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    Summary
    EudraCT Number:2021-004310-19
    Sponsor's Protocol Code Number:W00090GE303/EORTC-2139-MG
    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:2022-05-05
    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 number2021-004310-19
    A.3Full title of the trial
    Adjuvant encorafenib & binimetinib vs. placebo in fully resected stage IIB/C BRAF V600E/K mutated melanoma: a randomized triple-blind phase III study in collaboration with the EORTC Melanoma Group
    Estudio de fase III, aleatorizado y triple ciego en colaboración con el Grupo de Melanoma de la Organización Europea para la Investigación y el Tratamiento del Cáncer (EORTC) de encorafenib y binimetinib como tratamiento complementario comparado con placebo en el melanoma en estadio IIB/C completamente resecado con mutación V600E/K de BRAF
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Encorafenib used with binimetinib versus placebo in BRAF mutant stage IIB/C melanoma after surgery to evaluate the efficacy and safety in preventing melanoma recurrence
    Estudio de fase III aleatorizado y triple ciego del tratamiento complementario de la combinación de encorafenib y binimetinib comparado con placebo en el melanoma en estadio IIB/C completamente resecado con una mutación de BRAF
    A.4.1Sponsor's protocol code numberW00090GE303/EORTC-2139-MG
    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 SponsorPierre Fabre Médicament
    B.1.3.4CountryFrance
    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 supportPierre Fabre Médicament
    B.4.2CountryFrance
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPierre Fabre Médicament
    B.5.2Functional name of contact pointIsabelle Klauck
    B.5.3 Address:
    B.5.3.1Street Address45, Place Abel Gance
    B.5.3.2Town/ cityBoulogne
    B.5.3.3Post code92100
    B.5.3.4CountryFrance
    B.5.4Telephone number+3493227 541 4
    B.5.6E-mailisabelle.klauck@pierre-fabre.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 Yes
    D.2.1.1.1Trade name Braftovi
    D.2.1.1.2Name of the Marketing Authorisation holderPierre Fabre Médicament
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameEncorafenib
    D.3.2Product code W0090
    D.3.4Pharmaceutical form Capsule, hard
    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 INNEncorafenib
    D.3.9.1CAS number 1269440-17-6
    D.3.9.2Current sponsor codeW0090
    D.3.9.4EV Substance CodeSUB177218
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number75
    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 Yes
    D.2.1.1.1Trade name Mektovi
    D.2.1.1.2Name of the Marketing Authorisation holderPierre Fabre Médicament
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 namebinimetinib
    D.3.2Product code W0074
    D.3.4Pharmaceutical form Film-coated 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 INNBinimetinib
    D.3.9.1CAS number 606143-89-9
    D.3.9.2Current sponsor codeW0074
    D.3.9.4EV Substance CodeSUB179942
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number15
    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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Resected BRAF V600E/K stage IIB/C melanoma
    Melanoma resecado en etapa IIB/C con mutación BRAF V600E/K
    E.1.1.1Medical condition in easily understood language
    Stage IIB/C melanoma with mutation in the V600E/K gene after surgery
    Melanoma en estadio IIB/C con mutación en el gen V600E/K tras la cirugía
    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 10053571
    E.1.2Term Melanoma
    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
    To prospectively assess whether treatment with encorafenib and binimetinib prolongs recurrence-free survival (RFS) as compared to placebo in resected pT3b-4bN0 BRAF V600E/K melanoma participants.
    Evaluar prospectivamente si el tratamiento con encorafenib y binimetinib prolonga la supervivencia sin recurrencia (SSR) en comparación con placebo en participantes con melanoma pT3b-4bN0 BRAF V600E/K resecado.
    E.2.2Secondary objectives of the trial
    1.To prospectively assess whether treatment with encorafenib and binimetinib prolongs distant metastasis-free survival (DMFS) as compared to placebo.
    2.To prospectively assess whether treatment with encorafenib and binimetinib prolongs overall survival (OS) as compared to placebo.
    3.To assess the safety and tolerability of encorafenib and binimetinib.
    4.To compare the patient-reported health-related quality of life (HRQoL) between the two arms during the treatment duration and after treatment completion.
    5.To provide additional PK data to support PK modelling and exposure response (efficacy and safety) relationship developments in this indication.
    1. Evaluar prospectivamente si el tratamiento con encorafenib y
    binimetinib prolonga la supervivencia sin metástasis a distancia (SSMD) comparado con placebo.
