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    Summary
    EudraCT Number:2021-003028-34
    Sponsor's Protocol Code Number:JAB-21822-1001
    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:2021-11-17
    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 number2021-003028-34
    A.3Full title of the trial
    A Phase 1/2, Multi-Center, Open-Label Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Preliminary Evidence of Antitumor Activity of JAB-21822 Monotherapy and Combination Therapy in Adult Patients with Advanced Solid Tumors Harboring KRAS G12C Mutation
    Estudio de fase 1/2, multicéntrico y abierto para evaluar la seguridad, la tolerabilidad, la farmacocinética y los datos preliminares de actividad antitumoral de JAB-21822 en monoterapia y en combinación en pacientes adultos con tumores sólidos avanzados portadores de la mutación KRAS G12C
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study to investigate JAB-21822 Monotherapy and Combination Therapy in Adult Patients with Advanced Solid Tumors Harboring KRAS G12C Mutation
    Estudio para evaluar JAB-21822 en monoterapia y en combinación en pacientes adultos con tumores sólidos avanzados portadores de la mutación KRAS G12C
    A.4.1Sponsor's protocol code numberJAB-21822-1001
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT05002270
    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 SponsorJacobio Pharmaceuticals Co., Ltd.
    B.1.3.4CountryChina
    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 supportJacobio Pharmaceuticals Co., Ltd.
    B.4.2CountryChina
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationJacobio Pharmaceuticals Co., Ltd.
    B.5.2Functional name of contact pointJAB-21822-1001 clinical team
    B.5.3 Address:
    B.5.3.1Street AddressBuilding F2, No. 88 Kechuang 6th Street
    B.5.3.2Town/ cityBDA, Beijing
    B.5.3.3Post code101111
    B.5.3.4CountryChina
    B.5.4Telephone number+34900834223
    B.5.6E-mailRegistroEspanolDeEstudiosClinicos@druginfo.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 nameJAB-21822
    D.3.2Product code JAB-21822
    D.3.4Pharmaceutical form Tablet
    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 INNNot available
    D.3.9.1CAS number Not availabl
    D.3.9.2Current sponsor codeJAB-21822
    D.3.9.3Other descriptive nameJAB-21822 citrate
    D.3.9.4EV Substance CodeSUB234716
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin 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: 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 nameJAB-21822
    D.3.2Product code JAB-21822
    D.3.4Pharmaceutical form Tablet
    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 INNNot available
    D.3.9.1CAS number Not availabl
    D.3.9.2Current sponsor codeJAB-21822
    D.3.9.3Other descriptive nameJAB-21822 citrate
    D.3.9.4EV Substance CodeSUB234716
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Erbitux
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Europe B.V.
    D.2.1.2Country which granted the Marketing AuthorisationNetherlands
    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 nameCetuximab
    D.3.2Product code Cetuximab
    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 INNCetuximab
    D.3.9.1CAS number 205923-56-4
    D.3.9.4EV Substance CodeSUB01178MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin 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
    Phase 1: Advanced solid tumors, relapsed or refractory to standard therapy
    Phase 2: non-small cell lung cancer, metastatic colorectal cancer, and other solid tumors
    Fase 1: Tumores sólidos avanzados, recidivantes o refractarios a terapia estándar
    Fase 2: Cáncer de pulmón no microcítico, cáncer colorrectal metastásico y otros tumores sólidos
    E.1.1.1Medical condition in easily understood language
    Solid tumors
    Tumores sólidos
    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
    Dose Escalation Phase (Phase 1):
    - To evaluate the overall safety and tolerability of JAB-21822 monotherapy
    - To determine the maximum tolerated dose and a recommended Phase 2 dose of JAB-21822 monotherapy administered once daily in participants with relapsed or refractory solid tumors with KRAS G12C mutation

    Dose Expansion Phase (Phase 2):
    - To further evaluate preliminary antitumor activity, objective response rate, and duration of response of JAB-21822 monotherapy at the recommended Phase 2 dose in participants with relapsed and refractory non-small cell cancer and other solid tumors with KRAS G12C mutation, and in combination with cetuximab in metastatic colorectal cancer with KRAS G12C mutation
    Fase de escalado de dosis (fase 1):
    - Evaluar la seguridad y la tolerabilidad globales de JAB 21822 en monoterapia.
