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    Summary
    EudraCT Number:2022-001779-15
    Sponsor's Protocol Code Number:BGB-A317-Sitravatinib-301
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2022-10-13
    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 number2022-001779-15
    A.3Full title of the trial
    A Randomized Phase 3 Study of Tislelizumab in Combination With Sitravatinib in Patients With Locally Advanced or Metastatic Non-Small Cell Lung Cancer That Progressed on or After Platinum-Based Chemotherapy and Anti-PD-(L)1 Antibody
    Estudio de fase III aleatorizado de tislelizumab en combinación con sitravatinib en pacientes con cáncer de pulmón no microcítico localmente avanzado o metastásico que presentaron progresión durante o después de la quimioterapia con platino y anticuerpos anti-PD-(L)1
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Tislelizumab in Combination With Sitravatinib in Patients With Locally Advanced or Metastatic Non-Small Cell Lung Cancer
    Tislelizumab en combinación con sitravatinib en pacientes con cáncer de pulmón no microcítico localmente avanzado o metastásico
    A.4.1Sponsor's protocol code numberBGB-A317-Sitravatinib-301
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT04921358
    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 SponsorBeiGene, Ltd.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportBeiGene, Ltd.
    B.4.2CountryCayman Islands
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationBeiGene, Inc
    B.5.2Functional name of contact pointBeiGene Clinical Support
    B.5.3 Address:
    B.5.3.1Street Address1840 Gateway Drive, 3rd Floor
    B.5.3.2Town/ citySan Mateo, California
    B.5.3.3Post code94404
    B.5.3.4CountryUnited States
    B.5.6E-mailclinicaltrials@beigene.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 nametislelizumab
    D.3.2Product code BGB-A317
    D.3.4Pharmaceutical form Concentrate for concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNTislelizumab
    D.3.9.1CAS number 1858168-59-8
    D.3.9.2Current sponsor codeBGB-A317
    D.3.9.3Other descriptive nameBGN1, JHL2108
    D.3.9.4EV Substance CodeSUB193656
    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 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: 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 namesitravatinib
    D.3.2Product code MGCD516
    D.3.4Pharmaceutical form Capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNSitravatinib malate
    D.3.9.1CAS number 2244864-88-6
    D.3.9.2Current sponsor codeBGB-9468 malate
    D.3.9.3Other descriptive nameMGCD516 Malate, C19051610-G
    D.3.9.4EV Substance CodeSUB204209
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number35
    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: 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.2.1.1.1Trade name Docetaxel
    D.2.1.1.2Name of the Marketing Authorisation holderEVER Valinject GmbH
    D.2.1.2Country which granted the Marketing AuthorisationAustria
    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 namedocetaxel
    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 INNdocetaxel
    D.3.9.1CAS number 114977-28-5
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameAnhydrous docetaxel
    D.3.9.4EV Substance CodeSUB22289
    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 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 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 namesitravatinib
    D.3.2Product code MGCD516
    D.3.4Pharmaceutical form Capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNSitravatinib malate
    D.3.9.1CAS number 2244864-88-6
    D.3.9.2Current sponsor codeBGB-9468 malate
    D.3.9.3Other descriptive nameMGCD516 Malate, C19051610-G
    D.3.9.4EV Substance CodeSUB204209
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    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 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
    Locally Advanced or Metastatic Non-Small Cell Lung Cancer
    Cáncer de pulmón no microcítico localmente avanzado o metastásico
    E.1.1.1Medical condition in easily understood language
    Advanced Non-Small Cell Lung Cancer
    Cáncer de pulmón no microcítico avanzado
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    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 the overall survival (OS) of tislelizumab and sitravatinib combination therapy with that of docetaxel monotherapy
    - To compare the progression-free survival (PFS) of tislelizumab and sitravatinib combination therapy with that of docetaxel monotherapy, as assessed by the Independent Review Committee (IRC)
    -Comparar la supervivencia global (SG) del tratamiento combinado con tislelizumab y sitravatinib con la del docetaxel en monoterapia
    -Comparar la supervivencia sin progresión (SSP) del tratamiento combinado con tislelizumab y sitravatinib con la del docetaxel en monoterapia, evaluada por el comité de revisión independiente (CRI)
    E.2.2Secondary objectives of the trial
    - To compare the PFS of tislelizumab and sitravatinib combination therapy with that of docetaxel monotherapy, as assessed by the investigator
    - To compare the overall response rate (ORR), duration of response (DOR), and disease control rate (DCR) of tislelizumab and sitravatinib combination therapy with that of docetaxel monotherapy, as assessed by the IRC
    - To evaluate the safety and tolerability of tislelizumab and sitravatinib combination therapy compared with that of docetaxel monotherapy
    - To evaluate and compare health-related quality of life (HRQoL) between the tislelizumab and sitravatinib combination therapy with that of docetaxel monotherapy via patient reported outcomes using EORTC-QLQ-C30 (measuring general cancer) and its lung cancer module, QLQ-LC13, and the European Quality of Life 5-Dimension 5-Level (EQ-5D-5L)
    To characterize the pharmacokinetics (PK) of sitravatinib when given in combination with
    tislelizumab, if data permit
    -Comp. la superv. global SSP del tto comb. con tislelizumab y sitravatinib con la del docetaxel en monoterapia, según la evaluación del inv.
