR+/HER2-) locally advanced inoperable or metastatic breast cancer (MBC).
    Questo studio clinico si prefigge di testare il pembrolizumab (pembro)+ chemioterapia (chemio) su persone con un certo tipo di cancro alla mammella chiamato carcinoma mammario metastatico o localmente ricorrente non operabile, in candidati positivi al recettore ormonale, negativi al recettore 2 del fattore di crescita epidermico umano (HR+/HER2-)
    A.3.2Name or abbreviated title of the trial where available
    MK-3475-Pembrolizumab Plus Chemotherapy in HR+/HER2- Metastatic Breast Cancer
    MK-3475-Pembrolizumab più chemioterapia in candidati HR+/HER2- a carcinoma mammario metastatico
    A.4.1Sponsor's protocol code numberMK-3475-B49
    A.5.4Other Identifiers
    Name:INDNumber:124442
    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 SponsorMERCK SHARP & DOHME CORP. UNA SUSSIDIARIA DI MERCK & CO. 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 supportMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMSD Italia S.r.l.
    B.5.2Functional name of contact pointDivisione Ricerca Clinica
    B.5.3 Address:
    B.5.3.1Street AddressVia Vitorchiano 151
    B.5.3.2Town/ cityRoma (RM)
    B.5.3.3Post code00189
    B.5.3.4CountryItaly
    B.5.4Telephone number00390636191371
    B.5.5Fax number00390636380371
    B.5.6E-mailgcto.italy@merck.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 Yes
    D.2.1.1.1Trade name KEYTRUDA® (Pembrolizumab, MK-3475)
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp & Dohme B.V.- A.I.C n. EU/1/15/1024/002
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameNA
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Solution for injection/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.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    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) Yes
    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 Yes
    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 nameAbraxane
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Powder for solution for injection/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 INNPACLITAXEL ALBUMINA
    D.3.9.1CAS number 33069-62-4
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) 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: 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 Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameCaelyx pegylated liposomal
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Concentrate for solution for injection/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 INNPACLITAXEL ALBUMINA
    D.3.9.1CAS number 56390-09-1
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2
    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: 4
    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 Yes
    D.2.1.1.1Trade name Capecitabine
    D.2.1.1.2Name of the Marketing Authorisation holderAccord Healthcare S.L.U. - A.I.C n. EU/1/12/762/027
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 name-
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Film-coated 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 INNCAPECITABINA
    D.3.9.1CAS number 154361-50-9
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    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: 5
    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 Yes
    D.2.1.1.1Trade name Capecitabine
    D.2.1.1.2Name of the Marketing Authorisation holderSTADAPHARM GmbH - A.I.C. n. 84624.00.00
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    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 name-
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Film-coated 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 INNCAPECITABINA
    D.3.9.1CAS number 154361-50-9
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    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: 6
    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 Yes
    D.2.1.1.1Trade name Capecitabine
    D.2.1.1.2Name of the Marketing Authorisation holderSTADAPHARM GmbH - A.I.C. n. 84625.00.00
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    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 name-
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Film-coated 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 INNCAPECITABINA
    D.3.9.1CAS number 154361-50-9
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    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: 7
    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 Yes
    D.2.1.1.1Trade name Paclitaxel
    D.2.1.1.2Name of the Marketing Authorisation holderAmneal Pharma Europe Limited - A.I.C. n. 90953.00.00
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    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 namePaclitaxel
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Concentrate for solution for injection/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 INNPACLITAXEL
    D.3.9.1CAS number 33069-62-4
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number6
    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: 8
    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 Yes
    D.2.1.1.2Name of the Marketing Authorisation holderEVER Valinject GmbH –A.I.C. n. 96558.00.00
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    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 namePaclitaxel
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Concentrate for solution for injection/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 INNPACLITAXEL
    D.3.9.1CAS number 33069-62-4
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number6
    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: 9
    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 Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameCapecitabina
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Film-coated 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 INNCAPECITABINA
    D.3.9.1CAS number 154361-50-9
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    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: 10
    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 Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameCapecitabina
