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Clinical trials

The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
  • clinical trials conducted outside the EU/EEA that are linked to European paediatric-medicine development

  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   43871   clinical trials with a EudraCT protocol, of which   7290   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
    Examples: Cancer AND drug name. Pneumonia AND sponsor name.
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    Summary
    EudraCT Number:2022-001459-17
    Sponsor's Protocol Code Number:NuTide:323
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2023-01-24
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2022-001459-17
    A.3Full title of the trial
    A randomised, open-label, Phase II, dose/schedule optimisation study of NUC-3373/leucovorin/irinotecan plus bevacizumab (NUFIRI-bev) versus 5-FU/leucovorin/irinotecan plus bevacizumab (FOLFIRI-bev) for the treatment of patients with previously treated unresectable metastatic colorectal cancer
    Studio randomizzato, in aperto, di fase II, di ottimizzazione di dose/ schema posologico di NUC-3373/leucovorina/irinotecano più bevacizumab (NUFIRI-bev) rispetto a 5-FU/leucovorina/irinotecano più bevacizumab (FOLFIRI-bev) per il trattamento di pazienti con carcinoma del colon-retto metastatico non resecabile precedentemente trattato
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study of the effects of NUC-3373 in combination with standard anticancer drugs (NUFIRI-bev) compared with FOLFIRI-bev in patients with previously treated colorectal cancers that have spread into the surrounding tissue or to another part of the body.
    Uno studio degli effetti di NUC-3373 in combinazione con farmaci antitumorali standard (NUFIRI-bev) rispetto a FOLFIRI-bev nei pazienti con tumori colorettali precedentemente trattati che si sono diffusi nei tessuti circostanti o in un'altra parte del corpo.
    A.3.2Name or abbreviated title of the trial where available
    Phase II study of NUC-3373 in combination with other agents in patients with colorectal cancer
    Studio di fase II di NUC-3373 in combinazione con altri agenti in pazienti con cancro colon-rettale
    A.4.1Sponsor's protocol code numberNuTide:323
    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 SponsorNuCana plc
    B.1.3.4CountryUnited Kingdom
    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 supportNuCana plc
    B.4.2CountryUnited Kingdom
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationNuCana plc
    B.5.2Functional name of contact pointNuCana Clinical Study Information
    B.5.3 Address:
    B.5.3.1Street Address3 Lochside Way
    B.5.3.2Town/ cityEdimburgo
    B.5.3.3Post codeEH12 9DT
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number004413165711110
    B.5.6E-mailNuTide323@nucana.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 name5-Fluorouracile
    D.3.2Product code [non applicabile]
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNFLUOROURACILE
    D.3.9.1CAS number 51-21-8
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.4EV Substance CodeSUB07721MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeup to
    D.3.10.3Concentration number50
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameLevo-leucovorina
    D.3.2Product code [non applicabile]
    D.3.4Pharmaceutical form Solution for injection/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 INNCALCIO LEVOFOLINATO
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.3Other descriptive nameLevoleucovorin
    D.3.9.4EV Substance CodeSUB06054MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin 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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 3
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameBevacizumab
    D.3.2Product code [non applicabile]
    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 INNBEVACIZUMAB
    D.3.9.1CAS number 216974-75-3
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.4EV Substance CodeSUB16402MIG
    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 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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 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 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 nameNUC-3373 for infusion
    D.3.2Product code [non applicabile]
    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 INNFosifloxuridine nafalbenamide
    D.3.9.1CAS number 1332837-31-6
    D.3.9.2Current sponsor codeNUC-3373
    D.3.9.3Other descriptive nameNUC-3073; CPF-373
    D.3.9.4EV Substance CodeSUB198057
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number125
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameLeucovorin
    D.3.2Product code [non applicabile]
    D.3.4Pharmaceutical form Solution for injection/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 INNCALCIO FOLINATO
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.3Other descriptive nameLeucovorin
    D.3.9.4EV Substance CodeSUB06052MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin 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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 6
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameIrinotecano
    D.3.2Product code [non applicabile]
    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 INNIRINOTECAN CLORIDRATO TRIIDRATO
    D.3.9.1CAS number 97682-44-5
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.4EV Substance CodeSUB08295MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 7
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Irinotecan Hydrochloride 20mg/ml Concentrate for Solution for Infusion
    D.2.1.1.2Name of the Marketing Authorisation holderHospira UK Limited
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    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 nameIrinotecano
    D.3.2Product code [non applicabile]