    - Determinar la dosis máxima toleraada y una dosis recomendada para la fase 2 de JAB-21822 en monoterapia administrado una vez al día en participantes con tumores sólidos recidivantes o resistentes con la mutación KRAS G12C.

    Fase de expansión de dosis (Fase 2):
    - Evaluar de forma más exhaustiva la actividad antitumoral preliminar, la tasa de respuesta objetiva y la duración de la respuesta de JAB-21822 en monoterapia con la dosis recomendada para la fase 2 en participantes con cáncer de pulmón no microcítico recidivante y resistente y otros tumores sólidos con la mutación KRAS G12C y en combinación con cetuximab en el cáncer colorrectal metastásico con la mutación KRAS G12C.
    E.2.2Secondary objectives of the trial
    Dose Escalation Phase (Phase 1):
    - To evaluate preliminary antitumor activity of various dose levels of JAB-21822 monotherapy in participants with relapsed and refractory solid tumors with KRAS G12C mutation
    - To characterize the pharmacokinetic(s) profiles of JAB-21822 after a single dose and at steady state after multiple doses

    Dose Expansion Phase (Phase 2):
    - To determine progression-free survival, overall survival, time to response, and disease control rate
    - To further assess the overall safety and tolerability of JAB-21822 at the recommended Phase 2 dose as monotherapy and in combination with cetuximab
    - To further characterize the pharmacokinetic(s) profiles of JAB-21822 with sparse sampling using a population pharmacokinetic(s) analysis approach
    Fase de escalado de dosis (Fase 1):
    - Evaluar la actividad antitumoral preliminar de varios niveles de dosis de JAB-21822 en monoterapia en participantes con tumores sólidos recidivantes y resistentes con la mutación KRAS G12C.
    - Caracterizar los perfiles farmacocinéticos de JAB-21822 después de una dosis única y en estado de equilibrio después de varias dosis.

    Fase de expansión de dosis (Fase 2):
    -Determinar la supervivencia sin progresión, la supervivencia global, el tiempo hasta la respuesta y la tasa de control de la enfermedad.
    - Evaluar de forma más exhaustiva la seguridad y la tolerabilidad globales de JAB-21822 con la dosis recomendada para la fase 2 en monoterapia y en combinación con cetuximab.
    - Caracterizar de forma más exhaustiva los perfiles farmacocinéticos de JAB-21822 con obtención esporádica de muestras utilizando un método de análisis de farmacocinética poblacional.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    -Written ICF must be signed and dated by the participant prior to the performance of any study-specific procedures, sampling, or analyses.
    -≥18 years of age at the time of signing the ICF.
    -ECOG performance status score of 0 or 1.
    -Life expectancy ≥3 months.
    -Participant must be able to provide an archived tumor sample or tumor tissue from a newly obtained biopsy from the tumor site which has not been previously irradiated.
    -Histologically or cytologically confirmed solid tumors with KRAS G12C mutation by laboratories, which are either CLIA certified or recognized by local institution, and meets the following criteria:
    Phase 1; Cohort A0
    a.Have histologically or cytologically confirmed metastatic or locally advanced
    solid tumor that is not a candidate for curative intervention.
    b.Must have received at least 1 prior standard therapy for their tumor type and stage.
    Phase 2; Cohort A1, A2 and Cohort B1, B2
    A1:
    a.Has histologically or cytologically confirmed diagnosis of unresectable Stage
    IIIB or Stage IV NSCLC and is not a candidate for curative intervention.
    b.Must have received a platinum-based therapy and an immune checkpoint
    inhibitor unless such therapies are contraindicated or not available to the participant or the participant refused them. No more than 4 previous systemic regimens for the metastatic disease are allowed.
    c.Participant with actionable mutations must have received appropriate targeted therapies available per local standard unless such therapies are contraindicated or not available to the participant or the participant refused them. No more than 3 previous systemic regimens for the metastatic disease are allowed.
    d.Had received adjuvant or neoadjuvant chemotherapy and had
    recurrence/progression on or within 6 months of completion of the therapy is
    allowed to count the therapy as 1 previous regimen for the metastatic disease.
    e.KRAS G12C inhibitors naïve.
    A2:
    a.KRAS G12C inhibitors naïve.
