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    Summary
    EudraCT Number:2022-002540-42
    Sponsor's Protocol Code Number:XPORT-EC-042
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2022-10-19
    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 number2022-002540-42
    A.3Full title of the trial
    A PHASE 3, RANDOMIZED, PLACEBO-CONTROLLED, DOUBLE-BLIND, MULTICENTER TRIAL OF SELINEXOR IN MAINTENANCE THERAPY AFTER SYSTEMIC THERAPY FOR PATIENTS WITH P53 WILD-TYPE, ADVANCED OR RECURRENT ENDOMETRIAL CARCINOMA
    ENSAYO DE FASE III, MULTICÉNTRICO, ALEATORIZADO, CONTROLADO CON PLACEBO Y CON DOBLE ENMASCARAMIENTO SOBRE EL TRATAMIENTO DE MANTENIMIENTO CON SELINEXOR TRAS UN TRATAMIENTO SISTÉMICO EN PACIENTES CON CARCINOMA ENDOMETRIAL AVANZADO O RECURRENTE SIN MUTACIONES EN LA PROTEÍNA P53
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A MULTICENTER TRIAL OF SELINEXOR IN MAINTENANCE THERAPY FOR PATIENTS WITH ENDOMETRIAL CARCINOMA
    ENSAYO MULTICÉNTRICO DE SELINEXOR COMO TERAPIA DE MANTENIMIENTO PARA PACIENTES CON CÁNCER DE ENDOMETRIO
    A.3.2Name or abbreviated title of the trial where available
    XPORT-EC
    XPORT-EC
    A.4.1Sponsor's protocol code numberXPORT-EC-042
    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 SponsorKaryopharm Therapeutics Inc.
    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 supportKaryopharm Therapeutics Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationSofpromed Investigación Clínica SLU
    B.5.2Functional name of contact pointPatricio Javier Ledesma
    B.5.3 Address:
    B.5.3.1Street AddressC/ Gran Vía Asima 20 - 3rd Floor - Office 23
    B.5.3.2Town/ cityPalma de Mallorca
    B.5.3.3Post code07009
    B.5.3.4CountrySpain
    B.5.4Telephone number0034971439 900
    B.5.5Fax number0034971570 222
    B.5.6E-mailensayos@sofpromed.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 Yes
    D.2.1.1.1Trade name NEXPOVIO
    D.2.1.1.2Name of the Marketing Authorisation holderStemline Therapeutics B.V.
    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 nameSelinexor
    D.3.2Product code KPT-330
    D.3.4Pharmaceutical form Coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNSelinexor
    D.3.9.2Current sponsor codeKPT-330
    D.3.9.3Other descriptive nameSELINEXOR
    D.3.9.4EV Substance CodeSUB177942
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    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.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCoated tablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Selinexor/placebo will be given as maintenance therapy after combination chemotherapy for patients with p53 wild-type, advanced or recurrent endometrial cancer
    Selinexor/placebo se administrará como terapia de mantenimiento después de la quimioterapia combinada para pacientes con cáncer de endometrio avanzado o recurrente de tipo p53 salvaje
    E.1.1.1Medical condition in easily understood language
    Selinexor/placebo will be given as maintenance therapy after combination chemotherapy for patients with endometrial cancer
    Selinexor/placebo se administrará como terapia de mantenimiento después de la quimioterapia combinada para pacientes con cáncer de endometrio
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level PT
    E.1.2Classification code 10014733
    E.1.2Term Endometrial cancer
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10014734
    E.1.2Term Endometrial cancer metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level PT
    E.1.2Classification code 10014736
    E.1.2Term Endometrial cancer recurrent
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate the efficacy of selinexor compared to placebo as maintenance therapy
    Evaluar la eficacia de selinexor frente a placebo como terapia de mantenimiento
    E.2.2Secondary objectives of the trial
    To compare overall OS in selinexor and placebo arms
    To evaluate the safety and tolerability of selinexor
    To compare selinexor and placebo for time to first subsequent therapy
    To compare selinexor and placebo for time to second subsequent therapy
    To compare selinexor and placebo for time until second progression
    To assess the efficacy of selinexor compared to placebo, as assessed by a blinded independent central review (BICR)
    To evaluate health-related quality of life (HR-QoL) outcomes
    Comparar la SG en los brazos de selinexor y placebo
    Evaluar la seguridad y la tolerabilidad de selinexor
    Comparar selinexor frente a placebo en el tiempo transcurrido hasta el primer tratamiento posterior (TPTP)
    Comparar selinexor frente a placebo en el tiempo transcurrido hasta el segundo tratamiento posterior (TSTP)
    Comparar selinexor y placebo en el tiempo transcurrido hasta la segunda progresión
    Evaluar la eficacia del selinexor en comparación con placebo según lo determinado por una evaluación central independiente enmascarada (ECIE)
    Evaluar los resultados de la calidad de vida relacionada con la salud (CVRS)
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. At least 18 years of age at the time of signing informed consent.