    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 INNIRINOTECAN CLORIDRATO TRIIDRATO
    D.3.9.1CAS number 97682-44-5
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.4EV Substance CodeSUB08295MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 8
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Irinotecan Hydrochloride 20mg/ml Concentrate for Solution for Infusion
    D.2.1.1.2Name of the Marketing Authorisation holderPfizer SL
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    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 nameIrinotecan
    D.3.2Product code [non applicabile]
    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 INNIRINOTECAN CLORIDRATO TRIIDRATO
    D.3.9.1CAS number 97682-44-5
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.4EV Substance CodeSUB08295MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 9
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Calcium Folinate 10mg/ml Injection
    D.2.1.1.2Name of the Marketing Authorisation holderHospira UK Limited
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    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 nameLeucovorin
    D.3.2Product code [non applicabile]
    D.3.4Pharmaceutical form Solution for injection/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 INNCALCIO FOLINATO
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.3Other descriptive nameLeucovorin
    D.3.9.4EV Substance CodeSUB06052MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin 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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 10
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Normon calcium folinate 350 mg powder for solution for injection
    D.2.1.1.2Name of the Marketing Authorisation holderLaboratories Normon S.A.
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    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 nameLeucovorina
    D.3.2Product code [non applicabile]
    D.3.4Pharmaceutical form Powder for solution for injection/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 INNCALCIO FOLINATO
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.3Other descriptive nameLeucovorin
    D.3.9.4EV Substance CodeSUB06052MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number350
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 11
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Zirabev 25 mg/ml concentrate for solution for infusion
    D.2.1.1.2Name of the Marketing Authorisation holderPfizer Europe MA EEIG
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameBevacizumab
    D.3.2Product code [non applicabile]
    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 INNBEVACIZUMAB
    D.3.9.1CAS number 216974-75-3
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.4EV Substance CodeSUB16402MIG
    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 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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 12
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Zirabev 25 mg/ml concentrate for solution for infusion
    D.2.1.1.2Name of the Marketing Authorisation holderPfizer Europe MA EEIG
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameBevacizumab
    D.3.2Product code [non applicabile]
    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 INNBEVACIZUMAB
    D.3.9.1CAS number 216974-75-3
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.4EV Substance CodeSUB16402MIG
    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 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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 13
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Fluorouracil 25mg/ ml Injection
    D.2.1.1.2Name of the Marketing Authorisation holderHospira UK Limited
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    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 name5-Fluorouracile
    D.3.2Product code [non applicabile]
    D.3.4Pharmaceutical form Solution for injection/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 INNFLUOROURACILE
    D.3.9.1CAS number 51-21-8
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.4EV Substance CodeSUB07721MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeup to
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 14
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Fluorouracil 50mg/ml Injection
    D.2.1.1.2Name of the Marketing Authorisation holderHospira UK Limited
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    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 name5-Fluorouracile
    D.3.2Product code [non applicabile]
    D.3.4Pharmaceutical form Solution for injection/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 INNFLUOROURACILE
    D.3.9.1CAS number 51-21-8
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.4EV Substance CodeSUB07721MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeup to
    D.3.10.3Concentration number50
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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: 15
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name FLUOROURACILE PFIZER 50 mg/ml, solution à diluer pour perfusion
    D.2.1.1.2Name of the Marketing Authorisation holderPFIZER HOLDING FRANCE
    D.2.1.2Country which granted the Marketing AuthorisationFrance
    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 name5-Fluorouracile
    D.3.2Product code [non applicabile]
    D.3.4Pharmaceutical form Solution for injection/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 INNFLUOROURACILE
    D.3.9.1CAS number 51-21-8
    D.3.9.2Current sponsor codenon applicabile
    D.3.9.4EV Substance CodeSUB07721MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeup to
    D.3.10.3Concentration number50
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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
    Relapsed, unresectable, histologically or cytologically confirmed metastatic adenocarcinoma of colon or rectum with radiologically measurable disease.
