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    Summary
    EudraCT Number:2021-000203-20
    Sponsor's Protocol Code Number:MCLA-129-CL01
    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:2021-12-30
    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 number2021-000203-20
    A.3Full title of the trial
    Phase 1/2 dose escalation and expansion study evaluating MCLA-129, a human anti-EGFR and anti-c-MET bispecific antibody, in patients with advanced NSCLC and other solid tumors
    Studio di fase 1/2 di incremento della dose ed espansione volto a valutare MCLA-129, un anticorpo bispecifico umano anti-EGFR e anti-c-MET, in pazienti con carcinoma polmonare non a piccole cellule (NSCLC) avanzato e altri tumori solidi
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Phase 1/2 study of MCLA-129 in patients with NSCLC and other solid tumors
    Studio di fase 1/2 su MCLA-129 in pazienti con carcinoma polmonare non a piccole cellule (NSCLC) e altri tumori solidi
    A.3.2Name or abbreviated title of the trial where available
    -
    -
    A.4.1Sponsor's protocol code numberMCLA-129-CL01
    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 SponsorMERUS N.V.
    B.1.3.4CountryNetherlands
    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 supportMerus N.V.
    B.4.2CountryNetherlands
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMerus N.V.
    B.5.2Functional name of contact pointMCLA-129-CL01 Project Manager
    B.5.3 Address:
    B.5.3.1Street AddressYalelaan 62
    B.5.3.2Town/ cityUtrecht
    B.5.3.3Post code3584 CM
    B.5.3.4CountryNetherlands
    B.5.4Telephone number+31611288794
    B.5.6E-mailE.Wasserman@merus.nl
    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 name-
    D.3.2Product code [MCLA-129]
    D.3.4Pharmaceutical form 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 INNMCLA-129
    D.3.9.2Current sponsor codeMCLA-129
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    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) 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 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
    Advanced NSCLC and other solid tumors
    Carcinoma polmonare non a piccole cellule (NSCLC) avanzato e altri tumori solidi
    E.1.1.1Medical condition in easily understood language
    Advanced NSCLC and other solid tumors
    Carcinoma polmonare non a piccole cellule (NSCLC) avanzato e altri tumori solidi
    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 10061873
    E.1.2Term Non-small cell lung cancer
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10049280
    E.1.2Term Solid tumour
    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
    Primary Objective
    • To determine the maximum tolerated dose (MTD) and/or recommended phase 2 dose (RP2D) of single-agent MCLA-129 in patients with NSCLC, GC/GEJ adenocarcinoma, HNSCC or ESCC, with disease progression after prior therapy for advanced/metastatic disease.

    Phase 2
    Primary Objective
    • To evaluate the ORR in molecularly defined populations of advanced/metastatic solid tumors including NSCLC, GC/GEJ adenocarcinoma, and other selected solid tumors selected according to their molecular profile.
    Fase 1
    Obiettivo primario
    • Determinare la dose massima tollerata (MTD) e/o la dose raccomandata per la fase 2 (RP2D) di MCLA-129 come singolo agente in pazienti con NSCLC, adenocarcinoma GC/GEJ, HNSCC o ESCC, con progressione della malattia dopo una precedente terapia per malattia avanzata/metastatica.

    Fase 2
    Obiettivo primario
    • Valutare l’ORR in popolazioni con tumori solidi in stadio avanzato/metastatico, tra cui NSCLC, adenocarcinoma GC/GGE e altri tumori solidi selezionati in base al loro profilo molecolare.
    E.2.2Secondary objectives of the trial
    Phase 1
    Secondary Objectives
    • To evaluate preliminary antitumor activity in terms of best overall response (BOR), overall response rate (ORR), disease control rate (DCR), and duration of response (DoR).
    • To evaluate progression-free survival (PFS) and overall survival (OS).
    • To characterize the pharmacokinetics (PK) of MCLA-129 including development of a population PK model.
