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    Summary
    EudraCT Number:2021-001329-29
    Sponsor's Protocol Code Number:TIG-006
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2022-06-10
    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 number2021-001329-29
    A.3Full title of the trial
    A Multicenter, Open-Label, Phase I/II Study of EOS884448 in combination with standard of care and/or investigational therapies in participants with advanced solid tumors
    Estudio multicéntrico, abierto, de fase I/II de EOS884448 en combinación con el tratamiento estándar y/o terapias experimentales en participantes con tumores sólidos avanzados
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Multicenter, Open-Label, Phase I/II Study of EOS884448 in combination with standard of care and/or investigational therapies in participants with advanced solid tumors
    Estudio multicéntrico, abierto, de fase I/II de EOS884448 en combinación con el tratamiento estándar y/o terapias experimentales en participantes con tumores sólidos avanzados
    A.4.1Sponsor's protocol code numberTIG-006
    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 SponsoriTeos Belgium SA
    B.1.3.4CountryBelgium
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportiTeos Belgium SA
    B.4.2CountryBelgium
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationiTeos Belgium SA
    B.5.2Functional name of contact pointClinical Trials Department
    B.5.3 Address:
    B.5.3.1Street Addressrue des Frères Wright 29
    B.5.3.2Town/ cityGosselies
    B.5.3.3Post code6041
    B.5.3.4CountryBelgium
    B.5.4Telephone number+327191 99 50
    B.5.6E-mailservane.warot@iteostherapeutics.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 nameEOS-448
    D.3.2Product code EOS884448
    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 INNEOS884448
    D.3.9.1CAS number 2574438-65-4
    D.3.9.2Current sponsor codeEOS884448
    D.3.9.3Other descriptive nameEOS884448
    D.3.9.4EV Substance CodeSUB201286
    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 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 nameInupadenant hydrochloride
    D.3.2Product code EOS100850 HCl
    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 INNInupadenant hydrochloride
    D.3.9.1CAS number 2411004-22-1
    D.3.9.2Current sponsor codeEOS100850-HCl
    D.3.9.4EV Substance CodeSUB262050
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    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: 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 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 nameInupadenant hydrochloride
    D.3.2Product code EOS100850 HCl
    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 INNInupadenant hydrochloride
    D.3.9.1CAS number 2411004-22-1
    D.3.9.2Current sponsor codeEOS100850-HCl
    D.3.9.4EV Substance CodeSUB262050
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40
    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.2.1.1.1Trade name Dostarlimab
    D.2.1.1.2Name of the Marketing Authorisation holderGSK
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameDostarlimab
    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 INNDostarlimab
    D.3.9.2Current sponsor codeJEMPERLI
    D.3.9.3Other descriptive nameJEMPERLI
    D.3.9.4EV Substance CodeSUB195307
    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 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 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
    Advanced solid tumors
    Tumores sólidos avanzados
    E.1.1.1Medical condition in easily understood language
    Advanced solid Tumors
    Tumores sólidos avanzados
    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 LLT
    E.1.2Classification code 10065252
    E.1.2Term Solid tumor
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Primary
    Part 1 – Dose Finding:
    • To characterize the safety and tolerability of EOS884448 (EOS-448) in combination with standard of care and/or investigational therapies and of dostarlimab combined with inupadenant HCl in participants with advanced solid tumors.
    • To determine the recommended phase 2 dose (RP2D) of EOS-448 in combination with standard of care and/or investigational therapies and of inupadenant in combination with dostarlimab in participants with advanced solid tumors.
    Part 2 – Expansion:
    • To assess the antitumor activity (i) of the combination of EOS-448 with pembrolizumab in participants with first-line metastatic non-small-cell lung cancer (1L mNSCLC, Parts 2A and 2B); (ii) of the combination of EOS-448 with dostarlimab in first-line metastatic head and neck squamous cell carcinoma (1L mHNSCC, Parts 2C and 2D); (iii) of the combination of EOS-448 with inupadenant HCl in anti-PD-(L)1 resistant metastatic cutaneous melanoma (Part 2E).
