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    Summary
    EudraCT Number:2021-004564-94
    Sponsor's Protocol Code Number:MK-7684A-007
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-12-07
    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 number2021-004564-94
    A.3Full title of the trial
    A Randomized, Double-Blind, Phase 3 Study of MK-7684A Plus Chemotherapy Versus Pembrolizumab Plus Chemotherapy as First Line Treatment for Participants With Metastatic Non-Small Cell Lung Cancer
    Estudio de fase 3, aleatorizado y doble ciego de MK-7684A más quimioterapia, en comparación con pembrolizumab más quimioterapia, como tratamiento de primera línea en participantes con cáncer de pulmón no microcítico metastásico.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Clinical trial of MK-7684A plus chemotherapy compared to pembrolizumab plus chemotherapy for metastatic non-small cell lung cancer
    Ensayo clínico de MK-7684A más quimioterapia en comparación con pembrolizumab más quimioterapia para cáncer de pulmón no microcítico metastásico.
    A.3.2Name or abbreviated title of the trial where available
    A Phase 3 study of MK-7684A in combination with chemotherapy in metastatic NSCLC
    Estudio de fase 3 de MK-7684A en combinación con quimioterapia en el CPNM metastásico
    A.4.1Sponsor's protocol code numberMK-7684A-007
    A.5.4Other Identifiers
    Name:INDNumber:147424
    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 SponsorMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportMerck Sharp & Dohme Corp., a subsidiary of Merck & Co.,Inc
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMerck Sharp & Dohme de España SA
    B.5.2Functional name of contact pointInvestigación clínica
    B.5.3 Address:
    B.5.3.1Street AddressCalle Josefa valcárcel, 38
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28027
    B.5.3.4CountrySpain
    B.5.4Telephone number+3491321 06 00
    B.5.5Fax number+3491321 05 90
    B.5.6E-mailensayos_clinicos@merck.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 nameMK-7684A
    D.3.2Product code MK-7684A
    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 INNVibostolimab
    D.3.9.1CAS number 2231305-30-7
    D.3.9.2Current sponsor codeMK-7684
    D.3.9.4EV Substance CodeSUB203865
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNPembrolizumab
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.4EV Substance CodeSUB167136
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name KEYTRUDA (pembrolizumab,MK-3475)
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp & Dohme B.V.
    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.3.4Pharmaceutical 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 INNPembrolizumab
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.4EV Substance CodeSUB167136
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.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
    First-line treatment of metastatic NSCLC
    Tratamiento de primera línea del CPNM metastásico
    E.1.1.1Medical condition in easily understood language
    Adult participants that have non-small cell lung cancer (NSCLC) that has spread to other parts of the body and have not been treated for this condition
    Participantes adultos que tienen cáncer de pulmón no microcítico (CPCNP) que se ha extendido a otras partes del cuerpo y no han recibido tratamiento para esta afección.
    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 PT
    E.1.2Classification code 10059515
    E.1.2Term Non-small cell lung cancer metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    1. To compare MK-7684A in combination with chemotherapy to pembrolizumab in combination with chemotherapy with respect to progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 as assessed by blinded independent central review (BICR)
    2. To compare MK-7684A in combination with chemotherapy to pembrolizumab in combination with chemotherapy with respect to Overall Survival (OS)
    1.Comparar MK-7684A en combinación con quimioterapia y pembrolizumab en combinación con quimioterapia en cuanto a la supervivencia sin progresión (SSP) conforme a los Criterios de evaluación de la respuesta en tumores sólidos (RECIST), versión 1.1, según una revisión central independiente y enmascarada (RCIE).
    2.Comparar MK-7684A en combinación con quimioterapia y pembrolizumab en combinación con quimioterapia en cuanto a la supervivencia global (SG).
