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    Summary
    EudraCT Number:2021-003026-69
    Sponsor's Protocol Code Number:IO102-IO103-022
    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:2021-12-14
    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 number2021-003026-69
    A.3Full title of the trial
    A Phase II Multi-Arm (basket) Trial Investigating the Safety and Efficacy of IO102-IO103 in Combination with Pembrolizumab, as First-line Treatment for Patients with Metastatic Non-Small Cell Lung Cancer (NSCLC), Squamous Cell Carcinoma of Head and Neck (SCCHN), or Metastatic Urothelial Bladder Cancer (mUBC)
    Ensayo en fase II con varios grupos (en canasta) para investigar la seguridad y eficacia de IO102-IO103 en combinación con pembrolizumab, como tratamiento de primera línea para pacientes con cáncer de pulmón no microcítico (CPNM) metastásico, carcinoma de células escamosas de cabeza y cuello (CCECC) o carcinoma urotelial de vejiga metastásico (CUVm)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study investigating the use of IO102-IO103 in combination with pembrolizumab for patients with metastatic Non-Small Cell Lung Cancer (NSCLC), Squamous Cell Carcinoma of Head and Neck (SCCHN), or metastatic Urothelial Bladder Cancer (mUBC)
    A.3.2Name or abbreviated title of the trial where available
    A multi-arm(basket)study of IO102-IO103 and pembrolizumab in 1st line metastatic NSCLC,SCCHN or mUBC
    A.4.1Sponsor's protocol code numberIO102-IO103-022
    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 SponsorIO Biotech ApS
    B.1.3.4CountryDenmark
    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 supportIO Biotech ApS
    B.4.2CountryDenmark
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationTheradex (Europe) Ltd.
    B.5.2Functional name of contact pointEdyta Niemczyk
    B.5.3 Address:
    B.5.3.1Street Address2nd Floor, The Pinnacle, Station Way, West Sussex
    B.5.3.2Town/ cityCrawley
    B.5.3.3Post codeRH10 1JH
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number+441293 510319
    B.5.5Fax number+441293 510322
    B.5.6E-mailregulatory@theradex.co.uk
    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 nameIO102-IO103 + Montanide ISA 51 VG Sterile
    D.3.4Pharmaceutical form Emulsion for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNot yet assigned
    D.3.9.1CAS number 2130836-27-8
    D.3.9.2Current sponsor codeIO102, IDO LONG
    D.3.9.3Other descriptive nameIO102, IDO LONG
    D.3.9.4EV Substance CodeSUB191065
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.255
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNot yet assigned
    D.3.9.1CAS number 1431550-68-3
    D.3.9.2Current sponsor codeIO103
    D.3.9.3Other descriptive nameIO103
    D.3.9.4EV Substance CodeSUB218973
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.255
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Metastatic Non-Small Cell Lung Cancer (NSCLC), Metastatic Squamous Cell Carcinoma of Head and Neck (SCCHN), Metastatic Urothelial Bladder Cancer (mUBC)
    cáncer de pulmón no microcítico (CPNM) metastásico, carcinoma de células escamosas de cabeza y cuello (CCECC) metastásico, carcinoma urotelial de vejiga metastásico (CUVm)
    E.1.1.1Medical condition in easily understood language
    Lung Cancer, Head and Neck Cancer, Bladder Cancer
    Cáncer de pulmón, cáncer de cabeza y cuello, cáncer de vejiga
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 22.0
    E.1.2Level LLT
    E.1.2Classification code 10082179
    E.1.2Term Squamous cell carcinoma of head and neck metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10046722
    E.1.2Term Urothelial carcinoma bladder stage IV
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10059515
    E.1.2Term Non-small cell lung cancer metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective is to investigate the efficacy of IO102-IO103 in combination with pembolizumab in the frontline treatment of each of the different metastatic solid tumor indications (NSCLC PD-L1 ≥50%, SCCHN PD-L1 CPS ≥20 , or mUBC CPS ≥10 with the intent to expand a specific arm if a significant clinically relevant signal is observed.
    El objetivo principal es investigar la eficacia de IO102-IO103 en combinación con pembrolizumab en el tratamiento de primera línea de cada una de las diferentes indicaciones de tumores sólidos metastásicos (CPCNP con PD-L1 ≥50 %, CECyC con CPS PD-L1 ≥20 o MUBC con CPS ≥10) con la intención de ampliar el grupo específico si se observa una señal significativa clínicamente relevante
    E.2.2Secondary objectives of the trial
    The secondary objective is to investigate the safety of IO102-IO103 in combination with pembrolizumab in each of the 3 disease indications.
    El objetivo secundario es investigar la seguridad de IO102-IO103 en combinación con pembrolizumab en cada una de las 3 indicaciones de la enfermedad.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Patients with histologically or cytologically confirmed:
    Metastatic NSCLC (adenocarcinoma) (Arm A), who have not received prior systemic treatment for their metastatic disease and who have:
    • no known sensitizing genetic aberrations where there are approved therapies (such as EGFR, KRAS G12C, BRAF V600E, MET skipping mutations, and RET mutations or rearrangements)
    or
    Metastatic SCCHN (Arm B) with no prior therapy and who have:
    • Histologically- or cytologically-confirmed recurrent (without metastases) or metastatic SCCHN considered incurable by local therapies. Tumors of nasophyngeal origin (any histology) are excluded
    • Documented results of HPV status for oropharyngeal cancer.
    or
    Metastatic UBC (Arm C) with no prior therapy and not eligible for any platinum-containing chemotherapy:
    • Advanced/unresectable (inoperable) or metastatic urothelial cancer of the renal pelvis, ureter, bladder or urethra (transitional cell and mixed transitional/non transitional cell histologies permitted but transitional cell histology must be the dominant histology)