    Adenocarcinoma metastatico del colon o del retto recidivato, non resecabile, confermato istologicamente o citologicamente, con malattia radiologicamente malattia misurabile.
    E.1.1.1Medical condition in easily understood language
    Previously treated colorectal cancer that has spread from one part of the body to another and that cannot be removed surgically
    Cancro del colon-retto trattato in precedenza che si è diffuso da una parte del corpo ad un'altra e che non può essere rimosso chirurgicamente.
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level PT
    E.1.2Classification code 10052358
    E.1.2Term Colorectal cancer metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    • To compare progression-free survival (PFS) of NUC-3373 in combination with leucovorin (LV), irinotecan and bevacizumab (NUFIRIbev) with 5-fluorouracil (5-FU) in combination with LV, irinotecan and bevacizumab (FOLFIRI-bev)
    • To determine the optimal NUFIRI-bev dosing schedule
    • Confrontare la sopravvivenza libera da progressione (Progression Free Survival, PFS) di NUC-3373 in combinazione con leucovorina (LV), irinotecan e bevacizumab (NUFIRI-bev) con 5-fluorouracile (5-FU) in combinazione con LV, irinotecan e bevacizumab (FOLFIRI-bev)
    • Determinare lo schema posologico ottimale di NUFIRI-bev
    E.2.2Secondary objectives of the trial
    • To compare the efficacy of NUFIRI-bev to FOLFIRI-bev in terms of:
    o Objective response rate (ORR)
    o Duration of response (DoR)
    o Disease control rate (DCR)
    o Maximum percentage change in tumour size
    o Overall survival (OS)
    • To assess the safety and tolerability of NUFIRI-bev compared to
    FOLFIRI-bev
    • To assess the pharmacokinetics (PK) of NUFIRI-bev
    • Confrontare l’efficacia di NUFIRI-bev con FOLFIRI-bev in termini di:
    o Tasso di risposta obiettiva (Objective Response Rate, ORR),
    o Durata della risposta (Duration of Response, DoR)
    o Tasso di controllo della malattia (Disease Control Rate, DCR)
    o Variazione percentuale massima nella dimensione del tumore
    o Sopravvivenza globale (Overall Survival, OS)
    • Valutare la sicurezza e la tollerabilità di NUFIRI-bev rispetto a FOLFIRI-bev
    • Valutare la farmacocinetica (PK) di NUFIRI-bev
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Provision of written informed consent.
    2. Histological or cytological confirmation of colorectal adenocarcinoma (excluding appendiceal and anal canal cancers, as well as colorectal cancers of mixed histologies [e.g., mucinous adenocarcinoma, micropapillary, signet-ring cell carcinoma]) that is unresectable and/or metastatic.
    3. Measurable disease (as defined by RECIST v1.1).
    4. Received >=2 months of a first-line fluoropyrimidine and oxaliplatin-containing regimen for metastatic disease or relapsed within 6 months of completing a fluoropyrimidine and oxaliplatin-containing adjuvant therapy. Previous treatment with standard of care chemotherapy regimens in combination with molecular targeted therapies (e.g., VEGF and EGFR pathway inhibitors and immuno-oncology agents) is permitted. Previous treatment with maintenance therapy (e.g., capecitabine) is also allowed.
    5. Known RAS and BRAF status. Patients with wild-type KRAS tumours must have received prior treatment with an EGFR inhibitor, unless this was not standard of care according to relevant region-specific treatment recommendations.