    E.2.2Secondary objectives of the trial
    1. To evaluate MK-7684A in combination with chemotherapy to pembrolizumab in combination with chemotherapy with respect to Objective Response Rate (ORR) per RECIST 1.1 as assessed by BICR
    2. To evaluate the mean change from baseline in global health status/quality of life (QoL), physical functioning, dyspnea, cough, and chest pain for MK-7684A in combination with chemotherapy compared to pembrolizumab in combination with chemotherapy
    3. To evaluate the Time to True Deterioration (TTD) in global health status/QoL, physical functioning, dyspnea, cough, and chest pain for MK-7684A in combination with chemotherapy compared to pembrolizumab in combination with chemotherapy
    4. To evaluate the safety and tolerability of MK-7684A in combination with chemotherapy compared to pembrolizumab in combination with chemotherapy
    5. To evaluate DOR per RECIST 1.1 as assessed by BICR for MK-7684A plus chemotherapy compared to pembrolizumab plus chemotherapy
    1.Evaluar MK-7684A en combinación con quimioterapia, frente a pembrolizumab en combinación con quimioterapia, en cuanto a la TRO conforme a los criterios RECIST 1.1, según una RCIE.
    2.Evaluar la variación media con respecto al momento basal del estado de salud general/calidad de vida, la función física, la disnea, tos y dolor torácico con MK -7684A combinado con quimioterapia en comparación con pembrolizumab combinado con quimioterapia.
    3.Evaluar el tiempo transcurrido hasta un deterioro real (TDR) del estado de salud general/calidad de vida, función física, disnea, tos y dolor torácico con MK-7684A combinado con quimioterapia en comparación con pembrolizumab combinado con quimioterapia.
    4. Evaluar la seguridad y la tolerabilidad de MK-7684A combinado con quimioterapia en comparación con pembrolizumab combinado con quimioterapia.
    5. Evaluar la DR con MK-7684A más quimioterapia, en comparación con pembrolizumab más quimioterapia, conforme a los criterios RECIST 1.1, según una RCIE.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Has a histologically or cytologically confirmed diagnosis of Stage IV (T any, N any, M1a, M1b, M1c - AJCC eighth Edition) squamous or nonsquamous NSCLC
    2. Has measurable disease based on RECIST 1.1, as determined by the local site assessment
    3. Has provided tumor tissue (post diagnosis of metastatic disease is preferred) for determination of PD-L1 status before randomization
    4. Has confirmation that EGFR-, ALK-, or ROS1-directed therapy is not indicated as primary therapy (documentation of the absence of tumor-activating EGFR mutations [eg, DEL19 or L858R], AND absence of ALK and ROS1 gene rearrangements)
    5. Has not received prior systemic treatment for metastatic NSCLC
    6. Is male or female, from ≥18 years of age inclusive, at the time of signing the informed consent
    7. Has an ECOG PS of 0 or 1 assessed within 7 days before randomization
    8. Has a life expectancy of at least 3 months
    9. If male, agrees to the following during the intervention period and for at least the time needed to eliminate each study intervention after the last dose of study intervention. The length of time required to continue contraception for each study intervention is as follows:
    • Chemotherapy: at least 95 days from the last dose
    • Refrain from donating sperm
    PLUS either:
    • Abstains from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis) and agrees to remain abstinent
    OR
    • Uses contraception unless confirmed to be azoospermic (vasectomized or secondary to medical cause, documented from the site personnel’s review of the participant’s medical records, medical examination, or medical history interview as detailed below:
    - Uses a male condom plus partner use of an additional contraceptive method when having penile-vaginal intercourse with a WOCBP who is not currently pregnant
    - Contraceptive use by men should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. If the contraception requirements in the local label for any of the study interventions is more stringent than the requirements above, the local label requirements are to be followed
    10. A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies:
    • Not a WOCBP
    OR
    • Is a WOCBP and:
    - Uses a contraceptive method that is highly effective (with a failure rate of <1% per year), with low user dependency, or be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis), during the intervention period and for at least the time needed to eliminate each study intervention after the last dose of study intervention and agrees not to donate eggs (ova, oocytes) to others or freeze/store for her own use for the purpose of reproduction during this period. The length of time required to continue contraception for each study intervention is as follows:
    ◦ MK-7684A/pembrolizumab: 120 days
    ◦ Chemotherapy: 180 days
    - The investigator should evaluate the potential for contraceptive method failure (ie, noncompliance, recently initiated) in relationship to the first dose of study intervention. Contraceptive use by women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. If the contraception requirements in the local label for any of the study interventions is more stringent than the requirements above, the local label requirements are to be followed
    - Has a negative highly sensitive pregnancy test ( as required by local regulations) within 24 hours for urine or within 72 hours for serum before the first dose of study imtervention. If a urine test cannot be confirmed as negative (eg, an ambiguous result), a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive
    - Abstains from breastfeeding during the study intervention period and for at least 120 days after the last dose of study intervention
    - Medical history, menstrual history, and recent sexual activity has been reviewed by the investigator to decrease the risk for inclusion of a woman with an early undetected pregnancy
    11. The participant (or legally acceptable representative) has provided documented informed consent/assent for the study. The participant may also provide consent/assent for FBR. However, the participant may participate in the study without participating in FBR
    12. Has adequate organ function as defined in the protocol. Specimens must be collected within 10 days before the start of study intervention
    1. Tiene un diagnóstico confirmado histológica o citológicamente de CPNM epidermoide o no epidermoide en estadio IV
    2. Presenta enfermedad mensurable conforme a los criterios RECIST 1.1
    3. Ha proporcionado tejido tumoral para determinar PD-L1 antes de la aleatorización.
    4. Confirmación de tratamiento dirigido contra EGFR, ALK o ROS1 no indicado como tratamiento primario
    5. No recibido previamente tratamiento sistémico para CPNM metastásico.
    6. Varón o mujer con una edad mínima de 18 años a firma de IC.
    7. Estado funcional del ECOG de 0 o 1 en los 7 días previos a aleatorización.
    8. Esperanza de vida mínima de 3 meses.
    9. Si es varón, se compromete durante período de intervención y al menos el tiempo necesario para eliminar cada intervención del estudio después de última dosis de ésta.
    • Quimioterapia: al menos 95 días después de la última dosis.
    • Abstenerse de donar semen y abstenerse de mantener relaciones heterosexuales o utilizar anticonceptivos (preservativo masculino más uso por la pareja de un método anticonceptivo adicional)
    10. Podrán participar mujeres que no estén embarazadas ni en período de lactancia y que cumplan al menos 1 año de no estar en edad fértil o si está en edad fértil y utiliza un método anticonceptivo muy eficaz o practica la abstinencia a largo plazo y Persistente durante el período de intervención y durante el tiempo necesario para eliminar cada intervención del estudio después de recibir la última dosis de ésta. Se compromete a no donar óvulos a otras personas ni congelarlos /conservarlos para su propio uso. El tiempo que tendrá que mantenerse la anticoncepción con cada intervención del estudio es el siguiente:
    ◦ MK-7684A/pembrolizumab: 120 días.
    ◦ Quimioterapia: 180 días.
    - Tiene un resultado negativo en prueba de embarazo de alta realizada en las 24h (orina) o las 72h (suero) previas a la 1ª dosis de la intervención del estudio. Prueba de embarazo en suero cuando no pueda confirmarse prueba en orina negativo.
    - Abstenerse de dar pecho durante el período de intervención del estudio y durante al menos 120 días después de la última dosis de ésta.
    - El investigador revisa antecedentes médicos, menstruales y actividad sexual para reducir el riesgo de incluir a una mujer con un embarazo de poco tiempo no detectado.
    11. El participante (o su representante legal) ha otorgado su consentimiento informado documentado para el estudio. El participante también podrá otorgar su consentimiento o asentimiento para investigaciones biomédicas futuras. No obstante, podrá participar en el estudio principal sin necesidad de hacerlo en las investigaciones biomédicas futuras.
    12. Función orgánica adecuada. Las muestras se obtendrán en los 10 días previos al comienzo de la intervención del estudio.