    -Comp. la tasa de respuesta global (TRG), la duración de la resp. (DdR) y la tasa de control de la enfermedad (TCE) del tto comb. con tislelizumab y sitravatinib con las de docetaxel en monoterapia, según la eval. del CRI
    -Comp. la seguridad y tolerabilidad del tto comb. con tislelizumab y sitravatinib con las del docetaxel en monoterapia
    -Evaluar y comp. la calidad de vida relacionada con la salud (CVRS) del tto comb. de tislelizumab y sitravatinib con la del docetaxel en monoterapia mediante los resultados notif. por el paciente utilizando el cuestionario EORTC-QLQ-C30 (que mide el cáncer gral) y su módulo de cáncer de pulmón, QLQ-LC13, y el Cuestionario EU de calidad de vida de 5 dimensiones y 5 niveles (EQ-5D-5L)
    -Describir la farmacocinética (FC) del sitravatinib cuando se administra en comb. con tislelizumab, si los datos lo permiten
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Able to provide written informed consent and can understand and agree to comply with the requirements of the study and the schedule of assessments
    2. Age ≥ 18 years on the day of signing the informed consent form (or the legal age of consent if > 18 in the jurisdiction in which the study is taking place)
    3. Metastatic or unresectable locally advanced histologically or cytologically confirmed NCSLC, not amenable to treatment with curative intent
    4. Able to provide archival/fresh tumor tissues for biomarker analysis to assess PD-L1 expression and other biomarkers. Tumor tissues should be of good quality and acceptable sample type (see Section 7.7.1 for details). Written informed consent is required before performance of fresh tumor biopsies.
    5. No known EGFR or BRAF sensitizing mutation, or ALK rearrangement or ROS1 rearrangement
    6. Radiographic progression per RECIST v1.1 on or after anti-PD-(L)1-containing therapy for locally advanced and unresectable or metastatic NSCLC. If the anti-PD-(L)1-containing therapy is not the most recent systemic treatment, patients should also have radiographic progression per RECIST v1.1 on or after the most recent systemic treatment. Prior line(s) of treatment must include a platinum-based chemotherapy and an anti-PD-(L)1 antibody, with the anti-PD-(L)1 antibody administered in combination with, or sequentially before or after the platinum-based chemotherapy. Patients must have received no more than 2 lines of prior systemic therapy for locally advanced and unresectable or metastatic disease.
    7. Criterion deleted
    8. At least 1 measurable lesion as defined based on RECIST v1.1 by investigator
    9. Eastern Cooperative Oncology Group Performance Status ≤ 1
    10. Adequate organ function as indicated by the laboratory values detailed on p.59 of the protocol (obtained ≤ 7 days before randomization)
    11. Females of childbearing potential must be willing to use a highly effective method of birth control while on study treatment, and within 180 days after the last dose of study drug(s) and have a negative serum pregnancy test ≤ 7 days before randomization. See Appendix 10.
    12. Nonsterile males must be willing to use a highly effective method of birth control for the duration of the study and for ≥ 180 days after the last dose of study drug(s).

    More detailed information on each inclusion criteria can be found in the clinical trial protocol.