    6. Known UGT1A1 status, or patient consents to UGT1A1 status testing if unknown.
    7. Age >=18 years.
    8. Minimum life expectancy of >=12 weeks.
    9. ECOG Performance status 0 or 1.
    10. Adequate bone marrow function as defined by: absolute neutrophil count (ANC) >=1.5×109/L, platelet count >=100×109/L, and haemoglobin >=9 g/dL.
    11. Adequate liver function, as defined by: serum total bilirubin <=1.5×upper limit of normal (ULN), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) <=2.5×ULN (or <=5×ULN if liver metastases are present).
    12. Adequate renal function assessed as serum creatinine <1.5×ULN or glomerular filtration rate >=50 mL/min (calculated by the Cockcroft-Gault method).
    13. Serum albumin >=3 g/dL.
    14. Ability to comply with protocol requirements.
    15. Female patients of child-bearing potential must have a negative pregnancy test within 7 days prior to the first study drug administration.
    This criterion does not apply to patients who have had a previous hysterectomy or bilateral oophorectomy. Male patients and female patients of child-bearing potential must agree to practice true abstinence or to use two highly effective forms of contraception, one of which must be a barrier method. These forms of contraception must be used from the time of signing consent, throughout the treatment period, and for 6 months following the last dose of any study medication. Oral or injectable contraceptive agents cannot be the sole method of contraception.
    16. Patients must have been advised to take measures to avoid or minimize exposure to UV light for the duration of study participation and for a period of 4 weeks following the last dose of study medication.
    1. Conferimento del consenso informato scritto.
    2. Conferma istologica o citologica di adenocarcinoma del colon-retto (esclusi i tumori dell’appendice e del canale anale, nonché i tumori del colon-retto a istologie miste [per es., adenocarcinoma mucinoso, carcinoma micropapillare a cellule ad anello con castone]) non resecabile e/o metastatico.
    3. Malattia misurabile (definita secondo RECIST v1.1).
    4. Aver ricevuto >=2 mesi di un regime di prima linea contenente fluoropirimidina e oxaliplatino per malattia metastatica o aver recidivato entro 6 mesi dal completamento di una terapia adiuvante contenente fluoropirimidina e oxaliplatino. È consentito un precedente trattamento con regimi chemioterapici standard di cura in combinazione con terapie molecolari mirate (per es. inibitori del pathway di VEGF ed EGFR e agenti immuno-oncologici). È consentito anche il trattamento precedente con terapia di mantenimento (per es., capecitabina).
    5. Stato di RAS e BRAF noto. I pazienti con tumori KRAS wild-type devono aver ricevuto un precedente trattamento con un inibitore dell’EGFR, a meno che non si tratti di terapia standard secondo le raccomandazioni di trattamento regionali specifiche pertinenti.
    6. Stato noto di UGT1A1 o consenso del paziente all’analisi dello stato di UGT1A1 se non noto.
    7. Età >=18 anni.
    8. Aspettativa di vita minima >=12 settimane.
    9. Presentare uno stato di validità ECOG di 0 o 1.
    10. Adeguata funzione del midollo osseo definita da: conta assoluta dei neutrofili (ANC) >=1,5×109/l, conta piastrinica >=100×109/l ed emoglobina >=9 g/dl.
    11. Funzione epatica adeguata, definita da: bilirubina sierica totale <=1,5 volte il limite superiore della norma (ULN), aspartato aminotransferasi (AST) e alanina aminotransferasi (ALT) <=2,5 volte l’ULN (o <=5 volte l’ULN in presenza di metastasi epatiche).
    12. Funzione renale adeguata valutata come creatinina sierica <1,5 volte l’ULN o velocità di filtrazione glomerulare >=50 ml/min (calcolata mediante il metodo di Cockcroft-Gault).