    2. Evaluar prospectivamente si el tratamiento con encorafenib y
    binimetinib prolonga la supervivencia global (SG) comparado con placebo.
    3. Evaluar la seguridad y la tolerabilidad de encorafenib y binimetinib.
    4. Comparar la calidad de vida relacionada con la salud (CdVRS)
    notificada por el paciente entre los dos grupos durante el tiempo que
    dura el tratamiento y después de su finalización.
    5. Proporcionar datos de FC adicionales para respaldar el modelo de FC y los avances de la relación de exposición-respuesta (eficacia y seguridad) en esta indicación.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Molecular Pre-screening
    1.Before any related study activity, written informed consent must be given according to ICH/GCP, and national/local regulations;
    2.Male or female ≥ 18 years of age;
    3.Surgically resected, with tumor free margins, and histologically/pathologically confirmed new diagnosis of stage II (pT3b-pT4bN0) cutaneous melanoma per AJCC 8th edition;
    4.Sentinel node (SN) staged node negative (pN0);
    5.Sentinel node (SN) biopsy within 14 weeks from initial diagnosis of melanoma;
    6.Available tumor sample for central determination of the BRAFV600E/K mutation. FFPE tumor tissue block or a minimum of 10 slides, optimally up to 20 slides.
    Screening
    1.Before any related study activity, written informed consent must be given according to ICH/GCP, and national/local regulations;
    2.Melanoma confirmed centrally to be BRAF V600E/K mutation-positive;
    3.Participant still free of disease as evidenced by the required baseline imaging and physical/dermatological assessments performed respectively within 6 weeks and 2 weeks before the randomization (Day 1);
    4.Randomization within 12 weeks from full surgical resection including sentinel lymph node biopsy (SLNB);
    5.Recovered from definitive surgery (e.g. complete wound healing, no uncontrolled wound infections or indwelling drains);
    6.ECOG performance status of 0 or 1;
    7.Adequate haematological function:
    i.Absolute neutrophil count (ANC) ≥ 1.5 x 1000000000/L
    ii.Platelets ≥ 100 x 1000000000/L
    iii.Hemoglobin ≥ 9.0 g/dL
    8.Adequate renal function:
    Serum creatinine ≤ 1.5 × ULN; or calculated creatinine clearance ≥ 50 mL/min by Cockcroft Gault formula;
    9.Adequate electrolytes, defined as serum potassium and magnesium levels within institutional normal limits;
    10.Adequate hepatic function:
    i.Serum total bilirubin ≤ 1.5 x ULN and < 2 mg/dL
    ii.Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) ≤ 2.5 x ULN
    11.Adequate cardiac function:
    i.Left ventricular ejection fraction (LVEF) ≥ 50% as determined by a multigated acquisition (MUGA) scan or echocardiogram
    ii.Mean triplicate QT interval corrected for heart rate according to Fridericia’s formula (QTcF) value ≤ 480 msec and no history of QT syndrome
    12.Adequate coagulation function, defined as INR ≤1.5× ULN unless the patient is receiving anticoagulant therapy as long as PT or aPTT is within the therapeutic range;
    13.Negative serum β-HCG test (female patient of childbearing potential only) performed within 3 days prior to Day 1;
    14.Participants of childbearing / reproductive potential should use adequate birth control measures (see Appendix 4, section 10.4.2):
    Female participants are either postmenopausal for at least 1 year, surgically sterile for at least 6 weeks or must agree to take appropriate precautions to avoid pregnancy.
    Male participants must agree to take appropriate precautions to avoid fathering a child.
    Preselección molecular:
    1. Antes de cualquier actividad relacionada con el estudio, debe
    proporcionarse un consentimiento informado por escrito de acuerdo con las normas de Buena Práctica Clínica de la ICH, y la normativa nacional o local. 2.Hombre o mujer de ≥18 años de edad. 3.Resecado quirúrgicamente, con márgenes libres de tumor y
    confirmación histológica/patológica del nuevo diagnóstico de melanoma cutáneo en etapa II (pT3b-pT4bN0)a según AJCC, 8.ª edición.4.Ganglio centinela (GC) con estadio negativo (pN0);5.Biopsia del ganglio centinela (GC) en las 14 semanas siguientes al
    diagnóstico inicial de melanoma.6.Disponibilidad de una muestra tumoral para la determinación central de la mutación V600E/K de BRAF. Bloque de tejido tumoral fijado en formalina y embebido en parafina o un mínimo de 10 portaobjetos, idealmente hasta 20 portaobjetos.