    For mCRC:
    b.Have histologically or cytologically confirmed mCRC that is not a candidate
    for curative intervention.
    c.Have received no more than 4 prior systemic regimens of standard therapy for mCRC per local treatment standard deemed to be appropriate by the
    investigator unless such therapies are contraindicated, intolerable, or the
    participant refused them.
    d.Systemic regimens should include a fluoropyrimidine, irinotecan, and oxaliplatin.
    e.For mCRC participants with MSI-H disease, must have prior systemic
    regimens with checkpoint inhibitor unless such are contraindicated or not available to the participant or the participant refused them.
    f.Participant who had received adjuvant or neoadjuvant chemotherapy and had recurrence/progression on or within 6 months of completion of the therapy is allowed to count the therapy as 1 previous regimen for the metastatic disease.
    For all other solid tumors:
    g.Have histologically or cytologically confirmed metastatic or locally advanced
    solid tumor except NSCLC that is not a candidate for curative intervention.
    h.Must have received at least 1 prior standard therapy for their tumor type and stage.
    Cohort B:
    a.Cohort B:
    i.B1: KRAS G12C inhibitors naïve mCRC.
    ii.B2: KRAS G12C inhibitors treated mCRC.
    b.Have histologically or cytologically confirmed mCRC that is not a candidate
    for curative intervention.
    c.Has received no more than 4 prior systemic regimens of standard therapy for mCRC per local treatment standard deemed to be appropriate by the
    investigator unless such therapies are contraindicated, intolerable, or the
    participant refused them.
    d.Systemic regimens should include a fluoropyrimidine, irinotecan, and oxaliplatin. No prior use of EGFR inhibitors.
    e.For mCRC participants with MSI-H disease, must have prior systemic
    regimens with checkpoint inhibitor unless such therapies are contraindicated or not available to the participant or the participant refused them.
    f.Participant who had received adjuvant or neoadjuvant chemotherapy and had recurrence/progression on or within 6 months of completion of the therapy is allowed to count the therapy as 1 previous regimen for the metastatic disease.
    -At least 1 measurable lesion as defined by RECIST v1.1.
    - Women of childbearing potential must have a negative serum pregnancy test prior to study entry. Women of nonchildbearing potential must have had at least 12 continuous months of natural amenorrhea and an appropriate clinical profile, or have had surgical bilateral oophorectomy, hysterectomy, or bilateral tubal ligation >6 weeks prior to Screening.
    -Male or female participants: Male participants with female partners of childbearing potential and female participants of childbearing potential are required to use 2 forms of acceptable contraception, including 1 barrier method, during their participation in the study and for 3 months following the last dose of JAB-21822 or 2 months following the last dose of cetuximab, whichever is longer, for Cohort B1 and B2.
    1. Firmar y fechar el consentimiento informado antes de la realización de procedimientos, análisis u obtención de muestras específicos del estudio.
    2. ≥18 a la firma del consentimiento informado.
    3. Puntuación del ECOG de 0 o 1.
    4. Esperanza de vida ≥3 meses.
    5. Proporcionar una muestra tumoral de archivo o tejido tumoral de una biopsia reciente del foco tumoral no irradiado previamente.
    6. Tumor sólido con la mutación KRAS G12C confirmado histológica o citológicamente por un laboratorio certificado por la CLIA o reconocido por el centro local con los criterios siguientes:
    Fase 1; cohorte A0
    a. Tumor sólido metastásico o localmente avanzado confirmado histológica o citológicamente y no candidato a intervención curativa.
    b. Recibido al menos 1 tratamiento convencional previo para su tipo y estadio tumoral.
    Fase 2; cohortes A1, A2 y B1, B2
    A1:
    a. Diagnóstico confirmado histológica o citológicamente de CPNM en estadio IIIB o IV irresecable y no candidato a intervención curativa.
    b. Recibido un tratamiento a base de platino y un inhibidor de puntos de control inmunitario a menos que estén contraindicados, no disponibles o rechazados por el participante. No se permiten más de 4 tratamientos sistémicos previos para la enfermedad metastásica.
    c. Mutaciones susceptibles de actuación deben haber recibido los tratamientos dirigidos adecuados disponibles según las directrices locales a menos que estén contraindicados, no disponibles o rechazados por el participante.. No se permiten más de 3 tratamientos sistémicos previos para la enfermedad metastásica.
    d. Con quimioterapia adyuvante o neoadyuvante previa y recidiva o progresión durante el tratamiento o en los 6 meses tras a su finalización, se podrá contar como 1 tratamiento previo para la enfermedad metastásica.
    e. No tratamiento previo con inhibidores de KRAS G12C.
