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    Summary
    EudraCT Number:2020-005822-27
    Sponsor's Protocol Code Number:BLU-945-1101
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2021-07-08
    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 number2020-005822-27
    A.3Full title of the trial
    A Phase 1/2 Study Targeting Acquired Resistance Mechanisms in Patients with EGFR Mutant Non-Small Cell Lung Cancer
    Estudio de fase 1/2 de los mecanismos de resistencia adquirida en pacientes con cáncer de pulmón no microcítico con mutaciones de EGFR
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Phase 1/2 Study Targeting EGFR Resistance Mechanisms in NSCLC
    Estudio de fase 1/2 de los mecanismos de resistencia a anti-EGFR en el CPNM
    A.4.1Sponsor's protocol code numberBLU-945-1101
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04862780
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorBlueprint Medicines Corporation
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportBlueprint Medicines Corporation
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationBlueprint Medicines Corporation
    B.5.2Functional name of contact pointMedical Information
    B.5.3 Address:
    B.5.3.1Street Address45 Sidney Street
    B.5.3.2Town/ cityCambridge
    B.5.3.3Post codeMA 02139
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1 617-714-6707
    B.5.6E-mailmedinfo@blueprintmedicines.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameBLU-945
    D.3.4Pharmaceutical form Capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNBLU-945
    D.3.9.3Other descriptive nameBLU-945
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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 No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameBLU-945
    D.3.4Pharmaceutical form Capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNBLU-945
    D.3.9.3Other descriptive nameBLU-945
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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 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
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    EGFR Mutant Non-Small Cell Lung Cancer
    Cáncer de pulmón no micrócitico con mutaciones en el EGFR
    E.1.1.1Medical condition in easily understood language
    EGFR Mutant Non-Small Cell Lung Cancer
    Cáncer de pulmón no micrócitico con mutaciones en el EGFR
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10059515
    E.1.2Term Non-small cell lung cancer metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Phase 1:
    - To determine the MTD and RP2D of BLU 945.
    - To determine the safety and tolerability of BLU 945.
    Phase 2:
    - To assess anticancer activity of BLU 945 at the RP2D in patients with NSCLC harboring EGFR resistance mutations T790M and/or C797S
    Fase 1
    • Determinar la DMT y la DRF2 de BLU 945.
    • Evaluar la seguridad y la tolerabilidad de BLU 945.
    Fase 2
    • Evaluar la actividad antineoplásica (TRO) de BLU 945 con la DRF2 en pacientes con CPNM portadores de las mutaciones de resistencia EGFR T790M y/o C797S.
    E.2.2Secondary objectives of the trial
    Phase 1:
    - To assess anticancer activity
    - To characterize the PK profile of BLU 945 and correlate drug exposure with safety assessments .
    - Assess treatment-induced modulation of EGFR pathway biomarkers.
    Phase 2:
    - To assess additional measures of anticancer activity of BLU 945 at the RP2D in patients with NSCLC harboring EGFR resistance mutations T790M and/or C797S
    - To determine the safety and tolerability of BLU 945.
    - To assess the effect of BLU 945 on cardiovascular intervals, including QT, and rhythm
    - To characterize the PK profile of BLU 945 and correlate drug exposure with safety assessments, including changes in ECG intervals and antitumor activity
    - Assess treatment-induced modulation of EGFR pathway biomarkers.
    Fase 1: Evaluar la actividad antineoplásica (TRO y duración de la respuesta [DR]). •Caracterizar el perfil FC de BLU 945 y correlacionar la exposición al fármaco con las evaluaciones de la seguridad. •Evaluar la modulación de los biomarcadores de la vía del EGFR.
    Fase 2: Evaluar medidas adicionales de la actividad antineoplásica de BLU 945 con la DRF2 en pacientes con CPNM portadores de las mutaciones de resistencia EGFR T790M y/o C797S •Evaluar la seguridad y la tolerabilidad de BLU 945•Evaluar el efecto de BLU 945 sobre los intervalos cardíacos, incluidos QT y ritmo •Caracterizar el perfil FC de BLU-945 y correlacionar la exposición al fármaco con las evaluaciones de la seguridad, incluidos los cambios de los intervalos en el ECG, y con la actividad antineoplásica •Perfil de cambios farmacodinámicos en los niveles de expresión de los biomarcadores de la vía del EGFR
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1.≥18 years of age at the time of signing the informed consent.
