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    Summary
    EudraCT Number:2020-005565-13
    Sponsor's Protocol Code Number:17000139BLC2002
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-09-02
    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 ConcernedSpain - AEMPS
    A.2EudraCT number2020-005565-13
    A.3Full title of the trial
    A Phase 2, Open-Label, Multi-Center, Randomized Study of TAR-200 in Combination with Cetrelimab and Cetrelimab Alone in Participants with Muscle-Invasive Urothelial Carcinoma of the Bladder who are Scheduled for Radical Cystectomy and are Ineligible for or Refusing Platinum-Based Neoadjuvant Chemotherapy
    Estudio de fase 2, multicéntrico, aleatorizado y abierto, de TAR-200 en combinación con cetrelimab y monoterapia con cetrelimab en participantes con carcinoma urotelial de vejiga músculo-invasivo que se vayan a tratar con cistectomía radical y no sean elegibles o rechacen recibir tratamiento con quimioterapia neoadyuvante basada en platino
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 2, Open-Label, Multi-Center, Randomized Study of TAR-200 in Combination with Cetrelimab and Cetrelimab Alone in Participants with Muscle-Invasive Urothelial Carcinoma of the Bladder who are Scheduled for Radical Cystectomy and are Ineligible for or Refusing Platinum-Based Neoadjuvant Chemotherapy
    Estudio de fase 2, multicéntrico, aleatorizado y abierto, de TAR-200 en combinación con cetrelimab y monoterapia con cetrelimab en participantes con carcinoma urotelial de vejiga músculo-invasivo que se vayan a tratar con cistectomía radical y no sean elegibles o rechacen recibir tratamiento con quimioterapia neoadyuvante basada en platino
    A.3.2Name or abbreviated title of the trial where available
    SunRISe-4
    A.4.1Sponsor's protocol code number17000139BLC2002
    A.5.4Other Identifiers
    Name:INDNumber:149505
    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 SponsorJanssen-Cilag International NV
    B.1.3.4CountryBelgium
    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 supportJanssen Research & Development LLC
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationJanssen-Cilag International NV
    B.5.2Functional name of contact pointClinical Registry Group
    B.5.3 Address:
    B.5.3.1Street AddressArchimedesweg 29
    B.5.3.2Town/ cityLeiden
    B.5.3.3Post code2333 AG
    B.5.3.4CountryNetherlands
    B.5.4Telephone number+3171524 21 66
    B.5.5Fax number+3171524 21 10
    B.5.6E-mailClinicalTrialsEU@its.jnj.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 nameTAR-200
    D.3.2Product code JNJ-17000139
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravesical use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNgemcitabine hydrochloride
    D.3.9.1CAS number 122111-03-9
    D.3.9.2Current sponsor codeJNJ-17000139-AAC
    D.3.9.3Other descriptive nameGEMCITABINE HYDROCHLORIDE
    D.3.9.4EV Substance CodeSUB02324MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number225
    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 No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy Yes
    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 nameCetrelimab
    D.3.2Product code JNJ-63723283
    D.3.4Pharmaceutical form Lyophilisate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCetrelimab
    D.3.9.2Current sponsor codeJNJ-63723283
    D.3.9.3Other descriptive nameCNTO 8470, anti-PD-1
    D.3.9.4EV Substance CodeSUB193853
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number240
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typemonoclonal antibody
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Muscle-Invasive Urothelial Carcinoma of the Bladder
    Carcinoma urotelial de vejiga músculo-invasivo
    E.1.1.1Medical condition in easily understood language
    Bladder cancer
    Cáncer de vejiga
    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 10046714
    E.1.2Term Urothelial carcinoma bladder
    E.1.2System Organ Class 100000004864
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10046720
    E.1.2Term Urothelial carcinoma bladder stage II
    E.1.2System Organ Class 100000004864
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10046721
    E.1.2Term Urothelial carcinoma bladder stage III
    E.1.2System Organ Class 100000004864
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10046722
    E.1.2Term Urothelial carcinoma bladder stage IV
    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
    To determine the anti-tumor effects of TAR 200 in combination with Cetrelimab and Cetrelimab alone
    Determinar los efectos antitumorales de TAR-200 en combinación con cetrelimab y cetrelimab en monoterapia
    E.2.2Secondary objectives of the trial
    • To evaluate the safety and tolerability of up to 4 dosing cycles of TAR-200 in combination with cetrelimab and cetrelimab alone prior to RC

    • To determine the recurrence-free survival (RFS) in participants receiving TAR-200 in combination with cetrelimab and cetrelimab alone
    - Evaluar la seguridad y la tolerabilidad de hasta 4 ciclos de tratamiento de TAR-200 en combinación con cetrelimab y cetrelimab en monoterapia antes de la CR
    - Evaluar la supervivencia sin recidiva (SSR) en participantes que reciben TAR-200 en combinación con cetrelimab y cetrelimab en monoterapia.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. ≥18 years (or the legal age of consent in the jurisdiction in which the study is taking place)
    2. Histologically proven, cT2-T4a N0, M0 infiltrating urothelial carcinoma (AJCC 2017) of the bladder. Initial diagnosis must have been within 90 days of randomization date. Participants with variant histologic subtypes (eg squamous differentiation) are allowed if urothelial differentiation is predominant (eg, <20% variant histologic subtype).
