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    Summary
    EudraCT Number:2021-001933-38
    Sponsor's Protocol Code Number:ONCX-NAV-G301
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2021-11-02
    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 number2021-001933-38
    A.3Full title of the trial
    A Phase 3 Multicenter, Open-Label, Randomized Study of Navicixizumab Plus Paclitaxel and Navicixizumab Monotherapy in Comparison to Paclitaxel Monotherapy in Patients with Platinum-Resistant Epithelial Ovarian, Primary Peritoneal, or Fallopian Tube Cancer
    Estudio en fase III, multicéntrico, abierto y aleatorizado de Navicixizumab con paclitaxel y navicixizumab en monoterapia en comparación con paclitaxel en monoterapia en pacientes con cáncer de ovario epitelial resistente al platino, peritoneal primario o de trompa de Falopio
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study of Navicixizumab Plus Paclitaxel and Navicixizumab Monotherapy in Comparison to Paclitaxel Monotherapy in Patients with Platinum-Resistant Epithelial Ovarian, Primary Peritoneal, or Fallopian Tube Cancer
    Estudio de Navicixizumab con paclitaxel y navicixizumab en monoterapia en comparación con paclitaxel en monoterapia en pacientes con cáncer de ovario epitelial resistente al platino, peritoneal primario o de trompa de Falopio
    A.3.2Name or abbreviated title of the trial where available
    REVELARE
    A.4.1Sponsor's protocol code numberONCX-NAV-G301
    A.5.4Other Identifiers
    Name:IND Number:Number:130995
    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 SponsorOncXerna Therapeutics, Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportOncXerna Therapeutics, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationOncXerna Therapeutics, Inc.
    B.5.2Functional name of contact pointSusan MacIntyre
    B.5.3 Address:
    B.5.3.1Street Address300 Fifth Ave, Suite 6040
    B.5.3.2Town/ cityWaltham
    B.5.3.3Post codeMA 02451
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1774245-8299
    B.5.6E-mailsmacintyre@oncxerna.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 nameNavicixizumab
    D.3.2Product code OMP-305B83
    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 INNNavicixizumab
    D.3.9.1CAS number 1638338-43-8
    D.3.9.2Current sponsor codeOMP-305B83
    D.3.9.3Other descriptive nameNavicixizumab
    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 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 RoleComparator
    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 Paclitaxel AqVida 6 mg/ml concentrate for solution for infusion
    D.2.1.1.2Name of the Marketing Authorisation holderAqVida GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    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.3.4Pharmaceutical 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 INNPaclitaxel
    D.3.9.1CAS number 33069-62-4
    D.3.9.2Current sponsor codeN/A
    D.3.9.3Other descriptive namePaclitaxel
    D.3.9.4EV Substance CodeSUB09583MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number6
    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
    Patients With Platinum-Resistant Epithelial Ovarian, Primary Peritoneal, or Fallopian Tube Cancer
    Pacientes con cáncer de ovario epitelial resistente al platino, peritoneal primario o de trompa de Falopio
    E.1.1.1Medical condition in easily understood language
    Ovarian cancer
    Cáncer de ovario
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10033128
    E.1.2Term Ovarian cancer
    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
    • To compare the objective response rate (ORR) and evaluate the duration of response (DOR) in patients with B+ disease, as well as in all-comers, treated with navicixizumab in combination with weekly paclitaxel to patients treated with weekly paclitaxel monotherapy
    • To compare the progression-free survival (PFS) in patients with B+ disease, as well as in all-comers, treated with navicixizumab in combination with weekly paclitaxel to patients treated with weekly paclitaxel monotherapy
    • To compare the ORR and evaluate the DOR in patients with B+ disease, as well as in all-comers, treated with navicixizumab monotherapy to patients treated with weekly paclitaxel monotherapy
    • Comparar la tasa de respuesta objetiva (TRO) y evaluar la duración de la respuesta (DR) en pacientes con enfermedad B+, así como en todo tipo de pacientes, tratadas con navicixizumab en combinación con paclitaxel semanal frente a pacientes tratadas con paclitaxel en monoterapia semanal.
