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    Summary
    EudraCT Number:2022-002265-15
    Sponsor's Protocol Code Number:BO44157
    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:2022-12-21
    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 number2022-002265-15
    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
    STUDIO DI FASE II, RANDOMIZZATO, MULTICENTRICO, IN APERTO E CONTROLLATO SU RO7247669 DA SOLO O IN ASSOCIAZIONE A TIRAGOLUMAB RISPETTO AD ATEZOLIZUMAB IN PAZIENTI CON TUMORE UROTELIALE DELLA VESCICA LOCALMENTE AVANZATO O METASTATICO NON PRETRATTATO NON IDONEI A CHEMIOTERAPIA A BASE DI 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
    Studio su RO7247669 da solo o in associazione a Tiragolumab rispetto ad Atezolizumab in pazienti con tumore uroteliale della vescica localmente avanzato o metastatico non pretrattato non idonei a chemioterapia a base di platino.
    A.3.2Name or abbreviated title of the trial where available
    ND
    ND
    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 SponsorF. 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 number000000
    B.5.5Fax number000000
    B.5.6E-mailglobal.rochegenentechtrials@roche.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.2.1.1.1Trade 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.3.1Product nameTecentriq®
    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.3.9.2Current sponsor code-
    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 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: 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 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.3.9.2Current sponsor codeRO7247669
    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 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: 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 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.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
    Tumore uroteliale della vescica localmente avanzato o metastatico non pretrattato.
    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.
    Il tumore uroteliale della vescica è un tipo comune di cancro che si è diffuso dalla vescica ad altre parti del corpo causando mal di schiena, minzione dolorosa e frequente e sangue nelle urine.
    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)
    • Valutare l’efficacia di RO7247669 e RO7247669 in associazione a tiragolumab rispetto ad atezolizumab sulla base dell’ORR confermato
    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
    • Valutare l’efficacia di RO7247669 e RO7247669 in associazione a tiragolumab rispetto ad atezolizumab sulla base di PFS, OS, DOR, tasso di PFS (a 6 e 12 mesi), tasso di OS (a 6, 12 e 18 mesi) e DCR
    • Valutare la sicurezza di RO7247669 e RO7247669 in associazione a tiragolumab rispetto ad atezolizumab
    • Valutare la qualità di vita dei partecipanti trattati con RO7247669 e RO7247669 in associazione a tiragolumab rispetto ad atezolizumab
    • Caratterizzare il profilo PK di RO7247669 dopo la somministrazione di RO7247669 e RO7247669 in associazione a tiragolumab
    • Caratterizzare il profilo PK di tiragolumab dopo la somministrazione di tiragolumab in associazione a RO7247669
    • Caratterizzare il profilo PK di atezolizumab dopo la somministrazione di atezolizumab
    • Valutare la risposta immunitaria 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
    • Età >= 18 anni
    • Performance status secondo l’Eastern Cooperative Oncology Group (ECOG) <=2
    • Documentazione istologica o citologica di carcinoma a cellule di transizione (TCC) localmente avanzato o metastatico dell’epitelio di transizione
    • Mancata idoneità (ineleggibilità) al trattamento con chemioterapia a base di platino definita da uno dei seguenti criteri:
    • Performance Status secondo l’ECOG pari a 0 con GFR basale >= 15 mL/min/1,73 m2 e <= 30 mL/min/1,73 m2
    • Performance Status secondo l’ECOG pari a 1 o 2 con GFR basale >= 15 mL/min/1,73 m2 e <= 45 mL/min/1,73 m2
    • Performance status secondo l’ECOG pari a 0-2 con neuropatia di G >= 2