    E.4Principal exclusion criteria
    1. Known additional malignancy that is progressing or has required active treatment within the past 3 years
    2. Known active CNS metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable, (ie, without evidence of progression) for at least 4 weeks as confirmed by repeat imaging performed during study screening, are clinically stable and have not required steroid treatment for at least 14 days before the first dose of study intervention. Participants with asymptomatic brain metastases (ie, no neurological symptoms, no requirements for corticosteroids, no or minimal surrounding edema, and no lesion >1.5 cm) may participate
    3. Severe hypersensitivity (≥Grade 3) to MK-7684, MK-7684A, pembrolizumab, chemotherapy components, and/or any of its excipients
    4. Diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days before the first dose of study medication
    5. Active autoimmune disease that has required systemic treatment in past 2 years (ie, with use of disease modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment and is allowed
    6. History of (noninfectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease
    7. Active infection requiring systemic therapy
    8. Known history of HIV infection. No HIV testing is required unless mandated by local health authority
    9. Has a known history of Hepatitis B (defined as HBsAg reactive) or known active Hepatitis C virus (defined as HCV RNA [qualitative] is detected) infection
    10. History or current evidence of any condition, therapy, or laboratory abnormality, or other circumstance that might confound the results of the study or interfere with the participant's participation for the full duration of the study, such that it is not in the best interest of the participant to participate, in the opinion of the treating investigator
    11. Known psychiatric or substance abuse disorder that would interfere with the participant’s ability to cooperate with the requirements of the study
    12. Received prior therapy with an anti-TIGIT, anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another stimulatory or coinhibitory T-cell receptor (eg, CTLA-4, OX-40, CD137)
    13. Received prior systemic anticancer therapy for metastatic disease
    14. If the participant had major surgery, the participant must have recovered adequately from the procedure and/or any complications from the operation before starting study intervention
    15. Received prior radiotherapy within 2 weeks of start of study intervention or have had a history of radiation pneumonitis
    16. Received radiation therapy to the lung that is >30 Gray within 6 months of the first dose of study intervention
    17. Received a live or live attenuated vaccine within 30 days before the first dose of study intervention. Administration of killed vaccines are allowed
    18. Is unable to interrupt aspirin or other NSAIDs, other than an aspirin dose ≤1.3 g/day, for a 5-day period (8-day period for long-acting agents, such as piroxicam)
    19. Is unable or unwilling to take folic acid or vitamin B12 supplementation
    20. Currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks before the first dose of study intervention
    21. History of allogenic tissue/solid organ transplant
    1.Presencia de otra neoplasia maligna conocida que esté en progresión o que haya precisado tratamiento activo en los últimos 3 años.
    2.Metástasis activas en el SNC y/o meningitis carcinomatosa conocidas. Los pacientes con metástasis cerebrales tratadas anteriormente podrán participar siempre que se encuentren radiológicamente estables (es decir, sin signos de progresión) durante al menos 4 semanas según la confirmación en estudios de imagen repetidos durante la selección para el estudio, estén clínicamente estables y no hayan necesitado tratamiento con corticoides durante al menos 14 días antes de la primera dosis de la intervención del estudio. Podrán participar pacientes con metástasis cerebrales asintomáticas (es decir, sin síntomas neurológicos, sin necesidad de corticoides, sin edema circundante [o solo mínimo] y sin lesiones de más de 1,5 cm).
    3. Hipersensibilidad grave (grado ≥3) a MK-7684, MK-7684A, pembrolizumab, los componentes de la quimioterapia y/o a cualquiera de sus excipientes.
    4. Diagnóstico de inmunodeficiencia o está recibiendo tratamiento sistémico crónico con esteroides (en dosis superiores a 10 mg diarios de equivalente de prednisona) o cualquier otra forma de tratamiento inmunodepresor en los 7 días previos a la primera dosis de la medicación del estudio.
    5. Enfermedad autoinmunitaria activa que ha precisado tratamiento sistémico (es decir, fármacos modificadores de la enfermedad, corticoides o inmunodepresores) en los 2 últimos años. El tratamiento de reposición (ej: tiroxina, insulina o corticoides en dosis fisiológicas por insuficiencia suprarrenal o hipofisaria) no se considera una forma de tratamiento sistémico y se permite su uso.
