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    Summary
    EudraCT Number:2021-005487-22
    Sponsor's Protocol Code Number:A2A-005
    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:2022-06-10
    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 number2021-005487-22
    A.3Full title of the trial
    A randomized, double-blind, placebo-controlled, Phase 2 study evaluating efficacy and safety of inupadenant in combination with carboplatin and pemetrexed in adults with nonsquamous non-small cell lung cancer who have progressed on immunotherapy.
    Estudio en fase II aleatorizado, doble ciego, controlado con placebo, para evaluar la eficacia y la seguridad de inupadenant en combinación con carboplatino y pemetrexed en adultos con cáncer de pulmón no microcítico y no epidermoide que han progresado con la inmunoterapia
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A clinical study evaluating efficacy and safety of inupadenant in combination with carboplatin and pemetrexed in adults with metastatic nonsquamous non-small cell lung cancer who have progressed on immunotherapy.
    Ensayo clinico para evaluar la eficacia y la seguridad de inupadenant en combinación con carboplatino y pemetrexed en adultos con cáncer de pulmón no microcítico y no epidermoide que han progresado con la inmunoterapia
    A.4.1Sponsor's protocol code numberA2A-005
    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 SponsoriTeos Belgium SA
    B.1.3.4CountryBelgium
    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 supportiTeos Belgium SA
    B.4.2CountryBelgium
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationiTeos Belgium SA
    B.5.2Functional name of contact pointSally Ross
    B.5.3 Address:
    B.5.3.1Street Addressrue des Frères Wright 29
    B.5.3.2Town/ cityGosselies
    B.5.3.3Post code6041
    B.5.3.4CountryBelgium
    B.5.4Telephone number+3247471 05 85
    B.5.6E-mailsally.ross@iteostherapeutics.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 nameInupadenant 20 mg
    D.3.2Product code EOS100850
    D.3.4Pharmaceutical form Capsule
    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 INNInupadenant
    D.3.9.1CAS number 2411004-22-1
    D.3.9.2Current sponsor codeEOS100850
    D.3.9.4EV Substance CodeSUB218673
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameInupadenant 40 mg
    D.3.2Product code EOS100850
    D.3.4Pharmaceutical form Capsule
    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 INNInupadenant
    D.3.9.1CAS number 2411004-22-1
    D.3.9.2Current sponsor codeEOS100850
    D.3.9.4EV Substance CodeSUB218673
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40
    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
    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
    Nonsquamous non-small cell lung cancer
    cáncer de pulmón no microcítico
    E.1.1.1Medical condition in easily understood language
    Nonsquamous non-small cell lung cancer
    cáncer de pulmón no microcítico
    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
    Part 1 (Dose-Finding):
    • To evaluate safety and tolerability of inupadenant in combination with carboplatin and pemetrexed
    • To identify the inupadenant recommended Phase 2 dose (RP2D) to be used in combination with carboplatin and pemetrexed in Part 2 of the study

    Part 2 (Randomized):
    • To evaluate efficacy of inupadenant HCl in combination with carboplatin and pemetrexed compared to the efficacy of the placebo in combination with carboplatin and pemetrexed
    Parte 1 (determinación de la dosis):
    • Evaluar la seguridad y la tolerabilidad de inupadenant en combinación con carboplatino y pemetrexed.
    • Identificar la dosis recomendada para la fase II (DRF2) de inupadenant que se usará en combinación con carboplatino y pemetrexed en la parte 2 del estudio.