    2.Pathologically confirmed, definitively diagnosed, metastatic NSCLC harboring an activating EGFR mutation.
    3.Previously received at least 1 prior EGFR-targeted TKI. For patients enrolled to expansion Group 2, prior treatment must include an approved EGFR-targeted TKI with activity against the T790M mutation, such as osimertinib.
    4.EGFR mutation profile determined locally via a Sponsor-approved testing methodology, using either tumor tissue (ideally from a progressing lesion) and/or ctDNA in plasma. It is preferable that samples used for analysis be obtained during or after disease progression on the last EGFR-targeted TKI received.
    a.Dose escalation: At each dose level, slots may be reserved for patients with the mutations of interest.
    b.Expansion Groups: Patients must have NSCLC harboring EGFR T790M and C797S mutation (Group 1); EGFR T790M but not C797S (Group 2); or EGFR C797S but not T790M (Group 3).
    5.Pretreatment tumor sample (either an archival sample or a sample obtained by pretreatment biopsy) submitted for central analysis. It is preferable that pretreatment tumor samples be obtained from a progressing lesion, during or after disease progression on the last EGFR-targeted TKI received. Patients without archival tissue available, where biopsy is not considered safe and/or medically feasible, may be discussed with the study medical monitor and may be approved for enrollment on a case-by-case basis.
    6.Phase 2 Expansion Groups: Patient has at least 1 measurable target lesion evaluable by RECIST 1.1 as assessed by the investigator.
    7.Eastern Cooperative Oncology Group (ECOG) performance status is 0 2.
    8. Agrees to use contraception consistent with local regulations.
    1. Edad ≥ 18 años en el momento de la firma del consentimiento informado.
    2. CPNM metastásico confirmado anatomopatológicamente, diagnosticado de forma definitiva, con una mutación activadora del EGFR.
    3. Tratamiento previo con al menos 1 TKI dirigido al EGFR. En los pacientes incluidos en el grupo 2 de ampliación, el tratamiento previo debe incluir un TKI dirigido al EGFR aprobado con actividad contra la mutación T790M, como osimertinib.
    4. Perfil mutacional de EGFR determinado localmente mediante un método de análisis aprobado por el promotor, utilizando tejido tumoral (idealmente de una lesión en progresión) y/o ADNtc en plasma. Es preferible que las muestras utilizadas para el análisis se obtengan durante o después de la progresión de la enfermedad con el último TKI dirigido al EGFR que haya recibido el paciente.
    a. Escalada de la dosis: Podrán reservarse plazas para pacientes con las mutaciones de interés en cada nivel de dosis.
    b. Grupos de ampliación: Los pacientes deben tener CPNM con las mutaciones EGFR T790M y C797S (grupo 1), EGFR T790M pero no C797S (grupo 2) o EGFR C797S pero no T790M (grupo 3).
    5. Muestra tumoral previa al tratamiento (muestra de archivo o una muestra obtenida mediante biopsia antes del tratamiento) enviada para análisis central. Es preferible que las muestras previas al tratamiento se obtengan de una lesión en progresión, durante o después de la progresión de la enfermedad con el último TKI dirigido al EGFR que haya recibido el paciente. Los casos de pacientes que no tengan tejido de archivo disponible, cuando la biopsia no se considere segura y/o médicamente viable, podrán consultarse con el monitor médico del estudio y ser aprobados para su inclusión caso por caso.
    6. Los pacientes incluidos en dosis que previsiblemente originen niveles de exposición eficaces (se prevé que sean ≥ 100 mg una vez al día, aunque el promotor podrá modificar este requisito basándose en los datos FC y clínicos emergentes) deberán dar su consentimiento para una biopsia durante el tratamiento, para el envío de una muestra de tumor a un laboratorio central. Con la aprobación del promotor, podrá omitirse la biopsia durante el tratamiento en los pacientes en quienes el investigador considere que la biopsia no sería segura o viable. La obtención de estas muestras tumorales podrá suspenderse en determinadas cohortes de aumento de la dosis o grupos de ampliación, si el promotor determina que se han obtenido datos suficientes.
    7. Grupos de ampliación de la fase 2: El paciente tiene al menos una lesión diana mensurable evaluable según los criterios RECIST 1.1, según la valoración del investigador.