    • Pazienti per cui la chemioterapia non è ritenuta appropriata
    • Nessuna chemioterapia precedente per UC localmente avanzato o metastatico o recidivante inoperabile
    • Malattia misurabile; almeno una lesione misurabile in base ai criteri RECIST v1.1
    • Disponibilità di un campione tumorale residuo rappresentativo che soddisfa i criteri delineati prima dell’arruolamento nello studio e che risulta idoneo alla determinazione dello stato di PD L1, alla stratificazione e alla ricerca sui biomarcatori esplorativi secondo quanto valutato da un laboratorio centralizzato
    • Aspettativa di vita >= 12 settimane
    • Adeguata funzionalità ematologica, epatica e renale
    • Test dell’HIV negativo allo screening
    • Test negativo per l’antigene di superficie dell’epatite B (HBsAg) allo screening
    • Test positivo per l’anticorpo di superficie dell’epatite B (HBsAb) allo screening o test negativo per l’HBsAb allo screening
    • Test negativo per gli anticorpi diretti contro il virus dell’epatite C (HCV) allo screening o test positivo per gli anticorpi anti HCV seguito da un test negativo per l’HCV RNA allo screening
    • Adeguata funzione cardiovascolare
    • Intervallo QT corretto per il basale (QTcF) <= 480 ms. Se l’intervallo QTcF è superiore a 480 ms ma inferiore a 500 ms, il partecipante può essere sottoposto a una valutazione cardiaca ed essere preso in considerazione per il trattamento in assenza di evidenze clinicamente significative
    • Pressione arteriosa sistolica a riposo <= 150 mmHg e pressione arteriosa diastolica a riposo di 100 mmHg
    • Frequenza cardiaca a riposo compresa tra 45 e 100 bpm
    • Frazione di eiezione del ventricolo sinistro (LVEF) >= 50% valutata mediante ecocardiogramma transtoracico (TTE) o angiocardioscintigrafia all’equilibrio (MUGA) (TTE preferibile) nei 6 mesi precedenti l’inizio del trattamento in studio
    • Troponina T (TnT) o troponina I (TnI) <= 3 volte l’ULN del centro. I partecipanti con livelli di TnT o TnI compresi tra > 1 e < 3 volte l’ULN devono essere sottoposti a un’ulteriore valutazione della TnT o TnI entro 3 6 ore e potranno accedere allo studio solo se i livelli rimisurati rimarranno <= 3 volte l’ULN e non avranno subito modifiche > 20% rispetto alla prima analisi. Questi partecipanti devono essere anche sottoposti a una valutazione cardiaca e prendere in considerazione il consulto di un cardiologo per confermare l’assenza di evidenze clinicamente significative prima della somministrazione del trattamento in studio
    • Per le partecipanti di sesso femminile in età fertile: consenso a praticare l’astinenza dai rapporti eterosessuali o ad adottare metodi contraccettivi e consenso ad astenersi dalla donazione degli ovuli durante il periodo di trattamento e per 5 mesi dopo l’ultima dose di atezolizumab, 4 mesi dopo l’ultima dose di RO7247669 o 90 giorni dopo l’ultima dose di tiragolumab
    • Per i partecipanti di sesso maschile: consenso a praticare l’astinenza dai rapporti eterosessuali o ad adottare metodi contraccettivi e consenso ad astenersi dalla donazione del seme
    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
    • Gravidanza o allattamento o intenzione di iniziare una gravidanza durante il trattamento in studio o nei 5 mesi successivi l’ultima dose di atezolizumab, nei 4 mesi successivi l’ultima dose di RO7247669 o nei 90 giorni successivi l’ultima dose di tiragolumab
    • GFR < 15 mL/min/1,73 m2 calcolata con l’equazione CKD EPI o dialisi
    • Metastasi del sistema nervoso centrale (SNC) sintomatiche, non trattate o in progressione attiva
    • Storia di malattia leptomeningea
    • Dolore non controllato correlato al tumore
    • Versamento pleurico, versamento pericardico o ascite non controllati che necessitano di procedure ricorrenti di drenaggio
    • Ipercalcemia non controllata o sintomatica
    • Malattia autoimmune o immunodeficienza attiva o pregressa
    • Storia di fibrosi polmonare idiopatica, polmonite in organizzazione, polmonite indotta da farmaci o polmonite idiopatica, o evidenza di polmonite attiva alla TC del torace di screening