    • To assess changes in cytokines following administration of MCLA-129.
    • To assess the immunogenicity of MCLA-129.

    Phase 2
    Secondary Objectives
    • To evaluate preliminary antitumor activity in terms of BOR, DCR, and DoR.
    • To evaluate PFS and OS.
    • To characterize the safety and tolerability of MCLA-129 at the RP2D.
    • To characterize the PK of MCLA-129 including development of a population PK model.
    • To assess the immunogenicity of MCLA-129.
    Fase 1
    Obiettivi secondari
    • Valutare l’attività antitumorale preliminare in termini di migliore risposta complessiva (BOR), tasso di risposta complessiva (ORR), tasso di controllo della malattia (DCR) e durata della risposta (DoR).
    • Valutare la sopravvivenza libera da progressione (PFS) e la sopravvivenza globale (OS).
    • Caratterizzare la farmacocinetica (PK) di MCLA-129 e sviluppare un modello PK di popolazione.
    • Valutare le variazioni nelle citochine post-somministrazione di MCLA-129.
    • Valutare l’immunogenicità di MCLA-129.

    Fase 2
    Obiettivi secondari
    • Valutare l’attività antitumorale preliminare in termini di BOR, DCR e DoR.
    • Valutare la PFS e l’OS.
    • Caratterizzare la sicurezza e la tollerabilità di MCLA-129 alla RP2D.
    • Caratterizzare la PK di MCLA-129 e sviluppare un modello PK di popolazione.
    • Valutare l’immunogenicità di MCLA-129.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Signed informed consent before initiation of any study procedures.
    2. Age >=18 years at signature of informed consent.
    3. Histologically or cytologically confirmed solid tumors with evidence of metastatic or locally advanced unresected disease that is incurable:
    • Dose Escalation Part - Patients who have failed prior standard first-line treatment. Patients must have progressed on or be intolerant to therapies that are known to provide clinical benefit. There is no limit to the number of prior treatment regimens. Patients must have:
    - Non-small cell lung cancer (NSCLC) harboring activating EGFR mutations including tyrosine kinase inhibitor (TKI) sensitizing mutations (e.g., 19del and L858R), and/or approved TKI-resistance mutations (e.g., acquired TKI-resistance mutations, i.e., T790M, C797S, L792, L798I, exon 20 insertion), or any activating c-MET mutation/amplification (e.g., high-level c-MET amplification [MET/CEP7 >5 or cfDNA >=2 copies], or c-MET exon 14 skipping mutation).
    - Gastric/gastroesophageal junction (GC/GEJ) adenocarcinoma harboring an EGFR amplification (EGFR/CEP7 >=2 or cfDNA >=8 copies) or c-MET amplification (MET/CEP7 >5 or cfDNA >=2 copies).
    - Head and neck squamous cell cancer (HNSCC) or esophageal squamous cell cancer (ESCC).
    *NOTE: Patient identification will be based on previous treatment history with EGFR tyrosine kinase inhibitors and on local tests performed in CLIA-certified laboratories.
    • Cohort Expansion Part - Patients who have failed prior standard first-line treatment. Patients must have progressed on or be intolerant to therapies that are known to provide clinical benefit. There is no limit to the number of prior treatment regimens. Patients must have:
    - Cohort A: NSCLC harboring EGFR exon 20 insertions. Patients who have received a prior EGFR TKI or who are TKI-naïve are eligible.
    - Cohort B: NSCLC harboring acquired EGFR C797S TKI resistance.
    - Cohort C: NSCLC harboring a c-MET amplification (c-MET/CEP7 >5 copies or cfDNA >=2 copies).
    - Cohort D: GC/GEJ adenocarcinoma or other selected solid tumors harboring an EGFR amplification (EGFR/CEP7 >=2 or cfDNA >=8 copies) or c-MET amplification (MET/CEP7 >5 copies or cfDNA >=2 copies).