    Selección:
    1. Antes de cualquier actividad relacionada con el estudio, debe
    proporcionarse un consentimiento informado por escrito de acuerdo con las normas de Buena Práctica Clínica de la ICH, y la normativa nacional o local. 2. Melanoma confirmado centralmente positivo para
    la mutación V600E/K de BRAF. 3.Participante que siga libre de enfermedad, evidenciad. por las evaluaciones por imagen y físicas/dermatológicas iniciales requeridas, realizadas, respectivamente, en las 6 semanas y las 2 semanas antes de la aleatorización (día 1). 4. No haber transcurrido más de 12 semanas entre la resección quirúrgica (incluida la BGLC) y la aleatorización. 5.Haberse recuperado de una cirugía definitiva (p. ej., curación completa de la herida, ausencia de infecciones no controladas de la herida o de drenajes permanentes).6.Estado funcional de 0 o 1 según el ECOG. 7. Función hematológica adecuada: i. recuento absoluto de neutrófilos (RAN) ≥1,5 × 109/l ii. plaquetas ≥100 × 109/l iii. hemoglobina ≤9,0 g/dl. 8.Función renal adecuada: serocreatinina ≤1,5 × LSN; o aclaramiento de creatinina calculado ≥50 ml/min por la fórmula de Cockcroft-Gault. 9. Electrolitos adecuados, definidos como niveles de potasio y magnesio en suero dentro de los límites normales de la institución. 10. Función hepática adecuada: i. bilirrubina total en suero ≤1,5 × LSN y <2 mg/dl ii. alanina aminotransferasa (ALT) o aspartato aminotransferasa (AST) ≤2,5 × LSN. 11. Función cardíaca adecuada: i. FEVI ≥50 % determinada mediante exploración por MUGA o ecocardiograma ii. valor de QTcF medio por triplicado ≤480 ms según la fórmula de Fridericia y sin antecedentes de síndrome del QT. 12. Función de coagulación adecuada, definida como IIN ≤1,5 × LSN, a menos que el paciente esté en tratamiento con anticoagulantes, siempre y cuando el TP o TTPa esté dentro del rango terapéutico. 13. Resultado negativo en la prueba de β-HCG en suero (solo mujeres en edad fértil) realizada en los 3 días anteriores al día 1. 14. Las participantes en edad fértil o con capacidad de reproducción deben utilizar medidas anticonceptivas adecuadas (véase el Apéndice 4 apartado 10.4.2): Las mujeres deben ser posmenopáusicas desde hace al menos 1 año, esterilizadas quirúrgicamente desde hace al menos 6 semanas o deben acceder a tomar precauciones para evitar el embarazo.
    Los varones deben acceder a tomar las precauciones necesarias para
    evitar engendrar un hijo.
    E.4Principal exclusion criteria
    Molecular pre-screening
    1.Unknown ulceration status;
    2.Uveal and mucosal melanoma;
    3.Clinically apparent metastases (N+/M1);
    4.Microsatellites, satellites and/or in-transit metastases;
    5.Local (scar) recurrences.
    Screening
    1.Breast feeding women;
    2.Pregnancy;
    3.History or current evidence of retinal vein occlusion (RVO) or current risk factors for RVO.
    4.History of thromboembolic or cerebrovascular events ≤ 12 weeks prior to randomization;
    i.Note 1: Thromboembolic or cerebrovascular events include stroke, transient ischemic attacks, cerebrovascular accidents, hemodynamically significant deep vein thrombosis, pulmonary emboli, aortic aneurysm requiring surgical repair or recent peripheral arterial thrombosis;
    ii.Note 2: Participants with thromboembolic events related to indwelling catheters or other procedures may be enrolled;
    5.Previous or concurrent malignancy for the past 3 years. Except for non-melanoma skin cancer and any in situ cancer;
    6.Any condition with a life expectancy of less than 5 years;
    7.Participants with a prior cancer associated with RAS mutation;
    8.Previous treatment for melanoma beyond complete surgical resection (any prior systemic anticancer therapy; prior radiotherapy);
    9.Hypersensitivity to the study drugs or to any of the excipients;
    10.Participants with severe lactose intolerance;
    11.Impaired cardiovascular function or clinically significant cardiovascular diseases, including any of the following:
    i.History of acute myocardial infarction, acute coronary syndromes (including unstable angina, coronary artery bypass graft, coronary angioplasty or stenting) ≤ 6 months prior to randomization;
    ii.Congestive heart failure requiring treatment (New York Heart Association Grade ≥ 2);
    iii.Uncontrolled hypertension defined as persistent systolic blood pressure ≥ 150 mmHg or diastolic blood pressure ≥ 100 mmHg despite optimal therapy;
    iv.Presence of clinically significant cardiac arrhythmias including uncontrolled atrial fibrillation or uncontrolled paroxysmal supraventricular tachycardia (stable controlled atrial fibrillation or paroxysmal supraventricular tachycardia is accepted);
    12.Neuromuscular disorders that are associated with CK > ULN;
    13.Non-infectious pneumonitis and Interstitial Lung Disease;
    14.Positive SARs-CoV-2 or variants of SARs-CoV2 RT-PCR test at screening or suspected to be infected with SARs-CoV2 or variants of SARsCoV2 with confirmation pending;
    15.Participants with active bacterial, fungal, or viral infection, including, but not limited to: HBV, HCV, and known HIV or AIDS-related illness, or an infection requiring systemic therapeutic treatment within 2 weeks prior to randomization.
