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    Summary
    EudraCT Number:2021-005034-42
    Sponsor's Protocol Code Number:MK-7684A-008
    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 number2021-005034-42
    A.3Full title of the trial
    A Phase 3, Randomized, Double-Blind Study of MK-7684A in Combination with Etoposide and Platinum Followed by MK-7684A vs Atezolizumab in Combination with Etoposide and Platinum Followed by Atezolizumab for the First-Line Treatment of Participants with Extensive-Stage Small Cell Lung Cancer
    Estudio de fase 3, aleatorizado y doble ciego de MK-7684A en combinación con etopósido y platino seguido de MK-7684A en comparación con atezolizumab en combinación con etopósido y platino seguido de atezolizumab para el tratamiento de primera línea de participantes con cáncer de pulmón microcítico en estadio extenso
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Clinical Trial of MK-7684A with chemotherapy for extensive stage small cell lung cancer (ES-SCLC)
    Ensayo clínico de MK-7684A con quimioterapia para el cáncer de pulmón microcítico en estadio extenso (ES-SCLC)
    A.4.1Sponsor's protocol code numberMK-7684A-008
    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 S.A.
    B.5.2Functional name of contact pointInvestigación Clínica
    B.5.3 Address:
    B.5.3.1Street AddressC/ Josefa Valcárcel, 38
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28027
    B.5.3.4CountrySpain
    B.5.4Telephone number+34913210600
    B.5.5Fax number+34913210590
    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.3.4Pharmaceutical 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.3.9.3Other descriptive nameAnti-TIGIT humanized monoclonal IgG antibody
    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 TECENTRIQ®
    D.2.1.1.2Name of the Marketing Authorisation holderRoche Registration GmbH
    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 nameAtezolizumab
    D.3.4Pharmaceutical form Concentrate for 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 INNAtezolizumab
    D.3.9.1CAS number 1380723-44-3
    D.3.9.4EV Substance CodeSUB178312
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1200
    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
    Extensive-stage small-cell lung cancer
    Cáncer de pulmón microcítico en estadio extenso
    E.1.1.1Medical condition in easily understood language
    Extensive-stage small-cell lung cancer
    Cáncer de pulmón microcítico en estadio extenso
    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 10041068
    E.1.2Term Small cell lung cancer extensive stage
    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 overall survival for MK-7684A in combination with etoposide/platinum followed by MK-7684A to atezolizumab in combination with etoposide/platinum followed by atezolizumab.
    1. Comparar la supervivencia global entre MK-7684A en combinación con el tratamiento de base con etopósido/platino seguido de MK-7684A y atezolizumab en combinación con el tratamiento de base con etopósido/platino seguido de atezolizumab.
    E.2.2Secondary objectives of the trial
    1. To compare progression-free survival per RECIST 1.1 by blinded independent central review (BICR) for MK-7684A plus etoposide/platinum followed by MK-7684A to atezolizumab plus etoposide/platinum followed by atezolizumab.
    2. To evaluate objective response rate per RECIST 1.1 by BICR for MK-7684A plus etoposide/platinum followed by MK-7684A compared to atezolizumab plus etoposide/platinum followed by atezolizumab.
    3. To evaluate duration of response per RECIST 1.1 by BICR for MK-7684A plus etoposide/platinum followed by MK-7684A compared to atezolizumab plus etoposide/platinum followed by atezolizumab.
    4. To evaluate safety and tolerability based on proportion of adverse events.
    5. To evaluate change from baseline and time to true deterioration in global health status/quality of life, physical functioning, dyspnea, cough, chest pain for MK-7684A plus etoposide/platinum followed by MK-7684A compared to atezolizumab plus etoposide/platinum followed by atezolizumab.