    2. Histologically confirmed EC including: endometrioid, serous, undifferentiated, and carcinosarcoma.
    3. TP53 wt assessed by NGS, evaluated by a central vendor.
    4. Completed a single line, at least 12 weeks of platinum-based therapy (not including adjuvant or neoadjuvant therapy for Stage I-III disease) and achieved confirmed partial or complete response (PR or CR) by imaging, according to RECIST version 1.1. The patients should have received treatment for:
    Primary Stage IV disease, defined as:
    a. had a primary or later debulking surgery during first-line platinum-based therapy with R0 resection (R0 resection indicates a macroscopic complete resection of all visible tumor) and achieved CR after at least 12 weeks platinum-based therapy, OR
    b. had a primary or later debulking surgery during first-line platinum-based therapy with
    R1 resection (R1 resection indicates incomplete removal of all macroscopic disease) and achieved PR or CR after at least 12 weeks platinum-based chemotherapy, OR
    c. had no surgery and achieved PR or CR after at least 12 weeks platinum-based chemotherapy OR
    At first relapse (i.e., relapse after primary therapy including surgery and/or chemotherapy and/or immunotherapy for Stage I-IV disease), defined as:
    a. had Stage I – III disease at diagnosis and received, at initial diagnosis, adjuvant chemotherapy and relapsed later. Patients should have PR or CR after at least 12 weeks of platinum-based chemotherapy compared with the start of this chemotherapy at the time of relapse,
    b. had Stage I-III disease at diagnosis and did not receive adjuvant chemotherapy at initial diagnosis and relapsed later. Patients should have PR or CR after at least 12 weeks of platinum-based chemotherapy compared with the start of this chemotherapy at the time of relapse, OR
    c. had Stage IV disease at diagnosis and received initially chemotherapy with or without
    surgery and relapsed later. At the time of relapse, patients should have PR or CR after at
    least 12 weeks of platinum-based chemotherapy compared with the start of this chemotherapy at the time of relapse.
    5. Previous treatment with anti-programmed cell death protein 1(PD-1) or anti-programmed death-ligand 1(PD-L1) monoclonal antibody and concomitant biologic agents (e.g., bevacizumab, trastuzumab) is allowed.
    6. Must be able to initiate study drug 3 to 8 weeks after completion of their final dose of chemotherapy.
    7. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
    8. Patients must have adequate bone marrow function and organ function within 2 weeks before starting study drug as defined by the following laboratory criteria:
    a. Hepatic function: total bilirubin up to <3 x upper limit of normal (ULN); alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 x ULN in patients without liver metastasis. For patients with known liver involvement of their tumor: AST and ALT ≤5 x ULN
    b. Hematopoietic function within 1 week: Absolute neutrophil count (ANC) ≥1.5 x 109/L; platelet count ≥100 x 109/L; hemoglobin ≥9.0 g/dL per local laboratory results
    c. Renal function: estimated creatinine clearance (CrCl) of ≥20 mL/min, calculated using the standard local formula, as applicable
    9. In the opinion of the Investigator, the patient must:
    a. Have a life expectancy of at least 12 weeks, and
    b. Be fit to receive investigational therapy
    10. Premenopausal females of childbearing potential must have a negative pregnancy test (serum β-human chorionic gonadotropin test) prior to the first dose of study drug. Female patients of childbearing potential must agree to use highly effective methods of contraception throughout the study and for 90 days following the last dose of study drug.
