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    Summary
    EudraCT Number:2022-000503-13
    Sponsor's Protocol Code Number:DS7300-127
    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:2022-06-03
    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 number2022-000503-13
    A.3Full title of the trial
    A Phase 2, Multicenter, Randomized, Open-label Study of DS-7300a, a B7-H3 Antibody Drug Conjugate (ADC), in Subjects with Pretreated Extensive-stage Small Cell Lung Cancer (ES-SCLC)
    Estudio de fase II abierto, multicéntrico y aleatorizado de DS-7300a, un conjugado de anticuerpo y fármaco (CAF) B7-H3, en participantes con cáncer de pulmón microcítico en estadio avanzado (CPM-EA) pretratado
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    DS-7300a in Patients With Pretreated Extensive-Stage Small Cell Lung Cancer (ES-SCLC)
    DS-7300a en pacientes con cáncer de pulmón microcítico en estadio avanzado (CPM-EA) pretratado
    A.4.1Sponsor's protocol code numberDS7300-127
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT05280470
    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 SponsorDaiichi Sankyo, 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 supportDaiichi Sankyo, Inc.
    B.4.2CountryUnited States
    B.4.1Name of organisation providing supportDaiichi Sankyo, Co. Ltd.
    B.4.2CountryJapan
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationDaiichi Sankyo, Inc.
    B.5.2Functional name of contact pointClinical Trial Information Contact
    B.5.3 Address:
    B.5.3.1Street Address211 Mt. Airy Road
    B.5.3.2Town/ cityBasking Ridge
    B.5.3.3Post codeNJ, 07920
    B.5.3.4CountryUnited States
    B.5.4Telephone number003493489 43 50
    B.5.6E-mailCTRinfo@dsi.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.3.2Product code DS-7300a
    D.3.4Pharmaceutical form Powder for 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 INNIfinatamab deruxtecan
    D.3.9.2Current sponsor codeDS-7300a
    D.3.9.3Other descriptive nameHumanised IgG1 monoclonal antibody against B7-H3 conjugated to deruxtecan
    D.3.9.4EV Substance CodeSUB259137
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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) 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) No
    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
    Pretreated Extensive-stage Small Cell Lung Cancer (ES-SCLC)
    Cáncer de pulmón microcítico en estadio avanzado (CPM-EA) pretratado
    E.1.1.1Medical condition in easily understood language
    Pretreated Extensive-stage Small Cell Lung Cancer (ES-SCLC)
    Cáncer de pulmón microcítico en estadio avanzado (CPM-EA) pretratado
    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
    To assess the efficacy of DS-7300a in subjects with pretreated ES-SCLC
    Evaluar la eficacia de DS-7300a en participantes con CPM-EA pretratado
    E.2.2Secondary objectives of the trial
    - To further assess the efficacy of DS-7300a in subjects with pretreated ES-SCLC
    - To assess the safety and tolerability of DS-7300a in subjects with pretreated ES-SCLC
    - To evaluate the pharmacokinetics (PK) of DS-7300a
    - To assess the immunogenicity of DS-7300a
    - Evaluar en profundidad la eficacia de DS 7300a en participantes con CPM-EA previamente tratado
    - Evaluar la seguridad y la tolerabilidad de DS 7300a en participantes con CPM-EA previamente tratado
    - Evaluar la farmacocinética (FC) de DS 7300a
    - Evaluar la inmunogenicidad de DS 7300a
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Sign and date the informed consent form (ICF) prior to the start of any study- specific qualification procedures.
    2. Subject must have at least one lesion, not previously irradiated, amenable to core biopsy. Consent to provide a pretreatment biopsy tissue sample and on-treatment biopsy.
    3. Male or female subjects aged ≥18 years .
    4. Histologically or cytologically documented ES-SCLC.
    5. At least one measurable lesion according to RECIST v1.1 as assessed by the investigator.
    6. Prior therapy with at least one prior platinum-based line as systemic therapy for extensive-stage disease. Subjects with or without prior immune-checkpoint inhibitor therapy are eligible. Subject must not have received more than three previous lines of systemic therapy (re-challenge with platinum chemotherapy will be considered as one prior line of therapy).