    1Comparar la supervivencia sin progresión por RECIST1.1 según una evaluación central independiente y con enmascaramiento (ECIE) entre MK7684A más etopósido/platino seguido de MK7684A y atezolizumab más etopósido/platino seguido de atezolizumab
    2Determinar la tasa de respuestas objetivas por RECIST1.1 según ECIE con MK7684A más etopósido/platino seguido de MK7684A comparado con atezolizumab más etopósido/platino seguido de atezolizumab
    3Determinar la duración de respuesta por RECIST1.1,según ECIE con MK7684A más etopósido/platino seguido de MK7684A comparado con atezolizumab más etopósido/platino seguido de atezolizumab
    4Determinar la seguridad y tolerabilidad según la proporción de acontecimientos adversos
    5Determinar la variación media con respecto al momento basal del estado de salud general/calidad de vida,funcionamiento físico disnea,tos y dolor torácico con MK7684A más etopósido/platino seguido de MK7684A comparado con atezolizumab más etopósido/platino seguido de atezolizumab
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Has histologically or cytologically confirmed diagnosis of ES-SCLC in need of first-line therapy.
    2. Has ES-SCLC defined as Stage IV (T any, N any, M1a/b/c) by the American Joint Committee on Cancer, Eighth Edition or T3-T4 due to multiple lung nodules that are too extensive or have tumor/nodal volume that is too large to be encompassed in a tolerable radiation plan.
    3. Is male or female, at least 18 years of age at the time of providing documented informed consent.
    4. Male participants are eligible to participate if they agree 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 after the last dose of the intervention is as follows:
    - Etoposide, cisplatin, or carboplatin: 95 days
    - Blinded study intervention: no contraception measures
    • Refrain from donating sperm
    PLUS either:
    • Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis) and agree to remain abstinent
    OR
    • Must agree to use contraception unless confirmed to be azoospermic as detailed below:
    - Agree to use 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.
    5. A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies:
    • Is not a WOCBP
    OR
    • Is a WOCBP and using a contraceptive method that is highly effective, 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 after the last dose of the intervention is as follows:
    - Etoposide, cisplatin, or carboplatin: 180 days
    - Blinded study intervention: 5 months
    The investigator should evaluate the potential for contraceptive method failure in relationship to the first dose of study intervention.
    - A WOCBP must have a negative highly sensitive pregnancy test within 24 hours before the first dose of study intervention.
    - If a urine test cannot be confirmed as negative, a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive.
    - Additional requirements for pregnancy testing during and after study intervention are in Section 8.3.6 of the protocol.
    - The investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy.
    - 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.
    6. 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.
    7. Has measurable disease per RECIST 1.1 as assessed by the local site investigator/radiology. Lesions situated in a previously irradiated area are considered measurable if progression has been shown in such lesions. At least 1 lesion that meets the criteria for being measurable, as defined by RECIST 1.1, must be appropriate for selection as a target lesion.
    8. Submits a pretreatment archival tumor tissue sample or newly obtained core, incisional, or excisional biopsy of a tumor lesion not previously irradiated where such sample exists. Biopsy/tissue is preferred, but cytology sample by fine needle aspiration is allowed. The sample may be submitted after enrollment but must be submitted within 4 weeks after randomization.
