E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Advanced/metastatic hepatocellular carcinoma (HCC) |
Carcinoma epatocellulare avanzato/metastatico (HCC) |
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E.1.1.1 | Medical condition in easily understood language |
Advanced/metastatic hepatocellular carcinoma (HCC) |
Carcinoma epatocellulare avanzato/metastatico (HCC) |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10073071 |
E.1.2 | Term | Hepatocellular carcinoma |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
- To determine the RP2D (recommended Phase 2 dose) of relatlimab, nivolumab, and bevacizumab triplet combination in participants with advanced/metastatic HCC (hepatocellular carcinoma) who have not received prior systemic therapy - To compare PFS (progression-free survival) of the relatlimab, nivolumab, and bevacizumab triplet combination to nivolumab and bevacizumab doublet combination in all randomized participants with advanced/metastatic HCC who have not received prior systemic therapy |
- Determinare la RP2D (dose raccomandata per la fase 2) della combinazione con tripletta di relatlimab, nivolumab e bevacizumab in partecipanti con HCC (carcinoma epatocellulare) avanzato/metastatico che non hanno ricevuto una precedente terapia sistemica - Confrontare la PFS (sopravvivenza libera da progressione) della combinazione con tripletta di relatlimab, nivolumab e bevacizumab rispetto alla combinazione con doppietta di nivolumab e bevacizumab in tutti i partecipanti randomizzati con HCC avanzato/metastatico che non hanno ricevuto una precedente terapia sistemica |
|
E.2.2 | Secondary objectives of the trial |
- To estimate key efficacy endpoints of the relatlimab, nivolumab, and bevacizumab triplet combination and the nivolumab and bevacizumab in doublet combination in all randomized participants with advanced/metastatic HCC who have not received prior systemic therapy and all randomized participants who express LAG-3 (lymphocyte activation gene-3) (> and = 1%) by immunohistochemistry (IHC) - To determine the safety and tolerability of the relatlimab, nivolumab, and bevacizumab triplet combination in all treated participants with advanced/metastatic HCC who have not received prior systemic therapy |
- Stimare i principali endpoint di efficacia della combinazione con tripletta di relatlimab, nivolumab e bevacizumab e la combinazione con doppietta di nivolumab e bevacizumab in tutti i partecipanti trattati, con HCC avanzato/metastatico, che non hanno ricevuto una precedente terapia sistemica e in tutti i partecipanti randomizzati che esprimono LAG-3 (gene di attivazione dei linfociti 3) (> e = 1%) mediante immunoistochimica (IHC) - Determinare la sicurezza e la tollerabilità della combinazione con tripletta di relatlimab, nivolumab e bevacizumab in tutti i partecipanti randomizzati con HCC avanzato/metastatico che non hanno ricevuto una precedente terapia sistemica |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- 18 years of age - previously untreated for advanced/metastatic HCC - ECOG 0-1 - Child-Pugh A - Barcelona Clinical Liver Cancer stage B or C For detailed inclusion criteria, please refer to clinical protocol. |
- 18 anni di età - precedentemente non trattato per HCC avanzato/metastatico - ECOG 0-1 - Child-Pugh A - Barcelona Clinical Liver Cancer stadio B o C Per i criteri di inclusione dettagliati, fare riferimento al protocollo clinico. |
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E.4 | Principal exclusion criteria |
- fibrolamellar HCC, sarcomatoid HCC, or mixed cholangiocarcinoma and HCC - prior disease history with increased risk of bleeding - clinically significant ascites - use of anticoagulant therapies For detailed exclusion criteria, please refer to clinical protocol. |
- HCC fibrolamellare, HCC sarcomatoide o colangiocarcinoma misto e HCC - precedente storia di malattia con aumentato rischio di sanguinamento - ascite clinicamente significativa - uso di terapie anticoagulanti Per i criteri di esclusione dettagliati, fare riferimento al protocollo clinico. |
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E.5 End points |
E.5.1 | Primary end point(s) |