    Parte 1: Determinación de dosis:
    •Caracterizar la seguridad y tolerabilidad de EOS884448 (EOS-448) en combinación con el tratamiento estándar y/o terapias experimentales y de dostarlimab en combinación con inupadenant HCl en participantes con tumores sólidos avanzados
    •Establecer la dosis recomendada para la fase 2 (RP2D) de EOS-448 en combinación con el tratamiento estándar y/o terapias experimentales e inupadenant en combinación con dostarlimab en participantes con tumores sólidos avanzados
    Parte 2: Expansión:
    •Evaluar la actividad antitumoral (i) de la combinación de EOS-448 y pembrolizumab en cáncer metastásico de pulmón de células no pequeñas en primera línea (1L mNSCLC, partes 2A y 2B); (ii) de la combinación de EOS-448 y dostarlimab en carcinoma metastásico de células escamosas de cabeza y cuello en primera línea (1L mHNSCC, partes 2C y 2D), (iii) de la combinación de EOS-448 con inupadenant HCl en melanoma cutáneo metastásico resistente a anti-PD-(L)1 (parte 2E)
    E.2.2Secondary objectives of the trial
    Secondary
    Part 1 – Dose Finding:
    • To assess the antitumor activity of EOS-448 in combination with standard of care and/or investigational therapies and of inupadenant in combination with dostarlimab in participants with advanced solid tumors.
    • Overall Response Rate (ORR) will be defined according to RECIST v1.1.
    Part 1 and Part 2:
    • To assess the antitumor activity according to time-to-event in participants treated with EOS-448 in combination with standard of care and/or investigational therapies and of inupadenant in combination with dostarlimab in participants with advanced solid tumors.
    • To assess the pharmacokinetics (PK) and immunogenicity of EOS-448 in combination with standard of care and/or investigational therapies in participants with advanced solid tumors.
    • To assess the PK of inupadenant when the drug (free base or HCl salt) is administered in combination with (i) EOS-448, (ii) dostarlimab, or (iii) EOS-448 and dostarlimab
    Secundarios
    Parte 1:Determinación de la dosis:
    •Evaluar actividad antitumoral de EOS-448 en combinación con el tratamiento estándar y/o terapias experimentales y de inupadenant en combinación con dostarlimab en participantes con tumores sólidos avanzados
    •La tasa de respuesta general (ORR) se definirá según RECIST v1.1
    Parte 1 y parte 2:
    •Evaluar la actividad antitumoral según el tiempo de supervivencia en participantes tratados con EOS-448 en combinación con el tratamiento estándar y/o terapias experimentales y de inupadenant en combinación con dostarlimab en participantes con tumores sólidos avanzados
    •Evaluar (i) la farmacocinética (PK) y la inmunogenicidad de EOS-448 en combinación con el tratamiento estándar y/o terapias experimentales en participantes con tumores sólidos avanzados
    •Evaluar la farmacocinética (PK) de inupadenant cuando el fármaco (base libre o con sal HCl) se administra en combinacióncon (i)EOS-448,(ii)dostarlimab, o(iii) EOS-448 y dostarlimab
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Provide a signed written informed consent for the trial and consent for biopsies before and during administration of study treatment at Cycle 2 with an optional consent for biopsy at Cycle 5 and at disease progression, if applicable.
    Note: Part 1G only: Eligible participants will be allowed regardless of feasibility of pre and/or on treatment biopsies.
    2. Be > or =18 years of age on day of signing informed consent.
    3. Have measurable disease, per RECIST v1.1 for solid tumor (Appendix 8.1) based on local assessment.
    4. Have a predicted life expectancy of > or = 16 weeks.
    5. ECOG 0 or 1
    6. Have adequate organ function as defined by the following criteria collected within 10 days prior to start of study treatment. A participant not qualifying for any of these parameters on the initial screening assessment can be considered eligible providing that recovery is expected during the screening period and the criteria above are met prior to the start of therapy (Note: please refer to inclusion criterion #13 specific to Part 1G):
    a. Serum albumin > or =30 g/L (3.0 g/dL)
    b. Hemoglobin > or = 9.0 g/dL or > or = 5.6 mmol/L
    c. Platelet count > or =100×109/L
    d. Absolute neutrophil count > or = 1.2×109/L
    e. Measured or calculated creatinine clearance > or =30 mL/min for Parts 1A, 1D, 2A, 2B, 2C, 2D and ≥ 60 mL/min for Part 1B, 1C, 1E, 1F and 2E, using the formula of Cockroft and Gault (1976).
