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    Summary
    EudraCT Number:2022-000974-25
    Sponsor's Protocol Code Number:61186372NSC2005
    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:2022-12-22
    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 number2022-000974-25
    A.3Full title of the trial
    Evaluation of Amivantamab Infusion Related Reaction Mitigation
    Evaluación de la Mitigación de las Reacciones Relacionadas con la Infusión de Amivantamab.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Evaluation of Amivantamab Infusion Related Reaction Mitigation
    Evaluación de la Mitigación de las Reacciones Relacionadas con la Infusión de Amivantamab.
    A.4.1Sponsor's protocol code number61186372NSC2005
    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 SponsorJanssen-Cilag International NV
    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 supportJanssen Research & Development, LLC
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationJanssen-Cilag International NV
    B.5.2Functional name of contact pointGlobal Clinical Operations Spain
    B.5.3 Address:
    B.5.3.1Street AddressPaseo de las Doce Estrellas, 5-7
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28042
    B.5.3.4CountrySpain
    B.5.4Telephone number+34672 650377
    B.5.5Fax number+34917228628
    B.5.6E-maillbascone@its.jnj.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 nameLazertinib mesylate monohydrate
    D.3.2Product code JNJ-73841937-ZCY/YH25448AM
    D.3.4Pharmaceutical form Film-coated tablet
    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 INNLazertinib
    D.3.9.2Current sponsor codeJNJ-73841937-ZCY/YH25448AM
    D.3.9.3Other descriptive nameLazertinib mesylate monohydrate
    D.3.9.4EV Substance CodeSUB199596
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number80
    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 nameAmivantamab
    D.3.2Product code JNJ-61186372
    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 INNAmivantamab
    D.3.9.1CAS number 2171511-58-1
    D.3.9.2Current sponsor codeJNJ-61186372
    D.3.9.3Other descriptive nameANTI-EGFR/C-MET BISPECIFIC ANTIBODY
    D.3.9.4EV Substance CodeSUB193051
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    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) 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.IMP: 3
    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 Yes
    D.2.1.1.1Trade name Dexamethasone
    D.2.1.1.2Name of the Marketing Authorisation holdermibe GmbH Arzneimittel
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    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 nameDexamethasone
    D.3.4Pharmaceutical form Tablet
    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 INNDexamethasone
    D.3.9.1CAS number N/A
    D.3.9.2Current sponsor codeN/A
    D.3.9.3Other descriptive nameN/A
    D.3.9.4EV Substance CodeSUB07017MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number4
    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: 4
    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 Yes
    D.2.1.1.1Trade name Montelukast Sodium
    D.2.1.1.2Name of the Marketing Authorisation holderDr.Reddy's Laboratories Limited
    D.2.1.2Country which granted the Marketing AuthorisationUnited States
    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 nameMontelukast Sodium
    D.3.4Pharmaceutical form Tablet
    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 INNMontelukast Sodium
    D.3.9.1CAS number N/A
    D.3.9.2Current sponsor codeN/A
    D.3.9.3Other descriptive nameMontelukast sodium
    D.3.9.4EV Substance CodeSUB03324MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    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 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: 5
    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 Yes
    D.2.1.1.1Trade name Methotrexate
    D.2.1.1.2Name of the Marketing Authorisation holderAccord Healthcare, Inc.
    D.2.1.2Country which granted the Marketing AuthorisationUnited States
    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 nameMethotrexate
    D.3.4Pharmaceutical form Injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNMethotrexate
    D.3.9.1CAS number N/A
    D.3.9.2Current sponsor codeN/A
    D.3.9.3Other descriptive nameN/A
    D.3.9.4EV Substance CodeSUB08856MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin 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
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    EGFR-mutated Advanced or Metastatic Non-small Cell Lung Cancer
    Mutación del EGFR en Cáncer de Pulmón No Microcítico avanzado o metastásico
    E.1.1.1Medical condition in easily understood language
    A specific type of lung cancer called "Non-Small Cell Lung Cancer
    Tipo específico de Cáncer de Pulmón llamado "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 10061873
    E.1.2Term Non-small cell lung cancer
    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 separately assess the potential of dexamethasone, montelukast and methotrexate, administration, prior to IV amivantamab infusion, to decrease the incidence and/or severity of IRR, when amivantamab is given in combination with oral lazertinib, to reduce first-dose IRRs.