    Note: Participants receiving prophylactic antibiotics are exceptions and may participate.
    Note: Participants with a positive HBsAg (i.e., either acute or chronic active hepatitis) are excluded. Those with positive anti-HBcAb but negative HBsAg and anti-HBsAb profile may be eligible upon review and approval by the sponsor or designee.
    Note: Participants with positive HCV antibody but undetectable HCV viral load may be eligible upon review and approval by the sponsor or designee.
    Note: Participants with confirmed stable HIV disease may be eligible if they have viral load < 50 copies/mL and CD4 count > 200 cells/mm3, and on stable antiretroviral therapy for at least 6 months, provided that they meet all other study eligibility criteria. Testing for HIV is not mandated for study entry; however, testing must be performed at sites where mandated locally following local clinical practice.;
    16.Unable to ingest or digest tablets and capsules. This can be caused by any impaired gastrointestinal function or disease, such as for example: ulcerative diseases, malabsorption syndrome, small bowel resection, ileus, etc. Or any condition causing uncontrolled nausea, vomiting or diarrhea;
    17.Presence of any psychological, familial, sociological or geographical conditions potentially hampering compliance with the study protocol and follow-up schedule according to Investigators’s judgement; those conditions should be assessed with the patient before randomization in the trial;
    18.Participant is a family member of the investigator or any associate, colleague and employee assisting in the study conduct (secretary, nurse, technician) or is otherwise in a position likely to represent a conflict of interest, the participant is only eligible if the informed consent has been sought by an appropriately qualified individual who is completely independent of this relationship;
    19.Participation in a clinical study with administration of an investigational product within 4 weeks or five times the half-life of the investigational product, whichever is longer, before the first dose of study treatment;
    20.Participants who has forfeited his / her freedom by administrative or legal award or is under guardianship.
    Preselección molecular: 1. Estado d úlcera desconocido.2. Melanoma uveal y mucoso.3. Metástasis clínicamente evidentes (N+/M1).4. Microsatélites, satélites y/o metástasis en tránsito.5. Recidivas locales (cicatriz). Selección: 1. Mujeres en periodo d lactancia. 2. Mujeres embarazadas. 3. Antecedentes o pruebas actuales d oclusión d la vena retiniana (OVR) o factores d riesgo actuales para OVR. 4. Antecedentes de acontecimientos tromboembólicos o cerebrovasculares ≤12 semanas antes d aleatorización. i. Nota 1: Acontecimientos tromboembólicos o cerebrovasculares son: accidente cerebrovascular, accidentes isquémicos transitorios, trombosis venosa profunda (i.e., masiva o submasiva) hemodinámicamente significativa, embolia pulmonar, aneurisma aórtico k requiere reparación quirúrgica o trombosis arterial periférica reciente; ii. Nota 2: Se podrá inscribir a participantes con acontecimientos tromboembólicos relacionados con catéteres permanentes o con otros procedimientos. 5. Antecedentes d neoplasia maligna previa o concurrente en 3 años precedentes. Excepto cáncer d piel no melanoma y cualquier cáncer in situ. 6. Cualquier afección con esperanza d vida <5 años. 7. Participantes con cáncer previo asociado con mutación RAS. 8. Tratamiento previo para melanoma más allá d la resección
    quirúrgica completa (tratamiento antineoplásico sistémico previo; o