    *NOTE: Patient identification will be based on local tests performed in CLIA-certified laboratories or on commercial diagnostics (e.g., FoundationOne). Genetic aberrations in EGFR or c-MET will be retrospectively confirmed by central testing using a validated assay.
    4. Availability of archival or a fresh tumor tissue sample.
    5. Measurable disease as defined by RECIST version 1.1 by radiologic methods.
    6. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
    7. Life expectancy >=12 weeks, as per Investigator.
    8. Adequate organ function:
    • Absolute neutrophil count (ANC) >=1.5 X 109/L
    • Hemoglobin >=9 g/dL
    • Platelets >=100 x 109/L
    • Corrected total serum calcium within normal ranges
    • Serum magnesium within normal ranges (or corrected with supplements)
    • Alanine aminotransferase (ALT), aspartate aminotransferase (AST) <=3 x upper limit of normal (ULN) and total bilirubin <=1.5 x ULN (patients with Gilbert's syndrome are eligible if conjugated bilirubin value is within normal limits); in cases of liver involvement, ALT/AST <=5 x ULN and total bilirubin <=2 x ULN will be allowed
    • Serum creatinine <=1.5 x ULN or creatinine clearance >=50 mL/min calculated according to the Cockroft and Gault formula or MDRD formula for patients aged >65 years
    • Serum albumin >3.3 g/dL.
    1. Consenso informato firmato prima dell’inizio di tutte le procedure dello studio.
    2. Età >=18 anni al momento della firma del modulo di consenso informato.
    3. Tumori solidi istologicamente o citologicamente confermati, con evidenza di malattia metastatica o localmente avanzata non resecata e che non sia curabile:
    • Parte di incremento della dose - Pazienti che non hanno risposto a un precedente trattamento standard di prima linea. I pazienti devono aver manifestato progressione o essere intolleranti alle terapie note per fornire un beneficio clinico. Non vi è alcun limite in relazione al numero dei precedenti regimi di trattamento. I pazienti devono avere:
    - Tumore polmonare non a piccole cellule (NSCLC) con mutazioni di EGFR attivanti, tra cui mutazioni sensibilizzanti dell’inibitore della tirosin-chinasi (TKI) (per es. 19del e L858R) e/o mutazioni di resistenza ai TKI approvate (per es. mutazioni acquisite della resistenza ai TKI, ovvero T790M, C797S, L792 e L798I, inserzione dell’esone 20), o qualsiasi mutazione/amplificazione di c-MET attivante (per es., amplificazione di c-MET di alto livello [MET/CEP7 >5 o cfDNA >=2 copie] o mutazione di salto dell’esone 14 di c-MET).
    - Adenocarcinoma gastrico/della giunzione gastroesofagea (GC/GEJ) con amplificazione di EGFR (EGFR/CEP7 >=2 o cfDNA >=8 copie) o amplificazione di c-MET (MET/CEP7 >5 o cfDNA >=2 copie).
    - Tumore a cellule squamose di testa e del collo (HNSCC) o tumore a cellule squamose dell’esofago (ESCC).
    *NOTA: l’identificazione del paziente si baserà sull’anamnesi del trattamento precedente con inibitori tirosin-chinasici dell’EGFR e su test locali eseguiti presso laboratori certificati CLIA.
    • Parte di espansione della coorte - Pazienti che non hanno risposto al precedente trattamento standard di prima linea. I pazienti devono aver manifestato progressione o essere intolleranti alle terapie note per fornire un beneficio clinico. Non vi è alcun limite in relazione al numero dei precedenti regimi di trattamento. I pazienti devono avere:
    - Coorte A: NSCLC con inserzioni nell’esone 20 di EGFR. I pazienti che hanno ricevuto un precedente EGFR TKI o che sono naïve ai TKI sono idonei.
    - Coorte B: NSCLC con resistenza C797S acquisita a EGFR TKI.