    For all arms, any solitary metastases must be biopsied to confirm diagnosis of metastases from primary indication

    2. PD-L1 TPS or PD-L1 CPS (as confirmed prior to enrolment using the PD-L1 IHC DAKO 22C3 pharmDx assay, using local/central services):
    • Arm A (NSCLC): PD-L1 TPS ≥ 50%
    • Arm B (SCCHN): PD-L1 CPS ≥ 20; HPV +/-
    • Arm C (mUBC): PD-L1 CPS ≥ 10
    3. A female participant is eligible to participate if she is not pregnant not breastfeeding, and at least one of the following conditions applies:
    • Not a woman of childbearing potential (WOCBP)
    • A WOCBP who agrees to follow contraceptive guidance starting with the screening visit and through 120 days after last dose of pembrolizumab or 180 days after last dose of chemotherapy.
    Note: A WOCBP, i.e., fertile, following menarche and until becoming post-menopausal unless permanently sterile. Permanent sterilisation methods include hysterectomy, bilateral salpingectomy, and bilateral oophorectomy. Tubal ligation is not a method of permanent sterilisation. A postmenopausal state is defined as no menses for 12 months without an alternative medical cause.
    4. The participant (or legally acceptable representative if applicable) provides written informed consent for the trial in accordance with ICH-GCP and local legislation prior to admission to the trial.
    5. At least 18 years of age on day of signing informed consent.
    6. Have measurable disease per RECIST 1.1 as assessed by local site investigator/radiologist. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.
    7. Have provided a blood sample and archival tumor tissue sample or newly obtained core or excisional biopsy of a tumor lesion not previously irradiated. Formalin-fixed, paraffin embedded (FFPE) tissue blocks are preferred to slides.
    8. Have an ECOG performance status of 0 to 1.
    9. If participant received major surgery, they must have recovered adequately from the adverse events and/or complications from the intervention prior to starting trial treatment.
    10. Have adequate organ function as defined in the protocol. Specimens must be collected within 10 days prior to the start of trial treatment. Have adequate organ function as defined below. Specimens must be collected within 10 days prior to the start of trial treatment.
    Adequate organ function as defined by:
    • Haematology:
    Absolute neutrophil count ≥1500/μL or ≥1.5 × 10^9/L
    Platelets ≥ 100,000/μL or ≥ 100 × 10^9/L
    Hemoglobin ≥ 9.0 g/dL or ≥ 5.6 mmol/L. Criteria must be met without packed red blood cell transfusion within the prior 2 weeks. Participants can be on stable dose of erythropoietin (≥ approximately 3 months).
    • Renal:
    Creatinine ≤1.5 × ULN, or
    Measured or calculated creatinine clearance (CrCl) ≥50 mL/min for patients with creatinine levels >1.5 × institutional ULN;
    GFR can also be used in place of creatinine or CrCl
    • Hepatic:
    Total bilirubin ≤1.5 × ULN or direct bilirubin ≤ ULN for patients with total bilirubin levels ≤3 × ULN
    Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5 × ULN (≤5 × ULN for patients with liver metastases)
    Alkaline Phosphatase ≤2.5 × ULN
    • Endocrine:
    No uncontrolled endocrinopathies
    • Coagulation:
    International normalised ratio (INR) prothrombin time (PT) or activated partial thromboplastin time (aPTT) ≤1.5 × ULN unless patient is receiving anticoagulant therapy as long as PT or aPTT is within therapeutic range of intended use of anticoagulants.
    1. Pacientes con confirmación histológica o citológica de:
    Grupo A: El carcinoma pulmonar no microcítico (CPNM) adenocarcinoma metastásico, que no han recibido un tratamiento sistémico anteriormente para su cáncer metastatizante y que no tienen ninguna anomalía genética sensibilizante conocida para la que existen tratamientos aprobados.
    o
    Grupo B: Carcinoma de células escamosas de cabeza y cuello (CCECC), que no han recibido un tratamiento sistémico anteriormente para su cáncer metastatizante y que tienen CCECC metastásico o recurrente (sin metástasis) que se considera incurable con los tratamientos locales. Se excluyen los tumores de origen nasofaríngeo. Se debe conocer el estado del VPH.
    o
    Grupo C: Cáncer de urotelio (CU) metastásico o avanzado/irresecable que no han recibido un tratamiento sistémico anteriormente para su cáncer metastatizante y no apto para recibir ningún tipo de quimioterapia con platino. Esto incluye cánceres de la pelvis renal, el uréter, la vejiga y la uretra. Se permiten histologías mixtas pero la histología de células transicionales debe ser la dominante).
    Para todos los grupos, se deben hacer biopsias de todas las metástasis únicas para confirmar el diagnóstico de metástasis de la indicación primaria.