    Parte 2 (aleatorizada):
    • Evaluar la eficacia del CLH de inupadenant en combinación con carboplatino y pemetrexed comparada con la eficacia del placebo en combinación con carboplatino y pemetrexed.
    E.2.2Secondary objectives of the trial
    Part 1 Only:
    • To evaluate efficacy of inupadenant in combination with carboplatin and pemetrexed
    Part 2 Only:
    • To evaluate safety and tolerability of inupadenant in combination with carboplatin and pemetrexed vs. placebo in combination with both drugs
    • To evaluate additional measures of efficacy of inupadenant in combination with carboplatin and pemetrexed vs. placebo in combination with both drugs
    • To assess the effect of inupadenant in combination with carboplatin and pemetrexed vs. placebo in combination with both drugs on time to onset and/or deterioration of lung cancer specific symptoms
    Part 1 and Part 2:
    • To evaluate pharmacokinetics of inupadenant and active metabolite EOS100612 in combination with carboplatin and pemetrexed
    Please refer to Protocol Section 2 for other secondary objectives.
    Solo parte 1:
    • Evaluar la eficacia de inupadenant en combinación con carboplatino y pemetrexed.
    Solo parte 2:
    • Evaluar la seguridad y la tolerabilidad de inupadenant en combinación con carboplatino y pemetrexed comparado con el placebo en combinación con ambos fármacos.
    • Evaluar medidas adicionales de la eficacia de inupadenant en combinación con carboplatino y pemetrexed comparado con el placebo en combinación con ambos fármacos.
    • Evaluar el efecto de inupadenant en combinación con carboplatino y pemetrexed comparado con el placebo en combinación con ambos fármacos en el tiempo hasta la aparición o el empeoramiento de los síntomas específicos de cáncer de pulmón. Partes 1 y 2:
    • Evaluar la farmacocinética del inupadenant y el metabolito activo EOS100612 en combinación con carboplatino y pemetrexed.

    Consulten la Sección 2 del Protocolo para conocer otros objetivos secundarios.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Have signed an Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved informed consent form prior to any study-specific evaluation.

    2. Be ≥18 years of age at the time informed consent is signed.

    3. Have a confirmed diagnosis of metastatic (Stage IV) or locally advanced, unresectable (Stage III) NSCLC of nonsquamous pathology that has relapsed or progressed.

    4. Have measurable disease as defined by RECIST v1.1 criteria based on local assessment. A measurable tumor lesion in a previously irradiated site is acceptable if subsequent progression has been demonstrated in that lesion.

    5. Have PD-L1 expression status available either at the time of or after the diagnosis of advanced or metastatic NSCLC disease has been made.

    6. Can provide existing biopsy taken within 2 years prior to entering trial or have at least one lesion that is accessible for a fresh biopsy (this lesion for fresh biopsy must not be the measurable target tumor lesion).

    7. Have relapsed or progressed after prior anti-programmed death (PD)-ligand (L)1 therapy as follows:
    - Have received only 1 line of anti- PD-L1 therapy in the metastatic setting, without concomitant chemotherapy, and have progressed on the anti-PD-(L)1 therapy. Immuno-oncology (IO)/IO combination therapy (standard or investigational) is allowed. Progression on the anti-PD-(L)1 therapy is defined as demonstrated radiological or clinical disease progression on or after at least 12 weeks of antiPD-(L)1 treatment.

    OR

    - Have received single-agent durvalumab therapy post-chemoradiation in the Stage III setting and have progressed. Progression on durvalumab therapy is defined as demonstrated radiological or clinical disease progression on or after at least 12 weeks of durvalumab treatment.

    8. Have adequate organ function confirmed by the following laboratory values obtained within 14 days prior to treatment assignment:
    Hematological:
    - Absolute neutrophil count: ≥1,500 /mL
    - Platelets: ≥100,000 /mL
    - Hemoglobin: ≥9.5 g/dL or ≥5.9 mmol/L– 4 weeks without transfusions
    Renal:
    - Estimated glomerular filtration rate (Modification of Diet in Renal Disease method) (Levey, 1999) ≥ 60 mL/min
    Hepatic
    - Total bilirubin OR Direct bilirubin: ≤1.5× upper limit of normal (ULN) for total
    bilirubin OR ≤ULN for direct bilirubin for subjects with elevated total bilirubin levels; ≤1.5× ULN for direct bilirubin in case of Gilbert’s syndrome (hereditary indirect hyperbilirubinemia)
    - Alanine transaminase and aspartate transaminase: ≤3× ULN; ≤5× ULN if liver metastases
    Coagulation
    - International Normalized Ratio (INR) or Prothrombin Time (PTT): ≤1.5× ULN unless the subject is receiving anticoagulant therapy.