    • Comparar la supervivencia sin progresión (SSP) en pacientes con enfermedad B+, así como en todo tipo de pacientes, tratadas con navicixizumab en combinación con paclitaxel semanal frente a pacientes tratadas con paclitaxel semanal en monoterapia.
    • Comparar la TRO y evaluar la DR en pacientes con enfermedad B+, así como en todo tipo de pacientes, tratadas con navicixizumab en monoterapia frente a pacientes tratadas con paclitaxel en monoterapia semanal.
    E.2.2Secondary objectives of the trial
    • To evaluate overall survival (OS) in patients with B+ disease, as well as in all-comers, treated with navicixizumab in combination with weekly paclitaxel to patients treated with weekly paclitaxel monotherapy
    • To evaluate whether biomarker status on the Xerna™ TME Panel is a predictive biomarker for ORR, PFS, and OS in patients receiving treatment with navicixizumab either in combination with weekly paclitaxel or as monotherapy

    Other Secondary Objectives:
    • To evaluate the PFS and OS in patients treated with navicixizumab monotherapy vs patients treated with weekly paclitaxel monotherapy
    • To further characterize the antitumor activity and clinical benefit of navicixizumab in combination with weekly paclitaxel in comparison to weekly paclitaxel monotherapy or navicixizumab monotherapy
    • To characterize concordance between archived and core tumor samples in terms of Xerna™ TME Panel biomarker status
    Evaluar la supervivencia global (SG) en pacientes con enfermedad B+,así como en todo tipo de pacientes,tratadas con navicixizumab en combinación con paclitaxel semanal frente a pacientes tratadas con paclitaxel semanal en monoterapia/Evaluar si el estado de los biomarcadores en el panel de TME XernaTM es un biomarcador predictivo de la TRO,la SSP y la SG en pacientes que reciben tratamiento con navicixizumab en combinación con paclitaxel semanal o en monoterapia. Otros objetivos secundarios: Evaluar la SSP y la SG en pacientes tratadas con navicixizumab en monoterapia frente a pacientes tratadas con paclitaxel en monoterapia semanal/Caracterizar mejor la actividad antitumoral y el beneficio clínico de navicixizumab en combinación con paclitaxel semanal en comparación con paclitaxel semanal en monoterapia o navicixizumab en monoterapia/Caracterizar la concordancia entre las muestras tumorales de archivo y con aguja gruesa en términos del estado de biomarcadores del panel de MET XernaTM.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Patient provides signed informed consent to participate in the study prior to undergoing any study procedures, including screening procedures.
    2. Patient is ≥18 years old or age of majority in the country in which they reside, whichever is higher.
    3. Patient must have epithelial ovarian, fallopian tube, or primary peritoneal cancer consisting of one of the following histological subtypes:
    − adenocarcinoma not otherwise specified
    − clear cell adenocarcinoma
    − endometrioid adenocarcinoma
    − malignant Brenner's tumor
    − mixed epithelial carcinoma
    − malignant mixed Mullerian
    − serous adenocarcinoma
    − transitional cell carcinoma
    − undifferentiated carcinoma
    4. Patients must have received ≥2 and not more than 5 prior therapies, including at least 1 line of therapy containing bevacizumab (or biosimilar).
    − Adjuvant/neoadjuvant therapy is counted as only 1 regimen in the absence of intervening progression.
    − Maintenance therapy (e.g., bevacizumab or a PARP inhibitor will be considered part of the preceding line of therapy [i.e., not counted independently]).
    − Therapy changed due to toxicity in the absence of progression will be considered part of the same line (i.e., not counted independently).
    − Hormonal therapy will be counted as a separate line of therapy unless it was given as maintenance.
    − Patients with known BRCA-1 or -2 mutation should have received a prior PARP inhibitor.