    3. Participants with an individual intravesical tumor size of ≤3 cm following TURBT are eligible. Participants with persistent multifocal tumors at screening must undergo a second debulking, re-staging TURBT to reduce the tumor burden. Participants will be ineligible if any individual tumor is >3 cm.
    4. Deemed eligible for and willing to undergo RC by the attending urologist.
    5 Eastern Cooperative Oncology Group (ECOG) performance status Grade 0 or 1
    6.Thyroid function tests within normal range or stable on hormone supplementation per Investigator assessment.
    7. Adequate bone marrow, liver, and renal function (kindly refer to study protocol for further details)
    8. Participants must refuse cisplatin-based combination
    chemotherapy (and understand the risk and benefits of doing so)
    or be deemed ineligible for cisplatin-based chemotherapy by
    meeting at least one of the following criteria:
    • GFR <60 mL/min/1.73 m2 (assessed using the CKD-EPI equation)
    • Common Terminology Criteria for Adverse Events (CTCAE) version
    5.0 Grade ≥2 audiometric hearing loss
    • CTCAE version 5.0 Grade ≥2 peripheral neuropathy
    9. Prior systemic chemotherapy for indications other than urothelial
    cell carcinoma of the bladder is permitted, but interval between
    this treatment and study enrollment must exceed 24 months. All
    toxicities attributed to prior anti-cancer therapy other than
    alopecia and fatigue must have resolved to Grade 1 (NCI-CTCAE
    version 5.0) or baseline before administration of study drug.
    Participants with toxicities attributed to prior anticancer therapy
    which are not expected to resolve and result in long lasting
    sequelae, such as peripheral neuropathy after platinum-based
    therapy or audiometric hearing loss, are ineligible.
    10.All adverse events associated with any prior surgery must have
    resolved to CTCAE version 5.0 Grade <2 prior to randomization.
    11.Contraceptive use by men or women should be consistent with
    local regulations regarding the use of contraceptive methods for
    participants participating in clinical studies
    a. A female participant must be either of the following :
    i. Not of childbearing potential
    ii. Of childbearing potential and
    • practicing true abstinence, or • have a sole partner who is vasectomized, or
    • practicing at least 1 highly effective user independent method of contraception
    Participant must agree to continue the above throughout the study and for 6 months after the last dose of study treatment.
    Note: If a woman becomes of childbearing potential after start of the study, the woman must comply with point (ii), as described above.
    A female participant must also:
    • agrees to not donate eggs (ova, oocytes, or freeze for future use) for the purposes of assisted reproduction during the study and for at least 6 months after the last dose of study drug.
    • not be breastfeeding and not planning to become pregnant during the study and for at least 6 months after the last dose of study drug
    b. A male participant must wear a condom (with or without spermicidal foam/gel/film/cream/suppository) when engaging in any activity that allows for passage of ejaculate to another person during the study and for a minimum of 6 months after receiving the last dose of study treatment. His female partner, if of childbearing potential, must also be practicing a highly effective method of contraception
    If the male participant is vasectomized, he still must wear a condom (with or without spermicidal foam/gel/film/cream/suppository), but his female partner is not required to use contraception.