    9. Has an ECOG performance status of 0 to 1 assessed within 7 days before allocation/randomization.
    10. Has adequate organ function.
    11. Has a predicted life expectancy of >3 months.
    1Diagnóstico histológica/citológicamente de CPM-EE con necesidad de tratamiento de 1ªlínea
    2Presencia de CPM-EE, definido como estadio IV(cualquier T,cualquier N, M1a/b/c) según el American Joint Committee on Cancer, 8ªed, o T3-T4 debido a la presencia de múltiples nódulos pulmonares extensos o con un volumen tumoral/ganglionar demasiado grande para ser abarcado por un plan de irradiación tolerable
    3Mujer/varón≥18años en el momento de consentimiento informado
    4Podrán participar varones que se comprometan a lo siguiente durante el período de intervención y durante el tiempo necesario para eliminar cada intervención del estudio después de recibir la última dosis.El tiempo que tendrá que mantenerse la anticoncepción con cada intervención del estudio después de la última dosis es:
    -Etopósido, cisplatino/carboplatino:95días
    -Intervención del estudio enmascarada (MK-7684A/atezolizumab): ningún método
    •Abstenerse de donar semen
    Y:
    •Abstenerse de mantener relaciones heterosexuales,como modo de vida habitual y preferido (abstinencia a largo plazo y persistente) y compromiso de la abstinencia
    O
    •Comprometerse a usar mét. anticonceptivos a menos de presencia de azoospermia, según:
    -Comprometerse a usar preservativo masculino + uso por parte de la pareja de un mét. anticonceptivo adicional durante las relaciones sexuales con penetración vaginal con MEF que no estén embarazadas
    -El uso de anticonceptivos por los varones deberá cumplir la normativa local sobre métodos anticonceptivos para participantes en estudios clínicos.Si los requisitos de anticoncepción de la ficha técnica local de las intervenciones del estudio son más estrictos, deberán seguirse los requisitos de la ficha técnica local
    5Podrán participar mujeres que no estén embarazadas ni en período de lactancia y que cumplan al menos una de las condiciones siguientes:
    •No ser una MEF
    O
    •Ser una MEF y usar un mét. anticonceptivo muy eficaz, con baja dependencia de la usuaria, o practicar la abstinencia como modo de vida preferido y habitual (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 y comprometerse a no donar óvulos ni congelarlos/conservarlos para su propio uso con fines de reproducción durante este período. El tiempo que tendrá que mantenerse la anticoncepción con cada intervención del estudio después de la última dosis es:
    -Etopósido, cisplatino/carboplatino:180días
    -Intervención del estudio enmascarada (MK-7684A/atezolizumab):5meses
    El investigador deberá evaluar la posibilidad de fracaso del mét. anticonceptivo en relación con la 1ªdosis de intervención del estudio
    -Las MEF deberán dar negativo en una prueba de embarazo de alta sensibilidad realizada en las 24h previas a la 1ªdosis de la intervención del estudio
    -Cuando no pueda confirmarse que el resultado de una prueba en orina es negativo, será necesario hacer una prueba en suero. La participante será excluida si el resultado de la prueba de embarazo en suero es positivo
    -La sección 8.3.6 recoge otros requisitos relacionados con las pruebas de embarazo durante y después de la intervención del estudio
    -El investigador es responsable de revisar antecedentes médicos, menstruales y actividad sexual reciente para reducir el riesgo de incluir a una mujer con un embarazo no detectado
    -El uso de anticonceptivos por las mujeres deberá cumplir la normativa local sobre métodos anticonceptivos en estudios clínicos. Si los requisitos de anticoncepción de la ficha técnica local de las intervenciones del estudio son más estrictos, deberán seguirse los requisitos de la ficha técnica local.
    6El participante (o representante legal) ha otorgado su consentimiento/asentimiento informado. La participante también podrá otorgar su consentimiento/ asentimiento para investigaciones biomédicas futuras. No obstante, podrá participar en el estudio principal sin necesidad de hacerlo en investigaciones biomédicas futuras
    7Presencia de enfermedad mensurable conforme a RECIST 1.1 según la evaluación del investigador/ radiólogo. Las lesiones ubicadas en zona irradiada previamente se considerarán mensurables siempre que se haya constatado progresión en dichas lesiones. Presencia de al menos 1lesión que cumpla los criterios de lesión mensurable por RECIST 1.1 y que sea adecuada para elección como lesión diana.
    8Envío de una muestra de tejido tumoral de archivo previa al tratamiento o de biopsia reciente, con aguja gruesa, por incisión/escisión, de una lesión tumoral no irradiada previamente, si existen. Se prefiere una biopsia/muestra de tejido, aunque se permite una muestra citológica obtenida mediante aspiración con aguja fina. La muestra podrá enviarse después de la inclusión en el estudio, pero siempre en las 4semanas siguientes a la aleatorización
    9 ECOG 0 o 1 en 7 días previos a aleatorización
    10Presencia de función orgánica adecuada
    11Esperanza de vida>3 meses
    E.4Principal exclusion criteria
    1. Is considered a poor medical risk due to a serious, uncontrolled medical disorder or nonmalignant systemic disease. Examples include, but are not limited to, uncontrolled major seizure disorder, unstable spinal cord compression, or severe or life-threatening superior vena cava syndrome.