    2. Estado de PD-L1 determinado mediante la prueba PD-L1 IHC DAKO 22C3 (PharmDx):
    • Grupo A (CPNM): TPS PD-L1 ≥50 %
    • Grupo B (CCECC): CPS PD-L1 ≥ 20
    • Grupo C (CU): CPS PD-L1 ≥ 10
    3. Las mujeres participantes son aptas si al menos se cumple una de las siguientes condiciones:
    • No es una mujer en edad fértil.
    • Si es una mujer en edad fértil, que acceda a utilizar un método anticonceptivo desde el momento de la visita de selección y durante 120 días después de la última dosis de pembrolizumab o 180 días después de la última dosis de quimioterapia.
    4. Ofrece su consentimiento informado por escrito para realizar el ensayo conforme a las Buenas Prácticas Clínicas de la Conferencia Internacional de Armonización (ICH-GCP) y la legislación local antes de ser admitido en el ensayo.
    5. Debe tener, como mínimo, 18 años en el momento de firmar el consentimiento informado.
    6. Tener enfermedad mensurable según RECIST v. 1.1 conforme a la valoración de un investigador/radiólogo del centro local. Las lesiones situadas en una zona anteriormente irradiada se consideran mensurables si se ha demostrado progresión en dichas lesiones.
    7. Haber proporcionado una muestra de sangre y tejido de archivo o biopsia reciente con aguja gruesa o por excisión de una lesión tumoral no irradiada anteriormente. Se prefieren bloques de tejido fijados con formalina e incluidos en parafina (FFPE) en lugar de cortes.
    8. Tener un estado funcional ECOG de 0 a 1.
    9. Si el participante se ha sometido a cirugía mayor, debe haberse recuperado adecuadamente de los AA o de cualquier otra complicación derivada de la intervención antes de comenzar el tratamiento del ensayo.
    10. Tener un funcionamiento orgánico adecuado según se define más adelante. Las muestras deben tomarse en un plazo de 10 días antes del comienzo del tratamiento del ensayo.
    Un funcionamiento orgánico adecuado se define de la siguiente manera:
    • Hematología:
    Recuento absoluto de neutrófilos ≥ 1500/µL o ≥1,5 × 10^9/L
    Trombocitos ≥100 000/µL o ≥ 100 × 10^9/L
    Hemoglobina ≥ 9,0 g/dl o ≥ 5,6 mmol/L. Se deben cumplir los criterios sin transfusión de concentrado de eritrocitos durante las 2 semanas anteriores. Los participantes pueden recibir una dosis estable de eritropoyetina (≥ 3 meses).
    • Renal:
    Creatinina ≤ 1,5 × límite superior de la normalidad (LSN) o
    Aclaramiento de creatinina (AcCr) calculado o medido ≥50 ml/min para pacientes con niveles de creatinina > 1,5 × LSN institucional;
    La TFG también puede utilizarse en lugar de la creatinina o AcCr.
    • Hepático:
    Bilirrubina total ≤ 1,5 × LSN o bilirrubina directa ≤ LSN para pacientes con niveles de bilirrubina total ≤ 3 × LSN
    Aspartato aminotransferasa y alanina aminotransferasa ≤ 2,5 × LSN (≤ 5 × LSN para pacientes con metástasis hepáticas).
    Fosfatasa alcalina ≤ 2,5 × LSN
    • Endocrino:
    Sin endocrinopatías no controladas.
    • Coagulación:
    Relación internacional normalizada (RIN), tiempo de protrombina (TP) o tiempo parcial de tromboplastina activada (TPTa) ≤ 1,5 × LSN, a menos que el paciente reciba tratamiento anticoagulante, siempre que el TP o el TPTa estén dentro del intervalo terapéutico del uso previsto de los anticoagulantes
    E.4Principal exclusion criteria
    Arms A, B, and C:
    1. A WOCBP who has a positive urine pregnancy test (e.g. within 72 hours) prior to treatment. If at any time, a urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required
    2. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor other than for adjuvant or neoadjuvant treatment AND was discontinued from that treatment due to a Grade 3 or higher immune-related AE
    3. Has received prior systemic anti-cancer therapy in the first line setting for the participant's metastatic disease (treatment with chemotherapy and/or radiation as part of neoadjuvant/adjuvant therapy is allowed as long as completed at least 6 months prior to diagnosis of metastatic disease)
    4. Participants must have recovered from all AEs due to previous therapies to ≤ Grade 1 or baseline. Participants with ≤ Grade 2 neuropathy are eligible