    1. Capaz de proporcionar el consentimiento informado por escrito y de entender y aceptar cumplir los requisitos del estudio y el calendario de evaluaciones
    2. Tener ≥18 años en el momento de firmar el formulario de consentimiento informado (o la edad legal del consentimiento en la jurisdicción en la que se esté realizando el estudio si tiene >18 años)
    3. CPNM metastásico o no resecable localmente avanzado confirmado mediante histología o citología, no susceptible de tratamiento con intención curativa
    4. Capaz de proporcionar tejidos tumorales de archivo/en fresco para llevar a cabo un análisis de biomarcadores con el fin de evaluar la expresión de PD-L1 y otros biomarcadores. Los tejidos tumorales deben ser de buena calidad y de un tipo de muestra aceptable (véase el apartado 7.7.1 para obtener más información). Se requiere el consentimiento informado por escrito antes de la realización de biopsias tumorales en fresco.
    5. Sin mutación sensible conocida de EGFR o BRAF, ni reordenamiento de ALK o ROS1
    6. Progresión radiográfica según los RECIST v1.1 durante o después del tratamiento con anti-PD-(L)1 para el CPNM localmente avanzado y no resecable o metastásico. Si el tratamiento con anti-PD-(L)1 no ha sido el último tratamiento sistémico, los pacientes también deben presentar progresión radiográfica según los RECIST v1.1 durante o después del último tratamiento sistémico. Las líneas de tratamiento previas deben incluir quimioterapia con platino y anticuerpo anti-PD-(L)1, con administración del anticuerpo anti-PD-(L)1 en combinación con la quimioterapia con platino o antes o después de esta de manera secuencial. Los pacientes no deben haber recibido más de 2 líneas de tratamiento sistémico previo para la enfermedad localmente avanzada e irresecable o metastásica.
    7. El criterio se ha eliminado
    8. Al menos una lesión medible según la definición del investigador basada en los RECIST versión 1.1
    9. Estado funcional ≤1 del Eastern Cooperative Oncology Group (Grupo Oncológico Cooperativo de la Costa Este)
    10. Función orgánica adecuada según lo indicado por los valores analíticos detallados en la pág. 59 del protocolo (obtenidos ≤7 días antes de la aleatorización)
    11. Las mujeres con capacidad de concebir deben estar dispuestas a utilizar un método anticonceptivo de alta eficacia durante el tratamiento del estudio y en los 180 días posteriores a la última dosis de los fármacos del estudio, así como obtener un resultado negativo en la prueba de embarazo en suero ≤7 días antes de la aleatorización. Véase el Anexo 10.
    12. Los hombres que no sean estériles deben estar dispuestos a utilizar un método anticonceptivo de alta eficacia durante todo el estudio y durante ≥180 días después de la última dosis de los fármacos del estudio.

    Se puede encontrar información más detallada sobre cada criterio de inclusión en el protocolo del ensayo clínico.
    E.4Principal exclusion criteria
    1. Has received docetaxel as monotherapy or in combination with other therapies.
    2. Squamous NSCLC with central cavitation, or NSCLC with hemoptysis (> 50 mL/day)
    3. Patients with tumor shown by imaging to be located around important vascular structures or if the investigator determines that the tumor is likely to invade important blood vessels and may cause fatal bleeding.
    4. Active leptomeningeal disease for metastatic NSCLC, or uncontrolled or untreated brain metastasis.
    5. Active autoimmune diseases or history of autoimmune diseases that may relapse.
    6. Any active malignancy ≤ 2 years before randomization except for the specific cancer under investigation in this study and any locally recurring cancer that has been treated curatively
    7. Any condition that required systemic treatment with either corticosteroids (> 10 mg daily of prednisone or equivalent) or other immunosuppressive medication ≤ 14 days before randomization
    8. History of uncontrolled diabetes, or > Grade 1 laboratory test abnormalities in potassium, sodium, or corrected calcium despite standard medical management, or ≥ Grade 3 hypoalbuminemia ≤ 14 days before randomization
    9. History of interstitial lung disease, noninfectious pneumonitis or uncontrolled lung diseases, including pulmonary fibrosis and acute lung diseases.
    10. Severe chronic or active infection requiring systemic antibacterial, antifungal, or antiviral therapy (not including antiviral therapy for hepatitis or HIV) within 14 days before randomization
    11. Untreated HIV infection, if known. Patients with a known HIV infection are eligible if the following criteria are met:
    12. Untreated chronic hepatitis B or chronic hepatitis B virus (HBV) carriers with HBV DNA ≥ 500 IU/mL or 2500 copies/mL, or active hepatitis C virus (HCV) carriers
    13. Any major surgical procedure ≤ 28 days before randomization. Patients must have recovered adequately from the toxicity and/or complications from the intervention before randomization.