    8. Estado funcional del Eastern Cooperative Oncology Group (ECOG) de 0-2.
    9. El paciente o su tutor legal otorga el consentimiento informado para participar en el estudio.
    E.4Principal exclusion criteria
    1.Tumor harbors any additional known primary driver alterations including but not limited to pathologic abnormalities of EGFR exon 20, KRAS, BRAF V600E, NTRK1/2/3, HER2, ALK, ROS1, MET, or RET.
    2.NSCLC with mixed squamous cell histology as well as tumors with histologic transformation (NSCLC to SCLC and with epithelial to mesenchymal transition).
    3.Received the following anticancer therapy:
    a.EGFR-targeted TKI within 7 days prior to the first dose of study drug.
    b.Any immunotherapy or other antibody therapy (including EGFR-targeted antibodies or bi-specific antibodies) within 28 days prior to the first dose of study drug (immune-related toxicities must have resolved to < Grade 2 prior to starting BLU 945).
    c.Any other systemic anticancer therapy within 14 days or 5 half-lives prior to the first dose of study drug, whichever is the shortest, but with a minimum of 7 days in all circumstances. BLU 945 may be started within these washout periods if considered by the Investigator to be safe and within the best interest of the patient, with prior Sponsor approval.
    d.Radiotherapy to a large field or including a vital organ (including whole brain radiotherapy or stereotactic radiosurgery to brain) within 14 days before the first dose of study drug. Participant received radiotherapy to a focal site of disease that did not include a vital organ (such as a limb) within 7 days before the first dose of study drug.
    4.CNS metastases or spinal cord compression that is associated with progressive neurological symptoms or requires increasing doses of corticosteroids to control the CNS disease. If a patient requires corticosteroids for management of CNS disease, the dose must have been stable for the 2 weeks preceding treatment. Asymptomatic untreated CNS and leptomeningeal disease is allowed and, when measurable, should be captured as target lesions.
    5.Any of the following abnormalities on the latest laboratory test prior to the first dose of study drug (ie, within 7 days prior to Cycle 1 Day 1 [C1D1]):
    a.Absolute neutrophil count (ANC) <1.0×10^9/L.
    b.Platelet count <75×10^9/L.
    c.Hemoglobin ≤8.0 g/dL (red blood cell transfusion and erythropoietin may be used to reach at least 8.0 g/dL, but must have been administered at least 2 weeks prior to the first dose of study drug).
    d.Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >3× the upper limit of normal (ULN) if no hepatic metastases are present; >5× ULN if hepatic metastases are present.
    e.Total bilirubin >1.5× ULN; >3× ULN in presence of Gilbert’s disease.
    f.Estimated (Cockroft-Gault formula, Appendix 1) or measured creatinine clearance <40 mL/min.
    g.International normalized ratio (INR) >2.3 or prothrombin time (PT) >6 seconds above control or a patient-specific INR or PT abnormality that the treating investigator considers clinically relevant and/or increases the risk for hemorrhage in that individual patient.
    6.Known intracranial hemorrhage and/or bleeding diatheses.
    7.Clinically active ongoing interstitial lung disease (ILD) of any etiology, including drug-induced ILD, and radiation pneumonitis within 28 days prior to initiation of study treatment. Patients with prior ILD associated with clinically resolved COVID 19 infection may be enrolled upon discussion with, and approval by, the Medical Monitor.
    8.Any unresolved toxicities from prior therapy greater than Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 or that have not resolved to baseline at the time of starting study. Exceptions include alopecia and fatigue, and, upon discussion with and approval by the Medical Monitor, other toxicities that are not thought to present a risk to patient safety.
    9.Mean resting QT interval corrected using Fridericia’s formula (QTcF) >470 msec, a history of prolonged QT syndrome or Torsades de pointes, or a familial history of prolonged QT syndrome.
    10.Clinically significant, uncontrolled, cardiovascular disease including congestive heart failure Grade III or IV according to the New York Heart Association classification; myocardial infarction or unstable angina within the previous 6 months, uncontrolled hypertension, or clinically significant, uncontrolled arrhythmias, including bradyarrhythmia that may cause QT prolongation (eg, Type II second degree heart block or third degree heart block).
    Please, further information can be found in section 5.3 of the protocol.