    f. Adequate hepatic function within 28 days prior to C1D1: Total bilirubin < 1.5 X ULN (except participants with Gilbert's syndrome [hereditary indirect hyperbilirubinemia] who must have a total bilirubin of < or = 2.5 X ULN) and both AST and ALT < 3.0 X ULN.
    g. International normalized ratio (INR) < or = 1.5 × ULN unless participant is receiving anticoagulant therapy provided that prothrombin time (PT) or activated partial thromboplastin time (aPTT) is within therapeutic range of intended use of anticoagulants.
    7. Female participants of childbearing potential (defined as women with < 12 continuous months of amenorrhea with no identified cause other than menopause, or not surgically sterile), must have a negative pregnancy test within 7 days before the first administration of study treatment and agree to use highly efficient contraception, as defined in Appendix 8.5, during the treatment and until 60 days after the last administration of EOS-448 or inupadenant, 120 days after the last administration of pembrolizumab or dostarlimab whichever applicable date is the latest. Prolonged period may be required in case of chemotherapy according to summary of product characteristics (SmPC), package insert or equivalent document for the specific country/region and should follow local standard of care (SOC) beyond 120 days.
    8. Male participants with female partner(s) of childbearing potential must agree to remain sexually abstinent or use condoms during the treatment and 120 days after the last dose of the study medication whichever applicable date is the latest. Prolonged period may be required in case of chemotherapy according to SmPC and should follow local SOC beyond 120 days. In addition, male participants must forego sperm donation during this time.
    Additional inclusion criteria for Parts 1A, 1B, 1C, 1D, 1E and 1F (advanced solid tumors):
    9. Have histologically or cytologically confirmed advanced or metastatic solid tumor for whom no standard treatment with survival benefit is available.
    Additional inclusion criteria for Part 1G (1L mNSCLC):
    10. Have a histologically confirmed or cytologically confirmed newly diagnosed stage IV (M1a or M1b- AJCC 8th edition) nonsquamous NSCLC OR squamous NSCLC.
    11. Are eligible to receive anti-PD(L)1 therapy combined with chemotherapy in first line metastatic setting
    12. Have a documented PD-L1 status as determined by immunohistochemistry with anti-PD-L1 antibody (IHC 22C3 pharmDx or other method used as standard per local practices) from a core or excisional biopsy (fine needle aspirate is not sufficient).
    13. Have adequate organ function as defined by the following criteria collected within 10 days prior to start of study treatment. A participant not qualifying for any of these parameters on the initial screening assessment can be considered eligible providing that recovery is expected during the screening period and the criteria above are met prior to the start of therapy:
    a. Serum albumin > or = 30 g/L (3.0 g/dL)
    b. Hemoglobin > or = 9.0 g/dL or > or = 5.6 mmol/L
    c. Platelet count > or = 100 × 109/L
    d. Absolute neutrophil count > or = 1.5 × 109/L
    e. Measured or calculated creatinine clearance > or = 50 mL/min using the formula of Cockroft and Gault (1976).
    f. Adequate hepatic function within 28 days prior to C1D1: Total bilirubin < 1.5 X ULN (except participants with Gilbert's syndrome [hereditary indirect hyperbilirubinemia] who must have a total bilirubin of < or = 2.5 X ULN) and both AST and ALT < 3.0 X ULN.
    1. Proporcionar un consentimiento informado por escrito firmado para el estudio y el consentimiento para las biopsias antes y durante la administración del tratamiento del estudio en el ciclo 2, con un consentimiento opcional para la biopsia del ciclo 5 y en la progresión de la enfermedad, si procede.
    Nota: Parte 1G solo: Se admitirá a los participantes aptos independientemente de la viabilidad de las biopsias antes y/o durante el tratamiento.
    2. Tener 18 años o más el día de la firma del consentimiento informado.
    3. Sufrir una enfermedad medible según el RECIST v1.1 de tumores sólidos que se base en una evaluación realizada a nivel local.
