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    The EU Clinical Trials Register currently displays   43873   clinical trials with a EudraCT protocol, of which   7292   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

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    Summary
    EudraCT Number:2021-000553-40
    Sponsor's Protocol Code Number:CNIS793E12201
    National Competent Authority:France - ANSM
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2021-09-24
    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 ConcernedFrance - ANSM
    A.2EudraCT number2021-000553-40
    A.3Full title of the trial
    daNIS-3: An open-label, multi-center, phase II platform study evaluating the efficacy and safety of NIS793 and other new investigational drug combinations with standard of care (SOC) anti-cancer therapy for the second line treatment of metastatic colorectal cancer (mCRC)
    daNIS-3 : Etude « plateforme » de phase II, multicentrique, en ouvert, , évaluant l’efficacité et la sécurité d’emploi de NIS793 et d’autres nouveaux médicaments expérimentaux en association avec le traitement anticancéreux standard pour le traitement de deuxième ligne du cancer colorectal métastatique (CCRm)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study of NIS793 and other novel investigational combinations with SOC anti-cancer therapy for the second line treatment of mCRC
    Etude de NIS793 et d’autres nouveaux médicaments expérimentaux en association avec le traitement anticancéreux standard pour le traitement de deuxième ligne du CCRm
    A.4.1Sponsor's protocol code numberCNIS793E12201
    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 SponsorNovartis Pharma AG
    B.1.3.4CountrySwitzerland
    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 supportNovartis Pharma AG
    B.4.2CountrySwitzerland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationNovartis Pharma S.A.S
    B.5.2Functional name of contact pointInformation&Communication Médicales
    B.5.3 Address:
    B.5.3.1Street Address8/10 rue Henry Sainte Claire Deville, CS 40150
    B.5.3.2Town/ cityRueil-Malmaison
    B.5.3.3Post code92563
    B.5.3.4CountryFrance
    B.5.4Telephone number+33 1 5547 6600
    B.5.5Fax number+33 1 5547 6100
    B.5.6E-mailicm.phfr@novartis.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.3.2Product code NIS793
    D.3.4Pharmaceutical form Concentrate 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 INNnot yet available
    D.3.9.2Current sponsor codeNIS793
    D.3.9.3Other descriptive nameNIS793
    D.3.9.4EV Substance CodeSUB184323
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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 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 No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product name5-Fluorouracil
    D.3.4Pharmaceutical form Concentrate 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 INNFLUOROURACIL SODIUM
    D.3.9.1CAS number 51-21-8
    D.3.9.4EV Substance CodeSUB02225MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    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: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The 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 nameoxaliplatin
    D.3.4Pharmaceutical form Powder 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 INNOXALIPLATIN
    D.3.9.1CAS number 61825-94-3
    D.3.9.4EV Substance CodeSUB09490MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The 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 nameleucovorin
    D.3.4Pharmaceutical form Concentrate 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 INNleucovorin
    D.3.9.1CAS number 1492-18-8
    D.3.9.3Other descriptive nameFOLINIC ACID
    D.3.9.4EV Substance CodeSUB13910MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number15
    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: 5
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The 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 nameirinotecan
    D.3.4Pharmaceutical form Concentrate 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 INNIRINOTECAN
    D.3.9.1CAS number 97682-44-5
    D.3.9.4EV Substance CodeSUB08295MIG
    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 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: 6
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.5The 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 namebevacizumab
    D.3.4Pharmaceutical form Powder 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 INNBEVACIZUMAB
    D.3.9.1CAS number 216974-75-3
    D.3.9.4EV Substance CodeSUB16402MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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 No
    D.IMP: 7
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Folinate de calcium Kabi