    1. El tumor alberga otras alteraciones inductoras primarias conocidas, incluidas, entre otras, anomalías anatomopatológicas del exón 20 de EGFR, KRAS, BRAF V600E, NTRK1/2/3, HER2, ALK, ROS1, MET o RET
    2. CPNM de histología epidermoide mixta y tumores con transformación histológica (CPNM a cáncer de pulmón microcítico [CPM] y con transición de epitelial a mesenquimatoso)
    3. Recepción del siguiente tratamiento antineoplásico:
    a. TKI dirigido al EGFR en los 7 días previos a la primera dosis del fármaco del estudio.
    b. Cualquier inmunoterapia u otro tratamiento con anticuerpos (incluidos anticuerpos dirigidos contra el EGFR o anticuerpos biespecíficos) en los 28 días previos a la primera dosis del fármaco del estudio (las toxicidades de tipo inmunitario deben haberse resuelto a un grado < 2 antes de iniciar el tratamiento con BLU 945).
    c. Cualquier otro tratamiento antineoplásico sistémico en los 14 días previos o 5 semividas previas a la primera dosis del fármaco del estudio, lo que sea menos tiempo, pero con un mínimo de 7 días en cualquier caso. El tratamiento con BLU 945 podrá iniciarse dentro de estos períodos de lavado si el investigador considera que seguro y lo más conveniente para el paciente, con la aprobación previa del promotor.
    d. Radioterapia en un campo de gran tamaño o que incluya un órgano vital (como radioterapia cerebral total o radiocirugía estereotáctica cerebral) en los 14 días previos a la primera dosis del fármaco del estudio. Recepción de radioterapia en un foco de enfermedad que no incluya un órgano vital (como una extremidad) en los 7 días previos a la primera dosis del fármaco del estudio.
    4. Metástasis en el sistema nervioso central (SNC) o compresión de la médula espinal asociada a síntomas neurológicos progresivos o que requiera dosis crecientes de corticosteroides para controlar la enfermedad del SNC. Si un paciente necesita corticosteroides para el control de la enfermedad del SNC, la dosis deberá haberse mantenido estable durante las 2 semanas previas al tratamiento. Se permiten la enfermedad del SNC y la enfermedad leptomeníngea asintomáticas no tratadas y, cuando sean mensurables, deberán registrarse como lesiones diana.
    5. Cualquiera de las siguientes anomalías en el último análisis previo a la primera dosis del fármaco del estudio (es decir, en los 7 días previos al día 1 del ciclo 1 [D1C1]): a.Recuento absoluto de neutrófilos (RAN) < 1,0 × 10^9 /l.
    b. Recuento de plaquetas < 75 × 10^9l. c.Hemoglobina ≤ 8,0 g/dl (pueden utilizarse transfusión de eritrocitos y eritropoyetina para alcanzar el valor mínimo de 8,0 g/dl, pero deben haberse administrado al menos 2 semanas antes de la primera dosis del fármaco del estudio). d.Aspartato aminotransferasa (AST) o alanina aminotransferasa (ALT) > 3 × el límite superior de la normalidad (LSN) si no hay metástasis hepáticas; > 5 × LSN si hay metástasis hepáticas. e. Bilirrubina total >1,5 × LSN; >3× LSN en presencia de enfermedad de Gilbert. f. Aclaramiento de creatinina estimado (fórmula de Cockroft-Gault, apéndice 1) o medido <40 ml/min. g. Cociente internacional normalizado (INR) > 2,3 o tiempo de protrombina (TP) > 6 segundos por encima del valor de control o una anomalía del INR o el TP específica del paciente que el investigador responsable del tratamiento considere clínicamente relevante y/o que aumenta el riesgo de hemorragia en ese paciente individual.
    6. Hemorragia intracraneal y/o diátesis hemorrágica conocidas.
    7. Enfermedad pulmonar intersticial (EPI) clínicamente activa de cualquier etiología, incluidas EPI inducida por fármacos y neumonitis por radiación, en los 28 días previos al inicio del tratamiento del estudio. Los pacientes con una EPI previa asociada a infección por COVID-19 y clínicamente resuelta podrán ser reclutados previa consulta con el monitor médico y con la aprobación de este.
