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    Summary
    EudraCT Number:2022-002265-15
    Sponsor's Protocol Code Number:BO44157
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2023-01-16
    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 number2022-002265-15
    A.3Full title of the trial
    A PHASE II, RANDOMIZED, MULTICENTER, OPEN LABEL, CONTROLLED STUDY OF RO7247669 ALONE OR IN COMBINATION WITH TIRAGOLUMAB VERSUS ATEZOLIZUMAB IN PATIENTS WITH PREVIOUSLY UNTREATED LOCALLY ADVANCED OR METASTATIC UROTHELIAL BLADDER CANCER WHO ARE INELIGIBLE FOR PLATINUM-CONTAINING CHEMOTHERAPY
    ESTUDIO DE FASE II MULTICÉNTRICO, ALEATORIZADO, ABIERTO, CONTROLADO DE RO7247669 ADMINISTRADO SOLO O EN COMBINACIÓN CON TIRAGOLUMAB FRENTE A ATEZOLIZUMAB EN PACIENTES CON CARCINOMA UROTELIAL LOCALMENTE AVANZADO O METASTÁSICO, NO TRATADOS PREVIAMENTE, QUE NO SON APTOS PARA RECIBIR QUIMIOTERAPIA BASADA EN PLATINO
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Study of RO7247669 Alone or in Combination with Tiragolumab Versus Atezolizumab in Patients with Previously Untreated Locally Advanced or Metastatic Urothelial Bladder Cancer who are Ineligible for Platinum-Containing Chemotherapy
    Estudio de RO7247669 administrado Solo o en combinación con Tiragolumab frente a Atezolizumab en Pacientes Con Carcinoma Urotelial Localmente Avanzado O Metastásico, no Tratados Previamente, que no son aptos para recibir quimioterapia basada en platino
    A.4.1Sponsor's protocol code numberBO44157
    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 SponsorRoche Farma S. A. U. que realiza el ensayo en España y que actúa como representante F. Hoffmann-La Roche Ltd
    B.1.3.4CountrySwitzerland
    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 supportF. Hoffmann-La Roche Ltd
    B.4.2CountrySwitzerland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationF. Hoffmann-La Roche Ltd
    B.5.2Functional name of contact pointTrial Information Support Line-TISL
    B.5.3 Address:
    B.5.3.1Street AddressGrenzacherstrasse 124
    B.5.3.2Town/ cityBasel
    B.5.3.3Post code4070
    B.5.3.4CountrySwitzerland
    B.5.4Telephone number+34913257300
    B.5.5Fax number+34913248196
    B.5.6E-mailspain.start_up_unit@roche.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 namePD1-LAG3
    D.3.2Product code RO7247669/F01-01
    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 INNN/A
    D.3.9.3Other descriptive nameRO7247669
    D.3.9.4EV Substance CodeSUB272860
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 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.2.1.1.1Trade name Tecentriq®
    D.2.1.1.2Name of the Marketing Authorisation holderRoche Registration GmbH
    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.3.2Product code RO5541267/F03-01
    D.3.4Pharmaceutical form Concentrate 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 INNAtezolizumab
    D.3.9.1CAS number 1380723-44-3
    D.3.9.3Other descriptive nameAtezolizumab
    D.3.9.4EV Substance CodeSUB178312
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number60
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation 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 nametiragolumab
    D.3.2Product code RO7092284/F03-01
    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 INNTiragolumab
    D.3.9.1CAS number 1918185-84-8
    D.3.9.2Current sponsor codeRO7092284
    D.3.9.4EV Substance CodeSUB197861
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number60
    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.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
    Previously Untreated Locally Advanced or Metastatic Urothelial Bladder Cancer
    Carcinoma Urotelial Localmente Avanzado O Metastásico, no Tratados Previamente
    E.1.1.1Medical condition in easily understood language
    Urothelial Bladder Cancer is common type of cancer that has spread outside of the bladder to other parts of the body, this causes back pain, painful urination, frequent urination, and blood in urine.
