E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
participants with completely resected Stage III or Stage IV melanoma |
Partecipanti con melanoma allo stadio III o IV completamente resecato |
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E.1.1.1 | Medical condition in easily understood language |
participants who had a stage 3 or 4 melanoma surgically removed |
Partecipanti con melanoma allo stadio III o IV rimosso chirurgicamente |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10025671 |
E.1.2 | Term | Malignant melanoma stage IV |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10025670 |
E.1.2 | Term | Malignant melanoma stage III |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To compare the efficacy, as measured by RFS, provided by relatlimab and nivolumab FDC vs nivolumab monotherapy in participants with completely resected Stage III/IV NED melanoma. |
Primario Confrontare l’efficacia, misurata mediante l’RFS, fornita dalla FDC di relatlimab e nivolumab rispetto a nivolumab in monoterapia in partecipanti con melanoma NED allo stadio III/IV completamente resecato |
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E.2.2 | Secondary objectives of the trial |
-To compare the efficacy, as measured by distant metastasis-free survival (DMFS), provided by relatlimab and nivolumab FDC vs nivolumab monotherapy in participants with completely resected Stage III/IV NED melanoma. -To compare the OS provided by relatlimab and nivolumab FDC vs nivolumab monotherapy in participants with completely resected Stage III/IV NED melanoma. -To assess safety and toxicity of relatlimab and nivolumab FDC vs nivolumab monotherapy in participants with completely resected Stage III/IV NED melanoma. -To evaluate investigator-assessed outcomes on next-line therapies. |
Secondari • Confrontare l’efficacia, misurata mediante la distant metastasis-free survival (DMFS) fornita dalla FDC di relatlimab e nivolumab rispetto a nivolumab in monoterapia in partecipanti con melanoma NED allo stadio III/IV completamente resecato. • Confrontare l’OS fornita dalla FDC di relatlimab e nivolumab rispetto rispetto a nivolumab in monoterapia in partecipanti con melanoma NED allo stadio III/IV completamente resecato. • Valutare la sicurezza e la tossicità della FDC di relatlimab e nivolumab rispetto a nivolumab in monoterapia in partecipanti con melanoma NED allo stadio III/IV completamente resecato. • Valutare gli outcomes valutati dallo sperimentatore sulle terapie di linea successiva. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- All participants must have been diagnosed with either Stage IIIA (> 1 mm tumor in lymph node)/B/C/D or Stage IV melanoma by AJCC v8 and have histologically confirmed melanoma that is completely surgically resected (free of disease) with negative margins in order to be eligible. All melanomas, except uveal melanoma, regardless of primary site of disease, will be allowed. - All participants must have disease-free status documented by a complete physical examination within 14 days prior to randomization and imaging studies within 35 days prior to randomization. - Tumor tissue obtained from surgical specimen or biopsy during resection collected within 3 months prior to randomization, with an associated pathology report, must be submitted to the central laboratory prior to randomization. - Eastern Cooperative Oncology Group (ECOG) performance status = 1. - Participant must be = 18 years of age inclusive at the time of signing the informed consent. |
• Per essere idonei, tutti i partecipanti devono aver ricevuto una diagnosi di melanoma allo stadio IIIA (tumore linfonodale >1 mm)/B/C/D o allo stadio IV secondo l’AJCC v8 e presentare un melanoma confermato istologicamente completamente resecato chirurgicamente (senza malattia) con margini negativi. Saranno consentiti tutti i tipi di melanoma, fatta eccezione per il melanoma uveale, a prescindere dalla sede primaria della malattia. • Tutti i partecipanti devono avere uno stato libero da malattia, documentato da esame obiettivo completo entro 14 giorni prima della randomizzazione e studi di diagnostica per immagini condotti entro i 35 giorni precedenti la randomizzazione. • Un blocchetto di tessuto tumorale ottenuto da campione chirurgico o biopsia durante la resezione prelevato nei 3 mesi precedenti la randomizzazione, con un referto patologico associato, deve essere inviato al laboratorio centrale prima della randomizzazione. • Eastern Cooperative Oncology Group (ECOG) performance status = 1. • I Participanti devono avere almeno 18 anni al momento della firma del consenso informato |
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E.4 | Principal exclusion criteria |
- Prior immunotherapy treatment for any prior malignancy: No prior immunotherapies are permitted (such as, but not limited to, antiprogrammed death-1 (anti-PD-1), anti-programmed death ligand-1 (anti-PD-L1), anti-programmed death ligand-2 (PD-L2), or any other antibody or drug specifically targeting T-cell costimulation or immune checkpoint pathways). - Prior treatment with LAG-3 targeted agents. - Prior therapy for melanoma except surgery for the melanoma lesion(s) and/or adjuvant radiation therapy for central nervous system lesions. - Participants with an active, known, or suspected autoimmune disease. Participants with type I diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll. |