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Film-coated 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 INNCAPECITABINA
    D.3.9.1CAS number 154361-50-9
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    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: 11
    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 Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 namePaclitaxel
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Concentrate for solution for injection/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 INNCAPECITABINA
    D.3.9.1CAS number 33069-62-4
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number6
    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: 12
    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 Yes
    D.2.1.1.1Trade name Abraxane
    D.2.1.1.2Name of the Marketing Authorisation holderCelgene Europe BV -A.I.C n. EU/1/07/428/001
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 name-
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Powder for solution for injection/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 INNPACLITAXEL ALBUMINA
    D.3.9.1CAS number 33069-62-4
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) 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: 13
    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 Yes
    D.2.1.1.1Trade name Caelyx pegylated liposomal
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag International NV - A.I.C n. EU/1/96/011/003
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 name-
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Concentrate for solution for injection/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 INNdoxorubicina
    D.3.9.1CAS number 56390-09-1
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2
    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: 14
    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 Yes
    D.2.1.1.1Trade name Capecitabine
    D.2.1.1.2Name of the Marketing Authorisation holderAccord Healthcare S.L.U. -A.I.C n. E/1/12/762/020
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 name-
    D.3.2Product code [-]
    D.3.4Pharmaceutical form Film-coated 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 INNCAPECITABINA
    D.3.9.1CAS number 154361-50-9
    D.3.9.2Current sponsor code-
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    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 placeboSolution for injection/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
    Treatment of patients with HR+/HER2- locally recurrent inoperable or MBC whose tumors express PD-L1
    Trattamento di pazienti con HR+/HER2- locale ricorrente inoperabile o MBC i cui tumori esprimono PD-L1
    E.1.1.1Medical condition in easily understood language
    Hormone receptor positive/human epidermal growth factor receptor 2- negative (HR+/HER2-) locally advanced inoperable or metastatic breast cancer.
    Cancro al seno localmente avanzato, inoperabile o metastatico, positivo per il recettore ormonale e negativo per il recettore 2 del fattore di crescita epidermico umano (HR+/HER2-).
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10027475
    E.1.2Term Metastatic breast cancer
    E.1.2System Organ Class 100000004864
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10072740
    E.1.2Term Locally advanced breast cancer
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    1. To compare pembrolizumab + chemotherapy (CT) to placebo + CT with respect to progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) as assessed by blinded independent central review (BICR) in participants with programmed cell death ligand 1 (PD-L1) combined positive score (CPS) >=10 and >=1 tumors, separately
    Confrontare pembrolizumab più chemioterapia con placebo più chemioterapia in termini di sopravvivenza libera da progressione (PFS) secondo i criteri RECIST 1.1, valutata mediante revisione centralizzata indipendente in cieco (BICR), separatamente in partecipanti con tumori caratterizzati da CPS PD-L1 >=10 e >=1
    E.2.2Secondary objectives of the trial
    1. To compare pembrolizumab + CT to placebo + CT with respect to overall survival (OS) in participants with PD-L1 CPS >=10 and >=1;
    2. To compare pembrolizumab + CT to placebo + CT with respect to PFS per RECIST 1.1 by investigator in participants with CPS> =10 and >=1;
    3. To compare pembrolizumab + CT to placebo + CT with respect to objective response rate (ORR) per RECIST 1.1 by BICR in participants with CPS >=10 and >=1
    4. To compare pembrolizumab + CT to placebo + CT with respect to disease control rate (DCR) per RECIST 1.1 by BICR in participants with CPS >=10 and> =1
    5. To evaluate duration of response (DOR) per RECIST 1.1 by BICR in participants with CPS >=10 and >=1
    6. To evaluate safety and tolerability of pembrolizumab + CT
    For more Secondary objectives see the protocol
    Confrontare pembrolizumab più chemioterapia con placebo più chemioterapia in termini di:
    1 sopravvivenza globale (OS) separatamente in partecipanti con tumori caratterizzati da CPS PD-L1 >=10 e >=1
    2 sopravvivenza libera da progressione (PFS) secondo i criteri RECIST 1.1, valutata dallo sperimentatore, separatamente in partecipanti con tumori caratterizzati da CPS PD-L1 =10 e =1
    3 tasso di risposta obiettiva (ORR) secondo i criteri RECIST 1.1, valutato mediante BICR, in partecipanti con tumori caratterizzati da CPS PD-L1 =10 e =1
    4 tasso di controllo della malattia (DCR) secondo i criteri RECIST 1.1, valutato mediante BICR, separatamente in partecipanti con tumori caratterizzati da CPS PD-L1 =10 e =1
    Valutare:
    5 durata della risposta (DOR) secondo i criteri RECIST 1.1, mediante BICR, separatamente in partecipanti con tumori caratterizzati da CPS PD-L1 =10 e =1
    6 sicurezza e tollerabilità di pembrolizumab più chemioterapia

    Per altri obiettivi secondari si veda il protocollo
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Has locally recurrent inoperable or metastatic HR+/HER2- breast cancer, which has not been previously treated with cytotoxic chemotherapy in the noncurative setting.