    Evaluar por separado el potencial de la administración de dexametasona, montelukast y metotrexato, antes de la infusión de amivantamab i.v., para reducir la incidencia o la gravedad de las RRI, cuando amivantamab se administra en combinación con lazertinib oral, para reducir las RRI de la primera dosis
    E.2.2Secondary objectives of the trial
    1. To evaluate incidences and severity of individual IRR signs and symptoms (chills, dyspnea, flushing, nausea, chest discomfort, vomiting, tachycardia, hypotension, fever).
    2. To evaluate incidences non-IRR AEs.
    3. To measure IV amivantamab infusion related times.
    4. To estimate the anti-tumor activity of IV amivantamab and lazertinib following pre-medication with study treatment
    1. Evaluar la incidencia y la gravedad de los signos y síntomas individuales de RRI (escalofríos, disnea, rubefacción, náuseas, molestias en el pecho, vómitos, taquicardia, hipotensión, fiebre).
    2. Evaluar las incidencias de los AA que no sean RRI.
    3. Medir los tiempos relacionados con la infusión de amivantamab i.v.
    4. Estimar la actividad antitumoral de amivantamab i.v. y lazertinib tras la medicación previa con el tratamiento del estudio.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Be ≥18 years of age (or the legal age of consent in the jurisdiction in which the study is taking place) at the time of informed consent.
    Type of Participant and Disease Characteristics
    2. Participant must have advanced or metastatic NSCLC
    3. Progressed on or after prior treatment with osimertinib and platinum-based chemotherapy.
    Prior use of first-or-second generation EGFR TKI is allowed if administered prior to osimertinib.
    4. Previously identified EGFR-mutated NSCLC (EGFR Exon19 deletion or L858R) (identified locally in a Clinical Laboratory Improvement Amendments [CLIA]-certified laboratory [or equivalent])
    5. ECOG performance status grade of 0 or 1.
    6. Subject must have organ and bone marrow function as follows:
    a) Hemoglobin ≥9 g/dL
    b) ANC ≥1.5 x 109/L
    c) Platelets ≥75 x 10 9/L
    d) AST and ALT ≤3 x ULN
    e) Total bilirubin ≤1.5 x ULN; subjects with Gilbert’s syndrome can enroll if conjugated bilirubin is within normal limits
    f) Have an estimated glomerular filtration rate (eGFR), based on the Modified Diet in Renal Disease (MDRD) 4-variable formula (see Attachment 5), of >30 mL/min
    Sex and Contraceptive/Barrier Requirements
    7. Male or female (according to their reproductive organs and functions assigned by chromosomal complement at birth).
    8. A female participant using oral contraceptives must use an additional barrier contraceptive method.
    9. A female participant must be either of the following
    a. Not of childbearing potential: premenarchal; postmenopausal (>45 years of age with amenorrhea for at least 12 months); permanently sterilized (eg, bilateral tubal occlusion, hysterectomy, bilateral salpingectomy, bilateral oophorectomy); or otherwise, be incapable of pregnancy.
    b. Of childbearing potential and practicing at least 1 highly effective method(s) of birth control consistent with local regulations regarding the use of birth control methods for subjects participating in clinical studies, as described below:
    o Practicing true abstinence (when this is in line with the preferred and usual lifestyle of the participant), which is defined as refraining from heterosexual intercourse during the entire period of the study, including up to 6 months after the last dose of dexamethasone, montelukast, methotrexate, lazertinib or IV amivantamab is given. Periodic abstinence (calendar, symptothermal, post-ovulation methods) is not considered an acceptable contraceptive method.
    o Have a sole partner who is vasectomized.
    o Practicing 2 methods of contraception, including one highly effective method (ie, established use of oral, intravaginal, transdermal, injected or
    implanted hormonal methods of contraception; placement of an intrauterine device [IUD] or intrauterine system [IUS], tubal ligation procedures as
    consistent with local regulations), AND, a second method, (eg, condom with spermicidal foam/gel/film/cream/suppository or occlusive cap [diaphragm
    or cervical/vault caps] with spermicidal foam/gel/film/cream/suppository).
    o Participants must agree to continue contraception throughout the study and continuing through 6 months after the last dose of dexamethasone,
    montelukast, methotrexate, lazertinib or IV amivantamab.
    Note: If the childbearing potential changes after start of the study (eg, woman who is not heterosexually active becomes active, premenarchal woman experiences menarche) the woman must begin a method of birth control, including 1 highly effective method, as described above.