    13. Albumina sierica >= 3 g/dl.
    14. Capacità di rispettare i requisiti del protocollo.
    15. Le pazienti di sesso femminile in età fertile devono risultare negative al test di gravidanza nei 7 giorni precedenti la prima somministrazione del farmaco dello studio. Questo criterio non si applica alle pazienti che sono state sottoposte a precedente isterectomia o ovariectomia bilaterale. I pazienti di sesso maschile e le pazienti di sesso femminile in età fertile devono accettare di praticare l’effettiva astinenza o utilizzare due forme di contraccezione altamente efficaci, una delle quali deve essere un metodo barriera. Queste forme di contraccezione devono essere utilizzate dal momento della firma del consenso, per tutto il periodo di trattamento e per 6 mesi dopo l’ultima dose di qualsiasi farmaco dello studio. Gli agenti contraccettivi orali o iniettabili non possono essere l’unico metodo contraccettivo.
    16. Ai pazienti deve essere stato consigliato di adottare misure per evitare o ridurre al minimo l’esposizione alla luce UV per la durata della partecipazione allo studio e per un periodo di 4 settimane dopo l’ultima dose di farmaco dello studio.
    E.4Principal exclusion criteria
    1. History of hypersensitivity or current contra-indications to 5-FU, FUDR, or capecitabine.
    2. History of hypersensitivity or current contra-indication to any of the combination agents required for the study.
    3. History of allergic reactions attributed to components of the NUC-3373 drug product formulation (super refined polysorbate 80 [SRP80], dimethylacetamide [DMA]).
    4. Symptomatic central nervous system or leptomeningeal metastases.
    5. Symptomatic ascites, ascites currently requiring drainage procedures or ascites requiring drainage over the prior 3 months.
    6. Mutant BRAF V600E status.
    7. MSI high or dMMR.
    8. Prior treatment with irinotecan.
    9. Chemotherapy, hormonal therapy, radiotherapy (other than a short cycle of palliative radiotherapy [e.g., for bone pain]*), immunotherapy, biological agents, or exposure to another investigational agent within 21 days (or four times the half-life for molecular targeted agents, whichever is shorter) of first administration of study treatment:
    a. For nitrosoureas and mitomycin C within 6 weeks of first administration of study treatment
    b. Corticosteroid treatment is allowed during screening but should be weaned to a dose of <=10 mg prednisolone (or steroid equivalent) by Cycle 1 Day 1
    10. Residual toxicities from prior chemotherapy or radiotherapy which have not regressed to Grade <=1 severity (CTCAE v5.0), except for alopecia and residual Grade 2 neuropathy.
    11. History of other malignancies, except adequately treated nonmelanoma skin cancer, curatively treated in situ cancer of the cervix, surgically excised or potentially curatively treated ductal carcinoma in situ of the breast, or low-grade prostate cancer or patients after prostatectomy. Patients with previous invasive cancers are eligible if treatment was completed >3 years prior to initiating the current study treatment, and the patient has had no evidence or recurrence since then.
    12. Presence of an active bacterial or viral infection (including SARSCoV-2, Herpes Zoster, Varicella Zoster or chickenpox), known Human Immunodeficiency Virus (HIV) positive or known active hepatitis B or C.
    13. Presence of any uncontrolled concurrent serious illness, medical condition or other medical history, including laboratory results, which, in the Investigator's opinion, would be likely to interfere with the patient's ability to participate in the study or with the interpretation of the results (refer to protocol for further details).
    14. Any condition (e.g., known or suspected poor compliance, psychological instability, geographical location, etc.) that, in the judgment of the Investigator, may affect the patient's ability to provide informed consent and undergo study procedures.
    15. Patients with a history of haemoptysis (1/2 teaspoon or more of red blood) within 6 months prior to enrolment.
    16. Wound healing complications or surgery within 28 days of starting bevacizumab (wound healing must have been fully completed before starting bevacizumab).
    17. Unhealed wound, active gastric or duodenal ulcer, or bone fracture.
    18. Thromboembolic event in the 6 months before inclusion (e.g., transitory ischemic stroke, stroke, subarachnoid haemorrhage) except peripheral deep vein thrombosis treated with
    anticoagulants.
    19. Known inherited or acquired bleeding disorders.
    20. Red blood cell (RBC) transfusion dependence, defined as requiring more than 2 units of packed RBC transfusions during the 4-week period prior to screening.