• Precedente trattamento immunoterapico per qualsiasi malignità precedente: non sono consentite immunoterapie precedenti (come, a titolo esemplificativo ma non esaustivo, anti-proteina di morte programmata 1 (anti-PD-1), anti-ligando di morte programmata 1 (anti-PD-L1), anti-ligando di morte programmata 2 (PD-L2) o qualsiasi altro anticorpo o farmaco specificamente mirato alla costimolazione delle cellule T o ai pathway del checkpoint immunitario)
• Precedente trattamento con agenti mirati a LAG-3. • Precedente terapia per il melanoma eccetto intervento chirurgico della/e lesione/i del melanoma e/o radioterapia adiuvante per le lesioni a carico del SNC • Partecipanti con malattia autoimmune attiva, nota o sospetta. È consentito l’arruolamento di partecipanti con diabete mellito di tipo 1, ipotiroidismo che richiede soltanto terapia ormonale sostitutiva, disturbi cutanei (quali vitiligine, psoriasi o alopecia) che non richiedono il trattamento sistemico o con patologie di cui non si prevede la recidiva in assenza di un fattore scatenante esterno. |
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E.5 End points |
E.5.1 | Primary end point(s) |
-RFS time as assessed by the investigator. RFS is defined as the time between the date of randomization and the first date of documented recurrence (local, regional, distant, new primary melanoma, including melanoma in situ), or death due to any cause, whichever occurs first. Comparison of relatlimab and nivolumab FDC vs nivolumab monotherapy. |
Tempo alla RFS, come valutato dallo sperimentatore. La RFS è definita come il tempo che intercorre tra la data della randomizzazione e la prima data di recidiva documentata (melanoma primario nuovo, locale, regionale, distante, compreso il melanoma in situ) o il decesso per qualsiasi causa, a seconda di quale evento si verifichi prima. Confronto tra la FDC relatlimab/nivolumab rispetto a nivolumab monoterapia. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
approximately 56 months from the randomization of the first participant |
Circa 56 mesi dalla randomizzazione del primo partecipante |
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E.5.2 | Secondary end point(s) |
1/DMFS, by investigator, is defined as the time between the date of randomization and the date of first distant metastasis or date of death due to any cause, whichever occurs first. Comparison of relatlimab and nivolumab FDC vs nivolumab monotherapy. 2/OS is defined as the time between the date of randomization and the date of death due to any cause. Comparison of relatlimab and nivolumab FDC vs nivolumab monotherapy. 3/ Incidence and severity of AE, SAEs, AEs leading to DC, IMAEs, drugrelated AEs, deaths, laboratory abnormalities, and other select AEs, in all treated participants. 4/Duration of Treatment on next-line therapies, in all randomized subjects who received new anticancer therapy, tumor-directed radiotherapy, or tumor-directed surgery. 5/PFS2 defined as time from randomization to second recurrence/objective disease progression per investigator, or death from any cause, whichever occurs first. Evaluation of relatlimab and nivolumab FDC vs nivolumab monotherapy. |
1) La DMFS, secondo lo sperimentatore, è definita come il tempo che intercorre tra la data della randomizzazione e la data della prima metastasi distante o la data del decesso per qualsiasi causa, a seconda di quale evento si verifichi prima. Confronto tra la FDC relatlimab/nivolumab rispetto a nivolumab monoterapia. 2) L’OS è definita come l’intervallo di tempo tra la data di randomizzazione e la data di decesso per qualsiasi causa. Confronto tra la FDC relatlimab/nivolumab rispetto a nivolumab monoterapia. 3) Incidenza e gravità di EA, SAE, EA che portano all’interruzione, IMAE, EA correlati al farmaco, decessi, anomalie di laboratorio, e altri EA selezionati, in tutti i partecipanti. 4) Durata del trattamento con le terapie di linea successiva, in tutti i partecipanti randomizzati in tutti i soggetti randomizzati che hanno ricevuto una nuova terapia anticancro, radioterapia diretta contro il tumore o chirurgia diretta contro il tumore 5) PFS2, definita come l’intervallo di tempo che va dalla randomizzazione alla seconda recidiva/progressione obiettiva della malattia secondo lo sperimentatore o al decesso per qualsiasi causa, in base a quale evento si verifichi prima. Confronto tra la FDC relatlimab/nivolumab rispetto a nivolumab monoterapia |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1, 3, 4, and 5/ approximately 56 months from the randomization of the first participant 2/ approximately 72 months after the first participant is randomized |
1, 3, 4, and 5) circa 56 mesi dalla randomizzazione del primo partecipante 2) circa 72 mesi dopo che il primo partecipante è stato randomizzato |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 6 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Brazil |
Canada |
Chile |
China |
Israel |
Mexico |
United States |
Austria |
Belgium |
Denmark |
Finland |
France |
Germany |
Italy |
Norway |
Portugal |
Romania |
Spain |
Sweden |
Switzerland |
United Kingdom |
Czechia |
Argentina |
Greece |
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E.8.7 | Trial 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
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last follow-up visit of the last participant |
ultima visita di follow up dell’ultimo partecipante |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 9 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 19 |
E.8.9.2 | In all countries concerned by the trial years | 10 |
E.8.9.2 | In all countries concerned by the trial months | 5 |
E.8.9.2 | In all countries concerned by the trial days | 0 |