    2. Has received prior treatment (systemic therapy including investigational agents, curativeintent radiotherapy, or curative-intent surgical resection) for SCLC.
    3. Is expected to require any other form of antineoplastic therapy for SCLC while on study.
    4. Has received a live or live-attenuated vaccine within 30 days before the first dose of study intervention. Administration of killed vaccines are allowed.
    5. Is 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.
    6. Has a 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 prior the first dose of study medication.
    7. Has a known additional malignancy that is progressing or has required active treatment within the past 3 years.
    8. Has known active CNS metastases and/or carcinomatous meningitis. Participants with brain metastases may participate only if they satisfy all of the following:
    • Completed treatment (eg, whole brain radiation treatment, stereotactic radiosurgery, or equivalent) at least 14 days before the first dose of study intervention
    • Have no evidence of new or enlarging brain metastases confirmed by posttreatment repeat brain imaging (preferably using the same modality) performed at least 4 weeks after treatment and within the screening period, and
    • Are neurologically stable without the need for steroids at least 7 days before the first dose of study intervention as per local site assessment.
    9. Has a history of severe hypersensitivity reaction (≥Grade 3) to any study intervention and/or any of its excipients (refer to the IB and/or approved product label(s) for a list of excipients).
    10. Has an 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.
    11. Has a history of (noninfectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease.
    12. Has a known history of, or active, neurologic paraneoplastic syndrome.
    13. Has an active infection requiring systemic therapy.
    14. Has a known history of HIV infection. No HIV testing is required unless mandated by local health authority.
    15. 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.
    16. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator.
    17. Has a known psychiatric or substance abuse disorder that would interfere with the participant’s ability to cooperate with the requirements of the study.
    18. Has had an allogenic tissue/solid organ transplant.
    19. Has had major surgery within 3 weeks before receiving the first dose of study intervention or has not recovered adequately from toxicity and/or complications from an intervention prior to receiving the first dose of study intervention.
    20. Has symptomatic ascites or pleural effusion. A participant who is clinically stable following treatment for these conditions (including therapeutic thoraco- or paracentesis) is eligible.
    1.Se considera que el participante tiene un riesgo médico elevado debido a un trastorno médico grave y no controlado o una enfermedad sistémica no maligna. Algunos ejemplos son, entre otros, trastorno convulsivo importante no controlado, compresión medular inestable o síndrome de la vena cava superior grave o potencialmente mortal.
    2.Recepción de tratamiento previo (tratamiento sistémico, incluidos fármacos experimentales, radioterapia con intención curativa o resección quirúrgica con intención curativa) contra el CPM.
    3.Previsión de que se precise cualquier otra forma de tratamiento antineoplásico contra el CPM durante el estudio.
    4.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.
    5.Participación activa o pasada en un estudio de un fármaco en investigación o uso de un dispositivo en investigación en las cuatro semanas previas a la administración de la primera dosis de la intervención del estudio.
    6.Diagnóstico de inmunodeficiencia o recepción de tratamiento sistémico crónico con esteroides (en dosis superiores a 10 mg diarios de prednisona o equivalente) o cualquier otra forma de tratamiento inmunodepresor en los 7 días previos a la primera dosis de la medicación del estudio.
    7.Presencia de otra neoplasia maligna conocida que esté en progresión o que haya precisado tratamiento activo en los últimos tres años.
    8.Metástasis activas en el SNC y/o meningitis carcinomatosa conocidas. Los candidatos con metástasis cerebrales solo podrán participar en caso de cumplir todos los criterios siguientes:
    -Tratamiento finalizado (por ejemplo, radioterapia total cerebral, radiocirugía estereotáctica o equivalente) al menos 14 días antes de la primera dosis de la intervención del estudio.
    -Ausencia de signos de metástasis cerebrales nuevas o que hayan aumentado de tamaño confirmado mediante nuevos estudios de imagen cerebrales posteriores al tratamiento (preferiblemente con uso de la misma modalidad) realizados al menos 4 semanas después del tratamiento y dentro del período de selección.