    7. Documentation of radiological disease progression on or after most recent systemic therapy.
    8. Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1.
    9. Life-expectancy ≥3 months.
    10. Required baseline local laboratory data (within 7 days prior to Cycle 1 Day 1):
    a. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST):  ≤3 × upper limit of normal (ULN) in subjects with no liver metastasis and  ≤5.0 × ULN in subjects with liver metastasis
    b. Total bilirubin ≤1.5 × ULN (≤3 × ULN total and ≤1.5 × ULN direct bilirubin is acceptable for subjects with Gilbert’s syndrome)
    c. Absolute neutrophil count (ANC) ≥1.5 × 109/L (hematopoietic growth factors [eg, granulocyte colony stimulating factor {G-CSF}, granulocyte-macrophage colony-stimulating factor {GM-CSF}] support allowed up to 14 days before randomization)
    d. Platelet count ≥100 × 109/L (platelet transfusion is allowed up to 14 days before randomization)
    e. Hemoglobin ≥8.5 g/dL (transfusion and/or growth factor support allowed up to 14 days before randomization)
    f. Creatinine clearance ≥50 mL/min, as calculated using the Cockcroft-Gault equation
    g. International Normalized Ratio (INR)/prothrombin time (PT) and either partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT) ≤1.5 × ULN
    11. If the subject is a female of childbearing potential, she must have a negative serum pregnancy test within 7 days before the first dose of study drug and must be willing to use a highly effective birth control upon enrollment, during the Treatment Period, and for 7 months following the last dose of study drug. A female is considered of childbearing potential following menarche and until becoming postmenopausal (no menstrual period for a minimum of 12 months) unless permanently sterile (undergone a hysterectomy, bilateral salpingectomy or bilateral oophorectomy) with surgery at least 1 month before the first dose or confirmed by follicle stimulating hormone (FSH) test.
    12. If male, the subject must be surgically sterile or willing to use highly effective birth control upon enrollment, during the Treatment Period, and for 4 months following the last dose of study drug.
    13. Male subjects must not freeze or donate sperm starting at enrollment, throughout the Treatment Period, and for at least 4 months following the last dose of the study drug. Preservation of sperm may be considered prior to enrollment in this study.
    14. Female subjects must not donate, or retrieve for their own use, ova from the time of enrollment and throughout the Treatment Period, and for at least 7 months following the last dose of the study drug. They should refrain from breastfeeding throughout this time. Preservation of ova may be considered prior to enrollment in this study.
    15. Is willing and able to comply with scheduled visits, drug administration plan, laboratory tests, other study procedures, and study restrictions.
    1. Firmar y fechar el formulario de consentimiento informado (FCI) antes de iniciar cualquier procedimiento de cualificación específico del estudio.
    2. El participante debe tener al menos una lesión, no tratada con radioterapia previamente, susceptible de ser sometida a una biopsia con aguja gruesa. Deben consentir proporcionar una muestra de tejido de biopsia antes de empezar el tratamiento y durante éste.
    3. Participantes de ambos sexos ≥18 años.
    4. CPM-EA documentado histológica o citológicamente.
    5. Al menos una lesión medible de acuerdo con los RECIST v1.1 según la evaluación del investigador.
    6. Tratamiento previo con al menos una línea de tratamiento con un derivado del platino como tratamiento sistémico para la enfermedad en estadio avanzado. Los participantes con o sin tratamiento previo con inhibidores del punto de control inmunitario son aptos. Los pacientes no deben haber recibido más de 3 líneas de tratamiento sistémico anteriores (la repetición del tratamiento con platino se considerará como una línea de tratamiento anterior).