    9. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
    1. Firmar un consentimiento informado aprobado por el comité de ética independiente (CEI) antes de realizar ninguna evaluación específica del estudio.

    2. Tener ≥18 años en el momento de la firma del consentimiento informado.

    3. Tener un diagnóstico confirmado de CPNM no epidermoide, metastásico (estadio IV) o localmente avanzado, e irresecable (estadio III) que haya recidivado o progresado.

    4. Tener enfermedad mensurable definida según la v 1.1 de los criterios RECIST de acuerdo con la evaluación local. Se acepta una lesión tumoral mensurable en un punto previamente irradiado si se ha demostrado la progresión posterior de dicha lesión.

    5. Tener el estado de la expresión de PD-L1 disponible, ya sea en el momento del diagnóstico de CPNM avanzado o metastásico, o después de este.

    6. Poder proporcionar una biopsia obtenida en los 2 años anteriores a la entrada en el estudio o tener al menos una lesión accesible para realizar una biopsia en fresco y que no sea la lesión tumoral de referencia mensurable.


    7. Haber recidivado o progresado antes del tratamiento contra el ligando 1 (L1) de muerte programada (PD), de la siguiente forma:
    - Haber recibido una sola línea de tratamiento anti-PD-L1 en estado metastásico, sin quimioterapia concomitante, y haber progresado con el tratamiento anti-PD-L1. Se admite la inmunoncología (IO) o el tratamiento combinado con IO (estándar o en investigación). La progresión con el tratamiento anti-PD-L1 se define como progresión de la enfermedad demostrada radiológica o clínicamente durante o tras un mínimo de 12 semanas de tratamiento anti-PD-L1.

    O

    - Haber recibido durvalumab en monoterapia tras la radioquimioterapia en el estadio III y haber progresado. La progresión con el tratamiento con durvalumab se define como progresión de la enfermedad demostrada radiológica o clínicamente durante o tras un mínimo de 12 semanas de tratamiento con durvalumab.

    8. Tener un funcionamiento orgánico adecuado confirmado mediante los siguientes valores analíticos obtenidos en los 14 días anteriores a la asignación del tratamiento:
    Hemático:
    - Cifra absoluta de neutrófilos: ≥1500/ml
    - Plaquetas: ≥100 000/ml
    - Hemoglobina: ≥9,5 g/dl o ≥5,9 mmol/l; 4 semanas sin transfusiones
    Renal:
    - Filtración glomerular estimada (calculada mediante el método de modificación de la dieta en la enfermedad renal) (Levey, 1999) ≥60 ml/min
    Hepático:
    - Bilirrubina total O bilirrubina directa: ≤1,5 veces el límite superior de la normalidad (LSN) para la
    bilirrubina total O ≤LSN para la bilirrubina directa en pacientes con una concentración elevada de bilirrubina total y ≤1,5 veces el LSN de bilirrubina directa en casos de síndrome de Gilbert (hiperbilirrubinemia indirecta congénita)
    - Alanina transaminasa y aspartato transaminasa: ≤3 veces el LSN y ≤5 veces el LSN en caso de metástasis en el hígado
    Coagulación:
    - Cociente internacional normalizado (CIN) o tiempo de protrombina (TP): ≤1,5 veces el LSN, a menos que el paciente esté recibiendo anticoagulantes

    9. Estado funcional del Eastern Cooperative Oncology Group (ECOG) de 0 a 1.
    E.4Principal exclusion criteria
    1. Symptomatic and/or untreated central nervous system (CNS) metastases or leptomeningeal disease. Participants with asymptomatic previously treated CNS metastases are eligible provided they have been clinically stable for at least 4 weeks.

    2. Presence of active second malignancy, except for:
    a. History of malignancy that has been successfully treated, with no evidence of active cancer for 1 year prior to enrollment
    b. Surgically cured and/or low risk tumors e.g., early stage cervical or endometrial cancer, any cancer in situ, non-melanoma skin cancers.