    5. Patients must be considered platinum-resistant, defined as progression within 6 months from completion of a platinum-containing therapy. The date should be calculated from the last administered dose of platinum-containing therapy.
    6. Patient must be considered appropriate for treatment with weekly paclitaxel monotherapy as the next line of therapy.
    7. Patient must be willing and able to provide an FFPE archival or core tumor sample for determination of biomarker status on the Xerna™ TME Panel biomarker assay (positive or negative)prior to study treatment.
    8. Determination of B+ or B- status on the Xerna™ TME Panel biomarker assay.
    9. Presence of at least one measurable lesion, as defined by RECIST v1.1. Previously irradiated lesions can be considered as measurable if disease progression has been unequivocally demonstrated at that lesion since radiation.
    10. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 to 1.
    11. Adequate organ function defined as:
    − Absolute neutrophil count (ANC) ≥1.5 x 109/L.
    − Hemoglobin ≥9 g/dL. The patient may have been transfused to meet eligibility criteria; however, hemoglobin should remain stable and ≥9 g/dL for at least 1 week prior to first dose of study therapy.
    − Platelet count ≥100 x 109/L.
    − Total serum bilirubin ≤1.5 x institutional upper limit of normal (ULN). Patients with known Gilbert syndrome who have serum bilirubin level ≤3 x ULN may be enrolled upon discussion with the medical monitor.
    − Aspartate aminotransferase and alanine aminotransferase ≤3.0 x ULN or ≤5 x ULN (based on institutional limits) if there are documented metastases in the liver.
    − Serum creatinine ≤1.5 x ULN for the reference laboratory or a calculated creatinine clearance of ≥30 mL/min by the Cockcroft-Gault equation.
    − International normalized ratio and activated partial thromboplastin time (aPTT) within 1.5 x the institutional ULN. If a patient is receiving anticoagulant therapy, then prothrombin time/aPTT should be within therapeutic range of intended use.
    12. Women of childbearing potential must have a negative serum or urine pregnancy test in the 72 hours before the start of study treatment.
    13. Women of childbearing potential must agree to follow instructions for highly effective method(s)of contraception while receiving study treatment plus 6 months post-treatment completion. (See Appendix 1 for the definition of non-childbearing potential and complete contraception guidance.)
    14. Patients must have discontinued other anticancer interventions before Cycle 1 Day 1 (C1D1) as follows: (a) cytotoxic chemotherapy for at least 21 days; (b) biologic therapy (e.g., antibodies) or investigational agents within a period of 5 half-lives or 28 days (whichever is shorter); (c) non myelosuppressive agents for at least 14 days; (d) radiotherapy for at least 28 days, except for limited field palliative radiotherapy to non-target lesion that may be completed at least 14 days before C1D1.
    1.La paciente proporciona el consentimiento informado firmado para participar en el estudio antes de someterse a cualquier procedimiento del estudio, incluidos los procedimientos de selección
    2.La paciente tiene≥18 años de edad o la mayoría de edad en el país en el que reside, la que sea mayor.
    3.La paciente debe tener cáncer epitelial de ovario, trompa de Falopio o peritoneo primario que esté formado por uno de los siguientes subtipos histológicos: adenocarcinoma sin especificar/adenocarcinoma de células claras/adenocarcinoma endometrioide/tumor maligno de Brenner/carcinoma epitelial mixto
    /malignidad mixta mülleriana/adenocarcinoma seroso/carcinoma de células transicionales/carcinoma no diferenciado
    4.Las pacientes deben haber recibido ≥2 y no más de 5 tratamientos (ttos) previos, incluida al menos 1 línea de tratamiento(tto.) que contenga bevacizumab (o un producto biosimilar). El tto. adyuvante/neoadyuvante se cuenta como solo 1 pauta en ausencia de progresión/El tto. de mantenimiento (p. ej., bevacizumab, inhibidor de la poliadenosina difosfato-ribosa polimerasa [PARP] se considerará parte de la línea de tto. anterior [es decir, no se contará de forma independiente])/El tto. modificado debido a toxicidad en ausencia de progresión se considerará parte de la misma línea (es decir, no se contará de forma independiente)/El tto. hormonal se contará como una línea de tto. independiente, a menos que se administrara como mantenimiento/Las pacientes con mutación conocida del gen del cáncer de mama (BRCA)-1 o -2 deben haber recibido un inhibidor de PARP previo.