    4. Tener una esperanza de vida prevista mínima de 16 semanas.
    5. ECOG 1 o 2
    6. Disponer de una funcionalidad orgánica adecuada según los siguientes criterios recopilados en los 10 días anteriores al inicio del tratamiento del estudio. Un participante que no cumpla los requisitos de alguno de estos parámetros en la evaluación inicial de cribado puede considerarse un candidato apto siempre que esté prevista su recuperación durante el periodo de cribado y cumpla los criterios anteriores antes del inicio del tratamiento.
    f. Función hepática adecuada en los 28 días anteriores al C1D1: Bilirrubina total < 1,5 X ULN (excepto los participantes con síndrome de Gilbert [hiperbilirrubinemia indirecta
    hereditaria] que deben tener una bilirrubina total de ≤ 2,5 X ULN) y tanto AST como ALT < 3,0 X ULN.
    g. Coeficiente internacional normalizado (INR) < o = 1,5 × ULN, a menos que el participante esté recibiendo un tratamiento anticoagulante, siempre que el tiempo de protrombina
    (TP) o el tiempo de tromboplastina parcial activada (aPTT) estén dentro del rango terapéutico del uso previsto de los anticoagulantes.
    7. Las participantes en edad fértil (definidas como mujeres con < 12 meses continuos de amenorrea sin otra causa identificada que la menopausia o no estériles quirúrgicamente) deben contar con una prueba de embarazo negativa realizada en el plazo de los 7 días anteriores a la primera administración del tratamiento del estudio y aceptar utilizar métodos anticonceptivos de alta eficacia, según se define en el apéndice 8.5, durante el tratamiento y hasta 60 días después de la última administración de EOS-448 o inupadenant y 120 días después de la última administración de pembrolizumab o dostarlimab, la fecha que sea más tardía. En el caso de la quimioterapia, puede ser necesario un periodo prolongado según las indicaciones del resumen de las características del producto, el prospecto o el documento equivalente para el país/región específicos y se deberán seguir los tratamientos estándar locales después de transcurridos 120 días.
    8. Los participantes masculinos con pareja/s femenina/s en edad fértil deben comprometerse a mantener una abstinencia sexual o a utilizar preservativos durante el tratamiento y durante 120 días después de la última dosis de la medicación del estudio, la fecha que sea más tardía. En el caso de la quimioterapia, puede ser necesario un periodo prolongado según las indicaciones del resumen de las características del producto y se deberán seguir los tratamientos estándar locales después de transcurridos 120 días. Además, los participantes masculinos deben renunciar a la donación de esperma durante este tiempo.
    Criterios de inclusión adicionales aplicables a las partes 1A, 1B, 1C, 1D, 1E y 1F (tumores sólidos avanzados):
    9. Tener un tumor sólido avanzado o metastásico confirmado histológica o citológicamente para el que no se dispone de un tratamiento estándar que beneficie la supervivencia.
    Criterios de inclusión adicionales para la parte 1G (1L mNSCLC):
    10. Tener un tumor NSCLC escamoso o no escamoso de nuevo diagnóstico confirmado histológica o citológicamente en estadio IV (M1a o M1b- AJCC 8ª edición).
    11. Aptos para recibir un tratamiento anti-PD(L)1 en combinación con quimioterapia
    12. Tener un estado PD-L1 documentado y determinado por inmunohistoquímica con un anticuerpo anti-PD-L1 (IHC 22C3 pharmDx u otro método utilizado como tratamiento estándar local) de una biopsia central o de escisión (el aspirado con aguja fina no es suficiente).
    13. Disponer de una funcionalidad orgánica adecuada según los siguientes criterios recopilados en los 10 días anteriores al inicio del tratamiento del estudio. Un participante que no cumpla los requisitos de alguno de estos parámetros en la evaluación inicial de cribado puede considerarse un candidato apto siempre que esté prevista su recuperación durante el periodo de cribado y cumpla criterios anteriores antes del inicio del tratamiento
    E.4Principal exclusion criteria
    1. Have received any anti-cancer therapy, unless at least 4 weeks (or 5 half-lives, whichever is shorter) since the last dose of prior cytotoxic, biologic or any investigational agents (6 weeks for mitomycin C or nitrosoureas), have elapsed before the first administration of study treatment. Chronic treatment with non-investigational gonadotropin-releasing hormone analogs or other hormonal or supportive care is permitted.