    2. Has progressed on 2 or more lines of endocrine therapy for metastatic HR+/HER2-disease, with at least 1 given in combination with a CDK4/6 inhibitor. OR Has progressed on 1 line of endocrine therapy for metastatic HR+/HER2- disease and had a relapse within 24 months of definitive surgery for primary tumor while on adjuvant endocrine therapy. Prior treatment with a CDK4/6 inhibitor (in the metastatic and/or adjuvant setting) is required. OR If no prior treatment with a CDK 4/6 inhibitor, participants must have progressed within 6 months of starting 1 line of endocrine therapy for metastatic disease and had a relapse within 24 months of definitive surgery for primary tumor and while on adjuvant endocrine therapy.
    3. Has presented a documented progression (confirmed by scans per RECIST 1.1 as assessed by the investigator and/or histology [biopsy or cytology] for participants presenting with new metastatic lesions) during or after the last administered endocrine therapy prior to entering the study. o There is evidence of PD based on investigator review of at least 2 scans per RECIST 1.1 following initiation of the last endocrine therapy (or combination) for metastatic disease. o A laboratory report indicating tumor marker elevation cannot be used as documentation of local or distant disease recurrence.
    4. Is a chemotherapy candidate that meets the following criteria: o Participants who received taxane and/or anthracyclines in the neoadjuvant/adjuvant setting can be treated with same class of chemotherapy (taxane or anthracycline) if =12 months have elapsed between the completion of treatment with curative intent and first documented local or distant disease recurrence. o Participants who will be selected to receive liposomal doxorubicin must have a LVEF of at least 50% or above the institution limit of normal, as assessed by ECHO or MUGA scan performed prior to the first dose administration. o Participants who presented with de novo metastatic disease at initial breast cancer diagnosis, are eligible for the study, if they have progressed on 2 or more lines of endocrine therapy for metastatic HR+/HER2- disease, with at least 1 given in combination with a CDK4/6 inhibitor and they present a documented progression during the last administered endocrine therapy prior to entering the study.
    5. Provides a new or the last obtained core biopsy, preferably consisting of multiple cores, taken from a locally recurrent or a distant (metastatic) lesion not previously irradiated for central determination of hormone receptor status (ER and PgR), HER2, and PD-L1 status.
    6. Has centrally confirmed PD-L1 CPS =1 and HR+ (ER and/or PgR) /HER2– breast cancer as defined by the most recent ASCO/CAP
    7. Has an ECOG performance status of 0 or 1, as assessed within 7 days prior to the first dose of study treatment.
    8. Demonstrates adequate organ function, within 10 days prior to the start of study treatment.
    9. Participants are at least 18 years of age.
    10. Male participants are eligible to participate if they agree to the following during the study intervention period and for at least 90 days after the last dose of chemotherapy:
    • Refrain from donating sperm
    • Be abstinent from heterosexual intercourse or must agree to use contraception unless confirmed to be azoospermic

    For more Inclusion criteria see the protocol
    1. Ha un cancro al seno HR+/HER2- localmente ricorrente, inoperabile o metastatico, che non è stato precedentemente trattato con chemioterapia citotossica in un contesto non curativo.