    A male participant must also:
    • agree to not donate sperm for the purpose of reproduction during the study and for a minimum of 6 months after the last dose of study drug
    • not plan to father a child while enrolled in this study or within 6 months after the last dose of study drug
    12.A female participant of childbearing potential must have a negative serum or urine test at screening and within 72 hours of the first dose of study treatment and must agree to further serum or urine pregnancy tests during the study, that may exceed those listed in the Schedule of Activities
    13.Must sign an informed consent form (ICF) (or their legally acceptable representative must sign)
    1. ≥18 años (o edad legal del consentimiento en la jurisdicción en la que se esté realizando el estudio)
    2. Carcinoma urotelial de vejiga infiltrante en cT2-T4a N0, M0 demostrado histológicamente (Comité Conjunto Estadounidense sobre el Cáncer, AJCC 2017). El diagnóstico inicial debe haberse realizado en 90 días antes de la aleatorización. Los participantes con subtipos histológicos variantes (p. ej., diferenciación escamosa) pueden participar si la diferenciación urotelial es predominante (p. ej., <20 % de subtipo histológico variante).
    3. Los participantes con un tumor intravesical individual ≤3 cm después de la TURBT son aptos. Los participantes con tumores multifocales persistentes en la selección deben someterse a una segunda TURBT citorreductora y a reestadificación para reducir la carga tumoral. Los participantes no serán aptos si cualquier tumor es >3 cm.
    4. El urólogo responsable lo considera apto y dispuesto a someterse a CR
    5. Estado funcional del Grupo Oncológico Cooperativo del Este (ECOG) de 0 o 1
    6. Pruebas de función tiroidea dentro del intervalo normal o estable con suplementos hormonales según el investigador
    7. Actividad adecuada de la médula ósea, el hígado y la función renal
    8. Los participantes deben rechazar la quimioterapia combinada con cisplatino (y entender el riesgo y los beneficios de hacerlo) o ser considerados no aptos para la quimioterapia con cisplatino por cumplir al menos uno de los siguientes criterios:
    -TFG <60 ml/min/1,73 m2 (evaluada mediante la ecuación CKD-EPI)
    -Pérdida auditiva audiométrica de grado ≥2 de acuerdo con los Common Terminology Criteria for Adverse Events, CTCAE, versión 5.0 o posterior
    -Neuropatía periférica de grado ≥2 CTCAE, versión 5.0
    9. Se permite la quimioterapia sistémica previa para indicaciones distintas del carcinoma de células uroteliales de vejiga, pero el intervalo entre este tratamiento y la inscripción en el estudio debe superar los 24 meses. Todas las toxicidades atribuidas a tratamientos antineoplásicos anteriores (excepto alopecia y cansancio) deben haberse resuelto a grado 1 (CTCAE del NCI, versión 5.0) o al inicio antes de la administración del fármaco del estudio. Los participantes con toxicidades atribuidas a tratamientos antineoplásicos previos que no se espera que se resuelvan y que provoquen secuelas de larga duración, como neuropatía periférica después de un tratamiento con platino o pérdida de audición audiométrica, no son aptos
    10. Todos los acontecimientos adversos asociados a una intervención quirúrgica deben haberse resuelto a un grado <2 según la versión 5.0 de CTCAE antes de la aleatorización
    11. El uso de anticonceptivos por hombres o mujeres debe cumplir con las normativas locales sobre el uso de métodos anticonceptivos para los participantes de estudios clínicos
    a. Las participantes deberán reunir uno de los siguientes requisitos:
    i. No estar en edad fértil
    ii. Estar en edad fértil y
    • practicar la abstinencia total, o • tener una única pareja que se haya sometido a una vasectomía, o • utilizar al menos 1 método anticonceptivo altamente eficaz e independiente del usuario;
    a lo largo del estudio y 6 meses después de la última dosis del tratamiento del estudio. Nota: si una mujer entra en edad fértil después del inicio del estudio, debe cumplir con el punto (ii), como se describe antes
    Las participantes también deben cumplir lo siguiente:
    • aceptar no donar óvulos (ovocitos) con fines de reproducción asistida durante el estudio y durante al menos 6 meses después de la última dosis
    • no estar en periodo de lactancia y no tener previsto quedarse embarazada durante el estudio ni durante al menos 6 meses después de la última dosis
    b. Los participantes deben usar un preservativo (con o sin espuma/gel/película/crema/supositorio espermicida) cuando realicen cualquier acto que permita el paso de la eyaculación a otra persona durante el estudio y durante un mínimo de 6 meses después de recibir la última dosis. Su pareja femenina, si tiene capacidad de concebir, también debe utilizar un método anticonceptivo muy eficaz. Si el participante se ha sometido a una vasectomía, debe seguir usando un preservativo, pero su pareja femenina no está obligada a usar anticonceptivos.