    5.Las pacientes deben considerarse resistentes al platino, definidas como con progresión dentro de los 6 meses posteriores a la finalización de un tto. con platino. La fecha debe calcularse a partir de la última dosis administrada del tto. con platino.
    6.La paciente debe considerarse apropiada para el tto. con paclitaxel semanal en monoterapia como la siguiente línea de tto.
    7.La paciente debe estar dispuesta y ser capaz de proporcionar una muestra de tumor de archivo o con aguja gruesa FFIP para determinar el estado de los biomarcadores en el análisis de biomarcadores del panel de MET XernaTM (positivo o negativo) antes del tto. del estudio.
    8.Determinación del estado B+ o B- en el análisis de biomarcadores del panel de MET XernaTM.
    9.Presencia de al menos una lesión mensurable, según los criterios RECIST v1.1. Las lesiones irradiadas previamente pueden considerarse medibles si la progresión de la enfermedad se ha demostrado inequívocamente en esa lesión desde la radiación.
    10. Estado funcional según el Grupo Oncológico Cooperativo del Este de Estados Unidos de 0 a 1.
    11. Función orgánica adecuada, definida de la siguiente manera:Recuento absoluto de neutrófilos ≥1,5 x 109/l./Hemoglobina ≥9 g/dl. La paciente puede haber recibido una transfusión para cumplir los criterios de aptitud; sin embargo, la hemoglobina debe permanecer estable y ser ≥9 g/dl durante al menos 1 semana antes de la primera dosis del tto. del estudio/Recuento plaquetario ≥100 x 109/l./Bilirrubina sérica total ≤1,5 × límite superior de la normalidad (LSN) del centro. Las pacientes con síndrome de Gilbert conocido que tengan un nivel de bilirrubina sérica ≤3 x LSN podrán inscribirse tras consultarlo con el supervisor médico/Aspartato aminotransferasa y alanina aminotransferasa ≤3,0 x LSN o ≤5 x LSN (según los límites del centro) si hay metástasis documentadas en el hígado/Creatinina sérica ≤1,5 x LSN para el laboratorio de referencia o aclaramiento de creatinina calculado ≥30 ml/min mediante la ecuación de Cockcroft-Gault/Índice internacional normalizado y tiempo de tromboplastina parcial activada (TTPa) dentro de 1,5 x LSN del centro. Si un paciente está recibiendo tto. anticoagulante, entonces el tiempo de protrombina/TTPa debe estar dentro del intervalo terapéutico del uso previsto.
    12.Las mujeres en edad fértil deberán presentar una prueba de embarazo en orina o suero negativa en las 72 horas antes del inicio del tto. del estudio.
    13.Las mujeres en edad fértil deben aceptar seguir las instrucciones para el/los método(s) anticonceptivo(s) altamente eficaces mientras reciben el tto. del estudio, más 6 meses después de la finalización del tto. (Consulte el Apénd.1 para ver la definición de mujeres que no están en edad fértil y las directrices anticonceptivas completas).
    14.Las pacientes deben haber interrumpido otras intervenciones antineoplásicas antes del día 1 del ciclo 1 (D1C1) de la siguiente manera:(a)quimioterapia citotóxica durante al menos 21 días;(b)terapia biológica (p. ej., anticuerpos) o fármacos en investigación dentro de un período de 5 semividas o 28 días (lo que sea más corto);(c)fármacos no mielosupresores durante al menos 14 días;(d)radioterapia durante al menos 28 días, excepto radioterapia paliativa de campo limitada para lesión no diana, que puede haberse completado al menos 14 días antes del D1C1.
