E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Metastatic Pancreatic Cancer |
Cancer de pancreas avanzado |
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E.1.1.1 | Medical condition in easily understood language |
Advanced Cancer |
Cancer Avanzado. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10033605 |
E.1.2 | Term | Pancreatic cancer metastatic |
E.1.2 | System Organ Class | 100000004864 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objectives are: • To evaluate the time from randomization until death in both arms (OS). • To evaluate the safety and tolerability of VCN-01, IV administered at Week 1 and Week 14 in Arm II. |
Objetivos primarios: •Evaluar el tiempo que transcurre desde la aleatorización hasta la muerte en los dos grupos (supervivencia global [SG]). •Evaluar la seguridad y la tolerabilidad del VCN-01, administrado por vía intravenosa (i.v.) en la semana 1 y la semana 14 en el grupo II. |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives are: • To evaluate the time to progression (TTP) or PFS. • To determine the ORR. • To determine the disease control rate (DCR) (stable disease [SD] + PR + complete response [CR]). • To determine the landmark 1-year survival and PFS at the 1-year landmark. • To evaluate the duration of response (DoR). • To assess changes in tumor marker Ca 19.9 measured every 4 weeks while on study. |
Objetivos secundarios: •Evaluar el tiempo transcurrido hasta la progresión (TTP) o la supervivencia sin progresión (SSP). •Determinar la tasa de respuesta objetiva (TRO). •Determinar la tasa de control de la enfermedad (TCE) (enfermedad estable [EE] + respuesta parcial [RP] + respuesta completa [RC]). •Determinar la supervivencia y la SSP ambas con punto temporal de referencia de 1 año. •Evaluar la duración de la respuesta (DdR). •Evaluar los cambios en el marcador tumoral antígeno carbohidrato (Ca) 19.9 determinado cada 4 semanas mientras se continúe en el estudio. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Written informed consent obtained prior to any study-specific procedures or assessments. 2. Male/female patients aged 18 years or over. 3. Patients with histologically or cytologically confirmed, first line metastatic pancreatic adenocarcinoma stage IV de novo, who never received previous systemic treatment for their pancreatic cancer for which the established therapy is nab-paclitaxel/gemcitabine (clinical SoC). All patients must have at least one measurable tumor lesion that can be imaged for assessments determined by RECIST 1.1 (see APPENDIX 4). 4. Patients willing to comply with the study treatment. 5. Patients with a minimum life expectancy of 5 months. 6. ECOG performance status of 0 or 1. 7. Use of a reliable method of contraception in fertile men and women. Female patients of childbearing potential (i.e., female patients who are not postmenopausal or surgically sterile) must agree to use effective contraception. Male patients must agree to use effective contraception or be surgically sterile. 8. Adequate baseline organ function (hematologic, liver, renal and nutritional) within 1 week of randomization: Hematology: • Absolute neutrophil count ≥1.5x109 /L • Hemoglobin ≥9 g/dL • Platelets ≥100x109/L Coagulation (*except in patients on anticoagulants): • Prothrombin time or international normalized ratio ≤1x upper limit of normal (ULN) • Activated partial thromboplastin time ≤1.2xULN Hepatic: • Total bilirubin ≤1.5xULN • ALT and AST ≤2.5xULN (if there are no liver metastases) • ALT and AST <5xULN, and bilirubin <1.5xULN (if there are liver metastases) Renal: • Serum creatinine ≤1.5xULN, and if >1.5xULN: Estimated creatinine clearance >50 mL/min using Cockcroft and Gault formula Nutritional: • Serum Albumin ≥30 g/L Note: If laboratory or imaging procedures were performed for alternate reasons prior to signing consent, these can be used for screening purposes with consent of the patient. |