    10. A female participant of childbearing potential must have a negative serum (b-human chorionic gonadotropin [b-hCG]) at screening (within 72hours of the first dose of study treatment administration) and must agree to further serum or urine pregnancy tests during the study.
    11. A female must agree not to donate eggs (ova, oocytes) or freeze for future use for the purposes of assisted reproduction during the study and for a period of 6 months after receiving the last dose of study drug, lazertinib and IV amivantamab. Female participants should consider preservation of eggs prior to study treatment as anti-cancer treatments may impair fertility.
    12. A male participant must wear a condom when engaging in any activity that allows for passage of ejaculate to another person during the study and for 3 months after receiving the last dose of study treatment, lazertinib and IV amivantamab.

    Please refer to the protocol for full list of inclusion criteria
    1.Tener ≥18 años (o la edad legal de consentimiento en la jurisdicción en la que se realice el estudio) en el momento del consentimiento informado
    Tipo de paciente y características de la enfermedad
    2.CPNM avanzado o metastásico
    3.Presentar progresión de la enfermedad durante o después de un tratamiento previo con osimertinib y quimioterapia basada en platino. Se permite el uso previo de TKI del EGFR de primera o segunda generación si se administra antes de osimertinib
    4.CPNM con mutación en el EGFR (deleción del exón 19 o mutación L858R en el EGFR) previamente identificado (identificado localmente en un laboratorio certificado conforme a las enmiendas para la mejora de los laboratorios clínicos [CLIA] [o equivalente])
    5.Tener una puntuación del estado funcional del ECOG de 0 o 1
    6.Presentar una función orgánica y de la médula ósea como sigue:
    a) Hemoglobina ≥9 g/dl
    b) RAN ≥1,5 x 109/l
    c) Plaquetas ≥75 x 109/l
    d) AST y ALT ≤3 x LSN
    e) Bilirrubina total ≤1,5 x LSN; se pueden reclutar pacientes con síndrome de Gilbert si la bilirrubina conjugada está dentro de los límites normales
    f) Una filtración glomerular (FG) estimada >30 ml/min, basada en la fórmula de 4 variables de Modificación de la dieta en enfermedad renal (MDER) (véase el Anexo 5)
    Sexo y requisitos en cuanto a métodos anticonceptivos y de barrera
    7.Hombre o mujer (según sus órganos reproductores y funciones asignadas por el complemento cromosómico al nacer)
    8.Las pacientes que utilicen anticonceptivos orales deberán emplear un método anticonceptivo de barrera adicional
    9.Las pacientes deben cumplir una de las siguientes condiciones
    a. No encontrarse en edad fértil: premenárquica; posmenopáusica (>45 años con amenorrea durante al menos 12 meses); esterilizada permanentemente (por ejemplo, oclusión tubárica bilateral, histerectomía, salpingectomía bilateral, ovariectomía bilateral); o bien, ser incapaz de quedarse embarazada.
    b. Si está en edad fértil y utiliza 1 método anticonceptivo de alta eficacia en consonancia con la normativa local respecto al uso de métodos anticonceptivos para pacientes que participen en estudios clínicos, como se describe a continuación:
    o Practicar la verdadera abstinencia (cuando coincide con el estilo de vida preferido y habitual de la paciente), que se define como abstenerse de tener relaciones heterosexuales durante todo el periodo del estudio, incluso hasta 6 meses después de que se le haya administrado la última dosis de dexametasona, montelukast, metotrexato, lazertinib o amivantamab i.v. La abstinencia periódica (métodos del calendario, sintotérmico, posovulatorio) no se considera un método anticonceptivo aceptable
    o Tener una única pareja que se haya sometido a una vasectomía
    o Utilizar 2 métodos anticonceptivos, incluido un método de alta eficacia (es decir, uso establecido de métodos anticonceptivos hormonales orales, intravaginales, transdérmicos, inyectados o implantados; colocación de un dispositivo intrauterino [DIU] o sistema intrauterino [SIU], procedimientos de ligadura de trompas según la normativa local), Y un segundo método (p. ej., preservativo con espuma/gel/película/crema/supositorio espermicida o capuchón oclusivo [diafragma o capuchón/cubierta cervical] con espuma/gel/película/crema/supositorio espermicida)
    o Las pacientes deben comprometerse a continuar con los anticonceptivos durante todo el estudio y seguir hasta 6 meses después de la última dosis de dexametasona, montelukast, metotrexato, lazertinib o amivantamab i.v.