    D.2.1.1.2Name of the Marketing Authorisation holderKabi
    D.2.1.2Country which granted the Marketing AuthorisationFrance
    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 nameFolinate de calcium Kabi
    D.3.4Pharmaceutical form Concentrate 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 INNLeucovorin
    D.3.9.1CAS number 1492-18-8
    D.3.9.3Other descriptive nameFOLINIC ACID
    D.3.9.4EV Substance CodeSUB13910MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    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: 8
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name FOLINATE DE CALCIUM SANDOZ
    D.2.1.1.2Name of the Marketing Authorisation holderSANDOZ
    D.2.1.2Country which granted the Marketing AuthorisationFrance
    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 nameFOLINATE DE CALCIUM
    D.3.4Pharmaceutical form Concentrate 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 INNleucovorin
    D.3.9.1CAS number 1492-18-8
    D.3.9.3Other descriptive nameFOLINIC ACID
    D.3.9.4EV Substance CodeSUB13910MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    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
    metastatic colorectal cancer (mCRC)
    cancer colorectal métastatique (CCRm)
    E.1.1.1Medical condition in easily understood language
    colorectal cancer
    cancer colorectal
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level PT
    E.1.2Classification code 10061451
    E.1.2Term Colorectal 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 PT
    E.1.2Classification code 10052358
    E.1.2Term Colorectal 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
    Safety run-in: To confirm the recommended phase 2 dose (RP2D) of each investigational arm (NIS793 or any investigational drug(s) in combination with SOC) (SOC: either modified FOLFOX6 + bevacizumab or FOLFIRI+ bevacizumab chemotherapy regimen)
    Expansion part: To evaluate preliminary efficacy of each investigational arm (NIS793 or any investigational drug(s) in combination with SOC anti-cancer therapy) versus control arm(SOC anti-cancer therapy) in terms of progression-free survival (PFS) by Investigator's assessment per RECIST 1.1
    Partie Safety run-in: Confirmer la DRP2 pour chaque bras expérimental (NIS793 ou tout autre médicament expérimental en association avec le traitement standard) (Traitement standard : soit chimiothérapie FOLFOX6m + bévacizumab soit chimiothérapie FOLFIRI + bévacizumab)
    Phase d’extension: Evaluer l’efficacité préliminaire dans chaque bras expérimental (NIS793 ou tout autre médicament expérimental en association avec le traitement standard) par rapport au bras contrôle (traitement anticancéreux standard) en termes de survie sans progression évaluée par le médecin-investigateur selon les critères RECIST v1.1
    E.2.2Secondary objectives of the trial
    Safety run-in:
    1. To characterize the safety and tolerability of each investigational arm (NIS793 or any investigational drug(s) in combination with SOC)
    2. Preliminary anti-tumor activity of each investigational arm
    3. To characterize the pharmacokinetics (PK) of each investigational arm
    4. To characterize the immunogenicity of components of each investigational arm
    Expansion part:
    1. To evaluate and compare efficacy of each investigational arm and control arm in terms of ORR, DCR, DOR, TTR by Investigator's assessment per RECIST 1.1
    2. To evaluate and compare the overall survival (OS) of each investigational arm and control arm
    3. Safety and tolerability
    4. To characterize the PK of each investigational arm, control arm
    5. To characterize the immunogenicity of components of each investigational arm, control arm
    Safety run-in
    1.Caractériser la tolérance et la sécurité d’emploi dans chaque bras expérimental (NIS793 ou tout autre médicament expérimental en association avec le traitement standard)
    2.Evaluer l’activité antitumorale dans chaque bras expérimental
    3.Caractériser la pharmacocinétique (PK) dans chaque bras experimental
    4.Caractériser l’immunogénicité de médicaments composant les traitements évalués dans chaque bras expérimental
    Phase d’extension
    1.Evaluer et comparer l’efficacité dans chaque bras expérimental et dans le bras contrôle en termes de taux de réponse globale, taux de contrôle de la maladie, durée de la réponse et temps d’obtention de la réponse évalués par le médecin-investigateur selon les critères RECIST v1.1
    2.Evaluer et comparer la survie globale dans chaque bras expérimental et dans le bras contrôle
    3.Evaluer la sécurité d’emploi et la tolérance
    4.Caractériser la PK dans chaque bras expérimental et dans le bras contrôle
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Signed informed consent must be obtained prior to participation in the study.