    2. È progredito con 2 o più linee di terapia endocrina per la malattia HR+/HER2 metastatica, di cui almeno 1 somministrata in combinazione con un inibitore CDK4/6. O È progredito con 1 linea di terapia endocrina per la malattia metastatica HR+/HER2- e ha avuto una ricaduta entro 24 mesi dalla chirurgia definitiva per il tumore primario mentre era in terapia endocrina adiuvante. È richiesto un trattamento precedente con un inibitore CDK4/6 (in ambito metastatico e/o adiuvante). OPPURE se nessun trattamento precedente con un inibitore CDK 4/6, i partecipanti devono essere progrediti entro 6 mesi dall'inizio di una linea di terapia endocrina per la malattia metastatica e aver avuto una ricaduta entro 24 mesi dalla chirurgia definitiva per il tumore primario e durante la terapia endocrina adiuvante.
    3. Ha presentato una progressione documentata (confermata da scansioni per RECIST 1.1 come valutato dallo sperimentatore e/o istologia [biopsia o citologia] per i partecipanti che presentano nuove lesioni metastatiche) durante o dopo l'ultima terapia endocrina somministrata prima di entrare nello studio. o C'è evidenza di PD basata sulla revisione dello sperimentatore di almeno 2 scansioni per RECIST 1.1 dopo l'inizio dell'ultima terapia endocrina (o combinazione) per la malattia metastatica. o Un rapporto di laboratorio che indichi un aumento del marcatore tumorale non può essere usato come documentazione della recidiva di malattia locale o a distanza.
    4. o I partecipanti che hanno ricevuto taxano e/o antracicline nel setting neoadiuvante/adiuvante possono essere trattati con la stessa classe di chemioterapia (taxano o antracicline) se sono trascorsi =12 mesi tra il completamento del trattamento con intento curativo e la prima recidiva di malattia locale o a distanza documentata. o I partecipanti che saranno selezionati per ricevere la doxorubicina liposomiale devono avere un LVEF di almeno il 50% o superiore al limite di normalità dell'istituzione, come valutato da ECHO o MUGA scan eseguito prima della somministrazione della prima dose. o I partecipanti che hanno presentato una malattia metastatica de novo alla diagnosi iniziale di cancro al seno, sono eleggibili per lo studio, se sono progrediti su 2 o più linee di terapia endocrina per la malattia metastatica HR+/HER2-, con almeno 1 somministrata in combinazione con un inibitore CDK4/6 e presentano una progressione documentata durante l'ultima terapia endocrina somministrata prima di entrare nello studio.
    5. Fornisce una nuova biopsia del nucleo o l'ultima ottenuta, preferibilmente costituita da più nuclei, prelevata da una lesione localmente ricorrente o a distanza (metastatica) non irradiata in precedenza per la determinazione centrale dello stato dei recettori ormonali (ER e PgR), HER2 e PD-L1.
    6. Ha confermato centralmente PD-L1 CPS =1 e cancro al seno HR+ (ER e/o PgR) /HER2- come definito dal più recente ASCO/CAP
    7. Ha un ECOG performance status di 0 o 1, come valutato entro 7 giorni prima della prima dose di trattamento dello studio.
    8. 8. Dimostra una funzione d'organo adeguata, entro 10 giorni prima dell'inizio del trattamento dello studio.
    9. I partecipanti hanno almeno 18 anni di età.
    10. I partecipanti di sesso maschile possono partecipare se accettano quanto segue durante il periodo di intervento dello studio e per almeno 90 giorni dopo l'ultima dose di chemioterapia:
    - Astenersi dal donare lo sperma
    - Astinenza da rapporti eterosessuali o accettare di usare la contraccezione a meno che non sia confermato l'azoospermia

    Per ulteriori criteri di inclusione vedere il protocollo
    E.4Principal exclusion criteria
    1. Has breast cancer amenable to treatment with curative intent.
    2. Has a history or current evidence of any condition, therapy, or laboratory abnormality that is specifically contraindicated per the current locally-approved labeling, that might confound the results of the study, interfere with the participant's involvement for the full duration of the study, or is not in the best interest of the participant to be involved, in the opinion of the treating investigator.
    3. Has significant cardiac disease.
    4. Has advanced/metastatic, symptomatic visceral spread at risk of rapidly evolving into life-threatening complications, such as lymphangitic lung metastases, bone marrow replacement, carcinomatous meningitis, significant symptomatic liver metastases, shortness of breath requiring supplemental oxygen, symptomatic pleural effusion requiring supplemental oxygen, symptomatic pericardial effusion, symptomatic peritoneal carcinomatosis, or the need to achieve rapid symptom control.