    El cáncer urotelial de vejiga es un tipo común de cáncer que se ha diseminado fuera de la vejiga a otras partes del cuerpo, causa dolor de espalda, dolor al orinar, micción frecuente y sangre en orina
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10046714
    E.1.2Term Urothelial carcinoma bladder
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    • To evaluate the efficacy of RO7247669 and RO7247669 in combination with tiragolumab compared to atezolizumab on the basis of confirmed objective response rate (ORR)
    Evaluar la eficacia de RO7247669 cuando se administra solo y en combinación con tiragolumab comparado con atezolizumab en base a la tasa de respuesta objetiva confirmada (TRO)
    E.2.2Secondary objectives of the trial
    • To evaluate the efficacy of RO7247669 and RO7247669 in combination with tiragolumab compared to atezolizumab on the basis of PFS, OS, DOR, PFS rate (6 and 12 months), OS rate (6, 12 and 18 months) and DCR
    • To evaluate the safety of RO7247669 and RO7247669 in combination with tiragolumab compared to atezolizumab
    • To evaluate the quality of life of participants treated with RO7247669 and RO7247669 in combination with tiragolumab compared to atezolizumab
    • To characterize the RO7247669 PK profile after administration of RO7247669 and RO7247669 in combination with tiragolumab
    • To characterize the PK profile of tiragolumab after administration of tiragolumab in combination with RO7247669
    • To characterize the PK profile of atezolizumab after administration of atezolizumab
    • To evaluate the immune response to RO7247669
    -Evaluar la eficacia de RO7247669 cuando se administra solo y en combinación con RO7247669 comparado con atezolizumab basado en SPL, SG, DR, tasa de SLP (a los 6 y 12 meses), tasa de SG (s los 6, 12 y 18 meses y TCE
    - Evaluar la seguridad de RO7247669 cuando se administra solo y en combinación con tiragolumab comparado con atezolizumab
    - Evaluar la calidad de vida de los participantes tratados con RO7247669 solo o en combinación con tiragolumab comparado con atezolizumab
    - Definir el perfil FC de RO7247669 después de su administración como agente único y en combinación con tiragolumab
    - Definir el perfil FC de tiragolumab después de su administración de tiragolumab en combinación con RO7247669
    - Definir el perfil FC de atezolizumab después de su administración
    - Evaluar la respuesta inmune a RO7247669
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    • Age >= 18 years
    • Eastern Cooperative Oncology Group (ECOG) Performance Status of <= 2
    • Histologically or cytologically documented locally advanced or metastatic transitional cell carcinoma (TCC) of the urothelium
    • Considered to be ineligible ("unfit") to receive platinum-based chemotherapy defined by one of the following criteria:
    • ECOG Performance Status of 0 with baseline GFR ≥ 15 mL/min/1.73 m2 and ≤30 mL/min/1.73 m2
    • ECOG Performance Status of 1 or 2 with baseline GFR ≥ 15 mL/min/1.73 m2 and ≤ 45 mL/min/1.73 m2
    • ECOG Performance Status of 0-2 with G≥2 neuropathy
    • Patients for whom chemotherapy is not deemed appropriate
    • No prior chemotherapy for inoperable locally advanced or metastatic or recurrent urothelial carcinoma (UC)
    • Measurable disease; at least one measurable lesion as defined by response evaluation criteria in solid tumors, version 1.1 (RECIST v1.1)
    • Availability of a representative leftover tumor specimen that meet the criteria outlined prior to study enrollment, and that is suitable for determination of programmed death-ligand 1 (PD-L1) status, for stratification and for exploratory biomarker research as assessed by a central laboratory
    • Life expectancy >= 12 weeks
    • Adequate hematologic and end-organ function
    • Negative human immunodeficiency virus (HIV) test at screening
    • Negative hepatitis B surface antigen (HBsAg) test at screening
    • Positive hepatitis B surface antibody (HBsAb) test at screening, or a negative HBsAb at screening
    • Negative hepatitis C virus (HCV) antibody test at screening, or a positive HCV antibody test followed by a negative HCV ribonucleic acid (RNA) test at screening
    • Adequate cardiovascular function
    • Baseline-corrected QT (QTcF) interval <= 480 ms. If the QTcF interval is longer than 480 ms but shorter than 500 ms, the participant may undergo a cardiac evaluation and be considered for treatment in case of no clinically significant findings