    -Estado neurológicamente estable sin necesidad de corticoides durante al menos siete días antes de la primera dosis de la intervención del estudio según la evaluación del centro local.
    9.Antecedentes de reacción de hipersensibilidad grave (grado ≥3) a cualquier intervención del estudio o a cualquiera de sus excipientes (véase una lista de excipientes en el manual del investigador o la ficha técnica aprobada del producto).
    10.Presencia de una enfermedad autoinmunitaria activa que haya precisado tratamiento sistémico (es decir, fármacos modificadores de la enfermedad, corticoides o inmunodepresores) en los 2 últimos años. El tratamiento de reposición (por ejemplo, tiroxina, insulina o corticoides en dosis fisiológicas por insuficiencia suprarrenal o hipofisaria) no se considera una forma de tratamiento sistémico y se permitirá su uso.
    11.Antecedentes de neumonitis (no infecciosa)/enfermedad pulmonar intersticial con necesidad de corticoides o presencia de neumonitis/enfermedad pulmonar intersticial.
    12.Antecedentes o presencia activa de un síndrome paraneoplásico neurológico.
    13.Presencia de una infección activa con necesidad de tratamiento sistémico.
    14.Antecedentes conocidos de infección por el VIH. No será necesario realizar pruebas de VIH a menos que lo exijan las autoridades sanitarias locales.
    15.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 (definida como detección de ARN del virus de la hepatitis C [VHC] [cualitativo]).
    16.Antecedentes o datos presentes de cualquier proceso, tratamiento o anomalía analítica que, en opinión del investigador responsable del tratamiento, pueda confundir los resultados del estudio, dificultar la participación durante la totalidad del estudio o motivar que la participación no sea lo más conveniente para el posible participante.
    17.Presencia de un trastorno psiquiátrico o por abuso de sustancias que podría dificultar la capacidad del participante para colaborar en el cumplimiento de los requisitos del estudio.
    18.Recepción de un alotrasplante de órgano sólido o tejidos.
    19.Intervención de cirugía mayor en las tres semanas previas a la administración de la primera dosis de la intervención del estudio o ausencia de recuperación adecuada de la toxicidad o las complicaciones de una intervención antes de recibir la primera dosis de la intervención del estudio.
    20.Ascitis o derrame pleural sintomáticos. Podrán participar candidatos que se encuentren clínicamente estables tras recibir tratamiento por estos procesos (como toracocentesis o paracentesis terapéuticas).
    E.5 End points
    E.5.1Primary end point(s)
    1. Overall Survival (OS)
    1.Supervivencia global (SG)
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 37 months
    1.Hasta aproximadamente 37 meses
    E.5.2Secondary end point(s)
    1. Progression-Free Survival (PFS)
    2. Objective Response Rate (ORR)
    3. Duration of Response (DOR)
    4. Percentage of Participants Who Experienced an Adverse Event (AE)
    5. Percentage of Participants Who Discontinued Study Treatment Due to an AE
    6. 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)
    7. Change from Baseline in Physical Functioning (Items 1-5) Combined Score on the EORTC QLQ-C30
    8.Change from Baseline in Dyspnea Score (Item 8) on the EORTC QLQ-C30
    9. Change from Baseline in Cough Score (Item 31) on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Lung Cancer 13 (EORTC QLQ-LC13)
    10. Change from Baseline in Chest Pain Score (Item 40) on the EORTC QLQ-LC13
    11. Time to True Deterioration (TTD) in the Global Health Status/Quality of Life (Items 29 and 30) Combined Score on the EORTC QLQ-C30
    12. TTD in Physical Functioning (Items 1-5) Combined Score on the EORTC QLQ-C30
    13. TTD in Dyspnea Score (Item 8) on the EORTC QLQ-C30
    14. TTD in Cough Score (Item 31) on the EORTC QLQ-LC13
    15. TTD in Chest Pain Score (Item 40) on the EORTC QLQ-LC13
    1.Supervivencia sin progresión (SSP)
    2.Tasa de respuestas objetivas (TRO)
    3.Duración de la respuesta (DR)
    4.Porcentaje de participantes que experimentan acontecimientos adversos
    5.Porcentaje de participantes que discontinúan del tratamiento del estudio por un acontecimiento adverso