    8. Cualquier toxicidad no resuelta derivada del tratamiento previo y superior al grado 1 de los Criterios terminológicos comunes para acontecimientos adversos (CTCAE) o que no se haya resuelto hasta el estado basal en el momento de iniciar el estudio. Las excepciones son la alopecia y la fatiga y, tras una consulta con el monitor médico y con su aprobación, otras toxicidades que no se considere que supongan un riesgo para la seguridad del paciente.
    9. Intervalo QT medio en reposo corregido con la fórmula de Fridericia (QTcF) > 470 ms, antecedentes de síndrome de QT prolongado o torsades de pointes, o antecedentes familiares de síndrome de QT prolongado.
    Para mayor informacion, dirijase a la seccion 5.3 del protocolo
    E.5 End points
    E.5.1Primary end point(s)
    Phase 1:
    - MTD determination: DLT rate
    - RP2D determination: DLT, PK, PD, and preliminary safety and anticancer activity data
    -Overall safety profile of BLU-945, as assessed by the type, frequency, severity, timing, and relationship to study drug of adverse events (AEs), and changes in vital signs, electrocardiograms, safety laboratory tests, and ECOG performance status.
    Phase 2:
    - ORR, defined as the proportion of patients who experience a best response of confirmed CR or PR according to RECIST 1.1
    Fase 1
    • Determinación de la DMT: tasa de TLD
    • Determinación de la DRF2: TLD, FC, FD y datos preliminares de seguridad y actividad antineoplásica
    • Evaluar el perfil general de seguridad de BLU-945, frecuencia, gravedad, momento y relación con el fármaco en estudio de eventos adversos (EA) y cambios en los signos vitales, electrocardiogramas, pruebas de laboratorio de seguridad y estado funcional ECOG.

    Fase 2:
    • TRO, definida como la proporción de pacientes que presentan una mejor respuesta de RC o RP confirmada según los criterios RECIST 1.1.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Phase 1:
    - MTD determination: Up to 12 months
    - RP2D determination: Up to 12 months
    -Overall safety profile of BLU-945: Throughout Phase 1

    Phase 2:
    - ORR: Up to 30 months
    Fase 1:
    - Determinación de DMT: hasta 12 meses.
    - Determinación de DRF2 hasta 12 meses.
    -Perfil de seguridad general de BLU-945: a lo largo de la Fase 1

    Fase 2:
    - TRO: hasta los 30 meses
    E.5.2Secondary end point(s)
    Phase 1:
    - ORR, defined as the proportion of patients who experience a best response of confirmed CR or PR according to RECIST 1.1

    Phase 2:
    - DCR, defined as the proportion of patients who experience a best response of CR, PR, or stable disease (SD) according to RECIST 1.1
    - CBR, defined as the proportion of patients who experience a confirmed CR or PR, or SD with a duration of at least 16 weeks according to RECIST 1.1
    - PFS, defined as the time from the first dose of BLU 945 until the date of first documented progressive disease or death due to any cause, whichever occurs first
    - Overall survival (OS), defined as the time from the first dose of BLU 945 until the date of death due to any cause
    - Time to intracranial progression and intracranial response rate in accordance with modified RECIST criteria
    - Overall safety profile of BLU 945, as assessed by the type, frequency, severity, timing, and relationship to study drug of adverse events (AEs), and changes in vital signs, electrocardiograms, safety laboratory tests, and ECOG performance status.
    - ECG parameters extracted from continuous 12 lead Holter recordings for 25 patients in the expansion phase: The primary QTc parameter will be QTcF. Secondary parameters (other correction methods for QT, heart rate, PR, QRS, and T wave morphology) will also be evaluated.

    Phase 1 and Phase 2:
    - DOR, defined as the time from first documented response of CR or PR to the date of first documented progressive disease or death due to any cause, whichever occurs first
    - PK parameters of BLU-945
    - Profile pharmacodynamic changes in the EGFR pathway biomarker expression levels of dual specificity phosphatase (DUSP6) and sprouty RTK signaling antagonist 4 (SPRY4).
    Fase 1:
    • TRO, definida como la proporción de pacientes que presentan una mejor respuesta de RC o RP confirmada según los criterios RECIST 1.1.

    Fase 2:
    • TCE, definida como la proporción de pacientes que presentan una mejor respuesta de RC, RP o enfermedad estable (EE) según los criterios RECIST 1.1.