    También deben cumplir lo siguiente:
    • no donar esperma con fines de reproducción durante el estudio y durante un mínimo de 6 meses después de la última dosis
    • no tener previsto engendrar un hijo mientras participa en este estudio o en los 6 meses posteriores a la última dosis
    12. Una participante con capacidad de concebir debe tener un resultado negativo en una prueba de suero u orina en la selección y en las 72 horas previas a la primera dosis del tratamiento del estudio y debe aceptar someterse a más pruebas de embarazo en suero u orina durante el estudio, que pueden superar las enumeradas en el calendario de actividades
    13. Debe firmar un formulario de consentimiento informado (FCI) (o su representante legal debe firmarlo)
    E.4Principal exclusion criteria
    1.Active malignancies other than the disease being treated under study.
    2.Must not have received prior systemic chemotherapy, targeted small molecule therapy, or radiation therapy within 2 years prior to starting study treatment
    3.Must not have had urothelial carcinoma or histological variant at any site outside of the urinary bladder.
    4.Participants must not have evidence of cT4b, or N1-3, or M1 disease based on local radiology staging within 42 days prior to randomization.
    5.Presence of any bladder or urethral anatomic feature that, in the opinion of the Investigator, may prevent the safe placement, indwelling use, or removal of TAR-200.
    6.Uncontrolled adrenal insufficiency.
    7.A history of clinically significant polyuria with recorded 24-hour urine volumes greater than 4,000 mL.
    8.History of uncontrolled cardiovascular disease
    9.Must not have active tuberculosis.
    10.Has had an allogeneic tissue/solid organ transplant.
    11.Pyeloureteral tube externalized to the skin is exclusionary.
    12.Indwelling catheters are not permitted;
    13.Participants with an active, known or suspected autoimmune disease.
    14.Participants must not have clinically significant liver disease that precludes participant treatment regimens prescribed on the study
    15.Known human immunodeficiency virus infection.
    16.Evidence of active hepatitis B or C infection
    17.Concurrent urinary tract infection, defined as a symptomatic infection with a positive urine culture with a bacterial count of ≥105 colony forming units /mL in urine voided from women, or >104 CFU/mL in urine voided from men, or in straight-catheter urine from women.
    18.Active, uncontrolled urogenital bacterial, viral or fungal infections, including UTI. Skin/nail fungal infections are not exclusionary.
    19.Evidence of interstitial lung disease or active non-infectious pneumonitis.
    20.Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, unstable angina pectoris, or psychiatric illness/social situations that would limit compliance with study requirements.
    21.Participants who have had a history of acute diverticulitis, intra-abdominal abscess, gastrointestinal obstruction and abdominal carcinomatosis which are known risk factors for bowel perforation.
    22.Impaired wound healing capacity defined as skin/decubitus ulcers, chronic leg ulcers, known gastric ulcers, or unhealed incisions.
    23.Not recovered from adverse events due to a previously administered agent.
    24.Prior systemic chemotherapy for urothelial cell carcinoma of the bladder at any time.
    25.Pelvic radiotherapy administered less than 6 months prior to screening.
    26.Received a live virus vaccine within 30 days of planned start of study treatment
    27.Active autoimmune disease that has required systemic treatment in the past 2 years.
    28.Active infection requiring systemic intravenous therapy within 14 days prior to randomization.
    29.Received intervening intravesical chemotherapy or immunotherapy from the time of most recent cystoscopy/TURBT to starting study treatment.
    30.Prior treatment with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti cytotoxic T-lymphocyte antigen-4 (CTLA-4) antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways.
    31.Participants with a history of Grade ≥3 toxic effects when using anti-TNF or anti-IL-6 agents are excluded.
    32.Participants still recovering from toxicity of prior anticancer therapy which was received more than 24 months prior to enrollment (except toxicities which are not clinically significant such as alopecia, skin discoloration).
    33.Participants who require immunosuppressive medications
    34.Participants with a history of allergy to protein-based therapies and participants with a history of any significant drug allergy are excluded.