    6.Variación con respecto al momento basal en la puntuación del estado general de salud/calidad de vida (apartados 29 y 30) del cuestionario de calidad de vida Core-30 de la European Organization for Research and Treatment of Cancer (QLQ-C30 de la EORTC)
    7.Variación con respecto al momento basal en la puntuación del funcionamiento físico (apartados 1-5) del cuestionario QLQ-C30 de la EORTC
    8.Variación con respecto al momento basal en la puntuación de disnea (apartado 8) del cuestionario QLQ-C30 de la EORTC
    9.Variación con respecto al momento basal en la puntuación de tos (apartado 31) del cuestionario de calidad de vida de cancer de pulmón 13 de la European Organization for Research and Treatment of Cancer (EORTC QLQ-LC13)
    10.Variación con respecto al momento basal en la puntuación de dolor torácico (apartado 40) del cuestionario QLQ- LC13 de la EORTC
    11.Tiempo hasta el deterioro real en la puntuación de estado general de salud/calidad de vida (apartados 29 y 30 del cuestionario QLQ-C30 de la EORTC]
    12.Tiempo hasta el deterioro real en la puntuación de funcionamiento físico (apartados 1-5) del cuestionario QLQ-C30 de la EORTC
    13.Tiempo hasta el deterioro real en la puntuación de disnea (apartado 8) del cuestionario QLQ-C30 de la EORTC
    14.Tiempo hasta el deterioro real en la puntuación de tos (apartado 31) del cuestionario QLQ-LC13 de la EORTC
    15.Tiempo hasta el deterioro real en la puntuación de dolor torácico (apartado 40) del cuestionario QLQ- LC13 de la EORTC
    E.5.2.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 26 months
    2. Up to approximately 37 months
    3. Up to approximately 37 months
    4. Up to approximately 60 months
    5. Up to approximately 60 months
    6. Baseline and up to approximately 37 months
    7. Baseline and up to approximately 37 months
    8. Baseline and up to approximately 37 months
    9. Baseline and up to approximately 37 months
    10. Baseline and up to approximately 37 months
    11. Baseline and up to approximately 37 months
    12. Baseline and up to approximately 37 months
    13. Baseline and up to approximately 37 months
    14. Baseline and up to approximately 37 months
    15. Baseline and up to approximately 37 months
    1. Hasta aproximadamente 26 meses.
    2. Hasta aproximadamente 37 meses.
    3. Hasta aproximadamente 37 meses.
    4. Hasta aproximadamente 60 meses.
    5. Hasta aproximadamente 60 meses.
    6. Momento basal hasta aproximadamente 37 meses.
    7. Momento basal hasta aproximadamente 37 meses.
    8. Momento basal hasta aproximadamente 37 meses.
    9. Momento basal hasta aproximadamente 37 meses.
    10. Momento basal hasta aproximadamente 37 meses.
    11. Momento basal hasta aproximadamente 37 meses.
    12. Momento basal hasta aproximadamente 37 meses.
    13. Momento basal hasta aproximadamente 37 meses.
    14. Momento basal hasta aproximadamente 37 meses.
    15. Momento basal hasta aproximadamente 37 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 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 No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic Yes
    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 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 concerned4
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA84
    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
    Australia
    Mexico
    Turkey
    Argentina
    Austria
    Belgium
    Brazil
    Canada
    China
    Finland
    Germany
    Greece
    Hungary
    Ireland
    Israel
    Italy
    Japan
    Lithuania
    Netherlands
    Poland
    Portugal
    Romania
    Russian Federation
    Sweden
    Switzerland
    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 months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years5
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 234
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 216
    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 state16
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 258
    F.4.2.2In the whole clinical trial 450
    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
    Ninguno
    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 Decision2022-02-11
    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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