    3. Treatment with any prior systemic chemotherapy or >1 line of immunotherapy in the metastatic setting. Participants may have received prior chemotherapy or additional immunotherapy in the adjuvant setting, provided their first metastatic treatment occurred more than 6 months after completing adjuvant therapy).

    4. Have actionable mutation or genomic alteration in epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) genes or have been treated with EGFR or ALK targeted therapy. Participants with presence of other driver mutations are allowed if targeted therapy is not available as per local SOC.

    5. Preexisting gastrointestinal disorders/conditions that would, in the opinion of the Investigator, interfere with ingestion or absorption of inupadenant.

    6. History of or active (non-infectious) pneumonitis/ interstitial disease or lung fibrosis. (Note: Stage III participants with pneumonitis Grade 1 from the prior chemoradiation therapy that did not worsen on durvalumab therapy are allowed).

    7. Have active or a history of autoimmune disease requiring systemic treatment in the last 6 months (e.g., with disease modifying agents, corticosteroids, or immunosuppressive drugs) or persistent immune-mediated toxicity caused by checkpoint inhibitor therapy > Grade 2, with the exception of residual endocrinopathy being adequately treated, vitiligo, Type 1 diabetes mellitus (T1DM), or psoriasis not requiring systemic therapy. Replacement therapy (e.g., thyroxine, insulin, or corticosteroid replacement therapy for adrenal/pituitary insufficiency) is allowed.

    8. Have known active or chronic hepatitis B or C infection unless treated with antiviral therapy for at least 4 weeks with no detectable viral load at the time of screening; known infection with human immunodeficiency virus (HIV) unless receiving antiretroviral therapy with well-controlled disease documented at the time of screening by a CD4+ T-cell count > 350 cell/μL, HIV RNA level of < 50 copies/mL or the lower-limit of detection at least 12 weeks prior to screening, and a stable treatment regimen for at least 4 weeks prior to enrollment that has been limited to the use of abacavir, dolutegravir, emtricitabine, lamivudine, raltegravir, rilpivirine, or tenofovir. Participants are not required to be tested for the presence of such viruses prior to therapy on this protocol in the absence of a history of such infection or unless required by local health authorities.

    9. History of life-threatening toxicity related to prior immune therapy or any toxicity resulting in permanent discontinuation from prior therapy after rechallenge.

    10. Diagnosis of immunodeficiency or any condition requiring concurrent use of systemic immunosuppressants or corticosteroids (>10 mg daily prednisone equivalents). Premedication for chemotherapy or intravenous (IV) contrast is permitted; topical glucocorticoids or a short course of steroids (<5 days) are allowed ≤ 7 days prior to first dose of study treatment.

    11. Active infection requiring systemic antibacterial, antifungal, or antiviral therapy ≤ 7 days prior to first dose of study treatment.

    12. Oncologic treatment including chemotherapy, radiation, antibody therapy or other immunotherapy, gene therapy, vaccine therapy, targeted therapy, and/or experimental drugs administered ≤14 days (<28 days in case of checkpoint inhibitor therapy) prior to first dose of study treatment and/or ongoing adverse effects from such treatment > Grade 1, per NCI CTCAE version 5.0, with the exception for alopecia and Grade 2 peripheral neuropathy. (Note: Ongoing treatment with anti-cancer hormonal therapy for a previously treated cancer other than the disease under study is allowed).

    13. Non-study related minor surgical procedure ≤7 days, or major surgical procedure (requiring more than a 24-hour hospital admission) of ≤ 5 weeks prior to first dose of study treatment; in all cases, the participant must be sufficiently recovered and stable before treatment administration.

    Please refer to Protocol Section 3.5.2 for other exclusion criteria.
    1. Metástasis no tratadas o sintomáticas en el sistema nervioso central (SNC), o enfermedad leptomeníngea. Los participantes con metástasis en el SNC asintomáticas previamente tratadas podrán participar, siempre que lleven al menos 4 semanas clínicamente estables.