    2. Have received a live vaccine within 30 days prior to the first dose of IP. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacillus Calmette–Guérin (BCG), and typhoid vaccine. Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist) are live attenuated vaccines and are not allowed. All approved COVID-19 vaccines are authorized unless otherwise indicated by the sponsor.
    3. Have known primary CNS cancer.
    4. Have known CNS metastases (including leptomeningeal disease) unless previously treated and well controlled for at least one month (defined as clinically stable, no edema, no steroid dose changes in 8 weeks and stable in 2 scans at least 4 weeks apart).
    For Part 1G only: Have known CNS metastases (including leptomeningeal disease) unless previously treated and well controlled for at least 2 weeks, have no evidence of new brain metastases and also are off steroids 3 days prior to dosing with study treatment.
    5. Have concomitant second malignancies unless a complete remission was achieved at least 2 years before study entry with no additional therapy required or anticipated to be required during the study period.
    6. Have received lung radiation therapy of >30 Gy within 6 months of the first dose of study treatment.
    7. Have a history of Grade > or =2 pneumonitis, active autoimmune disease, or persistent immune-mediated toxicity caused by immune checkpoint inhibitor therapy of Grade ≥ 2 with the exception of residual endocrinopathy adequately substituted, vitiligo, Type 1 diabetes mellitus, or psoriasis not requiring systemic therapy.
    8. Have toxicity (except for alopecia) related to prior anti-cancer therapy and/or surgery, unless the toxicity is either resolved, returned to baseline or Grade 1, or deemed irreversible.
    9. Have any active neuropathy > Grade 2 (CTCAE v5.0).
    10. Have history of grade 3 or higher liver toxicity or life-threatening toxicity related to prior immune therapy or any toxicity that resulted in permanent discontinuation of prior immune therapy.
    11. Have any condition requiring concurrent use of systemic immunosuppressants or corticosteroids > 10 mg daily prednisone equivalents or other immunosuppressive medications within 14 days of study treatment administration (permitted: premedication/prophylaxis if indicated, treatment with a short course of steroids [< 5 days] up to 7 days before initiating study treatment, topical glucocorticoids, or steroid replacement doses for adrenal insufficiency).
    12. Have evidence of active infection that requires systemic antibacterial, antiviral, or antifungal therapy < or =7 days before the first dose of study treatment (except for viral infections that are presumed to be associated with the underlying tumor type required for study entry).
    13. Have uncontrolled or significant cardiovascular disease including, but not limited to, any of the following:
    a. Left ventricular ejection fraction < or = 50% determined by echocardiogram or other approved method of evaluation
    b. Myocardial infarction or stroke/transient ischemic attack within the past 2 years
    c. Uncontrolled angina within the past 6 months
    d History of clinically significant arrhythmias (such as atrial fibrillation and conduction disorders, ventricular tachycardia, ventricular fibrillation)
    e. QT interval corrected prolongation > 470 msec
    f. History of other clinically significant heart disease (e.g., cardiomyopathy, congestive heart failure with New York Heart Association functional classification III-IV see Appendix 8.3, pericarditis, significant pericardial effusion, or myocarditis)
    g. Cardiovascular disease-related requirement for daily supplemental oxygen therapy
    h. Diagnosis of deep vein thrombosis or pulmonary embolism within the past 6 months.
    i. History of stroke or arterial disease within the past 6 months.
    14. Have known active or chronic hepatitis B or C (unless treated with no detectable virus) (participants are NOT required to be tested for the presence of such viruses before therapy on this protocol).
    15. Have known history human immunodeficiency virus (HIV) (participants are NOT required to be tested for the presence of HIV before therapy on this protocol).