    E.4Principal exclusion criteria
    1. Non-epithelial ovarian carcinoma.
    2. Ovarian tumors with low malignant potential (i.e., borderline tumors).
    3. Primary platinum-refractory disease (defined as progression during or within 4 weeks after completion of the first platinum regimen).
    4. Patient has received an anti-angiogenic product other than bevacizumab or biosimilar.
    5. Patient has any of the following conditions related to cardiac function:
    − Symptomatic congestive heart failure (New York Heart Association Class II to IV; Appendix 2).
    − History of myocardial infarction, cerebral vascular accident, or transient ischemic attacks within 6 months prior to C1D1.
    − History of cardiac ischemia or heart failure within 6 months prior to C1D1.
    − Baseline B-type natriuretic peptide (BNP) value >100 pg/mL or N-terminal-proBNP (NT-proBNP)value of > 125 pg/mL.
    − LVEF <50%.
    − Peak tricuspid velocity >3.0 m/s on Doppler ECHO.
    − Clinically significant ECG abnormality, as assessed by the investigator.
    6. Blood pressure (BP) >140/90 mmHg. Patients taking antihypertensive medications must be taking ≤2 medications to obtain BP control of ≤140/90 mmHg.
    Note: Fixed-dose combination treatments should be considered 2 medications.
    7. Pregnant or lactating women.
    8. Active/unstable brain metastases including leptomeningeal disease.
    9. Known additional malignancy that was progressing or had required active treatment within 2 years prior to the first dose of study medication. Exceptions include malignancies with a negligible risk of metastasis or death, including basal cell basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (e.g., breast carcinoma, cervical cancer in situ).
    10. History of bowel obstruction, including sub-occlusive disease, related to the underlying disease and history of abdominal fistula, GI perforation, or intra-abdominal abscess. Evidence of recto sigmoid involvement by pelvic examination or bowel involvement on computed tomography (CT) scan or clinical symptoms of bowel obstruction.
    11. Pre-existing Grade ≥2 peripheral neuropathy, according to the CTCAE v5.0.
    12. Active infection requiring IV systemic therapy.
    13. Known hypersensitivity to any components of monoclonal antibodies, including navicixizumab or any of its excipients that, in the opinion of the investigator, suggests a high risk for a severe hypersensitivity reaction while on treatment.
    14. Known clinically significant bleeding disorder.
    15. Current use of full-dose oral or parenteral anticoagulants or thrombolytic agents for therapeutic purposes that has not been stable for >14 days prior to C1D1.
    Note: Prophylactic doses of anticoagulants, low-dose aspirin, and/or non-steroidal anti-inflammatory agents are allowed.
    16. Hemoptysis >2.5 mL within 8 weeks prior to C1D1 or serious bleeding from another site within this time frame.
    17. Major surgical procedure, or significant traumatic injury within 28 days prior to C1D1, or anticipation of need for major surgical procedure during the study.
    Note: Placement of a vascular access device will not be considered major surgery.
    18. Patients with an uncontrolled seizure disorder or active neurologic disease.
    19. Patients with a cardiac aneurysm.
    20. Known psychiatric, substance abuse disorder, or geographical travel limitations that would interfere with patient’s ability to cooperate with the requirements of the study.
    21. History or current evidence of any condition, therapy, or laboratory abnormality that may confound the results of the study, interfere with the patient's participation for the full duration of the study, or indicates a condition for which study participation is not in the best interest of the patient, in the opinion of the treating investigator.
    1.Carcinoma ovárico no epitelial.
    2.Tumores ováricos con bajopotencial maligno (es decir, tumores limítrofes).
    3.Enfermedad primaria resistente al platino (definida como progresión durante o en las 4semanas posteriores a la finalización de la primera pauta de platino).
    4.La paciente ha recibido un producto antiangiogénico distinto debevacizumab o un producto biosimilar.