    5. Has skin only disease. Participants who have metastatic disease fulfilling the previous criteria in addition to skin disease can be enrolled.
    6. Has a known germline BRCA mutation and has not received previous treatment with PARP inhibition.
    7. Has received prior chemotherapy for locally recurrent inoperable or metastatic breast cancer.
    8. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PDL2 agent or with an agent directed to another stimulatory or coinhibitory T-cell receptor.
    9. Has received prior systemic anticancer therapy with other investigational agents within 4 weeks prior to randomization.
    10. Has received palliative radiotherapy prior to start of study intervention and has not recovered from all radiation-related toxicities and/or requires corticosteroids, and/or has radiation pneumonitis. At least a 1-week washout is required for palliative radiation. Participants who received prior radiotherapy to >=25% of bone marrow are not eligible regardless of when it was received.
    11. Has received a live or live attenuated vaccine within 30 days prior to the first dose of study intervention.
    12. Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to the first dose of study intervention


    For more Exclusion Criteria see the protocol
    1. Presenta un carcinoma mammario assoggettabile a trattamento con intento curativo.
    2. Presenta anamnesi o evidenza in atto di qualsiasi condizione (ad es. trombocitopenia o anemia dipendente da trasfusione), terapia o anomalia di laboratorio specificamente controindicata in base alle informazioni di prescrizione attuali approvate a livello locale, che potrebbe confondere i risultati dello studio, interferire con la partecipazione del partecipante per l'intera durata dello studio oppure non è nel miglior interesse del partecipante, secondo il parere dello sperimentatore curante.
    3. Presenta una malattia cardiaca significativa, quale:
    • Anamnesi di infarto miocardico, sindrome coronarica acuta o angioplastica/stent/bypass coronarico negli ultimi 6 mesi;
    • Insufficienza cardiaca congestizia (CHF) di classe NYHA II-IV o anamnesi di CHF di classe NYHA III o IV.
    4. Presenta una diffusione viscerale sintomatica avanzata/metastatica a rischio di rapida evoluzione in complicazioni potenzialmente letali, come metastasi polmonari linfangitiche, sostituzione del midollo osseo, meningite carcinomatosa, metastasi epatiche sintomatiche significative, respiro affannoso che necessita di ossigeno supplementare, versamento pleurico sintomatico che necessita di ossigeno supplementare, versamento pericardico sintomatico, carcinomatosi peritoneale sintomatica o necessità di ottenere un rapido controllo dei sintomi.
    Note:
    • Possono essere arruolati i partecipanti con versamento pleurico sintomatico che presentano dispnea a riposo con necessità di ossigeno supplementare, ma i cui sintomi sono alleviati dal drenaggio del liquido.
    • Possono essere arruolati i partecipanti con versamento ascitico sintomatico causato da carcinomatosi peritoneale, alleviato dopo il drenaggio del liquido ascitico.
    • I partecipanti con metastasi epatiche sintomatiche includono i partecipanti con bilirubina in rapido aumento >1,5 volte il limite superiore della norma (ULN) in assenza di ostruzione biliare, con coinvolgimento di oltre il 50% del parenchima epatico causato dalla malattia.
    5. Presenta malattia solo cutanea. Possono essere arruolati i partecipanti con malattia metastatica che soddisfano i criteri precedenti oltre alla malattia cutanea.
    6. Presenta una mutazione BRCA accertata nella linea germinale (deleteria o sospetta deleteria) e non ha ricevuto nessun trattamento precedente con un inibitore delle PARP.
    7. Ha ricevuto una chemioterapia precedente per il carcinoma mammario metastatico o localmente ricorrente non operabile.
    8. Ha ricevuto una terapia precedente con un agente anti PD-1, anti PD-L1 o anti PD-L2 oppure con un agente mirato a un altro recettore delle cellule T stimolante o co-inibitorio (ad es. CTLA-4, OX-40, CD137).