    • Resting systolic blood pressure <= 150 mmHg and diastolic blood pressure 100 mmHg
    • Resting heart rate between 45-100 bpm
    • Left ventricular ejection fraction (LVEF) >= 50% assessed by either transthoracic echocardiogram (TTE) or multiple-gated acquisition (MUGA) scan (TTE preferred test) within 6 months prior to initiation of study treatment
    • Troponin T (TnT) or troponin I (TnI) <= 3 x institutional upper limit of normal (ULN). Participants with TnT or TnI levels between >1 and <3 x ULN should have a further TnT or TnI reading within 3-6 hours and will be permitted to enter the study only if repeat levels remain ≤ 3 x ULN and have not changed by > 20% compared to the first reading. These participants should also undergo a cardiac evaluation and consider consulting a cardiologist to confirm no clinically significant findings before they receive study treatment
    • For female participants of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraception and agreement to refrain from donating eggs during the treatment period and for 5 months after the final dose of atezolizumab, 4 months after the final dose of RO7247669, or 90 days after the final dose of tiragolumab
    • For male participants: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods, and agreement to refrain from donating sperm
    -Tener >=18 años
    - Estado funcional ECOG <= 2
    -Presentar carcinoma urotelial (CU) localmente avanzado o metastásico documentado histológica o citológicamente
    -Deben considerarse no elegibles (“no aptos”) para recibir quimioterapia basada en platino, basándose en uno de los siguientes criterios:
    • Estado funcional ECOG 0 con VSG basal >= 15 ml/min/1,73 m2 y <= 30 ml/min/1,73 m2
    • Estado funcional ECOG 1 o 2 con VSG basal >= 15 ml/min/1,73 m2 y <= 45 ml/min/1,73 m2
    • Estado funcional ECOG 0-2 con neuropatía de grado >= 2
    • Pacientes para los que la quimioterapia no se considera apropiada
    -No haber recibido previamente quimioterapia para CU localmente avanzado inoperable o metastásico o recurrente
    -Enfermedad medible; debe haber al menos una lesión medible definida de acuerdo con los criterios RECIST v1.1
    -Disponibilidad de una muestra de tumor representativa sobrante que cumpla los criterios descritos en la Sección 8.7 antes de la inclusión en el estudio y que sea adecuada para la determinación del estado de PD-L1, así como para la estratificación y la investigación exploratoria de biomarcadores, evaluada por un laboratorio central
    -Esperanza de vida >= 12 semanas
    - Función hematológica y de órganos diana adecuada
    -Prueba de VIH negativa en el período de selección
    -Prueba negativa del antígeno de superficie de la hepatitis B (HBsAg) en el período de selección
    -Prueba positiva para anticuerpos de superficie del virus de la hepatitis B (HBsAb) en el período de selección o HBsAb negativa en screening
    - Prueba negativa para anticuerpos contra el virus de la hepatitis C (VHC) en el período de selección o si es positiva, deberá realizarse una prueba de ARN del VHC en dicho período y el resultado debe ser negativo
    -Función cardiovascular adecuada
    - Intervalo QT corregido en función del valor basal (QTcF) <= 480 ms. Si el intervalo QTcF del participante es > 480 ms, pero < 500 ms, se puede realizar una evaluación cardíaca y considerar un tratamiento en caso de que no se observen hallazgos clínicamente significativos
    - Presión arterial en reposo <= 150 mm Hg (sistólica) y 100 mm Hg (diastólica
    - Frecuencia cardíaca en reposo entre 45 y 100 lpm
    - Fracción de eyección del ventrículo izquierdo (FEVI) >= 50% valorada con ecocardiograma transtorácico (ETT) o angiografía radioisotópica (el ETT es la opción preferida) en los 6 meses previos al inicio del tratamiento del estudio
    - Troponina T (TnT) o troponina I (TnI) <= 3 xLSN del centro. En los participantes con niveles de TnT o TnI entre > 1 y <3 xLSN, se repetirá la determinación en el transcurso de 3 a 6 horas y se les permitirá ser incluidos en el estudio únicamente si esta determinación muestra que los niveles siguen siendo <= 3 x LSN y no han variado > 20% en comparación con la primera determinación. En estos casos, se realizará también una evaluación cardíaca y se considerará una consulta con un cardiólogo para confirmar la ausencia de hallazgos clínicamente significativos antes de que estos pacientes reciban el tratamiento del estudio.