    5.La paciente presenta alguna de las siguientes afecciones relacionadas con la función cardíaca:Insuficiencia cardíaca congestiva sintomática (clases II a IV según la Asociación Neoyorquina de Cardiología [New York Heart Association]);Apéndice 2)/Antecedentes de infarto de miocardio, accidente vascular cerebral oaccidente isquémicotransitorio enlos 6meses anteriores al D1C1/Antecedentes de isquemia cardíaca o insuficiencia cardíaca en los 6meses anteriores al D1C1/Valor inicial del péptidonatriurético tipo B (BNP) >100pg/ml o valor de N-terminal-proBNP(NT-proBNP) >125pg/ml./Fracción de eyección ventricular izquierda <50%/Velocidad máxima tricuspídea >3,0m/s en la ECO Doppler/Anomalía clínicamente significativa en el ECG, según la evaluación del investigador.
    6.Presión arterial >140/90mmHg. Las pacientes que tomen medicamentos antihipertensivos deben estartomando≤2medicamentosparaobtenerun controldelaPA≤140/90mmHg.
    Nota:El tto. combinado condosis fija debe considerarse como 2medicamentos.
    7.Mujer embarazada o en periodode lactancia.
    8.Metástasis cerebrales activas/inestables, incluida enfermedad leptomeníngea.
    9.Neoplasia maligna adicional conocida que estaba progresando o había requerido tto. activo en los 2 años anteriores a la primera dosis delmedicamentodelestudio.Las excepciones incluyenneoplasias malignas con un riesgo insignificante de metástasis o muerte, incluidos carcinoma basocelular de la piel, carcinoma epidermoide de la piel o carcinoma in situ (p.ej., carcinoma de mama, cáncer cervicouterino in situ).
    10.Antecedentes de obstrucción intestinal,incluida enfermedad suboclusiva, relacionada con la enfermedad subyacente y antecedentes de fístula abdominal, perforación gastrointestinal o abscesointraabdominal. Signos de afectación rectosigmoidea mediante exploración pélvica o afectaciónintestinal en la tomografía axial computarizada (TAC) o síntomas clínicos de obstrucción intestinal.
    11.Neuropatía periférica preexistente de grado ≥2, de acuerdo con los CTCAE v5.0.
    12.Infección activa que requiera tto. sistémico intravenoso (i.v.).
    13.Hipersensibilidad conocida a cualquier componente de los anticuerpos monoclonales, incluidosnavicixizumab o cualquiera de sus excipientes que, en opinión del investigador, sugiera un altoriesgo de reacción de hipersensibilidad grave durante el tto.
    14.Trastorno hemorrágico clínicamente significativo conocido.
    15.Uso actual de anticoagulantes o fármacos trombolíticos orales o parenterales a dosis completas confines terapéuticos que no hayan sido estables durante >14días antes del D1C1.
    16.Hemoptisis >2,5 ml en las 8 semanas anteriores al D1C1 o hemorragia grave en otro lugar dentro de este intervalo de tiempo.
    17.Intervención quirúrgica mayor o lesión traumática significativa en los 28 días anteriores al C1D1 o previsión de necesidad de intervención quirúrgica mayor durante el estudio.Nota: La colocación de un dispositivo de acceso vascular no se considerará cirugía mayor.
    18. Paciente con un trastorno convulsivo no controlado o enfermedad neurológica activa.
    19. Paciente con aneurisma cardíaco.
    20. Paciente con trastorno psiquiátrico conocido, abuso de sustancias o limitaciones para desplazamientos geográficos que puedan interferir en la capacidad de la paciente para cooperar con los requisitos del estudio.
    21. Antecedentes o signos actuales de cualquier patología, tratamiento o anomalía de laboratorio que, a juicio del investigador encargado del tratamiento, pueda confundir los resultados del estudio, interferir en la participación de la paciente durante todo el estudio o que indiquen una afección para la que la participación de la paciente en el estudio no sea lo más beneficioso para la propia paciente.