    A2:
    a. No tratamiento previo con inhibidores de KRAS G12C.
    Para el CCRm:
    b. CCRm confirmado histológica o citológicamente y no candidato a intervención curativa.
    c. Recibido un máximo de 4 tratamientos sistémicos convencionales previos para el CCRm según las directrices de tratamiento locales que el investigador considere apropiadas a menos que estén contraindicados, no disponibles o rechazados por el participante.
    d. Los tratamientos sistémicos deben incluir una fluoropirimidina, irinotecán y oxaliplatino.
    e. Para CCRm y enfermedad con MSI-H, deben haber recibido tratamientos sistémicos previos con un inhibidor de puntos de control inmunitario a menos que estén contraindicados, no disponibles o rechazados por el participante.
    f. Con quimioterapia adyuvante o neoadyuvante previa y recidiva o progresión durante el tratamiento o en los 6 meses tras su finalización, se podrá contar como 1 tratamiento previo para la enfermedad metastásica.
    Para todos los demás tumores sólidos:
    g. Tumor sólido metastásico o localmente avanzado confirmado histológica o citológicamente, excepto CPNM, y no candidato a intervención curativa.
    h. Recibido al menos 1 tratamiento convencional previo para su tipo y estadio tumoral.
    Cohorte B:
    a. La cohorte B incluirá:
    i. Cohorte B1: CCRm no tratados previamente con inhibidores de KRAS G12C.
    ii. Cohorte B2: CCRm tratados con inhibidores de KRAS G12C.
    b. CCRm confirmado histológica o citológicamente y no candidato a intervención curativa.
    c. Recibido un máximo de 4 tratamientos sistémicos convencionales previos para el CCRm según las directrices de tratamiento locales que el investigador considere apropiadas a menos que estén contraindicados, no disponibles o rechazados por el participante.
    d. Los tratamientos sistémicos deben incluir una fluoropirimidina, irinotecán y oxaliplatino. Ausencia de uso previo de inhibidores del EGFR.
    e. Para CCRm y enfermedad con MSI-H, deben haber recibido tratamientos sistémicos previos con un inhibidor de puntos de control inmunitario a menos que estén contraindicados, no disponibles o rechazados por el participante.
    f. Con quimioterapia adyuvante o neoadyuvante previa y recidiva o progresión durante el tratamiento o en los 6 meses tras su finalización, se podrá contar como 1 tratamiento previo para la enfermedad metastásica.
    7. Tener al menos 1 lesión mensurable según los criterios RECIST v1.1.
    9. Mujeres en edad fértil: prueba de embarazo en suero negativa antes de entrar en el estudio. Mujeres no en edad fértil: al menos 12 meses continuos de amenorrea natural y un perfil clínico adecuado o ovariectomía bilateral, histerectomía o ligadura de trompas bilateral más de 6 semanas antes de la selección.
    10. Hombres o mujeres en edad fértil: Deberán utilizar dos métodos anticonceptivos aceptables, incluido un método de barrera, durante su participación en el estudio y durante 3 meses después de la última dosis de JAB-21822 o 2 meses después de la última dosis de cetuximab, lo que suponga más tiempo, en las cohortes B1 y B2.
    E.4Principal exclusion criteria
    -Participant has a history of solid tumor or hematological malignancy that is histologically distinct from the cancers under study, except for cervical carcinoma in situ, superficial noninvasive bladder tumors, breast ductal carcinoma in situ, prostatic intraepithelial neoplasia without evidence of prostate cancer, or curatively treated Stage I nonmelanoma skin cancer.
    -Participant has known serious allergy to cetuximab (Cohort B1 and B2 only) or to a G12C inhibitor (Cohort A0 and B2 only).
    -Participant has brain or spinal metastases except if treated by surgery, surgery plus radiotherapy or radiotherapy alone, with no evidence of radiographic progression or hemorrhage for at least 28 days before the start of treatment with the study drugs, and if applicable, on stable dose of systemic corticosteroids for at least 28 days before the start of treatment with the study drugs.