    radioterapia para melanoma).9. Hipersensibilidad a fármacos dl estudio o alguno d sus excipientes.10. Participantes con intolerancia grave a lactosa.11. Deterioro d la función cardiovascular o enfermedades cardiovasculares clínicamente significativas, incluyendo: i. Antecedentes d infarto agudo d miocardio, síndromes coronarios agudos (incluidos angina inestable, derivación aortocoronaria, angioplastia coronaria o colocación de endoprótesis) ≤6 meses antes d la aleatorización; ii. Insuficiencia cardíaca congestiva k requiere tratamiento (grado ≥2 d la New York Heart Association); iii.hipertensión no controlada definida como presión arterial sistólica persistente ≥150 mmHg o presión arterial diastólica ≥100 mmHg a pesar dl tratamiento adecuado; iv. Presencia d arritmias cardíacas clínicamente significativas como fibrilación auricular no controlada o taquicardia paroxística supraventricular no controlada (se acepta fibrilación auricular controlada estable o taquicardia paroxística supraventricular).12. Trastornos neuromusculares asociados a CK > LSN.13. Neumonitis no infecciosa y enfermedad pulmonar intersticial.14. Prueba RT-PCR dl SARS-CoV-2 o variantes dl SARS-CoV-2 positiva en selección o sospecha d infección por SARS-CoV-2 o var. dl SARS-CoV-2 con confirmación pendiente.15. Infección bacteriana, fúngica o vírica activa, incluidas, VHB, VHC y enfermedad conocida relacionada con VIH o SIDA, o infección k requiera tratamiento sistémico en 2 semanas anteriores a aleatorización. Nota: participantes k reciban antibióticos preventivos se incluyen en excepciones y pueden participar. Participantes con resultado + para AgHBs (i.e, hepatitis activa aguda o crónica) están excluidos. Pacientes con resultado + d prueba anti-AgHBc pero - para AgHBs y anti-AgHBs pueden ser aptos trasrevisión/aprobación dl promotor o su rep. Participantes con resultado + para Ac dl VHC pero con concentración vírica dl VHC indetectable pueden ser aptos tras revisión/aprobación dl Prom. o rep. Participantes con VIH confirmada y estable pueden ser aptos si tienen concentración vírica <50 copias/ml y cifra d CD4 >200 células/mm3 y están recibiendo tratamiento antirretrovírico estable durante al - 6 meses, siempre k cumplan todos los demás criterios d idoneidad para participar. Prueba d VIH no obligatoria para entrar, pero se debe realizar donde sea obligatorio según práctica clínica local. 16. Incapaz d ingerir o digerir comprimidos y cápsulas. Puede deberse a cualquier afectación d la función gastrointestinal o enfermedad, como p.ej.: enfermedades ulcerativas, síndrome d malabsorción, resección dl intestino delgado, íleo, etc. O cualquier enfermedad k provoque náuseas no controladas, vómitos o diarrea. 17. Presencia d cualquier circunstancia psicológica, familiar, sociológica o geográfica k pueda obstaculizar cumplimiento dl protocolo dl estudio y programa d seguimiento; estas circunstancias se deben evaluar con paciente antes d aleatorización en ensayo. 18. Si participante es miembro d la familia dl IP o cualquier asociado, compañero/empleado k ayude en realización dl estudio (secretarios, personal de enfermería, técnicos) o d otro modo puede presentar conflicto d intereses, participante solo será apto para participar si persona debidamente cualificada k sea completamente independiente d esta relación ha solicitado el CI.19. Participación en estudio clínico con administración d un PI durante 4 semanas o 5 veces la semivida dl PI, lo que sea más largo, antes d la 1ra dosis dl tratamiento dl estudio.20. Participantes k hayan perdido su libertad por sentencia administrativa o legal o estén bajo tutela
    E.5 End points
    E.5.1Primary end point(s)
    •Recurrence-free survival (RFS)
    Supervivencia sin recurrencia (SSR)
    E.5.1.1Timepoint(s) of evaluation of this end point
    Approximately 4.4 years from the accrual of the first patient.The longterm evaluation will take place 10 years from the randomization of the last patient.
    Aproximadamente 4,4 años después de la inclusión del primer
    participante. La evaluación a largo plazo tendrá lugar 10 años después
    de la aleatorización del último paciente.
    E.5.2Secondary end point(s)
    1.Distant metastasis-free survival (DMFS)
    2.Overall survival (OS)
    3.