    21. Uncontrolled hypertension.
    22. Severe proteinuria (nephrotic syndrome).
    23. Acute intestinal obstruction or sub-obstruction, history of inflammatory intestinal disease or extended resection of the small intestine. Presence of a colic prosthesis.
    24. History of abdominal fistulas, trachea-oesophageal fistulas, any other Grade 4 gastrointestinal perforations, non-gastrointestinal fistulas, or intra-abdominal abscesses 6 months prior to screening.
    25. Currently pregnant, lactating or breastfeeding.
    26. Required concomitant use of drugs known to prolong QT/QTc interval.
    27. Required concomitant use of strong CYP3A4 inducers or strong CYP3A4 inhibitors. The use of strong CYP3A4 inducers within 2 weeks of first receipt of study drug or the use of strong CYP3A4 inhibitors within 1 week of first receipt of study drug is also excluded.
    28. Use of strong UGT1A1 inhibitors within 1 week of first receipt of study drug.
    Please see the submitted Synopsis.
    1. Anamnesi di ipersensibilità o attuali controindicazioni a 5-FU, FUDR o capecitabina.
    2. Anamnesi di ipersensibilità o attuale controindicazione a uno qualsiasi degli agenti di combinazione richiesti per lo studio.
    3. Anamnesi di reazioni allergiche attribuite a componenti della formulazione del prodotto farmaceutico NUC-3373 (polisorbato 80 [SRP80] ultra-raffinato, dimetilacetamide [DMA]).
    4. Metastasi sintomatiche del sistema nervoso centrale o leptomeningee.
    5. Ascite sintomatica, ascite che attualmente richiede procedure di drenaggio o ascite che ha richiesto drenaggio nei 3 mesi precedenti.
    6. Stato mutante di BRAF V600E.
    7. MSI alta o dMMR.
    8. Precedente trattamento con irinotecan.
    9. Chemioterapia, terapia ormonale, radioterapia (diversa da un breve ciclo di radioterapia palliativa [per es., per il dolore osseo]*), immunoterapia, agenti biologici o esposizione a un altro agente sperimentale entro 21 giorni (o quattro volte l’emivita per gli agenti molecolari mirati, a seconda di quale sia il più breve) dalla prima somministrazione del trattamento dello studio:
    a. per le nitrosouree e la mitomicina C entro 6 settimane dalla prima somministrazione del trattamento dello studio
    b. Il trattamento con corticosteroidi è consentito durante lo screening, ma deve essere svezzato a una dose <=10 mg di prednisolone (o equivalente steroideo) entro il Giorno 1 del Ciclo 1
    10. Tossicità residue da precedente chemioterapia o radioterapia che non sono regredite alla gravità di grado <=1 (CTCAE v5.0), ad eccezione dell’alopecia e della neuropatia residua di grado 2.
    11. Anamnesi di altre neoplasie maligne, ad eccezione del carcinoma cutaneo non melanoma adeguatamente trattato, del carcinoma della cervice in situ trattato in modo curativo, del carcinoma duttale della mammella in situ chirurgicamente asportato o trattato in modo potenzialmente curativo, del carcinoma prostatico di basso grado o in caso di pazienti dopo prostatectomia. I pazienti con precedenti tumori invasivi sono idonei se il trattamento è stato completato >3 anni prima dell’inizio dell’attuale trattamento dello studio e il paziente non ha avuto alcuna evidenza o recidiva da allora.
    12. Presenza di un’infezione batterica o virale attiva (tra cui SARS-CoV-2, Herpes Zoster, Varicella Zoster o varicella), nota positività al virus dell’immunodeficienza umana (HIV) o epatite B o C attiva nota.
    13. Presenza di qualsiasi malattia seria, condizione medica o altra anamnesi medica concomitante non controllata, compresi i risultati di laboratorio, che, a giudizio dello sperimentatore, potrebbero interferire con la capacità del paziente di partecipare allo studio o con l’interpretazione dei risultati (riferirsi al protocollo per ulteriori dettagli).