    5. Has received prior radiotherapy to the lung >30 Gy within 6 months of start of trial treatment and have recovered from all radiation-related adverse events, not have require corticosteroids, and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) to non-central nervous system (CNS) disease
    6. Have a life expectancy of <3 months and/or rapidly progressing disease
    7. Have received a live or live attenuated vaccine within 30 days prior to the first dose of trial treatment. 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, and typhoid vaccine. Administration of killed vaccines, mRNA based (e.g. Covid-19) and vector based vaccines are allowed. Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines are live attenuated vaccines and are not allowed
    8. Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to the first dose of study treatment
    9. Has a diagnosis of immunodeficiency
    10. Received any of the following medications or procedures within 2 weeks prior to first dose of trial treatment: chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy
    11. Has a known additional malignancy that is progressing or has required active treatment within the past 2 years
    12. Has known active CNS metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable, i.e., without evidence of progression for at least 4 weeks by repeat imaging (note that the repeat imaging should be performed during trial screening), clinically stable and without requirement of steroid treatment for at least 14 days prior to first dose of trial treatment
    13. Has severe hypersensitivity (≥ Grade 3) to IO102 or IO103, pembrolizumab and/or any of their excipients
    14. Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed
    15. Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis/interstitial lung disease
    16. Has an active infection requiring systemic therapy
    17. Has a known history of HIV infection. No HIV testing is required unless mandated by local health authority
    18. Known adrenal insufficiency function (that is basal cortisol level <140nmol/L or <5 μg/dL)
    19. Has a known history of Hepatitis B (defined as Hepatitis B surface antigen reactive) or known active Hepatitis C virus (defined as HCV ribonucleic acid [RNA] [qualitative] is detected) infection
    20. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the patient's participation for the full duration of the trial, or is not in the best interest of the patient to participate, in the opinion of the treating investigator
    21. Has known psychiatric or substance abuse disorders that would interfere with cooperating with the requirements of the trial
    22. Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 180 days after last dose of trial treatment
    23. Has had an allogenic tissue/solid organ transplant
    24. Has progressive disease within six months of completion of curatively intended systemic treatment for locoregionally advanced SCCHN
    Grupos A, B y C:
    1. Mujer que haya tenido un resultado positivo en una prueba de embarazo en orina en un plazo de 72 horas antes del tratamiento.
    2. Ha recibido tratamiento anteriormente con un fármaco anti-PD-1, anti-PD-L1 o anti-PD-L2 o con un fármaco dirigido a otro receptor estimulador o coinhibidor de los linfocitos T (p. ej., CTLA-4, OX 40, CD137) salvo para tratamiento adyuvante o neoadyuvante y se interrumpió ese tratamiento debido a un acontecimiento adverso (AA) relacionado con la inmunidad de grado 3 o superior.
    3. Ha recibido un tratamiento antineoplásico sistémico anterior en primera línea para el cáncer metastatizante del participante (se permite el tratamiento con quimioterapia o radiación como parte de un tratamiento neoadyuvante/adyuvante, siempre que haya finalizado como mínimo 6 meses antes del diagnóstico de cáncer metastatizante).
    4. Los participantes deben haberse recuperado de todos los AA ocasionados por tratamientos anteriores hasta ≤ grado 1 o los valores iniciales. Los participantes con neuropatía de ≤ grado 2 son aptos.