    2. Age 18 years (or older, if required by local regulations) at the time of informed consent.
    3. Histologically or cytologically confirmed (by local laboratory and local clinical guidelines) metastatic colorectal adenocarcinoma that is not amenable to potentially curative surgery in the opinion of the investigator and progressed on or within 6 months after the last dose of one prior line of systemic anti-cancer therapy administered for metastatic disease.
    4. Presence of at least one measurable lesion assessed by CT and/or MRI according to RECIST 1.1.
    5. Eastern Cooperative Oncology Group (ECOG) Performance Status 0 or 1.
    6. Adequate organ function as defined by the following laboratory values (assessed by central laboratory for eligibility except where indicated):
    • Absolute neutrophil count ≥ 1.5 × 109/L
    • Platelets count ≥ 100 × 109/L
    • Hemoglobin ≥ 9 g/dL
    • Calculated creatinine clearance ≥ 60 mL/min (e.g. by using Cockcroft-Gault equation)
    • Albumin ≥ 3 g/dL
    • PT/INR and PTT ≤ 1.5 x ULN. Participants requiring therapeutic anticoagulants are eligible if coagulation parameters are within therapeutic range.
    • Total bilirubin ≤ 1.5 X ULN
    • Aspartate aminotransferase/serum glutamic oxaloacetic transaminase (AST/SGOT) and alanine aminotransferase /serum glutamic pyruvic transaminase (ALT/SGPT) ≤ 3.0 x ULN (≤5 x ULN in presence of liver metastasis). In participants with elevated ALT or AST, the values must be stable for at least 2 weeks and with no evidence of biliary obstruction by imaging.
    7. Women of child-bearing potential must have negative pregnancy tests during the screening period and before starting study treatment.
    8. Able to adhere to study visit schedule and other protocol requirements.
    9. Participant must have recovered from treatment related toxicities of prior anticancer therapies to grade ≤1 (CTCAE v5.0) at the time of screening, except alopecia.
    1. La signature du consentement éclairée doit être obtenue avant toute participation à l’étude.
    2. Patients âgés de 18 ans (ou plus âgés, si requis par les réglementations locales) au moment du consentement
    3. Patients atteints d’un adénocarcinome colorectal métastatique histologiquement ou cytologiquement confirmé (par le laboratoire local et selon les recommandations cliniques locales) qui, selon le médecin-investigateur, ne se prête pas à une chirurgie potentiellement curative et qui a progressé sous ou au cours des 6 mois suivant la dernière dose d’une précédente ligne de traitement anticancéreux systémique de la maladie métastatique
    4. Présence d’au moins une lésion mesurable par scanner et/ou imagerie par résonance magnétique (IRM) selon les critères RECIST v1.1
    5. Indice de performance ECOG (pour Eastern Cooperative Oncology Group) de 0 ou 1
    6. Fonction adéquate des organes, définie par les valeurs biologiques suivantes (évaluées par le laboratoire central pour l’éligibilité, sauf indication contraire) :
    • Nombre absolu de neutrophiles ≥ 1,5 × 109/l
    • Nombre de plaquettes ≥ 100 × 109/l
    • Hémoglobine ≥ 9 g/dl
    • Clairance calculée de la créatinine ≥ 60 ml/min (par ex. selon la formule de Cockcroft-Gault)
    • Albumine ≥ 3 g/dl
    • PT/INR et TTP ≤ 1,5 × LSN. Les patients nécessitant un traitement par anticoagulants sont éligibles si les paramètres de la coagulation se situent l’intervalle de référence.
    • Bilirubine totale ≤ 1,5 × LSN
    • Aspartate aminotransférase (ASAT) et aspartate aminotransférase (ALAT) ≤ 3,0 × LSN (≤ 5,0 × LSN pour les patients ayant des métastases hépatiques). Pour les patients ayant des valeurs élevées de l’ASAT ou de l’ALAT, ces valeurs doivent être stables pendant au moins 2 semaines sans qu’une obstruction biliaire ne soit observée par imagerie.