    6. Antecedentes de neumonitis (no infecciosa) /enfermedad pulmonar intersticial con necesidad de corticoides o presencia de neumonitis/enfermedad pulmonar intersticial.
    7. Infección activa con necesidad de tratamiento sistémico.
    8. Antecedentes conocidos de infección por el VIH. No será necesario realizar pruebas de VIH a menos que lo exijan las autoridades sanitarias locales.
    9. Antecedentes de infección por el virus de la hepatitis B (reactividad del antígeno de superficie del virus de la hepatitis B [HBsAg]) o de infección activa por el virus de la hepatitis C (detección de ARN del VHC [cualitativo]).
    10. Antecedentes o signos actuales de cualquier trastorno, tratamiento o anomalía analítica u otra circunstancia que, en opinión del investigador responsable del tratamiento, pueda confundir los resultados del estudio o interferir en la participación de la paciente durante todo el estudio, de modo que no le conviene participar.
    11. Trastorno psiquiátrico o por abuso de sustancias que podría dificultar la capacidad del participante para colaborar en el cumplimiento de los requisitos del estudio.
    12. Tratamiento previo con un fármaco anti-TIGIT, anti-PD-1, anti-PD-L1 o anti-PD-L2 o con un fármaco dirigido contra otro receptor de los linfocitos T estimulador o coinhibidor (p. ej., CTLA-4, OX-40 o CD137).
    13. Tratamiento antineoplásico sistémico previo para las metástasis.
    14. Si el participante se ha sometido a una operación de cirugía mayor, deberá haberse recuperado debidamente de la misma y/o de sus complicaciones antes de iniciar la intervención del estudio.
    15. Ha recibido radioterapia en las 2 semanas previas al comienzo de la intervención del estudio o tiene antecedentes de neumonitis por radiación.
    16. Radioterapia en el pulmón >30 Gy en los seis meses previos a la primera dosis de la intervención del estudio.
    17. Administración de una vacuna de microorganismos vivos o vivos atenuados en los 30 días previos a la primera dosis de la intervención del estudio. Se permite la administración de vacunas inactivadas.
    18. Imposibilidad de interrumpir el tratamiento con ácido acetilsalicílico u otros antiinflamatorios no esteroideos, excepto una dosis de ácido acetilsalicílico ≤1,3 g al día durante 5 días (8 días en caso de fármacos de acción prolongada, como piroxicam).
    19. No puede o no está dispuesto a tomar un suplemento de ácido fólico o vitamina B12.
    20. Está participando actualmente o ha participado en un estudio de un fármaco en investigación o ha usado un dispositivo en investigación en las cuatro semanas previas a la administración de la primera dosis de la intervención del estudio.
    21. Antecedentes de un alotrasplante de órgano sólido o tejidos.
    E.5 End points
    E.5.1Primary end point(s)
    1. Progression-Free Survival (PFS)
    2. Overall Survival (OS)
    1. Supervivencia sin progresión (SSP)
    2. Supervivencia global (SG)
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 33 months
    2. Up to approximately 42 months
    1. Hasta aproximadamente 33 meses
    2. hasta aproximadamente 42 meses
    E.5.2Secondary end point(s)
    1. Objective Response Rate (ORR)
    2. Change from Baseline in the Global Health Status/Quality of Life (Items 29 and 30) Combined Score on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)
    3. Change from Baseline in Physical Functioning (Items 1-5) Combined Score on the EORTC QLQ-C30
    4. Change from Baseline in Dyspnea Score (Item 8) on the EORTC QLQ-C30
    5. Change from Baseline in Cough Score (Item 31) on the European Organization for Research and Treatment of Cancer Quality of Life Lung Cancer-Specific Questionnaire Module (EORTC QLQ-LC13)
    6. Change from Baseline in Chest Pain Score (Item 40) on the EORTC QLQ- LC13
    7. Time to Deterioration (TTD) in the Global Health Status/Quality of Life (Items 29 and 30) Combined Score on the EORTC QLQ-C30
    8. TTD in Physical Functioning (Items 1-5) Combined Score on the EORTC QLQ- C30
    9. TTD in Dyspnea Score (Item 8) on the EORTC QLQ-C30
    10. TTD in Cough Score (Item 31) on the EORTC QLQ-LC13
    11. TTD in Chest Pain Score (Item 40) on the EORTC QLQ-LC13
    12. Number of Participants Who Experienced One or More Adverse Events (AEs)
    13. Number of Participants Who Discontinued Study Intervention Due to an AE
    14. Duration of Response (DOR)
    1.Tasa de respuestas objetivas (TRO)
    2.Variación con respecto al momento basal del estado general de salud/CdV (apartados 29 y 30 del QLQ-C30 de la EORTC).