    5. Ha recibido anteriormente radioterapia en el pulmón de >30 Gy en un plazo de 6 meses desde el inicio del tratamiento del ensayo y se ha recuperado de todos AA relacionados con la radiación, no necesitó corticoesteroides ni ha tenido neumonitis por radiación. Se permite 1 semana de lavado para radiación paliativa (≤ 2 semanas de radioterapia) para enfermedades fuera del sistema nervioso central (SNC).
    6. Tienen una esperanza de vida de <3 meses o enfermedad de rápida progresión.
    7. Ha recibido una vacuna viva o viva atenuada en un plazo de 30 días antes de recibir la primera dosis del tratamiento del ensayo.
    8. Está participando actualmente o ha participado en un ensayo de un fármaco o un dispositivo en fase de investigación dentro de las 4 semanas anteriores a la primera dosis del tratamiento del ensayo.
    9. Ha sido diagnosticado con inmunodeficiencia.
    10. Ha recibido alguna de las siguientes intervenciones en un plazo de 2 semanas antes de la primera dosis del tratamiento del ensayo: tratamiento crónico con esteroides sistémicos (≥ 10 mg de prednisona equivalente) o cualquier otra forma de tratamiento inmunodepresor.
    11. Tiene una neoplasia maligna adicional conocida que está progresando o ha necesitado tratamiento activo durante los 2 últimos años.
    12. Tiene metástasis activas en el SNC o meningitis carcinomatosa. Los pacientes con metástasis cerebrales anteriormente tratadas pueden participar siempre que estén radiológicamente estables, es decir, sin muestras de progresión durante al menos 4 semanas, lo que debe confirmarse con pruebas repetidas de diagnóstico por imagen estén clínicamente estables sin necesidad de tratamiento con esteroides durante al menos 14 días antes de recibir la primera dosis del tratamiento del ensayo.
    13. Tiene hipersensibilidad grave (≥ grado 3) a IO102 o IO103, pembrolizumab o cualquiera de sus excipientes.
    14. Tiene una enfermedad autoinmunitaria activa que ha necesitado tratamiento sistémico durante los últimos 2 años. Los tratamientos sustitutivos no se consideran una forma de tratamiento sistémico y están permitidos.
    15. Tiene antecedentes de neumonitis (no infecciosa) que necesita esteroides o tiene actualmente neumonitis/enfermedad pulmonar intersticial.
    16. Tiene una infección activa que necesita tratamiento sistémico.
    17. Tiene antecedentes conocidos de infección por el virus de la inmunodeficiencia humana o hepatitis B. Infección activa conocida con el virus de la hepatitis C.
    18. Tiene antecedentes o signos actuales de cualquier enfermedad, tratamiento o valor analítico alterado que podría dificultar la interpretación de los resultados del ensayo, interferir con la participación del paciente durante toda la duración del ensayo o no ser en el mejor interés del paciente, en opinión del investigador encargado del tratamiento.
    19. Tiene enfermedades psiquiátricas o toxicomanías conocidas que podrían interferir a la hora de cumplir los requisitos del ensayo.
    20. Está embarazada, en periodo de lactancia materna o espera engendrar un niño durante la duración prevista del ensayo, a partir de la visita de selección hasta 180 días después de recibir la última dosis del tratamiento del ensayo.
    21. Ha tenido un trasplante alogénico de víscera maciza/tejido.
    22. Tiene progresión del cáncer en un plazo de seis meses tras finalizar un tratamiento sistémico con intención curativa para CCECC locorregional avanzado.
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoints are Objective Response Rate (ORR) according to RECIST v1.1 or Progression-Free Survival (PFS) Rate at 6 months after last patient started treatment as per investigator assessments, whichever is earliest.
    Los criterios de valoración principales son: la tasa de respuesta objetiva (TRO) de acuerdo con RECIST v. 1.1 o la tasa de Supervivencia Libre de Progresión (SLP) a los 6 meses después de que el último paciente inició el tratamiento según las evaluaciones del investigador, lo que ocurra primero.
    E.5.1.1Timepoint(s) of evaluation of this end point
    ORR is based in accordance with RECIST v.1.1.