    35.Known hypersensitivity to any study component including:
    a.Gemcitabine (or other drug excipients) or chemically-related drugs,
    b.TAR-200 device constituent materials,
    c.TAR-200 Urinary Placement Catheter materials,
    d.Cetrelimab excipients or chemically-related drugs
    Refer to the TAR-200 IB and cetrelimab IB for complete information on excipients.
    36.Currently participating or has participated in a study of an investigational agent and received study therapy or investigational device within 4 weeks prior to enrollment.
    37.Participants with evidence of bladder perforation during diagnostic cystoscopy. Participant is eligible if perforation has resolved prior to dosing.
    38.Bladder post-void residual (PVR) volume >350mL at screening after second voided urine.
    39.Participants who have not recovered from the effects of major surgery or significant traumatic injury at least 14 days before randomization
    (Kindly refer Protocol section 5.2 "Exclusion Criteria" for detailed information)
    1. Neoplasias malignas activas distintas de la enfermedad en estudio
    2. Los participantes no deben haber recibido quimioterapia sistémica previa, tratamiento dirigido con micromoléculas o radioterapia en los 2 años antes del inicio del tratamiento
    3. No haber tenido carcinoma urotelial ni variante histológica en ningún lugar fuera de la vejiga
    4. No presentar indicios de enfermedad cT4b, N1-3, o M1 basándose en la estadificación radiológica local en un plazo de 42 días antes de la aleatorización
    5. Presencia de cualquier característica anatómica vesical o uretral que, según el investigador, impida la colocación segura, el uso permanente o la retirada de TAR-200
    6. Insuficiencia suprarrenal no controlada
    7. Antecedentes de poliuria clínicamente significativa con un volumen de orina de 24 horas registrado superior a 4000 ml
    8. Antecedentes de enfermedad cardiovascular no controlada
    9. No tener tuberculosis activa
    10. Haber recibido un alotrasplante de tejidos/órganos sólidos
    11. La presencia de un tubo pieloureteral exteriorizado a la piel supone la exclusión
    12. No se permiten catéteres permanentes
    13. Enfermedad autoinmunitaria activa, conocida o sospechada
    14. No tener hepatopatía clínicamente significativa que impida las pautas de tratamiento prescritas
    15. Infección conocida por el virus de la inmunodeficiencia humana
    16. Indicios de infección activa por el virus de la hepatitis B o C
    17. Infección urinaria concomitante (infección sintomática con un urocultivo positivo con un recuento bacteriano ≥105 unidades formadoras de colonias (UFC)/ml en orina de mujeres o >104 UFC/ml en orina de hombres o en orina de catéter recto de mujeres)
    18. Infecciones bacterianas, víricas o fúngicas urogenitales activas y no controladas, incluida la infección urinaria. Las infecciones fúngicas de la piel/uña no son excluyentes
    19. Indicios de neumopatía intersticial o neumonitis no infecciosa activa
    20. Afección intercurrente no controlada incluyendo, entre otras, infección en curso o activa, angina de pecho inestable o enfermedad psiquiátrica/situaciones sociales que pudieran limitar el cumplimiento de los requisitos del estudio
    21. Antecedentes de diverticulitis aguda, absceso intraabdominal, obstrucción gastrointestinal y carcinomatosis abdominal, que son factores de riesgo conocidos de perforación intestinal
    22. Alteración de la capacidad de cicatrización de heridas definida como úlceras cutáneas/por decúbito, úlceras crónicas en las piernas, úlceras gástricas conocidas o incisiones no cicatrizadas
    23. No se ha recuperado de acontecimientos adversos debido a un fármaco administrado previamente
    24. Quimioterapia sistémica previa para el carcinoma de células uroteliales de la vejiga en cualquier momento
    25. Radioterapia pélvica administrada menos de 6 meses antes de la selección
    26. Haber recibido una vacuna con virus vivos 30 días antes del inicio previsto del tratamiento del estudio
    27. Enfermedad autoinmunitaria activa que haya requerido tratamiento sistémico en los últimos 2 años
    28. Infección activa en los 14 días previos a la aleatorización que necesitase un tratamiento sistémico intravenoso
    29. Haber recibido quimioterapia intravesical o inmunoterapia desde el momento de la cistoscopia/TURBT más reciente hasta comenzar el tratamiento del estudio
    30. Tratamiento previo con un anticuerpo anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137 o antilinfocitos T citotóxicos anti-antígeno 4 (CTLA-4), o cualquier otro anticuerpo o fármaco dirigido específicamente a la coestimulación de linfocitos T o a las vías de punto de control
    31. Se excluye a los participantes con antecedentes de efectos tóxicos de grado ≥3 al usar fármacos anti-TNF o anti-IL-6
    32. Participantes que aún se están recuperando de la toxicidad de un tratamiento antineoplásico previo que se recibió más de 24 meses antes de la inscripción (excepto toxicidades que no son clínicamente significativas)