    2. Presencia de una segunda neoplasia maligna activa, excepto:
    a. Antecedentes de neoplasia maligna tratada con éxito, sin pruebas de cáncer activo durante un año antes de la inscripción.
    b. Tumores de escasa malignidad o curados quirúrgicamente, p. ej., cáncer cervicouterino o de endometrio en estadio inicial, cualquier cáncer localizado o cáncer de piel distinto del melanoma.


    3. Tratamiento con quimioterapia sistémica anterior o >1 línea de inmunoterapia en estadio metastásico. Los participantes pueden haber recibido quimioterapia anterior o inmunoterapia adicional complementaria, siempre que el primer tratamiento metastásico tuviese lugar más de 6 meses después de completar el tratamiento complementario.

    4. Tener mutación aprovechable o alteración genómica en los genes del receptor del factor de crecimiento epidérmico (EGFR) o la cinasa del linfoma anaplásico (ALK), o haber recibido tratamiento dirigido al EGFR o la ALK. Se admiten participantes con presencia de otras mutaciones oncoiniciadoras si no existe ningún tratamiento dirigido según el tratamiento de referencia local.

    5. Las enfermedades o trastornos digestivos ya existentes que, en opinión del investigador, pueden interferir en la ingestión o absorción de inupadenant.

    6. Antecedentes (o enfermedad activa) de neumonitis o neumopatía intersticial (no infecciosa), o fibrosis pulmonar (nota: se admitirá a los participantes en estadio III con neumonitis de grado 1 desde la radioquimioterapia anterior que no hayan empeorado con el tratamiento con durvalumab).

    7. Tener antecedentes o una enfermedad autoinmunitaria activa que haya requerido tratamiento sistémico en los últimos 6 meses (p. ej., con sustancias modificadoras de la enfermedad, corticoesteroides o inmunodepresores) o toxicidad inmunitaria persistente de grado >2 causada por un tratamiento inhibidor del punto de control, a excepción de la endocrinopatía residual tratada adecuadamente, el vitiligo, la diabetes mellitus de tipo 1 (DMT1) o psoriasis que no requiera tratamiento sistémico. Se admite el tratamiento sustitutivo (p. ej., tiroxina, insulina o tratamiento sustitutivo con corticoesteroides para la insuficiencia suprarrenal o hipofisaria).

    8. Tener infección por hepatitis B o C activa o crónica conocida, a menos que se haya tratado con antivíricos durante al menos 4 semanas sin carga vírica detectable en el momento de la selección; infección conocida por virus de la inmunodeficiencia humana (VIH), a menos que reciba tratamiento antirretrovírico con enfermedad bien controlada documentada en el momento de la selección mediante una cifra de linfocitos T CD4+ >350 células/μl, ARN del VIH <50 copias/ml o el límite inferior de detección al menos 12 semanas antes de la selección y una pauta de tratamiento estable durante al menos 4 semanas antes de la inscripción, que se limitará al uso de abacavir, dolutegravir, emtricitabina, lamivudina, raltegravir, rilpivirina o tenofovir. De no haber antecedentes de dicha infección, o a menos que lo requieran las autoridades sanitarias locales, los participantes no se tendrán que someter a un análisis de la presencia de dichos virus antes de recibir el tratamiento de este protocolo.

    9. Antecedentes de toxicidad potencialmente mortal relacionada con una inmunoterapia previa o toxicidad que derive en la suspensión permanente de un tratamiento previo tras la reexposición.

    10. Diagnóstico de inmunodeficiencia u otro trastorno que requiera el uso simultáneo de inmunodepresores o corticoesteroides sistémicos (>10 mg al día de equivalentes de la prednisona). Se admiten la medicación prequimioterápica o el contraste intravenoso (i.v.), así como los glucocorticoesteroides tópicos o un ciclo breve (<5 días) de corticoesteroides ≤7 días antes de la primera dosis del tratamiento del estudio.

    11. Infección activa que requiera tratamiento antibacteriano, antifúngico o antivírico sistémico ≤7 días antes de la primera dosis del tratamiento del estudio.