    7. Les femmes en mesure d’avoir des enfants doivent avoir un résultat négatif aux tests de grossesse réalisés pendant la période de sélection et avant l’instauration du traitement à l’étude.
    8. Capacité à respecter le calendrier des visites de l’étude et les autres exigences protocolaires
    9. Patients ayant récupéré, au moment de la sélection, de toute toxicité liée aux traitements anticancéreux antérieurs jusqu’à atteindre un grade ≤ 1 sur l’échelle CTCAE (pour Common Terminology Criteria for Adverse Events) v5.0, excepté une alopécie
    E.4Principal exclusion criteria
    1. Previously administered systemic TGF-β targeted therapies.
    2. Microsatellite instability-high (MSI-H)/mismatch repair-deficient (dMMR) and/or BRAFV600 mutation positive colorectal cancer (tests performed by local laboratory and per local guidelines).
    3. Known complete or partial dipyrimidine dehydrogenase (DPD) enzyme deficiency (testing for DPD enzyme deficiency is not mandatory unless required by local regulations and can be conducted at a local laboratory).
    4. For participants treated with irinotecan: Known history or clinical evidence of reduced UGT1A1 activity (testing for UGT1A1 status is not mandatory unless required by local regulations and can be conducted at a local laboratory).
    5. Presence of symptomatic CNS metastases, or CNS metastases that requires directed therapy (such as focal radiotherapy or surgery), or increasing doses of corticosteroids 2 weeks prior to study entry. Participants with treated symptomatic brain metastases should be neurologically stable for 4 weeks post-treatment and prior to study entry, and at a dose of ≤ 10 mg per day prednisone or equivalent for at least 2 weeks before administration of any study treatment.
    6. Known history of severe allergy or hypersensitivity to any of the study drugs or its excipients or to drugs of similar chemical classes (e.g. monoclonal antibodies), or contraindication to any of the study drugs as outlined in the ‘Contraindications’ or ‘Warnings and Precautions’ sections of the SOC local prescribing information
    7. Participant is currently receiving other anti-cancer therapy (medication or radiotherapy), or received other investigational product within 30 days or 5 half-lives prior to initiation of study treatment, whichever is longer.
    8. Participant is currently receiving any of the prohibited medications as outlined in the protocol or in the SOC anti-cancer therapy local prescribing information, and these cannot be discontinued ≥ 7 days or 5 half-lives, whichever is longer, before the first dose of that drug.
    9. Participant has not recovered from a major surgery performed prior to start of study treatment or has had a major surgery within 4 weeks days prior to start of study treatment.
    10. Radiation therapy ≤ 4 weeks or brain-radiotherapy ≤ 4 weeks prior to start of study treatment
    11. Impaired cardiac function or clinically significant cardio-vascular disease, such as:
    • Congestive heart failure requiring treatment (NYHA grade ≥2), or clinically significant arrhythmia (including uncontrolled atrial flutter/fibrillation)
    • Acute myocardial infarction, unstable angina pectoris, coronary stenting, or bypass surgery <6 months prior to study entry
    • LVEF < 50%
    • Elevated cardiac enzymes troponin I > 2 x ULN
    • Cardiac valvulopathy≥ grade 2
    • Uncontrolled hypertension defined by a systolic blood pressure ≥160 mg and/or diastolic blood pressure ≥100 mg Hg
    12. History of positive test for human immunodeficiency virus (HIV) infection
    13. Active or chronic hepatitis B virus (HBV) or hepatitis C virus infections.
    14. Active untreated or uncontrolled systemic fungal, bacterial or viral infection (including COVID-19), which in the opinion of the investigator places the study participant at an unacceptable risk.
    15. Use of hematopoietic growth factors or transfusion support ≤ 2 weeks prior to start of study treatment.
    16. Participant has conditions that are considered to have a high risk of clinically significant gastrointestinal tract bleeding or any other condition associated with or history of significant bleeding.