    9. Ha ricevuto una terapia antitumorale sistemica precedente con altri agenti sperimentali nelle 4 settimane precedenti alla randomizzazione
    10. Ha ricevuto radioterapia palliativa prima dell'inizio del trattamento dello studio e non si è ristabilito da tutte le tossicità correlate alle radiazioni e/o necessita di corticosteroidi e/o presenta polmonite da radiazioni. È necessario un washout di almeno 1 settimana per la radioterapia palliativa (definita da una durata della terapia =2 settimane). I partecipanti che hanno ricevuto una radioterapia precedente a =25% del midollo osseo non sono idonei, indipendentemente da quando è stata ricevuta.
    11. Ha ricevuto un vaccino vivo o vivo attenuato nei 30 giorni precedenti alla prima dose del trattamento dello studio. È consentita la somministrazione di vaccini inattivati.
    12. Sta partecipando o ha partecipato a uno studio con un agente sperimentale o ha usato un dispositivo sperimentale nelle 4 settimane precedenti alla prima dose del trattamento dello studio.

    Per altri criteri di esclusione si veda il protocollo.
    E.5 End points
    E.5.1Primary end point(s)
    1. Progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) by Blinded independent Central Review (BICR) in Participants With CPS >=10

    2. PFS per RECIST 1.1 by BICR in Participants With CPS >=1
    1. Sopravvivenza libera da progressione (PFS) secondo i criteri di valutazione della risposta nei tumori solidi, versione 1.1 (RECIST 1.1), mediante revisione centrale indipendente in cieco (BICR) nei partecipanti con CPS =10
    2. PFS secondo RECIST 1.1 mediante BICR nei partecipanti con CPS =1
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. Up to ~33 months
    2. Up to ~33 months
    1. Fino a ~33 mesi
    2. Fino a ~33 mesi
    E.5.2Secondary end point(s)
    1. Overall Survival (OS) per RECIST 1.1 by BICR in Participants With CPS >=10
    2. OS per RECIST 1.1 by BICR in Participants With CPS >=1
    3. PFS per RECIST 1.1 by Investigator in Participants With CPS >=10
    4. PFS per RECIST 1.1 by Investigator in Participants With CPS> =1
    5. Objective Response Rate (ORR) per RECIST 1.1 by BICR in Participants With CPS >=10
    6. ORR per RECIST 1.1 by BICR in Participants With CPS =1
    7. Disease Control Rate (DCR) per RECIST 1.1 by BICR in Participants With CPS >=10
    8. DCR per RECIST 1.1 by BICR in Participants With CPS >=1
    9. Duration of Response (DOR) per RECIST 1.1 by BICR in Participants With CPS =10
    10. DOR per RECIST 1.1 by BICR in Participants With CPS >=1
    11. Change From Baseline to end of Study in Global Health Status/Quality of Life Score on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) in Participants with CPS >=10
    12. Change From Baseline to end of Study in Global Health Status/Quality of Life Score on the EORTC QLQ-C30 in Participants with CPS >=1
    13. Change From Baseline to end of Study in Physical Functioning Score on the EORTC QLQ-C30 in Participants with CPS >=10
    14. Change From Baseline to end of Study in Physical Functioning Score on the EORTC QLQ-C30 in Participants with CPS >=1
    15. Change From Baseline to end of Study in Emotional Functioning Score on the EORTC QLQ-C30 in Participants with CPS >=10
    16. Change From Baseline to end of Study in Emotional Functioning Score on the EORTC QLQ-C30 in Participants with CPS >=1
    17. Change From Baseline to end of Study in Fatigue Score on the EORTC QLQ-C30 in Participants with CPS >=10
    1. Sopravvivenza globale (OS) secondo RECIST 1.1 mediante BICR nei partecipanti con CPS =10
    2. OS secondo RECIST 1.1 mediante BICR nei partecipanti con CPS =1
    3. PFS secondo RECIST 1.1 valutata dallo sperimentatore nei partecipanti con CPS =10
    4. PFS secondo RECIST 1.1 valutata dallo sperimentatore nei partecipanti con CPS =1
    5. Tasso di risposta obiettiva (ORR) secondo RECIST 1.1 mediante BICR nei partecipanti con CPS =10
    6. ORR secondo RECIST 1.1 mediante BICR nei partecipanti con CPS =1
    7. Tasso di controllo della malattia (DCR) secondo RECIST 1.1 mediante BICR nei partecipanti con CPS =10
    8. DCR secondo RECIST 1.1 mediante BICR nei partecipanti con CPS =1
    9. Durata della risposta (DOR) secondo RECIST 1.1 mediante BICR nei partecipanti con CPS =10
    10. DOR secondo RECIST 1.1 mediante BICR nei partecipanti con CPS =1