    7. Documentación de la progresión radiológica de la enfermedad durante o después del tratamiento sistémico más reciente.
    8. Estado general (EG) de 0 o 1 según la escala del Grupo Oncológico Cooperativo de la Costa Este (ECOG).
    9. Esperanza de vida ≥3 meses.
    10. Se requieren datos analíticos locales iniciales (en los 7 días anteriores al día 1 del ciclo 1):
    a. Alanina aminotransferasa (ALT) y aspartato aminotransferasa (AST):
    - ≤3 × el límite superior de la normalidad (LSN) en participantes sin metástasis hepática; y
    - ≤5,0 x LSN en participantes con metástasis hepática.
    b. Bilirrubina total ≤1,5 × LSN (≤3 × LSN en total y ≤1,5 × LSN de la bilirrubina directa es aceptable para los participantes con síndrome de Gilbert).
    c. Cifra absoluta de neutrófilos (CAN) ≥1,5 × 109/l (factores de crecimiento hematopoyético (G-CSF, factor estimulante de colonias de granulocitos y monocitos [GM-CSF]) permitido hasta 14 días antes de la aleatorización).
    d. Recuento de plaquetas ≥100 × 109/l (se permite la transfusión de plaquetas hasta 14 días antes de la aleatorización).
    e. Hemoglobina ≥8,5 g/dl (se permite la transfusión o el apoyo con factor de crecimiento hasta 14 días antes de la aleatorización).
    f. Aclaramiento de creatinina ≥50 ml/min, calculado mediante la ecuación de Cockcroft-Gault.
    g. Índice internacional normalizado (INR), tiempo de protrombina (TP) y tiempo de tromboplastina parcial (TTP) o tiempo de tromboplastina parcial activada (TTPa) ≤1,5 × LSN.
    11. Si la participante es una mujer con posibilidad de quedarse embarazada, debe tener un resultado negativo en la prueba de embarazo en suero dentro de los 7 días anteriores a la primera dosis del fármaco del estudio y debe estar dispuesta a utilizar un método anticonceptivo de gran eficacia tras la inscripción, durante el periodo de tratamiento y durante 7 meses después de la última dosis del fármaco del estudio. Se considera que una mujer puede quedarse embarazada después de la menarquía y hasta la posmenopausia (sin periodo menstrual durante un mínimo de 12 meses), a menos que sea permanentemente estéril (se haya sometido a una histerectomía, salpingectomía bilateral u ovariectomía bilateral) tras una intervención quirúrgica al menos desde 1 mes antes de la primera dosis o confirmado mediante la prueba de la hormona foliculoestimulante (FSH).
    12. Si es un hombre, debe ser estéril quirúrgicamente o estar dispuesto a usar un método anticonceptivo de gran eficacia tras la inscripción, durante el periodo de tratamiento y durante 4 meses tras la última dosis de fármaco del estudio.
    13. Los participantes varones no deben congelar ni donar esperma desde la inscripción, a lo largo del periodo de tratamiento y durante al menos 4 meses tras la última dosis del fármaco del estudio. Puede considerarse la conservación de esperma antes de la inscripción en este estudio.
    14. Las pacientes no deben donar, ni extraer para su propio uso, óvulos desde el momento de la inscripción, a lo largo de todo el periodo de tratamiento y durante al menos 7 meses después de la última dosis del fármaco del estudio. Deben abstenerse de dar el pecho durante este tiempo. Puede considerarse la conservación de óvulos antes de la inscripción en este estudio.
    15.Deben estar dispuestos y ser capaces de cumplir con las visitas programadas, el plan de administración del fármaco, las pruebas analíticas, otros procedimientos del estudio y las restricciones del estudio.