    17. Serious non-healing wounds.
    18. Stroke or transient ischemic attack, or other ischemic event, or thromboembolic event (e.g., deep venous thrombosis, pulmonary embolism) within 3 months before start of study treatment.
    19. Concurrent malignancy other than the disease under investigation with exception of malignancy that was treated curatively and has not recurred within 2 years prior to the date of screening. Fully resected basal or squamous cell skin cancers and any carcinoma in situ are eligible.
    20. Any significant medical condition, laboratory abnormality or psychiatric or social condition that would constitute unacceptable safety risks to the participants, contraindicate participant participation in the clinical study, limit the participant’s ability to comply with study requirements, or compromise participant’s compliance with the protocol and all requirements of the study as stated in the Informed Consent Form.
    21. Women of child-bearing potential, unless they are willing to use highly effective methods of contraception during treatment with study drugs and for 90 days after stopping NIS793 whichever is latest.
    22. Pregnant or breast-feeding women.
    1. Traitement systémique antérieur par anti-TGFβ
    2. Cancer colorectal avec une instabilité élevée de microsatellites (MSI-H)/ayant un défaut dans la réparation des mésappariements de l’ADN (dMMR ) et/ou présentant une mutation BRAFV600 (tests réalisés par le laboratoire local et selon les recommandations locales)
    3.Déficit connu, complet ou partiel, en dihydropyrimidine déshydrogénase
    4.Pour les patients traités par irinotécan : antécédents ou preuve clinique d’une activité réduite de l’UGT1A1 (le test du statut d’UGT1A1 n’est pas obligatoire sauf s’il est requis par les réglementations locales ; il peut alors être réalisé par un laboratoire local)
    5. Présence de métastases du système nerveux central symptomatiques ou nécessitant un traitement local (par ex. radiothérapie focale ou chirurgie) ou un traitement par des doses croissantes de corticoïdes au cours des 2 semaines précédant l’inclusion dans l’étude. Les patients ayant des métastases cérébrales symptomatiques traitées doivent être stables neurologiquement, pendant 4 semaines après le traitement et avant l’inclusion dans l’étude, et recevoir une dose ≤ 10 mg/jour de prednisone ou équivalent depuis au moins 2 semaines avant administration de tout traitement à l’étude.
    6. Antécédents d’allergie ou d’hypersensibilité sévère à l’un des médicaments à l’étude, à l’un de leurs excipients ou à des médicaments de la même classe chimique (par ex. anticorps monoclonaux) ou contre-indication à l’un des médicaments à l’étude telle que mentionnée dans les sections « Contre-indications » ou « Mises en garde spéciales et précautions d’emploi » des résumés des caractéristiques du produit (RCP) locaux du traitement anticancéreux standard
    7.Patients recevant un autre traitement anticancéreux (médicament ou radiothérapie) ou ayant reçu un autre traitement expérimental au cours des 30 jours précédant l’instauration du traitement à l’étude ou dans un délai correspondant à 5 demi-vies de ce traitement expérimental, selon la durée la plus longue
    8. Patients recevant tout médicament interdit tel que mentionné dans le protocole ou dans les RCP du traitement anticancéreux standard, et qui ne peut être arrêté ≥ 7 jours ou un délai correspondant à 5 demi-vies du médicament, selon la durée la plus longue, avant la première administration du traitement à l’étude
    9. Patients n’ayant pas récupéré d’une chirurgie majeure réalisée avant l’instauration du traitement à l’étude ou patients ayant eu une chirurgie majeure au cours des 4 semaines précédant l’instauration du traitement à l’étude
    10. Radiothérapie ou radiothérapie cérébrale au cours des ≤ 4 semaines avant l’instauration du traitement à l’étude
    11. Troubles de la fonction cardiaque ou maladie cardiovasculaire cliniquement significative, incluant entre autres:
    • Insuffisance cardiaque congestive nécessitant un traitement (grade ≥ 2 selon la classification fonctionnelle de NYHA) ou arythmie cliniquement significative (incluant flutter atrial et fibrillation atriale non contrôlés)
    • Infarctus aigu du myocarde, angine de poitrine instable, stent coronaire ou pontage chirurgical < 6 mois avant l’inclusion dans l’étude
    • Fraction d’éjection du ventricule gauche < 50 %
    • Augmentation des enzymes cardiaques (troponine I) > 2 × LSN
    • Valvulopathie cardiaque de grade ≥ 2
    • Hypertension artérielle non contrôlée définie par une tension artérielle systolique ≥ 160 mmHg et/ou une tension artérielle diastolique ≥ 100 mmHg
    12. Antécédents d’infection par le virus de l’immunodéficience humaine (VIH)
    13. Infection active ou chronique par le virus de l’hépatite B ou de l’hépatite C
    14. Infection fongique, bactérienne ou virale systémique (incluant COVID-19) active non traitée ou non contrôlée qui, selon le médecin-investigateur, expose le patient à un risque inacceptable
    15. Recours à des facteurs de croissance hématopoïétiques ou à un soutien transfusionnel ≤ 2 semaines avant l’instauration du traitement à l’étude
    16. Patients atteints de pathologies considérées comme présentant un risque élevé d’hémorragies digestives cliniquement significatives ou de toute pathologie associée à des hémorragies importantes ou ayant des antécédents d’hémorragies importantes
    17. Plaies graves ne cicatrisant pas
    18. Antécédents d’accident vasculaire cérébral, d’attaque ischémique transitoire ou de tout autre accident ischémique ou d’accident thromboembolique (par ex. thrombose veineuse profonde, embolie pulmonaire) au cours des 3 mois précédant l’instauration du traitement à l’étude
    19. Tumeur maligne autre que la maladie traitée dans le cadre de cette étude, à l’exception des tumeurs traitées de manière curative et n’ayant pas rechuté au cours des 2 ans précédant la sélection, des carcinomes cutanés basocellulaires ou épidermoïdes et des carcinomes in situ complètement réséqués
    E.5 End points
    E.5.1Primary end point(s)
    Safety run-in: Incidence of DLTs during the first treatment cycle (4 weeks) of treatment
    Expansion part: Progression-free survival (PFS) by Investigator’s assessment per RECIST 1.1
    Période de safety run-in:l’incidence des DLT au cours de la première cycle (4semaines) de traitement
    Période d'extension: survie sans progression évaluée par le médecin-investigateur selon les critères RECIST v1.1
    E.5.1.1Timepoint(s) of evaluation of this end point
    safety run-in: 4 weeks of treatment
    expansion part: until progression of the disease
    Période de safety run-in :4 semaines de traitement
    Période d'extension: jusqu’à progression de la maladie
    E.5.2Secondary end point(s)
    Safety run-in:
    1. Safety: Incidence and severity of AEs including changes in laboratory parameters, vital signs and ECG parameters
    2. Tolerability: Dose interruptions, reductions and dose intensity
    3. PFS, overall response rate (ORR), disease control rate (DCR), duration of response (DOR) and time to response (TTR)by Investigator's assessment per RECIST 1.1 and Overall survival (OS)
    4. Drug concentrations in serum or plasma of each investigational treatment and components of SOC therapy (bevacizumab, irinotecan, SN-38) over time and derived PK parameters (e.g. Ctrough, Cmax)
    5. Incidence of antidrug antibodies (ADA), prevalence at baseline and ADA incidence during the treatment for investigational treatment(s) and bevacizumab.
    expansion part:
    1. ORR, DCR, DOR, TTR by investigator's assessment by RECIST 1.1
    2. OS
    3. Incidence and severity of AEs, changes in laboratory parameters, vital signs and ECG parameters; dose interruptions, reductions and dose intensity
    4. Drug concentrations in serum or plasma of each investigational treatment and components of SOC therapy (bevacizumab, irinotecan, SN-38) over time and derived PK parameters (e.g. Ctrough, Cmax)
    5. Incidence of antidrug antibodies (ADA), prevalence at baseline and ADA incidence during the treatment for investigational treatment(s) and bevacizumab.