1. Obtención del consentimiento informado por escrito, antes de realizar cualquier procedimiento o evaluación específica de estudio. 2. Pacientes hombres y mujeres de 18 años o más. 3. Pacientes en primera linea de adenocarcinoma de páncreas metastásico estadio IV de novo confirmado histológica o citológicamente que nunca hayan recibido tratamiento sistémico previo para su cáncer de páncreas por el cual la terapia establecida es nab-paclitaxel/gemcitabina (clínica SoC). Todos los pacientes deben tener al menos una lesión tumoral medible, de las que se puedan obtener imágenes para las evaluaciones determinadas por RECIST 1.1. 4. Pacientes dispuestos a cumplir con el tratamiento del estudio. 5. Pacientes con una expectativa de vida mínima de 5 meses. 6. Estado de salud, ECOG de 0 o 1. 7. Uso de un método anticonceptivo confiable en hombres y mujeres fértiles. Pacientes mujeres en edad fértil (es decir, pacientes mujeres no postmenopáusicas o estériles quirúrgicamente) deben estar de acuerdo en usar un método de anticoncepción. Los pacientes varones deben estar de acuerdo en usar métodos anticonceptivos efectivos o ser quirúrgicamente estéril. 8. Función básica adecuada de los órganos (hematológicos, hepáticos, renales y nutricional) dentro de la 1ª semana de la aleatorización: Hematología: • Recuento absoluto de neutrófilos ≥1,5x109 /L • Hemoglobina ≥9 g/dL • Plaquetas ≥100x109/L Coagulación (*excepto en pacientes con anticoagulantes): • Tiempo de protrombina o índice internacional normalizado ≤1x límite superior de normales (LSN) • Tiempo de tromboplastina parcial activada ≤1,2xULN Hepático: • Bilirrubina total ≤1.5xULN • ALT y AST ≤2,5xULN (si no hay metástasis hepáticas) • ALT y AST <5xLSN y bilirrubina <1,5xLSN (si hay insuficiencia hepática). Metástasis) Renal: • Creatinina sérica ≤1,5xLSN. Y si >1,5xLSN: Aclaramiento estimado de creatinina >50 ml/min utilizando la fórmula de Cockcroft y Gault. Nutricional: • Albúmina sérica ≥30 g/L Nota: Si los procedimientos de laboratorio o de imágenes se realizaron por razones alternativas antes de firmar el consentimiento, estos pueden usarse con fines de detección con el consentimiento del paciente. |
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E.4 | Principal exclusion criteria |
1. Patients not willing to complete the study procedures for geographic, psychiatric, or social reasons. 2. Active infection or other serious illness or autoimmune disease at the moment of randomization. 3. Treatment with live attenuated vaccines in the last 3 weeks and with the adenovirus type-5 (Ad5)-based COVID-vaccine in the last 12 weeks before the administration of study treatment. 4. Known chronic liver disease (liver cirrhosis, chronic hepatitis). If there is a suspect of hepatic fibrosis, a fibroscan must be performed; patients with a value ≥9.5 kPa will be excluded. Note: Transient elastography (Fibroscan) is a non-invasive method for the assessment of hepatic fibrosis. 5. Treatment with another investigational agent within five of that treatment’s half-lives prior to infusion of study treatment. 6. Viral syndrome diagnosed during the 2 weeks before start of study treatment administration. 7. Chronic immunosuppressive therapy, except inhaled corticosteroids, and oral or IV corticosteroids with a dose lower than 10 mg prednisone or equivalent/day (exception: dexamethasone 1 mg/day as maximum). 8. Concurrent malignant hematologic or solid disease. Patients with a prior history of cancer can be allowed if complete remission for at least 3 years. 9. Patients in close contact (e.g., living in same house) with immunosuppressed patients (i.e., patients with chronic immunosuppressive therapy including high dose of corticosteroids, patients with acquired immunodeficiency syndrome (AIDS), and other chronic immune system diseases). 10. Patients with Li Fraumeni syndrome or with previously known retinoblastoma protein pathway germline deficiency. 11. A female patient, who is pregnant or lactating. 12. Patients receiving full-dose anticoagulant therapy or in whom these therapies cannot be withdrawn 2 days prior and 2 days after VCN-01 administration. Patients with uncontrolled coagulopathy should be excluded. 