    • Tubercolosi (TBC) attiva
    • Infezione attiva da virus di Epstein Barr (EBV) o infezione cronica attiva da EBV, nota o sospetta, allo screening
    • Malattia cardiovascolare/cerebrovascolare significativa nei 3 mesi precedenti l’inizio del trattamento in studio
    • Procedura di chirurgia maggiore, per ragioni diverse dalla diagnosi, nelle 4 settimane precedenti l’inizio del trattamento in studio o necessità prevista di una procedura di chirurgia maggiore durante lo studio
    • Storia di altra neoplasia maligna primaria diversa dal carcinoma uroteliale nei 5 anni precedenti il Giorno 1 del Ciclo 1, eccetto le neoplasie maligne soggette a un rischio trascurabile di metastasi o decesso
    • Infezione severa nelle 4 settimane precedenti l’inizio del trattamento in studio
    • Trattamento con antibiotici terapeutici orali o e.v. nelle 2 settimane precedenti l’inizio del trattamento in studio
    • Precedente trapianto allogenico di cellule staminali o di organi solidi
    • Qualsiasi altra malattia, disfunzione metabolica, obiettività o risultato degli esami clinici di laboratorio che rappresenta una controindicazione all’uso di un farmaco sperimentale, che può interferire con l’interpretazione dei risultati o che può esporre il paziente ad alto rischio di complicanze del trattamento
    • Trattamento con un vaccino vivo attenuato nelle 4 settimane precedenti l’inizio del trattamento in studio o necessità prevista di un vaccino vivo attenuato durante il trattamento o nei 5 mesi successivi l’ultima dose di atezolizumab, nei 4 mesi successivi l’ultima dose di RO7247669 o nei 90 giorni successivi l’ultima dose di tiragolumab
    • Trattamento in corso con una terapia antivirale per l’HBV
    • Trattamento con qualsiasi terapia antitumorale approvata, compresa chemioterapia o terapia ormonale, nelle 3 settimane precedenti l’inizio del trattamento in studio
    • Trattamento con una terapia sperimentale nei 28 giorni precedenti l’inizio del trattamento in studio
    • Precedente trattamento con agonisti di CD137 o terapie che bloccano i checkpoint immunitari
    • Trattamento con immunostimolanti sistemici nelle 4 settimane o nelle 5 emivite di eliminazione del farmaco precedenti l’inizio del trattamento in studio.
    • Trattamento con immunosoppressori sistemici nelle 2 settimane precedenti l’inizio del trattamento in studio o necessità prevista di immunosoppressori sistemici durante il trattamento in studio
    • Storia di reazioni allergiche anafilattiche severe agli anticorpi chimerici o umanizzati, o alle proteine di fusione
    • Ipersensibilità nota ai prodotti contenenti cellule ovariche di criceto cinese o a qualsiasi componente della formulazione di atezolizumab
    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. ORR confermato, inteso come la percentuale di partecipanti che ottengono una CR o PR in due occasioni consecutive a distanza di >= 4 settimane l’una dall’altra dopo la randomizzazione, secondo quanto stabilito dallo sperimentatore in base ai criteri RECIST v1.1
    E.5.1.1Timepoint(s) of evaluation of this end point
    1. Up to approximately 30 months for each individual
    1. Fino a circa 30 mesi per ciascun 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. PFS dopo la randomizzazione, intesa come il tempo intercorso dalla randomizzazione alla prima comparsa di progressione della malattia o al decesso per qualsiasi causa (a seconda della circostanza che si verifichi per prima), secondo quanto stabilito dallo sperimentatore in base ai criteri RECIST v1.1
    2. OS dopo la randomizzazione, intesa come il tempo intercorso dalla randomizzazione al decesso per qualsiasi causa
    3. DOR, intesa come il tempo intercorso dalla prima comparsa di una risposta obiettiva documentata alla progressione della malattia o al decesso per qualsiasi causa (a seconda della circostanza che si verifichi per prima), secondo quanto stabilito dallo sperimentatore in base ai criteri RECIST v1.1