    - Coorte C: NSCLC con amplificazione di c-MET (c-MET/CEP7 >5 copie o cfDNA >=2 copie).
    - Coorte D: adenocarcinoma GC/GEJ o altri tumori solidi selezionati che presentano un’amplificazione di EGFR (EGFR/CEP7 >=2 o cfDNA >=8 copie) o amplificazione di c-MET (MET/CEP7 >5 copie o cfDNA >=2 copie).
    *NOTA: l’identificazione del paziente si baserà sui test locali eseguiti presso laboratori certificati CLIA o sulla diagnostica commerciale (per es., FoundationOne). Le aberrazioni genetiche in EGFR o c-MET saranno confermate retrospettivamente mediante test centralizzato utilizzando un test convalidato.
    4. Disponibilità di un campione di tessuto tumorale d’archivio o fresco.
    5. Malattia misurabile definita secondo i criteri RECIST versione 1.1 mediante metodi radiologici.
    6. Stato di validità fisica dell’Eastern Cooperative Oncology Group (ECOG) di 0 o 1.
    7. Aspettativa di vita >=12 settimane, secondo lo Sperimentatore.
    8. Funzione degli organi adeguata (si prega di fare riferimento al Protocollo causa limite di caratteri).
    E.4Principal exclusion criteria
    1. Central nervous system metastases that are untreated or symptomatic, or require radiation, surgery, or continued steroid therapy (>10 mg prednisone or equivalent) to control symptoms within 14 days of study entry.
    2. Known leptomeningeal involvement.
    3. Participation in another clinical study or treatment with any investigational drug within 4 weeks prior to study entry.
    4. Prior treatment with a bispecific EGFR-c-MET antibody.
    5. Systemic anticancer therapy or immunotherapy within 4 weeks or 5 half-lives, whichever is shorter, of the first dose of study drug. For cytotoxic agents that have major delayed toxicity (e.g., mitomycin C, nitrosoureas), a washout period of 6 weeks is required. Note: For agents with long half-lives, enrollment before the fifth half-life requires Sponsor approval.
    6. Major surgery or radiotherapy within 3 weeks of the first dose of study drug. Patients who received prior radiotherapy to >=25% of bone marrow at any time are not eligible.
    7. Persistent grade >1 clinically significant toxicities related to prior antineoplastic therapies (except for alopecia); stable sensory neuropathy <=grade 2 NCI-CTCAE v5.0 and hypothyroidism <=grade 2 which is stable on hormone replacement are allowed.
    8. History of hypersensitivity reaction or any toxicity attributed to human proteins or any of the excipients that warranted permanent cessation of these agents.
    9. History of clinically significant cardiovascular disease including, but not limited to:
    • Diagnosis of deep vein thrombosis or pulmonary embolism within 1 month prior to first dose of study drug, or any of the following within 6 months prior to the first dose of study drug: myocardial infarction, unstable angina, stroke, transient ischemic attack, coronary/peripheral artery bypass graft, or any acute coronary syndrome.
    • Prolonged QT interval >480 msec or clinically significant cardiac arrythmia or electrophysiologic disease (i.e., placement of implantable cardioverter defibrillator or atrial fibrillation with uncontrolled rate). Patients with cardiac pacemakers who are clinically stable are eligible.
    • Uncontrolled (persistent) arterial hypertension: systolic blood pressure >180 mm Hg and/or diastolic blood pressure >100 mm Hg.
    • Congestive heart failure defined as NYHA class III-IV or hospitalization for CHF within 6 months of the first dose of study drug.
    • Clinically significant pericardial effusion.
    • Myocarditis.
    10. History of interstitial lung disease including drug-induced interstitial lung disease, radiation pneumonitis that requires treatment with prolonged steroids or other immune suppressive agents within 1 year.