    - Las mujeres potencialmente fértiles deben comprometerse a practicar la abstinencia sexual (es decir, abstenerse de mantener relaciones heterosexuales) o usar métodos anticonceptivos, así como a no donar óvulos durante el período de tratamiento y hasta 5 meses después de la administración de la última dosis de atezolizumab, 4 meses después de la última dosis de RO7247669 o 90 días después de la última dosis de tiragolumab
    - Los varones participantes deben comprometerse a practicar la abstinencia sexual (es decir, abstenerse de mantener relaciones heterosexuales) o usar métodos anticonceptivos, así como a no donar semen
    E.4Principal exclusion criteria
    • Pregnancy or breastfeeding, or intention of becoming pregnant during study treatment or within 5 months after the final dose of atezolizumab, 4 months after the final dose of RO7247669, or 90 days after the final dose of tiragolumab
    • Glomerular filtration rate (GFR) < 15 mL/min/1.73 m2 as calculated through use of the chronic kidney disease epidemiology collaboration (CKD-EPI) equation or receiving dialysis
    • Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases
    • History of leptomeningeal disease
    • Uncontrolled tumor-related pain
    • Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures
    • Uncontrolled or symptomatic hypercalcemia
    • Active or history of autoimmune disease or immune deficiency
    • History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan
    • Active tuberculosis (TB)
    • Active Epstein-Barr virus (EBV) infection or known or suspected chronic active EBV infection at screening
    • Significant cardiovascular/cerebrovascular disease within 3 months prior to initiation of study treatment
    • Major surgical procedure, other than for diagnosis, within 4 weeks prior to initiation of study treatment, or anticipation of need for a major surgical procedure during the study
    • History of another primary malignancy other than urothelial carcinoma within 5 years prior to Cycle 1, Day 1, with the exception of malignancies with a negligible risk of metastasis or death
    • Severe infection within 4 weeks prior to initiation of study treatment
    • Treatment with therapeutic oral or intravenous antibiotics within 2 weeks prior to initiation of study treatment
    • Prior allogeneic stem cell or solid organ transplantation
    • Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding that contraindicates the use of an investigational drug, may affect the interpretation of the results, or may render the patient at high risk from treatment complications
    • Treatment with a live, attenuated vaccine within 4 weeks prior to initiation of study treatment, or anticipation of need for such a vaccine during treatment or within 5 months after the final dose of atezolizumab, 4 months after the final dose of RO7247669, or 90 days after the final dose of tiragolumab
    • Current treatment with anti-viral therapy for HBV
    • Treatment with any approved anti-cancer therapy, including chemotherapy or hormonal therapy, within 3 weeks prior to initiation of study treatment
    • Treatment with investigational therapy within 28 days prior to initiation of study treatment
    • Prior treatment with CD137 agonists or immune checkpoint blockade therapies
    • Treatment with systemic immunostimulatory agents within 4 weeks or 5 drug-elimination half-lives prior to initiation of study treatment
    • Treatment with systemic immunosuppressive medication within 2 weeks prior to initiation of study treatment, or anticipation of need for systemic immunosuppressive medication during study treatment
    • History of severe allergic anaphylactic reactions to chimeric or humanized antibodies or fusion proteins
    • Known hypersensitivity to Chinese hamster ovary cell products or to any component of the atezolizumab formulation
    -Participantes que estén embarazadas o en período de lactancia o que tengan intención de quedarse embarazadas durante el tratamiento del estudio o en los 5 meses siguientes a la administración de la última dosis de atezolizumab o hasta 4 meses después de última dosis de RO7247669 o 90 días después de la última dosis de tiragolumab
    -VSG < 15 ml/min/1,73 m2 calculada mediante la fórmula CKD-EPI o pacientes sometidos a diálisis
    - Metástasis en sistema nervioso central (SNC) sintomáticas, no tratadas o en progresión activa
    -Antecedentes de enfermedad leptomeníngea
    - Dolor relacionado con el tumor no controlado