    E.4Principal exclusion criteria
    1. Prior treatment with orlotamab, enoblituzumab, or other B7-H3 targeted agents
    2. Prior treatment with an ADC that consists of an exatecan derivative (eg, trastuzumab deruxtecan)
    3. Inadequate washout period before Cycle 1 Day 1, defined as:
    a. Major surgery as deemed by the investigator <3 weeks
    b. Radiation therapy to the lung >30 Gy ≤6 months; palliative radiotherapy affecting lung areas at lower dose <3 weeks; any other palliative radiotherapy <2 weeks
    c. Cranial irradiation, including whole brain radiation therapy and stereotactic radiosurgery, <2 weeks
    d. Any systemic anticancer therapy <3 weeks and <6 weeks for nitrosoureas or mitomycin C or 5 half-lives, whichever is longer
    e. Antibody-based anticancer therapy <3 weeks
    f. Chloroquine or hydroxychloroquine <14 days
    4. Clinically active brain metastases, spinal cord compression or leptomeningeal carcinomatosis, defined as untreated or symptomatic, or requiring therapy with steroids or anticonvulsants to control associated symptoms
    5. Any of the following conditions within the past 6 months: cerebrovascular accident, transient ischemic attack or another arterial thromboembolic event
    6. Clinically significant corneal disease
    7. Uncontrolled or significant cardiovascular disease, including:
    a. QTcF interval >470 ms based on average of the screening triplicate 12-lead determinations
    b. Diagnosed or suspected long QT syndrome, or known family history of long QT syndrome
    c. History of clinically relevant ventricular arrhythmias, such as ventricular tachycardia, ventricular fibrillation, or Torsade de Pointes
    d. Bradycardia of less than 50 bpm unless the subject has a pacemaker
    e. History of second- or third-degree heart block
    f. Acute myocardial infarction within 6 months prior to screening
    g. Uncontrolled angina pectoris within 6 months prior to screening
    h. Symptomatic congestive heart failure defined as New York Heart Association Class 2 to 4
    i. Coronary/peripheral artery bypass graft or any coronary/peripheral angioplasty within 6 months prior to screening
    j. Grade ≥3 hypertension
    k. Complete left or right bundle branch block
    l. Left ventricular ejection fraction <50% by either an echocardiogram or a multigated acquisition scan
    8. History of (non-infectious) interstitial lung disease (ILD)/pneumonitis that required corticosteroids, current ILD/pneumonitis, or suspected ILD/pneumonitis that cannot be ruled out by imaging at screening
    9. Clinically severe pulmonary compromise resulting from intercurrent pulmonary illnesses including, but not limited to, any underlying pulmonary disorder, and potential pulmonary involvement caused by any autoimmune, connective tissue or inflammatory disorders, prior complete pneumonectomy, or requirement for supplemental oxygen.
    10. Chronic steroid treatment, except for low-dose inhaled steroids (for asthma/COPD) or topical steroids (for mild skin conditions)
    11. History of malignancy other than SCLC within the 3 years prior to enrollment, except adequately resected non-melanoma skin cancer, curatively treated in situ disease, superficial gastrointestinal tract tumors and non-muscle invasive bladder cancer curatively resected by endoscopic surgery
    12. History of allogeneic bone marrow, stem cell, or solid organ transplant
    13. Unresolved toxicities from previous anticancer therapy, defined as toxicities (other than alopecia) not yet resolved to NCI-CTCAE V5.0, Grade ≤1 or baseline
    14. History of hypersensitivity to the drug substances, inactive ingredients in the drug product or severe hypersensitivity reactions to other monoclonal antibodies
    15. Evidence of ongoing uncontrolled systemic bacterial, fungal, or viral infection (including HIV infection)
    16. Active or uncontrolled hepatitis B or C infection; subject is positive for hepatitis B or C virus based on the evaluation of results of tests for hepatitis B or hepatitis C infection, as per local regulations
    17. Active, known, or suspected autoimmune disease. Subjects with type I diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders not requiring systemic treatment within 6 months, or conditions not expected to recur in the absence of an external trigger are permitted to enroll