    Nota: Si la posibilidad de quedarse embarazada cambia una vez iniciado el estudio (p. ej., si una mujer que no es heterosexualmente activa se vuelve activa o si una mujer premenárquica experimenta menarquia), la mujer debe iniciar un método anticonceptivo, incluyendo 1 método de alta eficacia, como se describe anteriormente.
    10.Las pacientes en edad fértil deben presentar una prueba de embarazo en suero negativa (gonadotropina coriónica humana β [β-hCG]) en la selección (en las 72 horas anteriores a la primera dosis del tratamiento del estudio) y deben aceptar someterse a más pruebas de embarazo en suero u orina durante el estudio.
    11.La paciente debe comprometerse a no donar óvulos (ovocitos) ni congelarlos para usos futuros con fines de reproducción asistida durante el estudio y durante un periodo de 6 meses después de la última dosis del fármaco del estudio,lazertinib y amivantamab i.v. Las pacientes deben considerar la conservación de los óvulos antes del tratamiento del estudio, ya que los tratamientos contra el cáncer pueden afectar a la fertilidad
    12.Los pacientes deben utilizar un preservativo al realizar cualquier actividad que permita el pasodel esperma eyaculado a otra persona durante el estudio y durante 3 meses después de recibir la última dosis del tratamiento del estudio, lazertinib y amivantamab i.v.

    Consulte el protocolo para obtener una lista completa de los criterios de inclusión
    E.4Principal exclusion criteria
    Medical Conditions
    1. Subject has uncontrolled inter-current illness, including but not limited to:
    - Active infection (includes infection requiring treatment with antimicrobial therapy [participants will be required to complete antibiotics 1 week prior to study treatment] or diagnosed or suspected viral infection)
     Human immunodeficiency virus-positive participants are eligible if they meet all of the following:
    o No detectable viral load (ie, <50 copies/mL) at screening
    o CD4+ count >300 cells/mm3 at screening
    o No acquired immunodeficiency syndrome (AIDS)-defining opportunistic infection within 6 months of screening
    -Receiving highly active antiretroviral therapy (HAART). Any changes in HAART due to resistance/progression should occur at least 3 months prior to
    screening. A change in HAART due to toxicity is allowed up to 4 weeks prior to screening.
    Note: HAART that could interfere with study treatment is excluded (consult the sponsor for a review of medications prior to enrollment). Poorly controlled (persistent) hypertension: systolic blood pressure >180 mm Hg; diastolic blood pressure >100 mm Hg,
    o Uncontrolled diabetes
    o Active bleeding diathesis
    o Impaired oxygenation requiring continuous oxygen supplementation
    o Refractory nausea and vomiting
    o Chronic gastrointestinal diseases, inability to swallow the formulated product, or previous significant bowel resection that would preclude adequate absorption of study treatment
    o Any ophthalmologic condition that is either clinically unstable or requires treatment
    o Psychiatric illness/social situation that would limit compliance with study requirements.
    o Any condition for which, in the opinion of the investigator, participation would not be in the best interest of the participant (eg, compromise the
    well-being) or that could prevent, limit, or confound the protocol-specified assessments
     Subject has at screening positive hepatitis B (hepatitis B virus [HBV]) surface antigen (HbsAg)
    Note: Subjects with a prior history of HBV demonstrated by positive hepatitis B core antibody are eligible if they have at Screening 1) a negative HbsAg and 2) a HBV DNA (viral load) below the lower limit of quantification, per local testing. Subjects with a positive HbsAg due to recent vaccination are eligible if HBV DNA (viral load) is below the lower limit of quantification, per local testing.
     Subject has at screening positive hepatitis C antibody (anti-HCV).
    Note: Subjects with a prior history of HCV, who have completed antiviral treatment and have subsequently documented HCV RNA below the lower limit of quantification per local testing are eligible.
     Other clinically active infectious liver disease.
    2. Participant has active cardiovascular disease including, but not limited to:
     A medical history of deep vein thrombosis or pulmonary embolism within 1 month prior to first dose of study drug or any of the following within 6 months prior to the first dose of study drug: myocardial infarction, unstable angina, stroke, transient ischemic attack, uncontrolled hypertension, or clinically significant cardiac arrythmia. Clinically nonsignificant thrombosis, such as nonobstructive catheter--associated clots, are not exclusionary.