    16. Have been tested for COVID-19 and had a positive result within 2 weeks prior to first study dosing.
    1. Haber recibido cualquier tratamiento contra el cáncer, a menos que hayan transcurrido 4 semanas como mínimo (o 5 semividas, lo que sea inferior) desde la última dosis de agentes citotóxicos, biológicos o experimentales previos (6 semanas para mitomicina C o nitrosoureas), antes de la primera administración del tratamiento del estudio. Se permite el tratamiento crónico con análogos de la hormona liberadora de gonadotropinas que no sean experimentales u otros
    tratamientos hormonales o de apoyo. 2. Haber recibido una vacuna de virus vivo en los 30 días anteriores a la primera dosis de IP. Entre las vacunas de virus vivo se incluye, entre otras, las siguientes: sarampión, paperas, rubeola, varicela-zoster, fiebre amarilla, rabia, BCG y vacuna contra la fiebre tifoidea. Las vacunas inyectables contra la gripe estacional son generalmente vacunas de virus muertos y están permitidas; sin embargo, las vacunas intranasales contra la gripe son vacunas vivas atenuadas y no están permitidas. Todas las vacunas contra la COVID-19 aprobadas están autorizadas, a menos que el promotor indique lo contrario. 3. Tener un cáncer primario del sistema nervioso central (CNS) conocido. 4. Tener metástasis conocidas en el CNS (incluida la enfermedad leptomeníngea), a menos que hayan sido tratadas previamente y estén bien controladas durante al menos un mes (definidas como clínicamente estables, sin edema, sin cambios de dosis de esteroides en 8 semanas y estables en 2 escáneres con al menos 4 semanas de diferencia). Solo para la parte 1G: Tener metástasis conocidas en el CNS, a menos que hayan sido tratadas previamente y estén bien controladas durante al menos 2 semanas, no tener pruebas de nuevas metástasis cerebrales y, además, haber dejado de tomar esteroides 3 días antes de recibir el tratamiento del estudio. 5. Tener segundos cánceres malignos asociados, a menos que se haya logrado una remisión completa al menos 2 años antes de la incorporación al estudio, sin que se requiera o se prevea que vaya a ser necesario un tratamiento adicional durante el periodo del estudio. 6. Haber recibido radioterapia pulmonar de >30 Gy en los 6 meses previos a la primera dosis del tratamiento del estudio. 7. Tener antecedentes de neumonitis de Grado > o = 2, enfermedad autoinmune activa o toxicidad inmunomediada persistente causada por el tratamiento con inhibidores de los puntos de control inmunitarios de Grado> o = 2, con la excepción de endocrinopatía residual adecuadamente sustituida, vitíligo, diabetes mellitus de tipo 1 o psoriasis que no requiera tratamiento sistémico. 8. Presentar toxicidad relacionada con tratamientos anticancerosos y/o cirugías previas. 9. Presentar cualquier neuropatía activa > Grado 2. 10. Tener antecedentes de toxicidad hepática de grado 3 o toxicidad potencialmente mortal relacionada con tratamientos inmunitarios previos o cualquier toxicidad que haya provocado la interrupción permanente del tratamiento inmunitario anterior. 11. Cualquier condición que requiera el uso simultáneo de inmunosupresores sistémicos o corticosteroides > 10 mg diarios equivalentes de prednisona u otros medicamentos inmunosupresores dentro del plazo de 14 días anterior a la administración del tratamiento del estudio (se permite: medicación previa/profilaxis si está indicada, tratamientos con un curso corto de esteroides hasta 7 días antes de iniciar el tratamiento del estudio, glucocorticoides tópicos o dosis de reemplazo de esteroides para la insuficiencia suprarrenal). 12. Tener evidencia de una infección activa que requiera un tratamiento sistémico antibacteriano, antiviral o antimicótico < o =7 días antes de la primera dosis del tratamiento del estudio. 13. Tener una enfermedad cardiovascular no controlada o significativa: a. FEVI < o = 50 % determinada por ECG u otro método o b. Infarto de miocardio o accidente cerebrovascular/ataque isquémico transitorio en los últimos 2 años c. Angina no controlada en los últimos 6 meses d Antecedentes de arritmias clínicamente significativas e. Prolongación del QTc> 470 mseg. f. Antecedentes de otras enfermedades cardíacas clínicamente significativas g. Necesidad de tratamiento de complementación de oxígeno diaria relacionada con la enfermedad cardiovascular h. Diagnóstico de trombosis venosa profunda o embolia pulmonar en los últimos 6 meses. i. Antecedentes de accidente cerebrovascular o enfermedad arterial en los últimos 6 meses. 14. Tener hepatitis B o C activa o crónica conocida 15. Tener antecedentes conocidos del virus de inmunodeficiencia humana (VIH) 16. Haberse sometido a la prueba de la COVID-19 y haber obtenido un resultado positivo en las dos semanas anteriores a la primera dosis.