    -Derrame pleural, derrame pericárdico o ascitis no controlados que requieran procedimientos de drenaje frecuentes
    -Hipercalcemia no controlada o sintomática
    -Enfermedades autoinmunes o inmunodeficiencias en el pasado o activas
    -Antecedentes de fibrosis pulmonar idiopática, neumonía organizada (p. ej., bronquiolitis obliterante), neumonitis inducida por fármacos o neumonitis idiopática, o evidencia de neumonitis activa en la tomografía computarizada (TC) de tórax realizada en el período de selección
    -Tuberculosis (TB) activa
    -Infección por virus de Epstein-Barr (VEB) activa o infección por VEB crónica activa, conocida o presuntiva, en el período de selección
    -Enfermedad cardiovascular/cerebrovascular significativa en los 3 meses previos al inicio del tratamiento del estudio
    -Procedimientos de cirugía mayor que no sean con fines diagnósticos en las 4 semanas previas al inicio del tratamiento del estudio o que previsiblemente sean necesarios durante el estudio
    -Antecedentes de otras neoplasias malignas primarias que no sean carcinoma urotelial en los 5 años previos al día 1 del ciclo 1, exceptuando aquellas que tengan un riesgo insignificante de metástasis o muerte
    -Infecciones graves en las 4 semanas previas al inicio del tratamiento del estudio
    -Administración por vía oral o IV de antibióticos con fines terapéuticos en las 2 semanas previas al inicio del tratamiento del estudio
    -Pacientes sometidos previamente a trasplante alogénico de células madre o trasplante de órganos sólidos
    -Cualquier otra enfermedad, trastorno metabólico, hallazgo de la exploración física o de las pruebas de laboratorio clínico que contraindiquen el uso de un fármaco en investigación, puedan afectar a la interpretación de los resultados o implicar para el paciente un riesgo alto de complicaciones relacionadas con el tratamiento
    - Administración de una vacuna viva atenuada en las 4 semanas previas al inicio del tratamiento del estudio o que sea previsiblemente necesaria durante el tratamiento, así como en los 5 meses siguientes a la última dosis de atezolizumab, los 4 meses siguientes a la última dosis de RO7247669 o los 90 días siguientes a la última dosis de tiragolumab
    - Tratamiento antiviral para VHB en la actualidad
    -Administración de cualquier tratamiento antineoplásico aprobado, incluyendo quimioterapia u hormonoterapia, en las 3 semanas previas al inicio del tratamiento del estudio
    -Administración de un tratamiento experimental en los 28 días previos al inicio del tratamiento del estudio
    - Tratamiento previo con agonistas de CD137 o inhibidores de puntos de control inmunitario
    -Tratamiento con agentes inmunoestimuladores sistémicos en las 4 semanas previas al inicio del tratamiento del estudio o durante el equivalente a 5 semividas de eliminación del fármaco en ese período
    -Tratamiento con medicaciones inmunosupresoras sistémicas en las 2 semanas previas al inicio del tratamiento del estudio o que se requiera previsiblemente durante el mismo
    -Antecedentes de reacciones alérgicas anafilácticas graves a anticuerpos quiméricos o humanizados o a proteínas de fusión
    - Hipersensibilidad conocida a productos elaborados con células de ovario de hámster chino o a cualquiera de los componentes de la formulación
    E.5 End points
    E.5.1Primary end point(s)
    1. Confirmed ORR, defined as the proportion of participants with a complete response (CR) or partial response (PR) on two consecutive occasions >= 4 weeks apart after randomization, as determined by the investigator according to RECIST v1.1
    1. TRO confirmada, que se define como el porcentaje de participantes que presentan Respuesta completa (RC) o Respuesta parcial (RP) en dos ocasiones consecutivas con >= 4 semanas de diferencia después de la aleatorización, determinada por el investigador de acuerdo con los criterios RECIST v1.11
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 30 months for each individual
    1. Hasta aproximadamente 30 meses para cada individuo
    E.5.2Secondary end point(s)
    1. Progression-free survival (PFS) after randomization defined as the time from randomization to the first occurrence of disease progression or death from any cause (whichever occurs first), as determined by the investigator according to RECIST v1.1
    2. Overall survival (OS) after randomization, defined as the time from randomization to death from any cause
    3. Duration of response (DOR), defined as the time from the first occurrence of a documented objective response to disease progression or death from any cause (whichever occurs first), as determined by the investigator according to RECIST v1.1