    11. Previous or concurrent malignancy, excluding non-basal cell carcinomas of skin or carcinoma in situ of the uterine cervix, unless the tumor was treated with curative or palliative intent and in the opinion of the Investigator, with Sponsor agreement, the previous or concurrent malignancy condition does not affect the assessment of safety and efficacy of the study drug.
    12. Current dyspnea at rest of any origin, or other diseases requiring continuous oxygen therapy.
    13. Current serious illness or medical conditions including, but not limited to uncontrolled active infection, clinically significant pulmonary, metabolic or psychiatric disorders.
    14. Active Hepatitis B infection (HBsAg positive) without receiving antiviral treatment. Note: Patients with active hepatitis B must receive antiviral treatment with lamivudine, tenofovir, entecavir, or other antiviral agents, starting at least >=7 days before the initiation of the study treatment. Patients with antecedents of Hepatitis B (anti-HBc positive, HbsAg and HBV-DNA negative) are eligible.
    15-17. Please refer to protocol due to characters' limit.
    1. Metastasi del sistema nervoso centrale non trattate o sintomatiche o che richiedono radioterapia, intervento chirurgico o terapia steroidea continua (>10 mg di prednisone o equivalente) per controllare i sintomi nei 14 giorni precedenti l’ingresso nello studio.
    2. Coinvolgimento leptomeningeo noto.
    3. Partecipazione a un altro studio clinico o trattamento con qualsiasi farmaco sperimentale nelle 4 settimane precedenti l’ingresso nello studio.
    4. Precedente trattamento con un anticorpo bispecifico per EGFR e c-MET.
    5. Terapia antitumorale sistemica o immunoterapia entro 4 settimane o 5 emivite, a seconda di quale sia il periodo più breve, prima della prima dose del farmaco dello studio. Per gli agenti citotossici con tossicità grave ritardata (per es., mitomicina C e nitrosouree), è necessario un periodo di washout di 6 settimane. Nota: per gli agenti con emivite lunghe, l’arruolamento prima della quinta emivita richiede l’approvazione dello Sponsor.
    6. Intervento di chirurgia maggiore o radioterapia entro 3 settimane dalla prima dose del farmaco dello studio. I pazienti che hanno ricevuto una precedente radioterapia a >=25% del midollo osseo in qualsiasi momento non sono idonei.
    7. Tossicità persistenti di grado >1 clinicamente significative correlate a precedenti terapie antineoplastiche (eccetto per l’alopecia); sono consentite neuropatia sensoriale stabile di grado <=2 secondo i criteri comuni di terminologia per gli eventi avversi del National Cancer Institute (NCI-CTCAE) v5.0 e ipotiroidismo di grado <=2 stabile in terapia ormonale sostitutiva.
    8. Anamnesi di reazione di ipersensibilità o qualsiasi tossicità attribuita alle proteine umane o a uno qualsiasi degli eccipienti che ha giustificato l’interruzione permanente di questi agenti.
    9. Anamnesi di malattia cardiovascolare clinicamente significativa, tra cui, a titolo esemplificativo ma non esaustivo:
    • Diagnosi di trombosi venosa profonda o embolia polmonare entro 1 mese prima della prima dose del farmaco dello studio o di uno qualsiasi dei seguenti eventi nei 6 mesi precedenti la prima dose del farmaco dello studio: infarto miocardico, angina instabile, ictus, attacco ischemico transitorio, innesto di bypass aortocoronarico/periferico o qualsiasi sindrome coronarica acuta.
    • Intervallo QT prolungato >480 msec o aritmia cardiaca o malattia elettrofisiologica clinicamente significativa (ovvero, posizionamento di defibrillatore cardioverter impiantabile o fibrillazione atriale con frequenza non controllata). Sono idonei i pazienti con pacemaker cardiaci clinicamente stabili.
    • Ipertensione arteriosa non controllata (persistente): pressione arteriosa sistolica >180 mmHg e/o pressione arteriosa diastolica >100 mmHg.