    11. Variazione rispetto al basale fino al termine dello studio del punteggio relativo allo stato di salute globale/alla qualità di vita tramite il questionario European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30) nei partecipanti con CPS =10
    12. Variazione rispetto al basale fino al termine dello studio del punteggio relativo allo stato di salute globale/alla qualità di vita tramite il questionario EORTC QLQ-C30 nei partecipanti con CPS =1
    13. Variazione rispetto al basale fino al termine dello studio del punteggio relativo allo stato funzionale fisico tramite il questionario EORTC QLQ-C30 nei partecipanti con CPS =10
    14. Variazione rispetto al basale fino al termine dello studio del punteggio relativo allo stato funzionale fisico tramite il questionario EORTC QLQ-C30 nei partecipanti con CPS =1
    15. Variazione rispetto al basale fino al termine dello studio del punteggio relativo allo stato funzionale emotivo tramite il questionario EORTC QLQ-C30 nei partecipanti con CPS =10
    16. Variazione rispetto al basale fino al termine dello studio del punteggio relativo allo stato funzionale emotivo tramite il questionario EORTC QLQ-C30 nei partecipanti con CPS =1
    17. Variazione rispetto al basale fino al termine dello studio del punteggio relativo all’affaticamento tramite il questionario EORTC QLQ-C30 nei partecipanti con CPS =10
    E.5.2.1Timepoint(s) of evaluation of this end point
    1. Up to ~75 months
    2. Up to ~75 months
    3. Up to ~75 months
    4. Up to ~75 months
    5. Up to ~75 months
    6. Up to ~75 months
    7. Up to ~75 months
    8. Up to ~75 months
    9. Up to ~75 months
    10. Up to ~75 months
    11. Baseline and up to ~75 months
    12. Baseline and up to ~75 months
    13. Baseline and up to ~75 months
    14. Baseline and up to ~75 months
    15. Baseline and up to ~75 months
    16. Baseline and up to ~75 months
    17. Baseline and up to ~75 months
    1. Fino a ~75 mesi
    2. Fino a ~75 mesi
    3. Fino a ~75 mesi
    4. Fino a ~75 mesi
    5. Fino a ~75 mesi
    6. Fino a ~75 mesi
    7. Fino a ~75 mesi
    8. Fino a ~75 mesi
    9. Fino a ~75 mesi
    10. Fino a ~75 mesi
    11. Dal Baseline e fino a ~75 mesi
    12. Dal Baseline e fino a ~75 mesi
    13. Dal Baseline e fino a ~75 mesi
    14. Dal Baseline e fino a ~75 mesi
    15. Dal Baseline e fino a ~75 mesi
    16. Dal Baseline e fino a ~75 mesi
    17.Dal Baseline e fino a ~75 mesi
    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 No
    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 Yes
    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) Yes
    E.8.2.2Placebo Yes
    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 concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA70
    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
    Canada
    Chile
    China
    Guatemala
    Israel
    Japan
    Korea, Republic of
    Malaysia
    Mexico
    Philippines
    Russian Federation
    Turkey
    United States
    Austria
    France
    Germany
    Ireland
    Italy
    Netherlands
    Poland
    Portugal
    Spain
    Sweden
    United Kingdom
    Argentina
    Greece
    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
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years6
    E.8.9.1In the Member State concerned months2
    E.8.9.1In the Member State concerned days2
    E.8.9.2In all countries concerned by the trial years6
    E.8.9.2In all countries concerned by the trial months4
    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: 400
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 400
    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 state20
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 301
    F.4.2.2In the whole clinical trial 800
    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)
    Upon study completion, participants are discontinued and may be enrolled in a pembrolizumab extension study, if available.
    Al termine dello studio, i partecipanti non ricevono più il trattamento e possono essere arruolati in uno studio di estensione di pembrolizumab, se disponibile.
    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 Decision2021-06-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-04-21
    P. End of Trial
    P.End of Trial StatusOngoing
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