    4. PFS rate at 6 months and 12 months, defined as the proportion of participants who have not experienced disease progression or death from any cause as determined by the investigator according RECIST v1.1
    5. OS rate at 6 months, 12 months, and 18 months, defined as the proportion of participants who have not experienced death from any cause at 6 months, 12 months, and 18 months
    6. Disease control rate (DCR), defined as the proportion of participants with confirmed CR or PR as best response, or stable disease maintained for >= 12 weeks, per RECIST v1.1
    7. Incidence and severity of adverse events, with severity determined according to national cancer institute common terminology criteria for adverse events, version 5.0 (NCI CTCAE v5)
    8. Time to confirmed deterioration (TTCD) from randomization, in patient-reported pain, physical functioning, role functioning, and global health status (GHS)/ quality of life (QoL) scales as assessed through use of the european organisation for research and treatment of cancer (EORTC) item library (IL) 187; confirmed deterioration is defined as a decrease from baseline of >= 10 points (for the physical functioning, role functioning, and GHS/QoL scales) or an increase from baseline of >= 10 points (for the pain scale) that is either maintained for two consecutive assessments or followed by death from any cause within 3 weeks
    9. Mean and mean change from baseline in patient-reported pain, physical functioning, role functioning, and GHS/QoL scales as assessed through use of the EORTC IL187
    10. Maximum concentration of RO7247669
    11. Time of maximum concentration of RO7247669
    12. Clearance of RO7247669
    13. Volume of distribution at steady state of RO7247669
    14. Area under the curve of RO7247669
    15. Half-life of RO7247669
    16. Sparse pharmacokinetic (PK) of tiragolumab at specified timepoints
    17. Sparse PK of atezolizumab at specified timepoints
    18. Incidence of anti-drug antibodies (ADAs) to RO7247669
    19. Impact of ADAs to RO7247669 on exposure, activity, and safety
    1. supervivencia libre de progresión (SLP) después de la aleatorización, que se define como el tiempo transcurrido desde la aleatorización hasta el primer episodio de progresión de la enfermedad o la muerte por cualquier causa (lo que ocurra primero), determinada por el investigador de acuerdo con los criterios RECIST v1.1
    2. Supervivencia global (SG) después de la aleatorización, que se define como el tiempo transcurrido desde la aleatorización hasta la muerte por cualquier causa
    3. Duración de la respuesta (DR), que se define como el tiempo transcurrido desde que se documenta por primera vez una respuesta objetiva hasta la progresión de la enfermedad o la muerte por cualquier causa (lo que ocurra primero), determinada por el investigador de acuerdo con los criterios RECIST v1.1
    4. Tasa de supervivencia libre de progresión (SLP) a 6 y 12 meses, que se define como el porcentaje de participantes que no han manifestado progresión de la enfermedad o fallecido por cualquier causa, determinada por el investigador de acuerdo con los criterios RECIST v1.1
    5. Tasa de SG a 6, 12 y 18 meses, que se define como el porcentaje de participantes que no han fallecido por cualquier causa a los 6, 12 y 18 meses
    6. Tasa de control de la enfermedad (TCE), que se define como el porcentaje de participantes cuya mejor respuesta es RC o RP confirmada o con estabilización de la enfermedad mantenida durante >= 12 semanas, de acuerdo con los criterios RECIST v1.1
    7. Incidencia y severidad de los acontecimientos adversos, utilizando los criterios NCI CTCAE v5 para determinar el grado de severidad
    8. Tiempo hasta el deterioro confirmado (TDC) desde la aleatorización en las escalas de dolor, función física, función de rol y ESG/CV, reportados por el paciente, evaluado mediante el EORTC IL187; el deterioro confirmado se define como una disminución de >= 10 puntos (en las escalas de función física, función de rol y ESG/CV) o un aumento de >= 10 puntos (en la escala de dolor) respecto al valor basal, que se mantiene en dos evaluaciones consecutivas o va seguido de la muerte por cualquier causa en el transcurso de 3 semanas
    9. Media y variación media respecto al valor basal en las escalas de dolor, función física, función de rol y ESG/CV, reportados por el paciente, evaluadas mediante el EORTC IL187
    10. Concentración máxima RO7247669