    -Active infection requiring systemic treatment at the start of treatment in this trial.
    -Participants testing positive for HIV are NOT excluded from this study, but HIV positive participants must meet certain criteria.
    -Has active HBV or HCV.
    Note:Participants with HBV who have controlled infection (serum HBV DNA PCR that is below the limit of detection) are permitted. Participants with controlled infections must undergo periodic monitoring of HBV DNA.
    Note:Participants who are HCV antibody positive who have controlled infection may be enrolled into the study. Participants with controlled infections must undergo periodic monitoring of HCV RNA by their treating physician.
    -History (≤6 months before the start of treatment) of any severe and/or uncontrolled medical conditions or other conditions that, in the opinion of the investigator and sponsor, could affect the participant’s participation in the study.
    -History (≤6 months before the start of treatment with the study drugs) of any of the following: acute myocardial infarction, unstable angina pectoris, coronary artery bypass graft, or cerebrovascular accident.
    -Participants who have impaired cardiac function or clinically significant cardiac
    diseases.
    -Participants with QT interval >470 msec at Screening using QTcF, determined as the mean of 3 QTcF values from the screening triplicate ECG.
    -Participants experiencing unresolved Grade >1 toxicity before the start of treatment with the study drug except for hair loss (alopecia) and stable Grade 2 toxicities (stable defined as more than 3 months, if permitted by the investigator and medical monitor).
    -Women who are pregnant or breast-feeding.
    -Has received or will receive a live vaccine within 30 days prior to the first
    administration of study medication. Seasonal flu vaccines that do not contain live vaccine are permitted.
    -Has known psychiatric or substance abuse disorders that would interfere with
    cooperation with the requirements of the trial.
    -History of an allogeneic bone marrow or solid organ transplant.
    -Use of systemic anticancer agent or investigational drug is prohibited ≤28 days for biologics and IV chemotherapy, or ≤21 days or 5 half-lives (whichever is longer) for small molecules prior to the first dose of JAB-21822.
    -History of radiation therapy ≤14 days prior to the first dose of study drug.
    -Prophylactic administration of G-CSF, filgrastim, pegfilgrastim, blood transfusion, platelet packets, and erythropoietin are not allowed during ≤4 weeks before the start of treatment and during Cycle 1 of the Dose Escalation Phase.
    -Use of drugs known to be moderate or strong CYP3A4 inhibitors or inducers or
    sensitive CYP3A4 substrates or CYP3A4 substrates with a narrow therapeutic index is prohibited ≤14 days or 5 half-lives, whichever is longer, before the start of treatment with the study drug until the EOT visit. Some of these medications may be allowed at the investigator’s discretion after approval by the medical monitor.
    -Use of herbal drugs and supplements known to be moderate or strong CYP3A4 inhibitors or inducers or sensitive CYP3A4 substrates or CYP3A4 substrates with a narrow therapeutic index, or have another potential for clinically significant interaction with JAB-21822 are prohibited ≤14 days or 5 half-lives, whichever is longer, before the start of treatment with the study drug until the EOT visit.
    -History (≤28 days before the start of treatment with the study drugs) of major surgery or trauma or likelihood to require surgery at any time until the permanent discontinuation of treatment (the significance will be determined by the investigator after consultation with the medical monitor).
    -History (14 days or 5 half-lives, whichever is longer, before the start of treatment with the study drugs) of medications with known risk of Torsades de Pointes.
    -Use of agents that suppress gastric acidity and agents that delay gastric emptying within 3 days or 5 half-lives (whichever is longer) prior to start of treatment.
    1.Antecedentes de tumor sólido o neoplasia hematológica maligna histológicamente distinta de los cánceres en estudio, excepto carcinoma cervicouterino in situ, tumores vesicales no invasivos superficiales, carcinoma ductal de mama in situ, neoplasia intraepitelial prostática sin signos de cáncer de próstata o cáncer de piel distinto del melanoma en estadio I tratado con intención curativa.