1/ DLTs (dose-limiting toxicities) assessed by Investigator within a 6- week DLT window for the first approximately 12, 24, 36, or 48 treated participants in 2 arms combined, depending on data 2/ Progression-Free Survival PFS (treatment policy) assessed by BICR using RECIST v1.1 |
1/ DLT (tossicità dose-limitante) valutate dallo sperimentatore nell’arco di 6 settimane per i primi circa 12, 24, 36 o 48 partecipanti trattati in 2 bracci di combinazione, a seconda dei dati 2/ Sopravvivenza libera da progressione PFS (politica terapeutica) valutata dalla BICR utilizzando i criteri RECIST v1.1. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1/ 6-week DLT window after first dose date or until a DLT is observed in both relatlimab and bevacizumab (if it occurs less than 6 weeks) 2/ Tumor assessments should continue until disease progression (including progression on treatment beyond initial progression) or death or consent withdrawal, whichever is earlier, up to 5 years after last participant randomized |
1/ Finestra DLT di 6 settimane dopo la data della prima dose o fino a quando non si osserva una DLT sia in relatlimab che in bevacizumab (se si verifica in meno di 6 settimane) 2/ Le valutazioni del tumore devono continuare fino alla progressione della malattia (inclusa la progressione del trattamento oltre la progressione iniziale) o alla morte o alla revoca del consenso, a seconda di quale sia la prima, fino a 5 anni dopo l'ultimo partecipante randomizzato |
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E.5.2 | Secondary end point(s) |
1/ All endpoints assessed at the time of PFS primary endpoint assessment: - PFS (treatment policy) assessed by BICR using RECIST v1.1 in all randomized LAG-3 positive (> and = 1% by IHC) participants - Objective Response Rate (ORR) assessed by BICR using RECIST v1.1 in all randomized participants - ORR assessed by BICR using RECIST v1.1 in all randomized LAG-3 positive (> and =1% by IHC) participants - Overall Survival (OS) in all randomized participants - OS in all randomized LAG-3 positive (> and = 1% by IHC) participants 2/ Adverse Events (AEs), Serious Adverse Events (SAEs), select AEs, IMAEs (Immune-Mediated Adverse Events), related or not, from first dose to 30- or 135-days after the last dose |
1/ Tutti gli endpoint valutati al momento della valutazione dell’endpoint primario della PFS: - PFS (politica terapeutica) valutata dalla BICR utilizzando i criteri RECIST v1.1 in tutti i partecipanti randomizzati LAG-3-positivi (> e = 1% mediante IHC) - tasso di risposta obiettiva (ORR) valutato dalla BICR utilizzando i criteri RECIST v1.1 in tutti i partecipanti randomizzati - ORR valutato dalla BICR utilizzando i criteri RECIST v1.1 in tutti i partecipanti randomizzati LAG-3 positivi (> e = 1% mediante IHC) - sopravvivenza complessiva (OS) in tutti i partecipanti randomizzati - OS in tutti i partecipanti randomizzati LAG-3-positivi (> e = 1% mediante IHC) 2/ eventi avversi (EA), eventi avversi gravi (SAE), EA selezionati, IMAE (evento avverso immuno-mediato), correlati o meno, dalla prima dose a 30 o 135 giorni dall’ultima dose |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1/ PFS and ORR: Same Timeframe as primary endpoint of PFS by BICR OS: Up to 5 years after last participant randomized 2/ from first dose to 135-days after the last dose |
1/ PFS e ORR: stesso intervallo di tempo dell'endpoint primario di PFS da BICR OS: Fino a 5 anni dopo l'ultimo partecipante randomizzato 2/ dalla prima dose a 135 giorni dopo l'ultima dose |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Tolerability |
Tollerabilità |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
Safety Confirmation and Clinical Efficacy of triplet therapy |
Conferma di sicurezza ed efficacia clinica della terapia con tripletta |
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E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 22 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Canada |
China |
Hong Kong |
Japan |
Korea, Republic of |
Singapore |
Taiwan |
United States |
France |
Germany |
Italy |
Poland |
Spain |
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E.8.7 | Trial 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
|
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 10 |
E.8.9.2 | In all countries concerned by the trial days | 0 |