    18. Any evidence of severe or uncontrolled systemic diseases or other factors that, in the investigator’s opinion, makes it undesirable for the subject to participate in the study or would jeopardize compliance with the protocol
    19. Has received a live vaccine within 30 days prior to the first dose of study drug
    20. Female who is pregnant or breast-feeding or intends to become pregnant during the study
    21. Prior or ongoing clinically relevant illness, medical condition, surgical history, physical finding, or laboratory abnormality that, in the investigator’s opinion, could affect the safety of the subject; alter the absorption, distribution, metabolism or excretion of the study drug; or confound the assessment of study results
    1Tratamiento(tto)previo con orlotamab,enoblituzumab u otros fármacos dirigidos contraB7-H3
    2Tto previo con CAF qe consiste en derivado de exatecán(ej.trastuzumab deruxtecán)
    3Periodo reposo farmacológico inadecuado antes de D1C1:
    aIntervención quirúrgica mayor en opinión del investigador<3semanas
    bRadioterapia(RT)de pulmones>30Gy≤6meses;<RTpaliativa dirigida a zonas pulmonares a dosis más baja<3sem;otra RTpaliativa<2sem
    cRTcraneal,incl RTcerebral total y radiocirugía estereotáctica<2sem
    dTto antineoplásico sistémico<3semy<6sem para carmustinas o mitomicinaC o 5semividas,lo qe dure más
    eTto antineoplásico basado en anticuerpos<3semanas
    fCloroquina o hidroxicloroquina<14días
    4Metástasis cerebrales cl. activas,compresión de médula espinal o carcinomatosis leptomeníngea,definida como no tratada o sintomática,o qe requiera tto con corticoides o anticonvulsivos para controlar síntomas asociados
    5Cualquiera de estas afecciones en últimos 6 meses:accidente cerebrovascular,isquémico transitorio o acontecimiento tromboembólico arterial
    6Enf de la córnea cl. significativa
    7Enf cardiovascular no controlada o significativa:
    aIntervalo QTcF>470ms según promedio de las determinaciones de12derivaciones por triplicado en la selección
    bDiagnóstico o sospecha de síndrome de QTlargo o antecedentes familiares de síndrome de QTlargo
    cAntec. de arritmias ventriculares cl. relevantes,como taquicardia ventricular,fibrilación ventricular o taquicardia helicoidal
    dBradicardia<50 l.p.m.,salvo qe el participante tenga marcapasos
    eAntecedentes de bloqueo auriculoventricular2º o 3er grado
    fInfarto agudo miocardio 6meses antes de la selección
    gAngina de pecho no controlada 6meses antes de la selección
    hInsuficiencia cardíaca congestiva sintomática definida según asociación de cardiología de Nueva York.Clase2a4
    iInjerto de revascularización coronaria o periférica o angioplastia coronaria o periférica 6meses antes de la selección
    jHipertensión grado≥3
    kBloqueo rama izq o dcha completo
    lFracción de eyección del ventrículo izquierdo<50%evaluada mediante ecocardiografía o ventriculografía nuclear
    8Antecedentes de enf pulmonar intersticial(EPI)(no infecciosa)/neumonitis qe requirió tto con corticoides,EPI/neumonitis en curso o sospecha de EPI/neumonitis qe no puede descartarse mediante diagnóstico por imagen durante selección
    9Insuf pulmonar cl. grave resultante de enf. pulmonares intercurrentes,incluidas,entre otras,cualquier trastorno pulmonar subyacente y posible afectación pulmonar provocada por cualquier trastorno autoinmune,del tejido conjuntivo o inflamatorio,neumonectomía completa previa o requerimiento de oxígeno suplementario
    10Tto crónico con corticoides,excepto corticoides inhalados en dosis bajas(para el asma o la EPOC)o corticoesteroides tópicos(para afecciones cutáneas leves)
    11Antecedentes de tumores malignos distintos del CPM durante los 3 años antes de la inscripción,excepto cáncer cutáneo no melanocítico suficientemente resecado,enf. in situ tratada de manera curativa,tumores superficiales del tubo digestivo y cáncer de vejiga invasivo no muscular resecado de forma curativa mediante intervención quirúrgica endoscópica
    12Antecedentes de alotrasplante de médula ósea,células madre o trasplante de vísceras macizas
    13Efectos secundarios sin resolver de un tto antineoplásico anterior,definidos como efectos secundarios(distintos de alopecia)que aún no se hayan resuelto según los CTCAE del NCIv.5.0 grado≤1o a los valores iniciales