    2. Alergia grave conocida al cetuximab (sólo cohortes B1 y B2) o a un inhibidor de G12C (sólo cohortes A0 y B2).
    3. Metástasis cerebrales o medulares, excepto tratadas con cirugía, cirugía más radioterapia o radioterapia sola, sin signos de progresión radiológica ni hemorragia y, si procede, con una dosis estable de corticosteroides sistémicos durante al menos 28 días antes del comienzo del tratamiento con los fármacos del estudio.
    4. Infección activa que requiere tratamiento sistémico al comienzo del tratamiento en este ensayo.
    5. Un resultado positivo para el VIH NO es excluyente, pero los pacientes positivos deberán cumplir ciertos criterios.
    6. Infección activa por el VHB o el VHC.
    Nota: Se permitirá la participación de pacientes infectados por el VHB que presenten infección controlada (PCR de ADN del VHB en suero por debajo del límite de detección). Los participantes con infecciones controladas deben someterse a un control periódico del ADN del VHB. Nota: Podrán participar en el estudio pacientes con un resultado positivo para anticuerpos contra el VHC que presenten infección controlada. Los participantes con infecciones controladas deberán someterse a controles periódicos del ARN del VHC a criterio del médico responsable del tratamiento.
    7. Antecedentes (≤6 meses antes del inicio del tratamiento) de cualquier enfermedad grave o no controlada o de otras enfermedades que, en opinión del investigador y del promotor, puedan afectar a la participación del paciente en el estudio.
    8. Antecedentes (≤6 meses antes del inicio del tratamiento con los fármacos del estudio) de cualquiera de los siguientes: infarto agudo de miocardio, angina de pecho inestable, injerto de derivación de arteria coronaria o accidente cerebrovascular.
    9. Disfunción cardíaca o cardiopatía clínicamente significativa.
    10. Intervalo QT >470 ms en la selección utilizando el QTcF, determinado como la media de tres valores de QTcF del ECG por triplicado de selección.
    11. Toxicidad de grado >1 no resuelta antes del inicio del tratamiento con el fármaco del estudio, excepto alopecia y toxicidad de grado 2 estable (definida como una duración mayor de 3 meses, si lo permiten el investigador y el monitor médico).
    12. Mujeres embarazadas o lactantes.
    13. Recibido o por recibir una vacuna de microorganismos vivos en los 30 días previos a la primera administración de la medicación del estudio. Se permiten las vacunas antigripales estacionales que no contengan virus vivos.
    14. Trastorno psiquiátrico o por abuso de sustancias que podría dificultar el cumplimiento de los requisitos del estudio.
    15. Antecedentes de alotrasplante de médula ósea o de órgano sólido.
    16. Uso de antineoplásicos sistémicos o de fármacos en investigación durante ≤28 días en el caso de fármacos biológicos y quimioterapia IV, o durante ≤21 días o 5 semividas (lo que suponga más tiempo) en el caso de moléculas pequeñas antes de la primera dosis de JAB 21822.
    17. Antecedentes de radioterapia ≤14 días antes de la primera dosis del fármaco del estudio.
    18. Administración profiláctica de G-CSF, filgrastim, pegfilgrastim, transfusiones de sangre, concentrados de plaquetas o eritropoyetina durante ≤4 semanas antes del inicio del tratamiento o durante el ciclo 1 de la fase de aumento escalonado de la dosis.
    19-20. Uso de fármacos, fármacos a base de plantas y suplementos inhibidores o inductores moderados o potentes de la CYP3A4 o sustratos sensibles de la CYP3A4 o sustratos de la CYP3A4 con un índice terapéutico estrecho o que tengan otro potencial de interacción clínicamente significativa con JAB-21822 durante ≤14 días o 5 semividas, lo que suponga más tiempo, antes del inicio del tratamiento con el fármaco del estudio hasta la visita de FDT. Algunos de estos medicamentos podrán permitirse a criterio del investigador tras la aprobación por el monitor médico.
    21. Antecedentes (≤28 días antes del inicio del tratamiento con los fármacos del estudio) de cirugía mayor o traumatismo o probabilidad de necesitar cirugía en cualquier momento hasta la suspensión permanente del tratamiento (la importancia será determinada por el investigador tras consultar con el monitor médico).
    22. Antecedentes (14 días o 5 semividas, lo que suponga más tiempo, antes del comienzo del tratamiento con los fármacos del estudio) de uso de medicamentos con riesgo conocido de taquicardia helicoidal.