    14. Prior allogeneic stem cell transplantation or organ transplantation
    15. Any of the following cardiovascular risk factors:
    16. Patients with inadequately controlled hypertension
    17. Patients with hypersensitivity to tislelizumab, sitravatinib, docetaxel, to any ingredient in the formulation, or to any component of the container.
    18. Patients who use anticoagulants such as warfarin or similar agents requiring therapeutic INR monitoring.
    19. Within 4 weeks before randomization, patients with active bleeding disorder or any bleeding events ≥ CTCAE level 3, unhealed wounds, ulcers, or fractures
    20. Patients with a history of artery/deep vein thrombosis within 6 months before randomization, such as cerebrovascular incident (including temporary ischemic attack), deep vein thrombosis, and pulmonary embolism
    21. Received any Chinese herbal medicine or Chinese patent medicine for the treatment of NSCLC within 14 days before randomization, or received palliative radiation within 28 days before randomization for the lung or within 14 days before randomization for other organs.
    22. Unacceptable toxicity on prior anti-PD-(L)1 treatment, defined as on p. 63 of the protocol
    23. Patient was administered a live vaccine ≤ 28 days before randomization.
    24. Underlying medical conditions (including laboratory abnormalities) or alcohol or drug abuse or dependence that will be unfavorable for the administration of study drug, affect the explanation of drug toxicity or AEs, or result in insufficient or impaired compliance with study conduct according to the investigator’s judgement.
    25. Concurrent participation in another therapeutic clinical study.
    26. Unable to swallow capsules or with disease significantly affecting gastrointestinal function such as malabsorption syndrome, resection of the stomach or small bowel, bariatric surgery procedures, symptomatic inflammatory bowel disease, or partial or complete bowel obstruction.
    27. Patients with spinal cord compression due to metastatic disease not definitively treated with surgery and/or radiation or previously diagnosed and treated spinal cord compression without evidence that the disease has been clinically stable for > 2 weeks before randomization.
    28. Criterion deleted
    29. Prior randomization in a tislelizumab study regardless of the treatment arm, until the primary and key secondary endpoints of the study have read out.
    30. Patients with toxicities which have not recovered to baseline or stabilized, except for AEs not considered a likely safety risk (eg, alopecia, neuropathy and specific laboratory abnormalities).
    31. Women who are pregnant or are breastfeeding.
    32. Known COVID-19 antigen positive by a licensed test during the screening period.
    33. Uncontrollable pleural effusion, pericardial effusion, or ascites requiring frequent drainage (recurrence ≤ 14 days after intervention)

    More detailed information on each exclusion criteria can be found in the clinical trial protocol.
    1. Haber recibido docetaxel en monoterapia o en combinación con otros tratamientos.
    2. CPNM epidermoide con cavitación central o CPNM con hemoptisis (>50 ml/día)
    3. Pacientes con un tumor que, según la prueba de diagnóstico por la imagen, está ubicado alrededor de estructuras vasculares importantes, o si el investigador determina que es probable que el tumor invada vasos sanguíneos importantes y pueda causar hemorragias mortales.
    4. Enfermedad leptomeníngea activa para el CPNM metastásico o metástasis cerebral no controlada o no tratada.
    5. Enfermedades autoinmunitarias activas o antecedentes de enfermedades autoinmunitarias que puedan tener una recaída.
    6. Cualquier neoplasia maligna activa ≤2 años antes de la aleatorización, excepto el cáncer específico que se investiga en este estudio y cualquier cáncer local recidivante sometido a tratamiento curativo
    7. Cualquier afección que exigiera tratamiento con corticoesteroides (>10 mg diarios de prednisona o equivalente a la prednisona) u otro medicamento inmunosupresor en los ≤14 días previos a la aleatorización
    8. Antecedentes de diabetes no controlada o anomalías de grado >1 en los análisis en lo que respecta al potasio, sodio o calcio corregido a pesar del tratamiento médico estándar, o hipoalbuminemia de grado ≥3 ≤14 días antes de la aleatorización
    9. Antecedentes de enfermedad pulmonar intersticial, neumonitis no infecciosa o enfermedades pulmonares no controladas, incluida la fibrosis pulmonar y enfermedades pulmonares agudas.