    • Insufficienza cardiaca congestizia (ICC) di classe III-IV secondo la New York Heart Association (NYHA) o ricovero per ICC nei 6 mesi precedenti la prima dose del farmaco dello studio.
    • Versamento pericardico clinicamente significativo.
    • Miocardite.
    10. Anamnesi di malattia polmonare interstiziale, tra cui malattia polmonare interstiziale indotta da farmaci, infiammazione polmonare da radiazioni che richiede trattamento con steroidi prolungati o con altri agenti immunosoppressori entro 1 anno.
    11. Tumore maligno pregresso o concomitante, esclusi i carcinomi cutanei non a cellule basali o carcinoma in situ del collo dell’utero, a meno che il tumore non sia stato trattato con intento curativo o palliativo e, in base all’opinione dello Sperimentatore, con il consenso dello Sponsor, la condizione di tumore maligno pregressa o concomitante non influisca sulla valutazione della sicurezza e dell’efficacia del farmaco dello studio.
    12. Attuale dispnea a riposo di qualsiasi origine o altre malattie che richiedono una terapia con ossigeno continua.
    13-17. Si prega di fare riferimento al protocollo a causa del limite di caratteri.
    E.5 End points
    E.5.1Primary end point(s)
    Phase 1
    Primary endpoint
    1. Incidence and severity of DLTs during Cycle 1.

    Phase 2
    Primary endpoint
    2. ORR per RECIST v.1.1 based on Investigator assessment.
    Fase 1
    Endpoint primario
    1. Incidenza e gravità delle DLT durante il Ciclo 1.

    Fase 2
    Endpoint primario
    2. ORR secondo i criteri RECIST v.1.1, in base alla valutazione dello Sperimentatore.
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. Cycle 1
    2. Along the study phase 2
    1. Ciclo 1
    2. Lungo la fase 2 dello studio
    E.5.2Secondary end point(s)
    Phase 1
    Secondary endpoints
    1. Safety: Incidence, severity and relationship of AEs and SAEs; incidence, severity and changes in laboratory values; measures and changes in ECG and vital signs.
    2. Tolerability: Discontinuations due to AEs, dose modifications due to AEs.
    3. Efficacy: BOR, ORR, DCR, DoR, PFS and OS, per RECIST v1.1 based on Investigator assessment.
    4. Pharmacokinetics: MCLA-129 concentration CEOI, Cmax, C0h and PK parameters including AUC, CL, Vss, tmax and t1/2 and to develop a population PK model.
    5. Immunogenicity: Incidence and serum titers of antidrug antibodies against MCLA-129.
    6. Cytokines: Change from baseline in systemic cytokines.

    Exploratory endpoints
    7. Biomarkers: Change from baseline in biomarkers, and correlative analyses of biomarkers with antitumor response.

    Phase 2
    Secondary endpoints
    8. Efficacy: BOR, DCR, DoR, PFS and OS, per RECIST v1.1 based on Investigator assessment.
    9. Safety: Incidence, severity and relationship of AEs and SAEs; incidence, severity and changes in laboratory values; measures and changes in ECG and vital signs.
    10. Tolerability: Discontinuations due to AEs, dose modifications due to AEs.
    11. Pharmacokinetics: MCLA-129 concentration CEOI, Cmax, C0h, and PK parameters including AUC, CL, Vss, tmax and t1/2 and to develop a population PK model.
    12. Immunogenicity: Incidence and serum titers of antidrug antibodies against MCLA-129.

    Exploratory:
    13. Biomarkers: Change from baseline in biomarkers, and correlative analyses of biomarkers with antitumor response.
    Fase I
    Endpoint secondari
    1. Sicurezza: incidenza, gravità e relazione con EA e SAE; incidenza, gravità e variazioni nei valori di laboratorio; misure e variazioni nell’ECG e nei segni vitali.