    14. Qualsiasi condizione (per es., scarsa conformità nota o sospetta, instabilità psicologica, posizione geografica, ecc.) che, a giudizio dello sperimentatore, possa influire sulla capacità del paziente di fornire il consenso informato e sottoporsi alle procedure dello studio.
    15. Pazienti con anamnesi di emottisi (1/2 cucchiaino o più di sangue rosso) nei 6 mesi precedenti l’arruolamento.
    16. Complicanze di guarigione delle ferite o intervento chirurgico entro 28 giorni dall’inizio di bevacizumab (la guarigione della ferita deve essere stata completata completamente prima di iniziare bevacizumab).
    17. Ferita non guarita, ulcera gastrica o duodenale attiva o frattura ossea.
    18. Evento tromboembolico nei 6 mesi precedenti l’inclusione (per es. ictus ischemico transitorio, ictus, emorragia subaracnoidea), ad eccezione della trombosi venosa profonda periferica trattata con anticoagulanti.
    19. Disturbi emorragici ereditari o acquisiti noti.
    20. Dipendenza dalla trasfusione di globuli rossi (RBC), definita come la necessità di più di 2 unità di trasfusioni di globuli rossi concentrati durante il periodo di 4 settimane prima dello screening.
    21. Ipertensione non controllata.
    22. Grave proteinuria (sindrome nefrosica).
    23. Ostruzione o sub-ostruzione intestinale acuta, anamnesi di malattia infiammatoria intestinale o resezione estesa dell’intestino tenue. Presenza di una protesi colica.
    24. Anamnesi di fistole addominali, fistole tracheo-esofagee, qualsiasi altra perforazione gastrointestinale di grado 4, fistole non gastrointestinali o ascessi intra-addominali 6 mesi prima dello screening
    25. Attualmente in gravidanza o allattamento.
    26. Necessità di uso concomitante di farmaci di cui è noto che prolungano l’intervallo QT/QTc.
    27. Necessità di uso concomitante di forti induttori del CYP3A4 o forti inibitori del CYP3A4. È inoltre escluso l’uso di forti induttori del CYP3A4 entro 2 settimane dalla prima ricezione del farmaco dello studio o l’uso di forti inibitori del CYP3A4 entro 1 settimana dalla prima ricezione del farmaco dello studio.
    28. Uso di forti inibitori di UGT1A1 entro 1 settimana dalla prima ricezione del farmaco dello studio.
    Si prega di fare riferimento alla sinossi sottomessa.
    E.5 End points
    E.5.1Primary end point(s)
    PFS, according to Response Evaluation Criteria in Solid Tumours (RECIST) v1.1, defined as the time from randomisation to the first observation of objective tumour progression or death from any cause
    PFS, secondo i Criteri di valutazione della risposta nei tumori solidi (Response Evaluation Criteria in Solid Tumours, RECIST) v1.1, definita come il tempo dalla randomizzazione alla prima osservazione di progressione obiettiva del tumore o al decesso per qualsiasi causa
    E.5.1.1Timepoint(s) of evaluation of this end point
    End of trial
    Fine della sperimentazione
    E.5.2Secondary end point(s)
    Efficacy
    • ORR, defined as the percentage of patients achieving a complete or partial response to treatment
    • DoR, defined as the time from initial clinical response (partial response [PR] or complete response [CR]) to the first observation of tumour progression or death from any cause
    • DCR, defined as the percentage of patients demonstrating a best overall response (BOR) of CR, PR or stable disease (SD)
    • Maximum percentage change from baseline in tumour size according to RECIST v1.1
    • OS, defined as the time from randomisation to the time of death from any cause
    Safety
    Safety and tolerability will be assessed by evaluation of:
    • Treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs; per Common Terminology Criteria for Adverse Events [CTCAE] v5.0)
    • Deaths due to TEAEs
    • Treatment modifications due to TEAEs
    • Clinically-significant laboratory changes (per CTCAE v5.0)
    • Electrocardiograms (ECGs)
    Pharmacokinetics
    The PK of the NUFIRI-bev regimen will be assessed, including:
    • Concentration at end of infusion (Cinf)
    • Maximum concentration (Cmax)
    • Area under the plasma concentration-time curve (AUC)
    • Half-life (t1/2)
    • Volume of distribution (Vd)
    • Clearance (CL)
    The analytes measured in plasma will include, but are not limited to:
    • NUC-3373, 5-FU, a-fluoro-ß-alanine (FBAL), deoxyuridine (dUrd), irinotecan, SN-38
    Efficacia
    • ORR, definito come la percentuale di pazienti che ottiene una risposta completa o parziale al trattamento
    • DoR, definita come il tempo dalla risposta clinica iniziale (risposta parziale [Partial Response, PR] o risposta completa [Complete Response, CR]) alla prima osservazione di progressione del tumore o al decesso per qualsiasi causa
    • DCR, definita come la percentuale di pazienti che dimostra una migliore risposta complessiva (Best Overall Response, BOR) di CR, PR o malattia stabile (Stable Disease, SD)
    • Variazione percentuale massima rispetto al basale nella dimensione del tumore secondo i criteri RECIST v1.1
    • OS, definita come il tempo intercorso dalla randomizzazione al momento del decesso per qualsiasi causa
    Sicurezza
    La sicurezza e la tollerabilità saranno valutate mediante la valutazione di:
    • Eventi avversi emergenti dal trattamento (Treatment-Emergent Adverse Events, TEAE) ed eventi avversi seri (Serious Adverse Events, SAE; secondo i Criteri terminologici comuni per gli eventi avversi [Common Terminology Criteria for Adverse Events, CTCAE] v5.0)
    • Decessi dovuti a TEAE
    • Modifiche al trattamento dovute a TEAE
    • Modifiche clinicamente significative dei risultati di laboratorio (secondo i criteri CTCAE v5.0)
    • Elettrocardiogrammi (ECG)
    Farmacocinetica
    Sarà valutata la farmacocinetica (Pharmacokinetics, PK) del regime NUFIRI-bev, tra cui:
    • Concentrazione alla fine dell’infusione (Cinf)
    • Concentrazione massima (Cmax)
    • Area sotto la curva (Area Under the Curve, AUC) della concentrazione plasmatica-tempo
    • Emivita (t1/2)
    • Volume di distribuzione (Vd)
    • Clearance (CL)
    Gli analiti misurati nel plasma includeranno, a titolo esemplificativo ma non esaustivo:
    • NUC-3373, 5-FU, a-fluoro-ß-alanina (FBAL), deossiuridina (dUrd), irinotecan, SN-38
    E.5.2.1Timepoint(s) of evaluation of this end point
    End of trial
    Fine della sperimentazione
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    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 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) Yes
    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 EEA24
    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 Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    United States
    France
    Spain
    Germany
    Italy
    United Kingdom
    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
    The study will be considered complete when a total of 139 PFS events have occurred, unless the study is terminated early by decision of the Sponsor. In this case, the study will be considered complete after the last patient has completed their End of Treatment visit.
    Lo studio sarà considerato completo quando si sarà verificato un totale di 139 eventi di PFS, a meno che lo studio non venga interrotto anticipatamente per decisione dello Sponsor. In questo caso, lo studio sarà considerato completo dopo che l'ultimo paziente avrà completato la visita di fine trattamento.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months10
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months10
    E.8.9.2In all countries concerned by the trial 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: 111
    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 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 state32
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 72
    F.4.2.2In the whole clinical trial 171
    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)
    Following discontinuation of study treatment or at study completion/termination, patients will receive treatment in accordance with local standard of care.
    Dopo l'interruzione del trattamento dello studio o al completamento/termine dello studio, i pazienti riceveranno un trattamento conforme allo standard di cura locale.
    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 Decision2023-04-20
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2023-02-24
    P. End of Trial
    P.End of Trial StatusOngoing
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
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