    14Antecedentes de hipersensibilidad a medicamentos,principios inactivos del medicamento o reacciones intensas de hipersensibilidad a otros Ac monoclonales
    15Indicios de micosis o infección vírica o bacteriana sistémicas y no controladas(incl infección por VIH)
    16Infección activa o no controlada de HepBóC;el participante es positivo para HepBoC en función de la evaluación de los resultados de pruebas para la HepB o HepC,según normativa local
    17Enf autoinmune activa,conocida o sospechada.Se permite inscribir participantes con diabetes sacarina tipoI,hipotiroidismo qe solo requieran sustitución hormonal,trastornos de piel qe no requieran tto sistémico en plazo de6meses o afecciones qe no se espera qe se repitan en ausencia de desencadenante ext
    18Indicios de enf. sistémicas graves o no controladas u otros factores qe,en opinión del investigador,hagan no deseable qe participe en el estudio o qe pueda poner en peligro el cumplimiento del protocolo
    19Haber recibido vacuna con microbios vivos30días antes de1ªdosis del fármaco de estudio
    20Mujer embarazada/en periodo de lactancia o qe pretende quedarse embarazada durante el estudio
    21Enf cl. relevante,afección médica,antecedentes quirúrgicos,hallazgos físicos o anomalías analíticas previas o en curso qe,en opinión del investigador,podrían afectar a la seguridad del participante;alterar la absorción,distribución,metabolismo o excreción del fármaco de estudio o confundir durante la evaluación de los resultados del estudio
    E.5 End points
    E.5.1Primary end point(s)
    Objective response rate (ORR), defined as the proportion of subjects with a best overall response (BOR) of confirmed complete response (CR) or confirmed partial response (PR) assessed by blinded independent central review (BICR) based on RECIST v1.1.
    La tasa de respuesta objetiva (TRO), definida como la proporción de participantes con una mejor respuesta general (MRG) de la respuesta completa (RC) confirmada o la respuesta parcial (RP) confirmada, mediante la evaluación central independiente enmascarada (ECIE) según los RECIST v.1.1.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Every 6 weeks (±7 days) in the first 36 weeks after Day 1 of Cycle 1, and thereafter every 12 weeks (±7 days).
    Cada 6 semanas (±7 días) durante las primeras 36 semanas tras el Día 1 del Ciclo 1 y, a continuación, cada 12 semanas (±7 días).
    E.5.2Secondary end point(s)
    Efficacy endpoints:
    - Progression-free survival (PFS), duration of response (DoR), disease control rate (DCR) and time to response (TTR) assessed by the investigator and BICR based on RECIST v1.1
    - Overall survival (OS)
    - Objective response rate (ORR) assessed by the investigator based on RECIST v1.1

    Safety endpoints:
    - Incidence of treatment-emergent adverse event (TEAEs) and other safety parameters during the study (serious adverse events [SAE], adverse event of special interest [AESIs]) based on National Cancer Institute- Common Terminology Criteria for Adverse Events version 5.0 (NCI-CTCAE V5.0)

    PK parameters:
    - Plasma Pharmacokinetic (PK) parameters (eg, time to reach maximum plasma concentration [Tmax], half life [t1/2], maximum concentration (Cmax), lowest concentration [Ctrough], area under the curve [AUC]) for DS-7300a, total anti-B7-H3 antibody, and MAAA-1181a

    ADA:
    - Antidrug antibodies (ADA)
    Criterios de valoración de la eficacia:
    - Supervivencia sin progresión (SSP), duración de la respuesta (DR), tasa de control de la enfermedad (TCE) y tiempo hasta la respuesta (TR) evaluados por el investigador y ECIE, según los RECIST v1.1.
    - Supervivencia general (SG)
    - Tasa de respuesta objetiva (TRO) según la evaluación del investigador, basada en los RECIST v1.1.

    Criterios de valoración de la seguridad:
    - Incidencia de acontecimientos adversos surgidos durante el tratamiento (AAST) y otros parámetros de seguridad durante el estudio (acontecimientos adversos graves [AAG], acontecimientos adversos de especial interés [AAEI] clasificados según la versión 5.0 de los Criterios terminológicos comunes
    para acontecimientos adversos (CTCAE del INC v.5.0) del Instituto Nacional del Cáncer (Estados Unidos).