    33. Participantes que requieren inmunodepresores
    34. Se excluye a los participantes con antecedentes de alergia a tratamientos con proteínas y a participantes con antecedentes de alergia farmacológica significativa
    35. Hipersensibilidad conocida a cualquier componente del estudio, como:
    a. Gemcitabina (u otros excipientes de fármacos) o a fármacos relacionados con la quimioterapia
    b. Materiales constitutivos del TAR-200
    c. Materiales del catéter de colocación urinaria TAR-200
    d. Excipientes de cetrelimab o a fármacos relacionados con la quimioterapia
    Consulte el MI de TAR-200 y el de cetrelimab para obtener información sobre los excipientes
    36. Participación en ese momento o haber participado en un estudio de un producto en fase de investigación y haber recibido el tratamiento del estudio o un dispositivo en investigación en las 4 semanas previas a la inscripción
    (Consulte la sección 5.2 “Criterios de exclusión” del protocolo para obtener información detallada)
    E.5 End points
    E.5.1Primary end point(s)
    pCR rate at radical cystectomy (RC)
    Tasa de RCp en el momento de la cistectomía radical (CR)
    E.5.1.1Timepoint(s) of evaluation of this end point
    At time of RC planned within 6 weeks after the Week 9 visit
    En el momento de la CR planeada no más tarde de 6 semanas después de la visita de la semana 9
    E.5.2Secondary end point(s)
    • Frequency and grade of adverse events (AEs)
    • Laboratory abnormalities
    • Recurrence-free survival (RFS)
    • Frecuencia y grado de los acontecimientos adversos (AAs)
    • Anomalías analíticas
    • Supervivencia sin recidiva (SSR)
    E.5.2.1Timepoint(s) of evaluation of this end point
    •Frequency and grade of adverse events (AEs)
    From the signing of the ICF until 100 days after last dose of study
    drug; thereafter (study follow-up phase) all study drug-related
    serious adverse events should be reported
    •Laboratory abnormalities :
    At different timepoints specified in the protocol
    •Recurrence-free survival (RFS)
    At Week 6, RC visit, and every 12 weeks post RC until Week 108.
    Additionally (follow-up phase), when clinically indicated.
    • Frecuencia y grado de los acontecimientos adversos (AAs):
    Desde la firma del FCI y hasta 100 días después de la última dosis del fármaco del estudio; después (fase de seguimiento del estudio) se deben reportar todos los acontecimientos adversos graves relacionados con el medicamento del estudio
    • Anomalías analíticas
    En los diferentes momentos especificados en el protocolo
    • Supervivencia sin recidiva (SSR)
    En la semana 6, visita de CR y cada 12 semanas después de la CR hasta la semana 108. Además (fase de seguimiento), cuando esté clínicamente aconsejado.
    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 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) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA49
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Korea, Republic of
    United States
    European Union
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    The end of study is considered as approximately 2 years after the last randomized participant receives RC. The final data from the study site will be sent to the Sponsor (or designee) after completion of the final participant assessment at that study site, in the time frame specified in the Clinical Trial Agreement.
    El fin del estudio se considera aproximadamente 2 años después de que el último paciente aleatorizado haya recibido la CR. Los datos finales del centro del estudio se enviarán al promotor (o designado) después de que se haya completado la evaluación final del participante en el centro del estudio, en el plazo de tiempo especificado en el Contrato del Ensayo Clínico.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days30
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months6
    E.8.9.2In all countries concerned by the trial days30
    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: 60
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 100
    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 Yes
    F.3.3.7.1Details of other specific vulnerable populations
    In case the subject is unable to read or write, legal representative signature will be required.
    Si el sujeto no puede leer or escribir, se requerirá firma del representante legal
    F.4 Planned number of subjects to be included
    F.4.1In the member state15
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 89
    F.4.2.2In the whole clinical trial 160
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    None
    Ninguno
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2021-10-26
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-09-22
    P. End of Trial
    P.End of Trial StatusOngoing
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