    12. Tratamiento oncológico, incluidos quimioterapia, radioterapia, tratamiento con anticuerpos u otro tipo de inmunoterapia, genoterapia, vacunas, tratamiento dirigido o fármacos experimentales administrados ≤14 días (<28 días en el caso de los inhibidores del punto de control) antes de la primera dosis del tratamiento del estudio o efectos adversos en curso de dicho tratamiento de grado >1, según la versión 5.0 de los CTCAE del NCI, a excepción de la alopecia y la neuropatía periférica de grado 2 (nota: se admite el tratamiento en curso con hormonoterapia oncológica para un cáncer tratado previamente y diferente a la enfermedad objeto de estudio).
    E.5 End points
    E.5.1Primary end point(s)
    Part 1 (Dose-Finding):
    • Incidence of adverse events (AEs), serious adverse events (SAEs), dose-limiting toxicities (DLTs), AEs leading to discontinuation, deaths, and clinically significant laboratory abnormalities.

    Part 2 (Randomized):
    • Progression-free survival (PFS), defined as time from randomization to the date of first documented radiological progression using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 criteria or death due to any cause.
    Parte 1 (determinación de la dosis):
    • Incidencia de acontecimientos adversos (AA), acontecimientos adversos graves (AAG), toxicidades limitantes de la dosis (TLD), AA que provoquen la suspensión, muertes y anomalías analíticas clínicamente significativas.

    Parte 2 (aleatorizada):
    • Supervivencia sin progresión (SSP), definida como el tiempo transcurrido desde la aleatorización hasta la fecha de la primera progresión radiológica documentada mediante la versión 1.1 de los criterios de evaluación de la respuesta en los tumores sólidos (RECIST v1.1) o la muerte por cualquier causa.
    E.5.1.1Timepoint(s) of evaluation of this end point
    AEs/SAEs/DLTs: Continuously from first intake of study drug up to 30 day follow-up visit or start of a new therapy, whichever date is first. Also at unscheduled visits.

    Vital signs: Screening (Scr); Day (D) 1, D8 and D15 of Cycles 1 and 2; D1 for Cycle 3 onwards; End of Treatment (EoT); D30 after last dose then every 12 weeks until death, withdrawal of consent, lost to follow-up, or end of study

    Hematology and serum/plasma chemistry: Scr; D1, D8 and D15 of Cycles 1 and 2; on D1 for Cycle 3 onwards; EoT; D30 after last dose

    ECOG: Scr; D1 of all cycles; EoT; D30 after last dose

    ECG: Scr; D1 of cycles 1-4; EoT

    ECHO: Scr; EoT

    Tumor assessment: every 6 weeks for the first 24 weeks of treatment, then every 12 weeks until end of study (more frequently, if clinically indicated).
    AA, AAG y TLD: de forma continua desde la primera toma del medicamento del estudio hasta la visita de seguimiento de los 30 días o el inicio de un nuevo tratamiento, lo que ocurra primero. También en visitas no programadas.

    Constantes vitales: selección (sel.), día (D) 1, D8 y D15 de los ciclos 1 y 2, D1 del ciclo 3 en adelante, fin del tratamiento (FdT), D30 después de la última dosis y, luego, cada 12 semanas hasta la muerte, la retirada del consentimiento, la pérdida de contacto durante el seguimiento o el fin del estudio.

    Hemograma y bioquímica sanguínea/plasmática: sel., D1, D8 y D15 de los ciclos 1 y 2, D1 del ciclo 3 en adelante, FdT y D30 después de la última dosis.

    ECOG: sel., D1 de todos los ciclos, FdT y D30 después de la última dosis.
    ECG: sel., D1 de los ciclos 1-4
    E.5.2Secondary end point(s)
    Part 1 (Dose-Finding) Only:
    •Overall response rate (ORR); duration of response; percent change in tumor size (CTS) from baseline; disease control rate, PFS, overall survival (OS).