    2. Tollerabilità: interruzioni dovute a EA e modifiche della dose dovute a EA.
    3. Efficacia: BOR, ORR, DCR, DoR, PFS e OS, in base ai criteri RECIST v1.1, secondo la valutazione dello Sperimentatore.
    4. Farmacocinetica: concentrazione di MCLA-129 CEOI, Cmax, C0 h e parametri di PK, tra cui AUC, CL, Vss, tmax e t1/2 e sviluppo di un modello PK di popolazione.
    5. Immunogenicità: incidenza e titoli sierici di anticorpi antifarmaco contro MCLA-129.
    6. Citochine: variazione rispetto al basale delle citochine sistemiche.

    Endpoint esplorativi
    7. Biomarcatori: variazione rispetto al basale nei biomarcatori e analisi correlative dei biomarcatori con la risposta antitumorale.

    Fase 2
    Endpoint secondari
    8. Efficacia: BOR, DCR, DoR, PFS e OS, secondo i criteri RECIST v1.1 in base alla valutazione dello Sperimentatore.
    9. Sicurezza: incidenza, gravità e relazione con EA e SAE; incidenza, gravità e variazioni nei valori di laboratorio; misure e variazioni nell’ECG e nei segni vitali.
    10. Tollerabilità: interruzioni dovute a EA e modifiche della dose dovute a EA.
    11. Farmacocinetica: concentrazione di MCLA-129 CEOI, Cmax, C0 h e parametri di PK, tra cui AUC, CL, Vss, tmax e t1/2 e sviluppo di un modello PK di popolazione.
    12. Immunogenicità: incidenza e titoli sierici di anticorpi antifarmaco contro MCLA-129.

    Endpoint esplorativi
    13. Biomarcatori: variazione rispetto al basale nei biomarcatori e analisi correlative dei biomarcatori con la risposta antitumorale.
    E.5.2.1Timepoint(s) of evaluation of this end point
    1,2. Along phase1
    3. Every 8wks after start treatment until progression
    4. Cycle 1:Day1,4,8,15,22. Cycle 2:Day1&15. Cycle 3:Day1, then every 4 cycles after Day1
    5. Day1 Cycles1,2,3 then every 4 cycles & EoT visit
    6. Cycle1 only, on Day1 pre-dose, 2,4&22 h post-end of infusion (EOI) and Day15, pre-dose, 2&4 h post-EOI
    7. Cycle1:Pre-dose Day1,EOI,22 h post- EOI; Any time on Days4 or 5 & 8; pre-dose and EOI, Day15; Day22 Cycle2:pre-dose & EOI on Days1&15
    8. Every 8 wks after start treatment until progression
    9,10. Along phase2
    11. Cycles1,2,3 then every 4 cycles
    12. Day1 Cycles1,2,3 then every 4 cycles
    13. ctDNA: Pre-dose Day 1 Cycle 1. Plasma & Serum PD: Cycle 1: Pre-dose Day 1,EOI,22 h post-EOI; any time on Days 4 or 5,&8; pre-dose & EOI Day 15; Day 22. Cycle 2: pre-dose & EOI on Day 1 & 15
    -
    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) 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 No
    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 trial1
    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 concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA12
    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
    Singapore
    Belgium
    Italy
    Korea, Republic of
    Netherlands
    Spain
    United States
    France
    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
    The study will be closed after the last patient on study has been followed-up for 12 months or initiates a new anticancer treatment, whichever occurs first.
    -
    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 months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 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: 72
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 108
    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 state31
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 101
    F.4.2.2In the whole clinical trial 180
    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)
    In the event of premature discontinuation of the trial for patients who have proven clinical benefit with MCLA-129, the Sponsor will provide MCLA-129 on a case-by-case basis outside the context of the study.
    Continued evidence of clinical benefit will need to be provided by the Investigator every 3 months to ensure continued provision of study drug.
    -
    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 Decision2022-04-22
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-12-14
    P. End of Trial
    P.End of Trial StatusOngoing
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