    10. Infección crónica o activa grave que requiera tratamiento sistémico antibacteriano, antifúngico o antivírico (sin incluir el tratamiento antivírico para la hepatitis o el VIH) en los 14 días previos a la aleatorización
    11. Infección por VIH no tratada, si se conoce. Los pacientes con infección por VIH conocida son aptos si cumplen los siguientes criterios:
    12. Hepatitis B crónica no tratada o portadores crónicos del virus de la hepatitis B (VHB) con ADN del VHB ≥500 UI/ml o 2500 copias/ml, o portadores activos del virus de la hepatitis C (VHC)
    13. Cualquier intervención quirúrgica significativa ≤28 días antes de la aleatorización. Los pacientes deben haberse recuperado adecuadamente de la toxicidad o las complicaciones de la intervención antes de la aleatorización.
    14. Alotrasplante de células madre o trasplante de órganos previos
    15. Cualquiera de los siguientes factores de riesgo cardiovascular:
    16. Pacientes con hipertensión insuficientemente controlada
    17. Pacientes con hipersensibilidad a tislelizumab, sitravatinib, docetaxel, a cualquier ingrediente de la formulación o a cualquier componente del envase.
    18. Pacientes que tomen anticoagulantes como la warfarina u otros fármacos similares que requieran supervisión terapéutica del INR.
    19. En las 4 semanas anteriores a la aleatorización, pacientes con trastorno hemorrágico activo o cualquier acontecimiento hemorrágico de nivel ≥3 según los CTCAE, heridas, úlceras o fracturas no cicatrizadas
    20. Pacientes con antecedentes de trombosis arterial/venosa profunda en los 6 meses anteriores a la aleatorización, como un accidente cerebrovascular (incluido un accidente isquémico temporal), una trombosis venosa profunda y una embolia pulmonar
    21. Haber recibido alguna fitoterapia china o un medicamento de patente china para el tratamiento del CPNM en los 14 días anteriores a la aleatorización, o haber recibido radiación paliativa para el pulmón en los 28 días anteriores a la aleatorización o para otros órganos en los 14 días anteriores a la aleatorización.
    22. Toxicidad inaceptable en el tratamiento previo con anti-PD-(L)1, según la definición de la pág. 63 del protocolo
    23. Se administró al paciente una vacuna elaborada con microbios vivos ≤28 días antes de la aleatorización.
    24. Afecciones médicas subyacentes (incluidas anomalías analíticas) o abuso o dependencia del alcohol o de sustancias que sean desfavorables para la administración del fármaco del estudio, que afecten a la explicación de la toxicidad o los AA del fármaco, o que provoquen un cumplimiento insuficiente o deficiente de la realización del estudio según el criterio del investigador.
    25. Participación simultánea en otro estudio clínico terapéutico.
    26. Incapacidad para tragar las cápsulas o enfermedad que afecte de forma significativa al funcionamiento gastrointestinal, por ejemplo, síndrome de malabsorción, resección gástrica o del intestino delgado, intervenciones de cirugía bariátrica, enfermedad inflamatoria intestinal sintomática u obstrucción intestinal parcial o total.
    27. Pacientes con compresión de la médula espinal causada por metástasis que no se haya tratado definitivamente con cirugía o radioterapia o compresión medular diagnosticada previamente y tratada, sin datos de que la enfermedad haya estado clínicamente estable durante >2 semanas antes de la aleatorización.

    Para la lista completa de criterios de exclusión por favor consulte el protocolo
    E.5 End points
    E.5.1Primary end point(s)
    - OS, defined as the time from randomization to death from any cause
    - PFS, defined as the time from randomization to the first occurrence of disease progression as determined by the IRC based on Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, or death from any cause, whichever occurs first
    -SG, definida como el período de tiempo transcurrido entre la aleatorización y la muerte por cualquier causa
    -SSP, definida como el tiempo transcurrido desde la aleatorización hasta la primera aparición de progresión de la enfermedad documentada determinada por el CRI de acuerdo con los Criterios de evaluación de la respuesta en tumores sólidos (RECIST, por sus siglas en inglés) v1.1 o la muerte por cualquier causa, lo que suceda antes
    E.5.1.1Timepoint(s) of evaluation of this end point
    approximately 32 months
    aproximadamente 32 meses
    E.5.2Secondary end point(s)
    - PFS, defined as the time from randomization to the first occurrence of disease progression as determined by the investigator based on RECIST v1.1, or death from any cause, whichever occurs first
    - ORR, defined as the proportion of patients with partial response or complete response as determined by the IRC based on RECIST v1.1
    - DOR, defined as the time from the first occurrence of a documented objective response to the time of the first occurrence of disease progression, as determined by the IRC based on RECIST v1.1, or death from any cause, whichever comes first
    - DCR, defined as the proportion of patients whose best overall response (BOR) is complete response, partial response or stable disease as determined by the IRC based on RECIST v1.1
    - HRQoL, defined as changes in patient-reported outcomes (PRO), according to the European Organisation for Research and Treatment of Cancer (EORTC) core cancer (QLQ-C30) and its lung cancer module, QLQ-LC13, and the European Quality of Life 5-Dimension 5-Level (EQ-5D-5L) from time of randomization to End of Treatment Visit, death or drop out, whichever comes first.