     Prolonged QT interval corrected with Fridericia's formula (QTcF) >470 msec
     Congestive heart failure (CHF), defined as New York Heart Association (NYHA) class III-IV or hospitalization for CHF (any NYHA class; refer to Appendix: New York Heart Association Criteria) within 6 months of study Day 1.
    3. Participant has a medical history of ILD, including drug-induced ILD or radiation pneumonitis.
    4. Prior treatment with antiPD-1 or antiPD-L1 antibody within 6 weeks of planned first dose of study treatment or immune-mediated rash from checkpoint inhibitors that has not resolved prior to enrollment.
    5. Participant has symptomatic brain metastases. A participant with asymptomatic or previously treated and stable brain metastases may participate in this study. Participants who have completed definitive therapy, are not on steroids, and have a stable clinical status for at least 2 weeks prior to study treatment are allowed. If brain metastases are diagnosed on Screening imaging, the participant may be enrolled, or rescreened for eligibility, after definitive treatment if above criteria are met.
    6. Any toxicities from prior anticancer therapy must have resolved to CTCAE version 5.0 Grade 1 or baseline level (except for alopecia [any grade], Grade ≤2 peripheral neuropathy, and Grade ≤2 hypothyroidism stable on hormone replacement therapy).

    Please refer to the protocol for full list of exclusion criteria
    Afecciones médicas
    1.Padecer enfermedad intercurrente no controlada, que incluye, entre otras:
    •Infección activa (incluye infección que requiera un tratamiento antimicrobiano [se requerirá que los pacientes completen el tratamiento con antibióticos 1 semana antes de comenzar el tratamiento del estudio] o sospecha o diagnóstico de infección vírica)
    Los pacientes seropositivos para el virus de la inmunodeficiencia humana son elegibles si cumplen todos los requisitos siguientes:
    o Sin carga vírica detectable (es decir, <50 copias/ml) en el momento de la selección.
    oRecuento de CD4+ >300 células/mm3 en el momento de la selección.
    oNinguna infección oportunista que defina un síndrome de inmunodeficiencia adquirida (SIDA) en los 6 meses anteriores a la selección.
    Estar recibiendo un tratamiento antirretroviral de gran actividad (TARGA). Cualquier cambio de TARGA debido a resistencia/progresión debe tener lugar al menos 3 meses antes de la selección. Se permite un cambio de TARGA debido a la toxicidad hasta 4 semanas antes de la selección.
    Nota: Se excluye cualquier TARGA que pueda interferir con el tratamiento del estudio (consulte al promotor para revisar la medicación previa al reclutamiento). Hipertensión mal controlada (persistente): presión arterial sistólica >180 mmHg; presión arterial diastólica >100 mmHg,
    oDiabetes no controlada
    oDiátesis hemorrágica activa
    oDeterioro de la oxigenación que requiera suplemento de oxígeno continuo
    oNáuseas y vómitos resistentes
    oEnfermedades gastrointestinales crónicas, incapacidad para tragar la formulación del producto o resección intestinal importante previa que impida la absorción suficiente del tratamiento del estudio
    oCualqier afección oftalmológica que sea clínicamente inestable o requiera tratamiento
    oSituación social o enfermedad psiquiátrica que limiten el cumplimiento de los requisitos del estudio
    oCualquier enfermedad para la cual, en opinión del investigador, la participación no redundaría en interés del paciente (p. ej., si afectara a su bienestar) o podría impedir, limitar o confundir las evaluaciones especificadas en el protocolo
    •Resultado positivo para el antígeno de superficie de la hepatitis B (virus de la hepatitis B [VHB]) (HBsAg) en la selección
    Nota: Los pacientes con antecedentes previos de VHB demostrado por un resultado positivo para anticuerpos contra el núcleo de la hepatitis B son elegibles si en la selección presentan 1) un resultado negativo para HBsAg y 2) un ADN del VHB (carga vírica) por debajo del límite inferior de cuantificación, según las pruebas locales. Los pacientes con un resultado positivo para HBsAg debido a una vacunación reciente son elegibles si el ADN del VHB (carga vírica) está por debajo del límite inferior de cuantificación, según las pruebas locales
    •El paciente presenta anticuerpos contra la hepatitis C (anti-VHC) en la selección
    Nota: Los pacientes con antecedentes previos de VHC que hayan completado un tratamiento antivírico y hayan documentado posteriormente un ARN del VHC por debajo del límite inferior de cuantificación, según las pruebas locales, son elegibles
    •Otra enfermedad hepática infecciosa clínicamente activa
    2.Padecer una enfermedad cardiovascular activa, incluidas, entre otras:
    •Una historia clínica de trombosis venosa profunda o embolia pulmonar en el plazo de 1 mes antes de la administración de la primera dosis del fármaco del estudio, o diagnóstico de cualquiera de los siguientes en los 6 meses anteriores a la primera dosis del fármaco del estudio: infarto de miocardio, angina inestable, accidente cerebrovascular, accidente isquémico transitorio, hipertensión no controlada o arritmia cardíaca clínicamente significativa. La trombosis clínicamente no significativa, como los coágulos no obstructivos asociados a catéter, no es excluyente.