    Parámetros de FC:
    - Parámetros de Farmacocinética (FC) en plasma (ej.: tiempo hasta alcanzar la concentración máxima (Tmáx); semivida (t1/2); concentración máxima (Cmáx); concentración más baja (Cmín); área bajo la curva (ABC) para DS-7300a, anticuerpo anti-B7-H3 total y MAAA-1181a

    ADA:
    - Anticuerpos antifármaco (AAF)
    E.5.2.1Timepoint(s) of evaluation of this end point
    Efficacy (ORR, PFS, DOR, DCR, TTR, OS): every 6 weeks (±7 days) in the first 36 weeks after Day 1 of Cycle 1, and thereafter every 12 weeks (±7 days)

    Safety (TEAE, AESI etc.): continuously between first dose and final database lock (including Follow-up Period)

    PK:
    Cycle 1: pre-dose, EOI*, 3, 6 and 24h post start of infusion, Day 4, Day 8, Day 15 and Day 22**
    Cycle 2: pre-dose and EOI
    Cycle 3: pre-dose, EOI, 3 and 6h post start of infusion
    Cycle 4 and every 2 cycles thereafter: pre-dose
    *EOI is defined as at the end of IV infusion and flush
    **if treatment planned at Cycle 2 Day 1 is interrupted or will be delayed

    ADA:
    Cycle 1, Cycle 2 and Cycle 3 Day 1 pre-dose,
    Every 4 cycles pre-dose (Cycle 7 Day 1, Cycle 11 Day 1 etc.),
    End of treatment
    30-day safety FU visit
    Eficacia(TRO,SSP,DR,TCE,TR,SG):cada 6 semanas(±7días)durante las 1as 36semanas tras el Día1 Ciclo1 y,a continuación,cada12semanas (±7 días)
    Seguridad(AAST,AAEI,etc.):continuamente entre la 1ªdosis y el cierre de base de datos final(incluyendo el período de seguimiento)
    FC:
    Ciclo1:Pre-dosis, FdI*, 3, 6 y 24 horas tras el comienzo de la infusión,Día4,Día8,Día15 y Día22*
    Ciclo2:Pre-dosis y FdI
    CIclo3:Pre-dosis, FdI, 3 y 6 horas tras el comienzo de la infusión
    Ciclo4 y, acontinuación,cada2ciclos:Pre-dosis
    *FdI se define como el final de la infusión IV y lavado
    **Si el tratamiento planificado en el Día 1 del Ciclo 2 se interrumpe o retrasa
    ADA:
    Ciclos1,2y3-Día1 pre-dosis
    Cada4 ciclos pre-dosis(Ciclo 7 Día 1,C11D1,etc.)
    Final tratamiento
    Visita de seguimiento de seguridad-30días
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    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
    Immunogenicity, Biomarkers
    Inmunogenicidad, Biomarcadores
    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 Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Dosificación diferente del mismo producto
    different dosage of the same product
    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 concerned7
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA19
    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
    China
    Japan
    Korea, Republic of
    Taiwan
    United States
    France
    Spain
    Germany
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    Overall end of study is defined as the date of completion of the last long-term survival follow-up (LTSFU) Visit.
    El final del estudio (FDE) general se define como la fecha de finalización de la última visita de seguimiento de la supervivencia a largo plazo (SSLP).
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months5
    E.8.9.1In the Member State concerned days27
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months5
    E.8.9.2In all countries concerned by the trial days27
    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: 28
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 112
    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 state14
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 38
    F.4.2.2In the whole clinical trial 140
    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)
    At the overall end of the study, remaining subjects who derive benefit from treatment with DS-7300a may be offered to take part in an alternative study if one becomes available. In the event of early termination of the study, the Sponsor will consider providing DS-7300a to subjects who benefit from treatment according to legal regulations in the corresponding countries. Alternatively, these subjects may also be treated with standard of care.
    Cuando se alcance el final del estudio general,se podrá ofrecer a los sujetos restantes que obtengan beneficios del tratamiento con DS-7300a, participar en un estudio alternativo, si hay alguno disponible. En caso de finalización temprana del estudio, el Promotor considerará proporcionar DS-7300a a los sujetos que se beneficien del tratamiento, de acuerdo con las normas legales de los países correspondientes. Alternativamente, estos sujetos también podrán ser tratados con el tratamiento estándar
    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 Decision2022-10-14
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-09-20
    P. End of Trial
    P.End of Trial StatusOngoing
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