    E.5 End points
    E.5.1Primary end point(s)
    • ORR, defined as the proportion of patients with a confirmed best overall response (BOR) of complete response (CR) or partial response (PR), by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
    • PFS, defined as the time from randomization to the date of first documentation of objective disease progression or death (any cause), whichever occurs first
    • TRO, definida como la proporción de pacientes con una mejor respuesta global (MRG) confirmada de respuesta completa (RC) o respuesta parcial (RP), según los Criterios de evaluación de la respuesta en tumores sólidos, versión 1.1 (RECIST v1.1).
    • SSP, definida como el tiempo desde la aleatorización hasta la fecha de la primera documentación de progresión de la enfermedad objetiva o la muerte (por cualquier causa), lo que ocurra primero.
    E.5.1.1Timepoint(s) of evaluation of this end point
    As defined in the primary end point(s)
    Como se define en el/los criterio/s de valoración primarios
    E.5.2Secondary end point(s)
    • OS, defined as the time from randomization to death
    • Time to response (TTR), defined as the time from randomization to first documentation of response(CR or PR)
    • Disease control rate (DCR), defined as the proportion of patients with stable disease (SD) or a confirmed BOR of CR or PR
    • DOR, defined as the time from first documentation of response (CR or PR) to documentation of objective disease progression or death due to any cause, whichever occurs first
    • Changes in measures of health-related QOL (EORTC QLC-30 and supplemental ovarian cancer module [QLQ-OV28]; EQ-5D-5L)
    • Concordance in Xerna™ TME Panel biomarker status between archived and core tumor samples collected during the screening period.
    • SG, definida como el tiempo desde la aleatorización hasta la muerte.
    • Tiempo hasta la respuesta, definido como el tiempo transcurrido desde la aleatorización hasta la primera documentación de respuesta (RC o RP).
    • Tasa de control de la enfermedad, definida como la proporción de pacientes con enfermedad estable o una MRG confirmada de RC o RP.
    • DR, definida como el tiempo desde la primera documentación de respuesta (RC o RP) hasta la documentación de progresión de la enfermedad objetiva o la muerte por cualquier causa, lo que ocurra primero.
    • Cambios en las medidas de la CdV relacionada con la salud (QLC-30 de la EORTC y módulo suplementario de cáncer de ovario [QLQ-OV28]; EQ-5D-5L).
    • Concordancia en el estado de biomarcadores del panel de MET XernaTM entre las muestras tumorales de archivo y con aguja gruesa recogidas durante el periodo de selección.
    E.5.2.1Timepoint(s) of evaluation of this end point
    As defined in the secondary end point(s)
    Como se define en el/los criterio/s de valoración secundarios
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Tolerability, Immunogenicity, Biomarker Analysis, Quality of life (QOL)
    Tolerabilidad, Inmunogenicidad, Análisis de biomarcador, Calidad de Vida (CdV)
    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) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    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 No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial3
    E.8.3 The trial involves single site in the Member State concerned 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 concerned12
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA64
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Canada
    Korea, Republic of
    United States
    Belgium
    France
    Germany
    Italy
    Poland
    Romania
    Spain
    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 is defined as the date of the last visit of the last patient. Follow-up for survival will continue until the last patient has completed a minimum of 12 months of follow-up or approximately 75 % of the population has died, whichever is later.
    El final del estudio está definido como la fecha de la última visita del último paciente. El seguimiento de la supervivencia continuará durante 12 meses después de que se inscriba a la última paciente o de que aproximadamente el 75 % de la población haya muerto, lo que ocurra más tarde.
    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 months10
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 100
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 250
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male No
    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 state45
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 200
    F.4.2.2In the whole clinical trial 400
    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)
    Patients receiving clinical benefit from navicixizumab either as monotherapy or in combination with paclitaxel may continue receiving treatment after the end of the study based on approval from the sponsor.
    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 Decision2021-12-30
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-12-13
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
    P.Date of the global end of the trial2023-06-30
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