    •Intervalo QT prolongado corregido con la fórmula de Fridericia (QTcF) >470 ms
    •Insuficiencia cardíaca congestiva (ICC), definida como de clase III-IV de la New York Heart Association (NYHA), u hospitalización por ICC (cualquier clase de la NYHA; véase el Apéndice: Criterios de la New York Heart Association) en los 6 meses anteriores al día 1 del estudio
    3.Contar con una historia clínica de EPI, incluida EPI inducida por fármacos o neumonitis por radiación.
    4.Tratamiento previo con anticuerpos antiPD-1 o antiPD-L1 en las 6 semanas previas a la primera dosis programada del tratamiento del estudio o erupción cutánea inmunomediada por los inhibidores de puntos de control que no se haya resuelto antes del reclutamiento.

    Consulte el protocolo para obtener una lista completa de los criterios de exclusión
    E.5 End points
    E.5.1Primary end point(s)
    Rate of IRRs occurring on Cycle 1 Day 1 following administration of lazertinib and IV amivantamab combination therapy.
    Tasa de RRI que ocurren en el Día 1 del Ciclo 1 después de la administración de la terapia combinada de lazertinib y amivantamab IV.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Please refer to schedule of assessments in the Protocol.
    Consulte el calendario de evaluaciones en el Protocolo.
    E.5.2Secondary end point(s)
     Rates and severity of these individual AEs during Cycle 1 Day 1.
    -Rates and severity of these individual AEs following subsequent administrations up to 3 months.
    -Rates of IRR following subsequent administrations.
    -Severity of infusion-related reactions.
    -Incidence of other adverse events.
    -Median time to complete infusion for pre-amivantamab infusion medications, IV amivantamab infusion, and post-amivantamab infusion medications on C1D1.
    -Percent of patients completing amivantamab infusion within 4 hours on C1D1.
    -Overall response rate (ORR) and duration of response (DOR) as determined by investigator, according to the Response Criteria in Solid Tumors (RECIST) v1.1.
    -Tasas y gravedad de estos EA individuales durante el Día 1 del Ciclo 1.
    -Tasas y gravedad de estos AA individuales después de administraciones subsiguientes hasta 3 meses.
    -Tasas de RRI tras administraciones posteriores.
    -Gravedad de las reacciones relacionadas con la perfusión.
    -Incidencia de otros eventos adversos.
    -Tiempo medio para completar la infusión para medicamentos de infusión antes de amivantamab, infusión de amivantamab IV y medicamentos de infusión posteriores a amivantamab en C1D1.
    -Porcentaje de pacientes que completan la infusión de amivantamab dentro de las 4 horas en C1D1.
    -Tasa de respuesta general (ORR) y duración de la respuesta (DOR) según lo determine el investigador, de acuerdo con los Criterios de respuesta en tumores sólidos (RECIST) v1.1.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Please refer to schedule of assessments in the Protocol.
    Consulte el calendario de evaluaciones en el Protocolo.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis Yes
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic 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) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    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 No
    E.8.2.4Number of treatment arms in the trial3
    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 concerned8
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA15
    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
    Korea, Democratic People's Republic of
    United States
    France
    Spain
    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
    LVLS
    Última Visita del Último Paciente
    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 months6
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months6
    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: 60
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 60
    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 No
    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 state24
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 50
    F.4.2.2In the whole clinical trial 120
    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)
    SOC
    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 Decision2023-04-12
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2023-03-29
    P. End of Trial
    P.End of Trial StatusOngoing
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