    - Incidence and severity of treatment-emergent adverse events (TEAEs) graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v5.0
    - Plasma concentrations and the derived PK parameters of sitravatinib if data permit
    -SSP, definida como el tiempo transcurrido desde la aleatorización hasta la primera aparición de progresión de la enfermedad documentada determinada por el investigador de acuerdo con los RECIST v1.1 o la muerte por cualquier causa, lo que suceda antes
    -TRG, definida como la proporción de pacientes con respuesta parcial o respuesta completa determinada por el CRI de acuerdo con los RECIST v1.1
    -DdR, definida como el tiempo transcurrido desde la primera aparición de una respuesta objetiva documentada hasta el momento de la primera aparición de progresión de la enfermedad, determinada por el CRI de acuerdo con los RECIST v1.1, o la muerte por cualquier causa, lo que suceda antes
    -TCE, definida como la proporción de pacientes cuya mejor respuesta global (MRG) sea una respuesta completa, una respuesta parcial o enfermedad estable determinada por el CRI de acuerdo con los RECIST v1.1
    -CVRS, definida como cambios en los resultados comunicados por el paciente (RNP), de acuerdo con el cuestionario básico del cáncer (QLQ-C30) de la Organización Europea para la Investigación y el Tratamiento del Cáncer (EORTC, por sus siglas en inglés) y su módulo para el cáncer de pulmón, el QLQ-LC13, y el Cuestionario europeo de calidad de vida de 5 dimensiones y 5 niveles (EQ-5D-5L, por sus siglas en inglés) desde el momento de la aleatorización hasta la visita de fin del tratamiento, la muerte o la retirada, lo que suceda antes
    -Gradificación de la incidencia e intensidad de los acontecimientos adversos surgidos durante el tratamiento (AAST) según los Criterios terminológicos comunes para acontecimientos adversos del Instituto Nacional del Cáncer (NCI-CTCAE, por sus siglas en inglés), v5.0
    -Concentraciones plasmáticas y parámetros FC derivados del sitravatinib, si los datos lo permiten
    E.5.2.1Timepoint(s) of evaluation of this end point
    approximately 32 months
    aproximadamente 32 meses
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic 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) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    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 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) Yes
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    docetaxel
    docetaxel
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned9
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA25
    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
    Australia
    China
    United States
    France
    Netherlands
    Spain
    Germany
    Italy
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    The end of study is defined as the timepoint when the final data point is collected from the last patient in the study. This is when the last patient dies, withdraws consent, completes all study assessments, or is lost to follow-up. Alternatively, the end of study is when the sponsor decides to terminate the study.
    El final del estudio se define como el momento en que se recopila el último dato del último paciente del estudio. Esto ocurre cuando el último paciente fallece, retira su consentimiento, completa todas las evaluaciones del estudio o resulta ilocalizable para el seguimiento. Como alternativa, el final del estudio tiene lugar cuando el promotor decide finalizar el estudio.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months8
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months8
    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: 210
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 210
    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 No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    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 state36
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 45
    F.4.2.2In the whole clinical trial 420
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    At the end of study, any patients who, in the opinion of the investigator, continue to benefit from tislelizumab and/or sitravatinib at study termination will be offered the option to continue treatment in a company-sponsored clinical study until the loss of benefit, termination of the study by sponsor or the study drug(s) is commercially available in the country of the patient’s residence.
    Al final del estudio, a cualquier paciente que, en opinión del investigador, siga beneficiándose de tislelizumab o sitravatinib en el momento de la finalización del estudio se le ofrecerá la opción de continuar con el tratamiento en un estudio clínico financiado por la empresa hasta la pérdida de beneficios, la finalización del estudio por parte del promotor o hasta que los fármacos del estudio se encuentren disponibles comercialmente en el país de residencia del paciente.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2022-11-15
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-10-26
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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