    23. Uso de fármacos que suprimen la acidez gástrica y fármacos que retrasan el vaciamiento gástrico en los 3 días o 5 semividas (lo que suponga más tiempo) previos al comienzo del tratamiento del estudio.
    E.5 End points
    E.5.1Primary end point(s)
    Dose Escalation Phase (Phase 1):
    - Safety and tolerability of repeated cycles from first drug administration up to the end of the follow-up period
    o Incidence, nature, and severity of treatment-emergent adverse events, treatment-related adverse events, and death per National Cancer Institute
    Common Terminology Criteria for Adverse Events Version 5
    - Treatment-emergent changes in clinical laboratory measurements, electrocardiogram findings, vital signs, Eastern Cooperative Oncology Group performance status, and physical examination findings
    - Number and proportion of participants who experience at least 1 dose-limiting toxicity during the first 21 days of treatment

    Dose Expansion Phase (Phase 2):
    - Objective response rate defined as the percentage of participants with partial response or complete response based on Response Evaluation Criteria in Solid Tumors Version 1.1
    - Duration of response
    Aumento escalonado de dosis (fase 1):
    - Seguridad y tolerabilidad de ciclos repetidos desde la primera administración del fármaco hasta el final del período de seguimiento.
    --Incidencia, naturaleza e intensidad de los AAST, los AART y los fallecimientos según los CTCAE del NCI v5.
    - Variaciones surgidas durante el tratamiento en las determinaciones analíticas, los hallazgos del ECG, las constantes vitales, el estado funcional según la clasificación del ECOG y los hallazgos de la exploración física.
    - Número y proporción de participantes que presenten al menos 1 RALD durante los primeros 21 días de tratamiento.

    Ampliación de dosis (fase 2):
    - Tasa de respuesta objetiva, definida como el porcentaje de participantes con respuesta parcial o completa conforme a los criterios RECIST v1.1.
    - Duración de la respuesta
    E.5.1.1Timepoint(s) of evaluation of this end point
    -Dose Escalation phase: Number of participants with dose limiting toxicities; Time Frame: At the end of Cycle 1
    -Dose Escalation and Dose Expansion phase: Number of participants with adverse events; Time Frame: Up to 4 years; Patients will be assessed for incidence and severity of adverse events according to NCI-CTCAE criteria
    -Dose Expansion phase: Overall response rate; Time Frame: Up to 4 years - from baseline to RECIST confirmed Progressive Disease
    -Dose Expansion phase: Duration of response; Time Frame: Up to 4 years; DOR is defined as the time from the participant's initial objective response (CR or PR) to disease progression per CTCAE v1.1 or death due to any cause, whichever occurs first
    - Fase de escalado de dosis: Número de participantes con toxicidades limitantes de la dosis; Marco temporal: Al final del ciclo 1.
    - Fases de escalado y de ampliación de la dosis: Número de participantes con AAs; Marco temporal: Hasta 4 años. Los participantes serán evaluados en cuanto a la incidencia y gravedad de los AAs según los criterios NCI-CTCAE.
    -Fase de ampliación de la dosis: Tasa de respuesta global; Marco temporal: Hasta 4 años - desde el momento basal hasta progresión de la enfermedad confirmada por RECIST.
    -Fase de ampliación de la dosis: Duración de la respuesta; Marco temporal: Hasta 4 años. DR definida como el tiempo desde la respuesta objetiva inicial (RC o RP) hasta la progresión de la enfermedad por CTCAE v1.1 o muerte por cualquier causa, lo que ocurra primero.
    E.5.2Secondary end point(s)
    Dose Escalation Phase (Phase 1):

    - Objective response rate defined as the percentage of participants with partial response or complete response based on RECIST v1.1
    - disease control rate, time to response, duration of response, and progression-free survival
    - PK parameters of JAB-21822 including, but not limited to, Cmax, tmax, Ctrough, AUC0-τ, AUC0-t, AUC0-inf, t½, CL/F, Vz/F, Rac Cmax, and Rac AUC

    Dose Expansion Phase (Phase 2):

    - progression-free survival and time to response
    - overall survival
    - disease control rate
    - Safety and tolerability of repeated cycles from first drug administration up to the end of the follow-up period
    o Incidence, nature, and severity of treatment-emergent adverse events, treatment-related adverse events, and death per National Cancer Institute Common Terminology Criteria for Adverse Events Version 5
    - Treatment-emergent changes in clinical laboratory measurements, ECG findings, vital signs, Eastern Cooperative Oncology Group performance status, and physical examination findings
    -PK parameters of JAB-21822 and potential factors (covariates) that impact the PK parameters
    Escalado de dosis (fase 1):
    -Tasa de respuesta objetiva, definida como el porcentaje de participantes con respuesta parcial o completa conforme a los criterios RECIST v1.1.