    11. Tiempo de la concentración máxima RO7247669
    12. Aclaramiento RO7247669
    13. Volumen de distribución en estado estacionario RO7247669
    14. Área bajo la curva RO7247669
    15. Semivida RO7247669
    16. FC de tiragolumab en muestras dispersas en momentos específicos
    17. FC de atezolizumab en muestras dispersas en momentos específicos
    18. Incidencia de anticuerpos antifármaco (ADA) RO7247669
    19. Influencia de los ADA RO7247669 en la exposición, actividad y seguridad
    E.5.2.1Timepoint(s) of evaluation of this end point
    1-3. Up to approximately 30 months
    4. At 6 and 12 months
    5. At 6, 12, and 18 months
    6. Up to 12 weeks
    7. Until 90 days after the final dose of study treatment
    8. From baseline up to 3 weeks
    9. From baseline at Day 1 of Cycles 1, 2, 4, 5, 6, Early Discontinuation Visit and Long-Term Follow-Up
    10-15. At Days 1, 8, and 15 of Cycle 1, Day 1 of every cycle after Cycle 1, Days 8 and 15 of Cycle 5, at time of disease progression or at the End of treatment visit (if samples were not already collected at time of disease progression).
    16-17. At Day 1 of Cycles 1, 2, 3, 4, 8, 12, 16, and at the End of treatment visit
    18-19. At Day 1 of every cycle and at the End of treatment visit
    1-3. Hasta aproximadamente 30 meses
    4. A los 6 y 12 meses
    5. A los 6, 12 y 18 meses
    6. Hasta 12 semanas
    7. Hasta 90 días después de la dosis final del tratamiento del estudio
    8. Desde el momento basal hasta 3 semanas
    9. Desde el momento basal en el día 1 de los ciclos 1, 2, 4, 5, 6, visita de interrupción temprana y seguimiento a largo plazo
    10-15 En los días 1, 8 y 15 del ciclo 1, día 1 de cada ciclo después del ciclo 1, días 8 y 15 del ciclo 5, en el momento de la progresión de la enfermedad o en la visita de final de tratamiento (si las muestras no se recogieron ya en el momento de la progresión de la enfermedad).
    16-17 En el día 1 de los ciclos 1, 2, 3, 4, 8, 12, 16, y en la visita de final de tratamiento
    18-19 En el día 1 de cada ciclo y en la visita de final de tratamiento
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled 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 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 concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA30
    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
    Brazil
    China
    Korea, Republic of
    United States
    France
    Poland
    Spain
    Germany
    Greece
    Italy
    United Kingdom
    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
    A participant is considered to have completed the study if he or she has completed all phases of the study, including the last visit/last scheduled procedure shown in the schedule of activities (see Section 1.3, Table 1 in the Protocol). The end of the study is expected to occur approximately 30 months after the last participant is enrolled
    Se considera que un participante ha completado el estudio si ha completado todas las fases del estudio, incluida la última visita/último procedimiento programado que se muestra en el calendario de actividades (véase la Sección 1.3, Tabla 1 del Protocolo). Se espera que el final del estudio ocurra aproximadamente 30 meses después de que se randomice el último participante.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months0
    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: 120
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 120
    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 state24
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 120
    F.4.2.2In the whole clinical trial 240
    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)
    The Sponsor will offer continued access to Roche IMPs (atezolizumab, RO7247669, and tiragolumab) free of charge to eligible participants in accordance with the Roche Global Policy on Continued Access to Investigational Medicinal Product, as outlined in section 6.6 of the study protocol.
    El promotor ofrecerá acceso continuo a los PEI de Roche (atezolizumab, RO7247669 y tiragolumab) de forma gratuita a los participantes elegibles de acuerdo con la Política global de Roche sobre el acceso continuo al medicamento en investigación, como se describe en la sección 6.6 del protocolo del estudio.
    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 Decision2023-03-23
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2023-03-21
    P. End of Trial
    P.End of Trial StatusOngoing
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