    Période de safety run-in :
    1. Sécurité : incidence et gravité des EI, y compris les modifications des paramètres de laboratoire, des signes vitaux et des paramètres ECG
    2. Tolérabilité : interruptions de dose, réductions et intensité de la dose
    3. PFS, taux de réponse global (ORR), taux de contrôle de la maladie (DCR), durée de réponse (DOR) et temps de réponse (TTR) selon l'évaluation de l'investigateur selon RECIST 1.1 et survie globale (OS)
    4. Concentrations de médicament dans le sérum ou le plasma de chaque traitement expérimental et composants de la thérapie SOC (bevacizumab, irinotécan, SN-38) au fil du temps et paramètres PK dérivés (par exemple Ctrough, Cmax)
    5. Incidence des anticorps anti-médicaments (ADA), prévalence à l'inclusion et incidence des ADA pendant le traitement pour le(s) traitement(s) expérimental(s) et le bevacizumab.

    Période d'extension
    1. ORR, DCR, DOR, TTR par évaluation de l'investigateur par RECIST 1.1
    2. OS
    3. Incidence et gravité des EI, modifications des paramètres de laboratoire, des signes vitaux et des paramètres ECG ; interruptions de dose, réductions et intensité de la dose
    4. Concentrations de médicament dans le sérum ou le plasma de chaque traitement expérimental et composants de la thérapie SOC (bevacizumab, irinotécan, SN-38) au fil du temps et paramètres PK dérivés (par exemple Ctrough, Cmax)
    5. Incidence des anticorps anti-médicaments (ADA), prévalence à l'inclusion et incidence des ADA pendant le traitement pour le(s) traitement(s) expérimental(s) et le bevacizumab.

    E.5.2.1Timepoint(s) of evaluation of this end point
    safety run-in:
    1,2 - 4 weeks of treatment
    3 - end of treatment
    4,5 - at protocol defined timepoints
    expansion part:
    1, 2, 3 - at the end of treatment
    4,5 - at protocol defined timepoints
    safety run-in:
    1,2- 4 semaines de traitement
    3- fin de traitement
    4,5- intervalles définies dans le protocole
    expansion part:
    1,2,3- fin de traitement
    4,5- intervalles définies dans le protocole
    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 Yes
    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 Yes
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    platform study
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    SoC chemotherapy
    E.8.2.4Number of treatment arms in the trial3
    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 concerned4
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA37
    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
    Australia
    Canada
    Israel
    Japan
    Korea, Republic of
    Singapore
    Taiwan
    United States
    Belgium
    France
    Germany
    Hungary
    Italy
    Netherlands
    Spain
    Switzerland
    United Kingdom
    Czechia
    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
    When all participants
    • have completed 2 years of potential survival follow-up or 80% OS events for each treatment arm have occurred
    • until death or lost to follow-up, or withdrawal of consent
    • another clinical study with NIS793 or any other new investigational drug becomes available in this participant population and all participants ongoing are eligible to be transferred to that clinical study, in the event of an early study termination decision, the date of that decision.
    Lorsque tous les participants
    • ont terminé 2 ans de suivi de survie potentiel ou 80 % d'événements d’OS pour chaque bras de traitement dans lequel ils se sont produits
    • une autre étude clinique avec NIS793 ou tout autre nouveau médicament expérimental devient disponible dans cette population de participants et tous les participants en cours sont éligibles pour être transférés à cette étude clinique, en cas de décision d'arrêt anticipé de l'étude, à la date de cette décision.
    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 months2
    E.8.9.1In the Member State concerned days10
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months2
    E.8.9.2In all countries concerned by the trial days10
    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: 114
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 76
    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 state15
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 82
    F.4.2.2In the whole clinical trial 190
    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)
    n/a
    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 Decision2021-12-10
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-10-20
    P. End of Trial
    P.End of Trial StatusCompleted
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