13. Untreated brain metastases and/or leptomeningeal carcinomatosis with progressive symptoms despite corticosteroid coverage. Patients with brain metastases with stable symptoms can be included. 14. Any other condition, disease, metabolic dysfunction (e.g., uncontrolled diabetes mellitus), active or uncontrolled infection/inflammation, physical examination finding, mental state or clinical laboratory finding that would contraindicate participation in the clinical study due to safety concerns or compliance with clinical study procedures. 15. Patients with previous pneumonitis or interstitial lung disease. 16. Patients with pre-existing sensory neuropathy >G1. 17. Patients with known risk factors for bowel perforation, i.e., history of diverticulitis, intraabdominal abscess, intestinal obstruction or abdominal carcinomatosis. 18. Patients with QT interval corrected by Fridericia (QTcF) assessment >450 ms for men or >470 ms for women and left ventricular ejection fraction (LVEF) evaluation less than 50% measured by ECHO or multigated acquisition scan. |
1. Pacientes que no estén dispuestos a completar los procedimientos del estudio por razones geográficas, psiquiátricas o sociales. 2. Infección activa u otra enfermedad grave o enfermedad autoinmune en el momento de la aleatorización. 3. Tratamiento con vacunas vivas atenuadas en las últimas 3 semanas y con la vacuna COVID, basada en adenovirus tipo 5 (Ad5), en las últimas 12 semanas antes de la administración del tratamiento del estudio. 4. Enfermedad hepática crónica conocida (cirrosis hepática, hepatitis crónica). Si hay sospecha de fibrosis hepática, se debe realizar un fibroscan; se excluirán los pacientes con un valor ≥ 9,5 kPa. Nota: La elastografía transitoria (Fibroscan) es un método no invasivo para la evaluación de fibrosis hepática. 5. Tratamiento con otro producto en investigación en un periodo inferior a cinco vidas medias de dicho fármaco, previamente a la administración de VCN-01 6. Síndrome viral diagnosticado durante las 2 semanas anteriores al inicio de la administración del tratamiento del estudio. 7. Terapia inmunosupresora crónica, excepto corticoides inhalados y corticoides orales o intravenosos a dosis inferior a 10 mg de prednisona o equivalente/día (excepción: dexametasona 1 mg/día como máximo). 8. Enfermedad hematológica o sólida maligna concurrente. Los pacientes con antecedentes de cáncer pueden ser admitidos si la remisión es completa durante al menos 3 años. 9. Pacientes en estrecho contacto (p. ej., que viven en la misma casa) con pacientes inmunodeprimidos (es decir, pacientes con terapia inmunosupresora que incluye altas dosis de corticosteroides, pacientes con síndrome de inmunodeficiencia adquirida (SIDA) y otras enfermedades crónicas del sistema inmunitario). 10. Pacientes con síndrome de Li Fraumeni o con deficiencia de la línea germinal en la vía de la proteína de la retinoblastoma previamente conocida. 11. Paciente mujer, que esté embarazada o en periodo de lactancia. |
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E.5 End points |
E.5.1 | Primary end point(s) |
• OS • Safety and tolerability |
• OS • seguridad y tolerabilidad |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Along the study |
A lo largo del estudio |
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E.5.2 | Secondary end point(s) |
• PFS or TTP • ORR • DCR (SD + PR + CR) • Landmark 1-year survival and PFS at the 1-year landmark • DoR • Changes in tumor marker Ca 19.9 |
• PFS or TTP • ORR • DCR (SD + PR + CR) • Punto de referencia de supervivencia a 1 año y PFS en el punto de referencia de 1 año • DoR • Cambios en el marcador tumoral Ca 19.9 |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Along the study |
A lo largo del estudio |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 9 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial 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
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LVLS |
ULTIMA VISITA ULTIMO PACIENTE EN EL ENSAYO |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 3 |