    •Severity of adverse events and SAEs on-study graded according to NCI CTCAE Version 5.0
    •Changes from baseline and worst value on-study for clinical safety laboratory assessments, physical examinations, vital signs, ECGs, ECHO, dermatological examinations, ophthalmic examinations and ECOG performance status
    •Incidence of dose interruptions, dose modifications and discontinuation due to AEs and incidence of AEs requiring additional therapy
    4.
    •The change in the HRQoL from baseline to the average of the scores during the treatment
    •The change in the HRQoL from baseline to the average of the scores at months 18, 24, and 30
    5.Sparse PK sampling in all participants to quantify plasma concentrations of encorafenib, binimetinib, and their metabolites (LHY746 and AR00426032, respectively) using validated assays
    1. Supervivencia sin metástasis a distancia (SSMD).
    2. Supervivencia general.
    • Incidencia y gravedad de los AA y de los AAG según los CTCAE del NCI
    V5.0
    • Cambios desde el inicio y el peor valor durante el estudio para las
    evaluaciones analíticas de la seguridad clínica, las exploraciones físicas,
    las constantes vitales, los ECG, las ecocardiografías, las exploraciones
    dermatológicas, las exploraciones oftálmicas y el estado funcional según
    el ECOG.
    • Incidencia de interrupciones de la dosis, modificaciones de la dosis e
    interrupción debido a AA, así como incidencia de AA que requieren
    tratamiento adicional.
    4.
    • El cambio en la CdVRS desde el inicio hasta el promedio de las
    puntuaciones durante el tratamiento.
    • El cambio en la CdVRS desde el inicio hasta el promedio de las
    puntuaciones durante los meses 18, 24 y 30.
    5. Obtención de muestras aisladas para FC en todos los participantes para cuantificar las concentraciones plasmáticas del encorafenib, el binimetinib y sus metabolitos (LHY746 y AR00426032, respectivamente) mediante ensayos validados.
    E.5.2.1Timepoint(s) of evaluation of this end point
    1.At the time of DFMS analysis (Approximately 6.0 years from first patient in)
    2.At the time of the OS analysis (7 years from accrual end)
    3.At the time of the RFS analysis (Approximately 4.4 years from first patient in)
    4.At the time of the RFS analysis (Approximately 4.4 years from first patient in)
    5.At the time of the RFS analysis (Approximately 4.4 years from first patient in)
    1. En el momento del análisis de la supervivencia sin metástasis (distant metastasis free survival, DMFS) (aproximadamente 6,0 años desde la inclusión del primer paciente).
    2. En el momento del análisis de la supervivencia general (overall survival, OG) (7 años después de la finalización de la inclusión).
    3.En el momento del análisis de la supervivencia sin recidiva (relapse free survival, RFS) (aproximadamente 4,4 años desde la inclusión del primer paciente)
    4.En el momento del análisis de la supervivencia sin recidiva (relapse free survival, RFS) (aproximandamente 4,4 años desde la inclusión del primer paciente)
    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 No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others 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) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Triple ciego
    Triple blind
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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 concerned10
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA83
    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
    Argentina
    Australia
    Brazil
    Canada
    Israel
    New Zealand
    South Africa
    Austria
    France
    Poland
    Sweden
    Netherlands
    Spain
    Switzerland
    Germany
    Italy
    Belgium
    Norway
    Russian Federation
    Serbia
    Ukraine
    United Kingdom
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    End of study is defined as the point when all patients have had the opportunity to be followed for 10 years from study entry. If the last participant discontinues the follow-up for one of the following reasons: withdrawal of consent, loss to follow-up, or death, the end of study participation is defined as the time point when one of these events occurred for the last participant.
    El final del estudio se define como el momento en que todos los pacientes hayan tenido la oportunidad de someterse a un seguimiento durante 10 años después la aleatorización. Si el último participante interrumpe el seguimiento por uno de los siguientes motivos: retirada del consentimiento, pérdida de contacto durante el o muerte, el final del estudio se define como el momento en el que se produjo uno de estos acontecimientos para el último participante.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years13
    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 years13
    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: 652
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 163
    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 state150
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 450
    F.4.2.2In the whole clinical trial 815
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Patients will be treated as per standard of care depending on the disease stage at recurrence/relapse.
    Las pacientes se tratarán según la práctica clínica habitual en función
    del estadio de la enfermedad en el momento de la recidiva/recaída.
    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 Decision2022-05-04
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-04-08
    P. End of Trial
    P.End of Trial StatusOngoing
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