    4. Tasso di PFS a 6 e 12 mesi, inteso come la percentuale di partecipanti non andati incontro a progressione della malattia o decesso per qualsiasi causa, secondo quanto stabilito dallo sperimentatore in base ai criteri RECIST v1.1
    5. Tasso di OS a 6, 12 e 18 mesi, inteso come la percentuale di partecipanti non andati incontro a decesso per qualsiasi causa a 6, 12 e 18 mesi
    6. DCR, inteso come la percentuale di partecipanti che ottengono come migliore risposta una CR o PR confermata o in cui la malattia si mantiene stabile per >= 12 settimane secondo i criteri RECIST v1.1
    7. Incidenza e severità degli eventi avversi, con severità stabilita in base ai criteri NCI CTCAE v5
    8. TTCD dalla randomizzazione nelle scale relative a dolore, attività fisica, ruolo e GHS/QoL riferiti dai pazienti, valutate tramite il questionario EORTC IL187; per peggioramento confermato si intende una riduzione >= 10 punti rispetto al basale (nelle scale relative ad attività fisica, ruolo e GHS/QoL) o un aumento >= 10 punti rispetto al basale (nella scala relativa al dolore) che si mantiene per due valutazioni consecutive o è seguito da decesso per qualsiasi causa entro 3 settimane
    9. Media e variazione media rispetto al basale nelle scale relative a dolore, attività fisica, ruolo e GHS/QoL riferiti dai pazienti, valutate tramite il questionario EORTC IL187
    10. Concentrazione massima di RO7247669
    11. Tempo alla concentrazione massima di RO7247669
    12. Clearance di RO7247669
    13. Volume di distribuzione allo stato stazionario di RO7247669
    14. Area sottesa alla curva di RO7247669
    15. Emivita di RO7247669
    16. Campionamento ridotto per l’analisi PK di tiragolumab in specifici punti temporali
    17. Campionamento ridotto per l’analisi PK di atezolizumab in punti temporali specifici
    18. Incidenza di ADA anti RO7247669
    19. Impatto degli ADA anti RO7247669 su esposizione, attività e sicurezza
    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. Fino a circa 30 mesi
    4. A 6 e 12 mesi
    5. A 6, 12, e 18 mesi
    6. Fino a 12 settimane
    7. FIno a 90 giorni dopo la dose finale del trattamento in studio
    8.Dal basale fino a 3 settimane
    9. Dal basale al Giorno 1 dei Cicli 1, 2, 4, 5, 6, Visita di interruzione precoce e Follow-up a lungo termine
    10-15. Ai Giorni 1, 8, e 15 del Ciclo 1, GIorno 1 di ogni ciclo dopo il CIclo 1, GIorni 8 e 15 del Ciclo 5, alla progressione di malattia o alla Visita di fine trattamento (se i campioni non sono stati ancora raccolti al momento della progressione di malattia).
    16-17. Al Giorno 1 dei Cicli 1, 2, 3, 4, 8, 12, 16, e alla visita di fine trattamento
    18-19. Al Giorno 1 di ogni ciclo e alla visita di fine trattamento
    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 concerned9
    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 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
    Australia
    Brazil
    China
    Korea, Republic of
    Mexico
    United States
    France
    Poland
    Spain
    Germany
    Greece
    Italy
    Denmark
    Turkey
    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
    Si considera che un partecipante abbia completato lo studio se lui o lei ha completato tutte la fasi dello studio, incluse l'ultima visita/le ultime procedure previste, come da programma delle attività (vedi Sez. 1.3, Tabella 1 nel Protocollo). E' previsto che la fine dello studio si verifichi circa 30 mesi dopo l'arruolamento dell'ultimo partecipante.
    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 state27
    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.
    Lo Sponsor offirà gratuitamente continuità di accesso agli IMP Roche (atezolizumab, RO7247669, etiragolumab) ai partecipanti eleggibili in accordo alla Policy Globale di Roche sulla continuità di accesso all’IMP, come delineato nella sezione 6.6 del protocollo di studio.
    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 Decision2023-02-24
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-12-21
    P. End of Trial
    P.End of Trial StatusOngoing
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