    - Tasa de control de la enfermedad, tiempo hasta la respuesta, duración de la respuesta y supervivencia libre de progresión.
    - Parámetros FC de JAB-21822, tales como Cmáx, tmáx, Cmín, AUC0-τ, AUC0-t, AUC0 inf, t½, CL/F, Vz/F, TA Cmáx y TA AUC.

    Fase de ampliación de la dosis (fase 2):
    -Supervivencia libre de progresión y tiempo hasta la respuesta
    -Supervivencia global
    -Tasa de control de la enfermedad
    -Seguridad y tolerabilidad de ciclos repetidos desde la primera administración del fármaco hasta el final del período de seguimiento.
    --Incidencia, naturaleza e intensidad de los AAST, los AART y los fallecimientos según los CTCAE del NCI v5.
    -Variaciones surgidas durante el tratamiento en las determinaciones analíticas, los hallazgos del ECG, las constantes vitales, el estado funcional según la clasificación del ECOG y los hallazgos de la exploración física.
    -Parámetros FC de JAB-21822 y posibles factores (covariables) que influyen en los parámetros FC.
    E.5.2.1Timepoint(s) of evaluation of this end point
    -Dose Escalation and Dose Expansion phase: Peak Plasma Concentration (Cmax); Time Frame: Up to 4 years
    -Dose Escalation and Dose Expansion phase: Area under the plasma concentration versus time curve; Time Frame: Up to 4 years
    -Dose Escalation phase: Overall response rate; Time Frame: Up to 4 years - from baseline to RECIST confirmed Progressive Disease
    -Dose Escalation phase: Duration of response; Time Frame: Up to 4 years
    -Dose Escalation and Dose Expansion phase: Disease Control Rate; Time Frame: Up to 4 years
    -Dose Escalation and Dose Expansion phase: Progression-free survival; Time Frame: Up to 4 years
    -Fases de escalado y de ampliación de dosis: Concentración pico en plasma (Cmax) y área bajo la curva de concentración plasmática-tiempo; Marco temporal: Hasta 4 años
    -Fase de escalado de dosis: Tasa de respuesta global; Marco temporal: Hasta 4 años - desde el momento basal hasta progresión de la enfermedad confirmada por RECIST. Duración de la respuesta; Marco temporal: Hasta 4 años
    Fases de escalado y de ampliación de dosis: Tasa de control de la enfermedad; Marco temporal: Hasta 4 años. Supervivencia libre de progresión; Marco temporal: Hasta 4 años
    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
    Phase 1/2
    Fase 1/2
    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.8.3 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 concerned11
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA28
    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
    Israel
    United States
    Hungary
    Poland
    Spain
    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
    Last subject last visit
    Última visita de último paciente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years4
    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: 68
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 68
    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 state40
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 60
    F.4.2.2In the whole clinical trial 136
    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)
    After patient permanently discontinues the study treatment, patient will be followed at least 30 days or until all treatment related toxicity has been resolved, if there is any. Then patient will be followed every 3 months for survival status for up to 3 years or death, whichever happens first. The following anti-cancer treatments after discontinue of the study will be decided by treating physicians per standard of care by discussion with patients.
    Una vez que el paciente abandone definitivamente el tratamiento será seguido durante un periodo de 30 días o hasta que se haya resuelto la toxicidad debida al tratamiento, si la hubiera. Posteriormente la supervivencia del paciente será seguida cada 3 meses hasta un máximo de 3 años o la muerte, lo que ocurra primero. Una vez que el paciente abandone el estudio, los tratamientos anticancerosos posteriores serán decididos de acuerdo con éste por los médicos que le tratan, según práctica habitual.
    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 Decision2022-02-25
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-01-26
    P. End of Trial
    P.End of Trial StatusOngoing
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