    3.Variación con respecto al momento basal del funcionamiento físico (apartados 1-5 del QLQC30 de la EORTC).
    4.Variación con respecto al momento basal de Disnea (apartado 8 del QLQC30 de la EORTC).
    5.Variación con respecto al momento basal de Tos (apartado 31 del QLQ-LC13 de la EORTC).
    6.Variación con respecto al momento basal de Dolor torácico (apartado 40 del QLQ-LC13 de la EORTC).
    7.TDR Tiempo transcurrido entre el momento basal y el primer deterioro del estado general de salud/CdV (apartados 29 y 30 del QLQ-C30 de la EORTC).
    8.TDR del funcionamiento físico (apartados 1-5 del QLQC30 de la EORTC).
    9.TDR de Disnea (apartado 8 del QLQC30 de la EORTC).
    10.TDR de Tos (apartado 31 del QLQ-LC13 de la EORTC).
    11.TDR de Dolor torácico (apartado 40 del QLQ-LC13 de la EORTC).
    12.Número de participantes que experimentan uno o más acontecimientos adversos (AA).
    13.Número de participantes discontinuados del estudio por AA
    14.DR tiempo transcurrido entre la primera prueba documentada de RC o RP y la progresión de la enfermedad o la muerte por cualquier causa.
    E.5.2.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 42 months
    2. Baseline and Up to approximately 42 months
    3. Baseline and Up to approximately 42 months
    4. Baseline and Up to approximately 42 months
    5. Baseline and Up to approximately 42 months
    6. Baseline and Up to approximately 42 months
    7. Up to approximately 42 months
    8. Up to approximately 42 months
    9. Up to approximately 42 months
    10. Up to approximately 42 months
    11. Up to approximately 42 months
    12. Up to approximately 42 months
    13. Up to approximately 42 months
    14. Up to approximately 42 months
    1.Hasta aproximadamente 42 meses
    2.Momento basal y hasta aproximadamente 42 meses
    3.Momento basal y hasta aproximadamente 42 meses
    4.Momento basal y hasta aproximadamente 42 meses
    5.Momento basal y hasta aproximadamente 42 meses
    6.Momento basal y hasta aproximadamente 42 meses
    7.Hasta aproximadamente 42 meses
    8.Hasta aproximadamente 42 meses
    9.Hasta aproximadamente 42 meses
    10.Hasta aproximadamente 42 meses
    11.Hasta aproximadamente 42 meses
    12.Hasta aproximadamente 42 meses
    13.Hasta aproximadamente 42 meses
    14.Hasta aproximadamente 42 meses
    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 No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic Yes
    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 Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the 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 concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA32
    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
    Chile
    Colombia
    Mexico
    Thailand
    Turkey
    Argentina
    Austria
    Brazil
    China
    Germany
    Israel
    Japan
    Korea, Republic of
    Poland
    Russian Federation
    Spain
    Taiwan
    Ukraine
    United Kingdom
    United States
    France
    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
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years5
    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 years5
    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: 315
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 385
    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 state42
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 177
    F.4.2.2In the whole clinical trial 700
    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)
    None
    Ningun
    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 Decision2022-02-16
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-01-05
    P. End of Trial
    P.End of Trial StatusOngoing
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