    E.5 End points
    E.5.1Primary end point(s)
    Part 1 – Dose Finding:
    • Incidence and frequency of adverse events (AEs), serious adverse events (SAEs), dose-limiting toxicities (DLTs), AEs leading to discontinuation, deaths, vital signs, electrocardiogram (ECG) abnormalities, LVEF, and clinically significant laboratory abnormalities.
    Part 2 – Expansion:
    • Overall Response Rate (ORR) will be defined according to RECIST v1.1.
    • Incidence and frequency of AEs, SAEs, DLTs, AEs leading to discontinuation, deaths, vital signs, ECG abnormalities, LVEF, and clinically significant laboratory abnormalities.
    Parte 1: Determinación de la dosis:
    • Incidencia y frecuencia de efectos adversos (AE), efectos adversos graves (SAE), toxicidades limitantes de dosis (DLT), AE que conducen al abandono del estudio, que provocan fallecimientos, anomalías en las
    constantes vitales, en el electrocardiograma (ECG), LVEF y anomalías de laboratorio importantes a nivel clínico.
    Parte 2: Expansión:
    • La tasa de respuesta general (ORR) se definirá según RECIST v1.1.
    • Incidencia y frecuencia de AE, SAE, DLT, AE que conducen al abandono del estudio, que provocan fallecimientos, anomalías en las constantes vitales, en el electrocardiograma (ECG), LVEF y anomalías de laboratorio importantes a nivel clínico.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Please refer to:
    • Table 16 and Table 17 for Part 1A
    • Table 18 and Table 19 for Part 1B
    • Table 20 and Table 21 for Part 1C
    •Table 22 and Table 23 Part 1D
    • Table 24 and Table 25 for Part 1E
    • Table 26 and Table 27 for Part 1F
    • Table 28 and Table 29 for Part 1G
    • Table 30 and Table 31 for Parts 2A and 2B
    • Table 32 and Table 33 for Parts 2C and 2D
    • Table 34 and Table 35 for Part 2E of study protocol
    Consulte:
    - Cuadro 16 y Cuadro 17 para la Parte 1A
    - Cuadro 18 y Cuadro 19 para la Parte 1B
    - Cuadro 20 y Cuadro 21 para la Parte 1C
    -Tabla 22 y Tabla 23 Parte 1D
    - Cuadro 24 y Cuadro 25 para la Parte 1E
    - Cuadro 26 y cuadro 27 de la parte 1F
    - Cuadro 28 y cuadro 29 para la parte 1G
    - Cuadros 30 y 31 para las partes 2A y 2B
    - Cuadros 32 y 33 para las partes 2C y 2D
    - Tabla 34 y Tabla 35 para la Parte 2E del protocolo de estudio
    E.5.2Secondary end point(s)
    Part 1 – Dose Finding:
    • Overall Response Rate (ORR) will be defined according to RECIST v1.1.
    Part 1 and Part 2:
    • Duration of Response (DOR), Disease Control Rate (DCR defined as the proportion of participants with a best response of partial response [PR], complete response [CR] or prolonged stable disease [SD]), progression-free-survival (PFS, time from starting treatment until disease progression or death for any reason) will be defined according to RECIST v1.1.
    • Summary measures of PK parameters of EOS-448 and incidence of anti-drug antibodies (ADA) to EOS-448.
    • Summary measures of PK parameters of inupadenant.
    • Summary measures of PK parameters of dostarlimab and incidence of anti-drug antibodies (ADA) to dostarlimab.
    Part 1 and Part 2:
    • Change from baseline of PD and exploratory biomarkers in the tumor and in peripheral blood.
    • Explore the association between PK and PD biomarkers.
    • Explore the relationships between PD and other exploratory biomarkers, before and/or after treatment, and clinical outcomes.
    Parte 1 - Determinación de la dosis:
    - La tasa de respuesta global (ORR) se definirá de acuerdo con RECIST v1.1.