    • TBC, definida como la proporción de pacientes que presentan RC o RP confirmadas o EE con una duración de al menos 16 semanas según los criterios RECIST 1.1.
    • SSP, definida como el tiempo transcurrido desde la primera dosis de BLU-945 hasta la fecha de la primera progresión documentada de la enfermedad o la muerte por cualquier causa, lo que ocurra antes.
    • Supervivencia global (SG), definida como el tiempo transcurrido desde la primera dosis de BLU-945 hasta la fecha de la muerte por cualquier causa.
    • Tiempo hasta la progresión intracraneal y tasa de respuesta intracraneal de acuerdo con los criterios REC'IST modificados.
    • Parámetros ECG extraídos de registros continuos Holter de 12 derivaciones de 25 pacientes de la fase de ampliación: El parámetro principal de QTc será el QTcF. Se evaluarán también parámetros secundarios (otros métodos de corrección del QT, frecuencia cardíaca, PR, QRS y morfología de la onda T).

    Fase 1 y 2:
    • DR, definida como el tiempo transcurrido desde la primera respuesta de RC o RP documentada hasta la fecha de la primera progresión documentada de la enfermedad o la muerte por cualquier causa, lo que ocurra antes.
    • Parámetros farmacocinéticos de BLU-945
    • Perfil de cambios farmacodinámicos en los niveles de expresión de los biomarcadores de la vía del EGFR (fosfatasa de doble especificidad [DUSP6] y antagonista de la señalización de RTK Sprouty 4 [SPRY4]).
    E.5.2.1Timepoint(s) of evaluation of this end point
    Phase 1:
    - ORR: Up to 12 months
    Phase 2:
    -DCR and CBR: Up to 30 months
    -PFS and OS: Up to 42 months
    -Time to intracranial progression and intracranial response rate: Up to 42 months
    -Overall safety profile: Up to 42 months
    -ECG parameters: Up to 25 months

    Phase 1 and Phase 2:
    -DOR: Up to 42 months
    -PK parameters: Up to 42 months
    -Profile pharmacodynamic changes in the EGFR pathway biomarker expression of DUSP6 and SPRY4: Up to 42 months
    Fase 1:
    • TRO: hasta los 12 meses
    Fase 2:
    • TCE, y TBC: hasta los 30 meses
    • SG y SSP: hasta los 42 meses
    • Tiempo hasta la progresión intracraneal y tasa de respuesta: hasta los 42 meses
    • Perfil de seguridad global: hasta los 42 meses
    • Parámetros ECG: hasta los 25 meses

    Fase 1 y Fase 2:
    -DR: hasta los 42 meses
    -Parametros PK: hasta los 42 meses
    - Perfil de cambios farmacodinámicos en los niveles de expresión de los biomarcadores de la vía del EGFR (DUSP6 y antagonista de la señalización de RTK Sprouty 4 [SPRY4]): hasta los 42 meses
    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 No
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    E.7.1.1First administration to humans Yes
    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 No
    E.8.1.2Open Information not present in EudraCT
    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 trial3
    E.8.3 The trial involves single site in the Member State concerned Yes
    E.8.4 The trial involves multiple sites in the Member State concerned No
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA6
    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
    Canada
    Japan
    Korea, Republic of
    Singapore
    Taiwan
    United States
    France
    Germany
    Netherlands
    Spain
    United Kingdom
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    LPLV
    Ultimo Paciente Ultima Visita
    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 days
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months6
    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: 76
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 45
    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 state3
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 19
    F.4.2.2In the whole clinical trial 120
    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)
    If supported by appropriate clinical rationale, adequate drug supply, and establishment of appropriate mechanisms for continued provision of BLU-945 patients who remain on treatment at end of study may be allowed to continue receiving BLU-945 until disease progression or other criteria for discontinuation of treatment are met or commercial availability of BLU-945.
    Si está respaldado por una justificación clínica adecuada, el suministro adecuado de medicamentos y el establecimiento de mecanismos apropiados para la administración continua de BLU-945, los pacientes que permanecen en tratamiento al final del estudio pueden continuar recibiendo BLU-945 hasta la progresión de la enfermedad u otros criterios para suspender tratamiento o disponibilidad comercial de BLU-945.
    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 Decision2021-10-22
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-09-03
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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