    Part 2 (Randomized) Only:
    • Incidence and frequency of AEs, SAEs, and AEs leading to dose modifications, deaths, and clinically significant laboratory abnormalities.
    • ORR; duration of response; percent CTS from baseline; disease control rate; OS.
    • Time to definitive deterioration in global health status/quality of life (QoL), shortness of breath and pain per European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life of Cancer Patients (QLQ-C30) questionnaire.
    • Time to definitive 10-point deterioration symptom scores of pain, cough, and dyspnea per EORTC Lung (QLQ-LC13) questionnaire.
    Part 1 and Part 2:
    • Summary measures of pharmacokinetic (PK) parameters of inupadenant and EOS100612 on Day1 followed by Cmax and trough (Cmin) level monitoring at steady state.
    Please refer to Protocol Section 2 for other secondary endpoints.
    Solo parte 1 (determinación de la dosis):
    • Tasa de respuesta global (TRG), duración de la respuesta, cambio porcentual en el tamaño del tumor (CTT) desde el inicio, índice de control de la enfermedad, SSP y supervivencia global (SG).

    Solo parte 2 (aleatorizada):
    • Incidencia y frecuencia de AA, AAG y AA que provoquen modificaciones de la dosis, muertes y anomalías analíticas clínicamente significativas.
    • TRG, duración de la respuesta, CTT porcentual desde el inicio, índice de control de la enfermedad y SG.
    • Tempo hasta el empeoramiento definitivo del estado de salud general o la calidad de vida (CdV), dificultad para respirar y dolor según el cuestionario de calidad de vida de los pacientes con cáncer (QLQ-C30) de la Organización europea para la investigación y el tratamiento del cáncer (EORTC).
    • Tempo hasta la puntuación de 10 puntos de los síntomas de empeoramiento definitivo del dolor, tos y disnea según el cuestionario sobre pulmón de la EORTC (QLQ-LC13). Partes 1 y 2:
    • Resumen de las mediciones de los parámetros farmacocinéticos (FC) del inupadenant y el EOS100612 el día, 1 seguido de la supervisión de las concentraciones máxima y mínima en situación de equilibrio.
    Consulte la Sección 2 del Protocolo para conocer otros criterios de valoración secundarios.
    E.5.2.1Timepoint(s) of evaluation of this end point
    AEs/SAEs and tumour assessment: as above.

    Survival status: every 12 weeks until death, withdrawal of consent, lost to follow-up, or end of study.

    QoL questionnaire: Days 1 of all Cycles; EoT; Day 30 after last dose.

    PK: Days 1 and 8 of Cycles 1 and 2; Day 1 of cycles 3 and 4 and once anytime between cycle 5 and cycle 12; EoT.
    Unscheduled PK sample should be collected at the onset of the first Grade ≥3 AE(s) that is at least possibly related to the study drug.
    AA/AAG y evaluación del tumor: como se ha indicado.

    Estado de supervivencia: cada 12 semanas hasta la muerte, la retirada del consentimiento, la pérdida de contacto durante el seguimiento o el fin del estudio.

    Cuestionario de CdV: día 1 de todos los ciclos, FdT y 30 después de la última dosis.

    FC: días 1 y 8 de los ciclos 1 y 2, día 1 de los ciclos 3 y 4, una vez en algún momento entre los ciclos 5 y 12, y FdT.
    La muestra no programada para FC se obtendrá en el momento de la aparición del primer AA de grado ≥3 que esté al menos posiblemente relacionado con el medicamento del estudio.
    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 No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Determination of RP2D
    Determinación de RP2D
    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) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    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) 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 concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA46
    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
    Canada
    United States
    France
    Poland
    Spain
    Switzerland
    Czechia
    Germany
    Italy
    Belgium
    Georgia
    Hungary
    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
    LVLS
    LPLV
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months10
    E.8.9.1In the Member State concerned days17
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months10
    E.8.9.2In all countries concerned by the trial days17
    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: 48
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 144
    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 state12
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 122
    F.4.2.2In the whole clinical trial 192
    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 Decision2022-08-24
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-07-29
    P. End of Trial
    P.End of Trial StatusOngoing
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