    Complete or partial response must be confirmed by a second evaluation carried out at least 4 weeks later.

    The endpoint of PFR will be analyzed either 6 months after the last patient started treatment or after the target ORR is achieved, whichever is earliest.
    La tasa de respuesta objetiva (TRO) se evaluará según RECIST v.1.1.

    Las respuestas completas o parciales deben confirmarse mediante una segunda evaluación realizada al menos 4 semanas después.

    La tasa de supervivencia libre de progresión se analizará 6 meses después de que el último paciente haya comenzado el tratamiento o después de que se alcance la TRO, lo que ocurra primero.

    E.5.2Secondary end point(s)
    The Key secondary endpoints are the following:
    • Progression-free survival (PFS)
    • Duration of response (DOR)
    • Complete response rate (CRR)
    • Disease control rate (DCR)
    • Overall survival (OS)
    • Time to response (TTR)
    • Safety

    Safety secondary endpoint:
    • Incidence of participants with AEs [ Up to 3 years ]
    • Incidence of participants with SAEs [ Time Frame: Up to 3 years ]
    • Incidence of treatment-related AEs [ Time Frame: Up to 3 years ]
    • Incidence of treatment-related SAEs [ Time Frame: Up to 3years ]
    • Incidence of AEs causing discontinuation of trial treatment
    Los criterios de evaluación secundarios clave son los siguientes:
    • Supervivencia libre de progresión (SLP)
    • Duración de la respuesta (DR)
    • Tasa de respuesta completa (TRC)
    • Tasa de control de la enfermedad (TCE)
    • Supervivencia global (SG)
    • Tiempo hasta la respuesta (THR)
    • Seguridad

    Criterio de valoración secundario de seguridad:
    Incidencia de participantes con EA [hasta 3 años] Incidencia de participantes con EAG [Marco de tiempo: hasta 3 años]
    Incidencia de EA relacionados con el tratamiento [Marco de tiempo: hasta 3 años]
    Incidencia de EAG relacionados con el tratamiento [Marco de tiempo: hasta 3 años]
    Incidencia de EA que provocan la interrupción del tratamiento del ensayo
    E.5.2.1Timepoint(s) of evaluation of this end point
    Secondary end points will be assessed on an ongoing basis for up to 3 years.

    OS will evaluated at 6 monthly intervals after first dose.
    Los criterios de valoración secundarios se evaluarán de forma continua durante un máximo de 3 años.
    La SG se evaluará a intervalos de 6 meses después de la primera dosis.


    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 No
    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 No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled 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 No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the 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 concerned6
    E.8.5The trial involves multiple Member States No
    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
    Spain
    United Kingdom
    United States
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    Last visit of the last subject
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months6
    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 months6
    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: 70
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 20
    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 state38
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 38
    F.4.2.2In the whole clinical trial 90
    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)
    Following completion of trial treatment, patients are to be followed-up post trial treatment every 12 weeks for disease status until the last patient has been treated for 35 cycles plus 30 days follow-up or until death, withdrawal of consent, or lost-to-follow-up.

    After the LPLV, it is anticipated that patients will go on to receive treatment according to local practice and standard of care.

    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 Decision2022-05-09
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-04-28
    P. End of Trial
    P.End of Trial StatusOngoing
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