    Parte 1 y Parte 2:
    - La duración de la respuesta (DOR), la tasa de control de la enfermedad (DCR, definida como la proporción de participantes con una mejor respuesta parcial [PR], respuesta completa [CR] o enfermedad estable prolongada [SD]), la supervivencia sin progresión (PFS, tiempo desde el inicio del tratamiento hasta la progresión de la enfermedad o la muerte por cualquier motivo) se definirán de acuerdo con RECIST v1.1.
    - Medidas de resumen de los parámetros PK de EOS-448 e incidencia de anticuerpos antifármaco (ADA) contra EOS-448.
    - Medidas de resumen de los parámetros PK de inupadenant.
    - Medidas de resumen de los parámetros PK de dostarlimab y la incidencia de anticuerpos (ADA) contra dostarlimab.
    Parte 1 y Parte 2:
    - Cambio desde la línea de base de los biomarcadores de EP y exploratorios en el tumor y en la sangre periférica.
    - Explorar la asociación entre los biomarcadores de PK y PD.
    - Explorar las relaciones entre la EP y otros biomarcadores exploratorios, antes y/o después del tratamiento, y los resultados clínicos.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Please refer to:
    • Table 16 and Table 17 for Part 1A
    • Table 18 and Table 19 for Part 1B
    • Table 20 and Table 21 for Part 1C
    •Table 22 and Table 23 Part 1D
    • Table 24 and Table 25 for Part 1E
    • Table 26 and Table 27 for Part 1F
    • Table 28 and Table 29 for Part 1G
    • Table 30 and Table 31 for Parts 2A and 2B
    • Table 32 and Table 33 for Parts 2C and 2D
    • Table 34 and Table 35 for Part 2E of study protocol
    Consulte:
    - Cuadro 16 y Cuadro 17 para la Parte 1A
    - Cuadro 18 y Cuadro 19 para la Parte 1B
    - Cuadro 20 y Cuadro 21 para la Parte 1C
    -Tabla 22 y Tabla 23 Parte 1D
    - Cuadro 24 y Cuadro 25 para la Parte 1E
    - Cuadro 26 y cuadro 27 de la parte 1F
    - Cuadro 28 y cuadro 29 para la parte 1G
    - Cuadros 30 y 31 para las partes 2A y 2B
    - Cuadros 32 y 33 para las partes 2C y 2D
    - Tabla 34 y Tabla 35 para la Parte 2E del protocolo de estudio
    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 Yes
    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 No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other Yes
    E.7.1.3.1Other trial type description
    First time of administration of two combinations
    Primera administración de dos combinaciones
    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 Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Estudio en cesta, evaluando seguridad, tolerabilidad, RP2D, PK, PD, actividad antitumoral de EOS-448
    Basket study, evaluating the safety, tolerability, RP2D, PK, PD, antitumor activity of EOS-448
    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 trial4
    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 EEA20
    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
    United States
    France
    Spain
    Italy
    Belgium
    United Kingdom
    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
    End of study visit will be defined as the last safety follow-up visit/call or the last assessment/phone call during the long-term follow-up whichever occurs last.
    La visita de fin de estudio se definirá como la última visita/llamada de seguimiento de seguridad o la última evaluación/llamada telefónica durante el seguimiento a largo plazo, lo que ocurra en último lugar.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months9
    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 months9
    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: 69
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 207
    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 state30
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 175
    F.4.2.2In the whole clinical trial 276
    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 case of discontinuation for any reason other than disease progression (Section 3.6.4.1 of Protocol), collection of tumor assessments will continue, regardless of safety follow-up, until disease progression, death, withdrawal of consent, start of a new anti-cancer therapy, whichever occurs first.
    En caso de interrupción por cualquier motivo que no sea la progresión de la enfermedad (sección 3.6.4.1 del protocolo), la recogida de evaluaciones tumorales continuará, independientemente del seguimiento de seguridad, hasta la progresión de la enfermedad, la muerte, la retirada del consentimiento o el inicio de un nuevo tratamiento contra el cáncer, lo que ocurra primero.
    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 Decision2022-11-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-10-04
    P. End of Trial
    P.End of Trial StatusOngoing
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