    11. Written informed consent signed in accordance with federal, local, and institutional guidelines prior to the first screening procedure
    1. Tener al menos 18 años en el momento de firmar el consentimiento informado.
    2. Tener un diagnóstico de CE confirmado mediante un análisis histológico: endometrioide, de tipo seroso, indiferenciado o carcinosarcoma.
    3. No presentar mutaciones en el gen TP53 según lo determinado en un estudio NGS evaluado por un proveedor central.
    4. Haber completado un único tratamiento de primera línea previo con un derivado del platino durante al menos 12 semanas (sin incluir el tratamiento adyuvante o neoadyuvante para la enfermedad en estadio I-III) y presentar RP o RC confirmada mediante una prueba de imagen según criterios RECIST v1.1. Todas las pacientes deben haber recibido tratamiento para:
    Enfermedad primaria en estadio IV, definida como:
    a. haberse sometido a una cirugía citorreductora primaria o posterior durante el tratamiento de primera línea con un derivado del platino con resección R0 (resección macroscópica completa de todo el tumor visible) y presentar RC tras al menos 12 semanas de tratamiento con un derivado del platino; O BIEN
    b. haberse sometido a una cirugía citorreductora primaria o posterior durante el tratamiento de primera línea con un derivado del platino con resección R1 (resección incompleta de toda la enfermedad macroscópica) y presentar RP o RC tras al menos 12 semanas de la quimioterapia con un derivado del platino; O BIEN
    c. no haberse sometido a ningún procedimiento quirúrgico y presentar una RP o RC tras al menos 12 semanas de quimioterapia con un derivado del platino.
    O BIEN
    En el momento de la primera recidiva (es decir, tras completar una primera línea de tratamiento, incluida cirugía citorreductora, quimioterapia o inmunoterapia para la enfermedad estadio I-IV), definida como:
    a. presentar una enfermedad de estadio I-III en el momento del diagnóstico, haber recibido quimioterapia adyuvante tras el diagnóstico inicial y presentar una recidiva posterior. Estas pacientes deben presentar RP o RC tras haber completado al menos 12 semanas de quimioterapia con un derivado del platino en comparación con el inicio de esta quimioterapia en el momento de la recidiva; O BIEN
    b. presentar una enfermedad de estadio I-III en el momento del diagnóstico, no haber recibido quimioterapia adyuvante tras el diagnóstico inicial y presentar una recidiva posterior.
    Estas pacientes deben presentar RP o RC tras haber completado al menos 12 semanas de quimioterapia con un derivado del platino en comparación con el inicio de esta quimioterapia en el momento de la recidiva; O BIEN
    c. presentar una enfermedad de estadio IV en el momento del diagnóstico, haber recibido una primera línea de tratamiento con o sin cirugía citorreductora, y presentar una recidiva posterior. Estas pacientes deben presentar RP o RC en el momento de la recidiva, tras haber completado al menos 12 semanas de quimioterapia con un derivado del platino en comparación con el inicio de esta quimioterapia en el momento de la recidiva.
    5. Se permite que las pacientes hayan recibido tratamiento previo con un anticuerpo monoclonal dirigido frente a la proteína 1 de muerte celular programada (PD 1) o el ligando 1 de la proteína 1 de muerte celular programada (PD L1) y biofármacos concomitantes (ej. Bevacizumab, trastuzumab).
    6. Poder iniciar el tratamiento con el fármaco en estudio entre 3 y 8 semanas después de la última dosis de la quimioterapia anterior.
    7. Estado ECOG de 0-1.
    8. Función adecuada de la médula ósea y los órganos en las 2 semanas previas al comienzo del tratamiento de estudio:
    a. Función hepática: bilirrubina total <3 veces el límite superior de la normalidad (LSN) y alanina transaminasa (ALT) y aspartato transaminasa (AST) ≤2,5 veces el LSN en pacientes sin metástasis hepáticas. En pacientes con afectación hepática conocida del tumor: niveles de AST y ALT ≤5 veces el LSN.
    b. Función hematopoyética en la semana previa: recuento absoluto de neutrófilos (RAN) ≥1,5 x 109/L, plaquetas ≥100 x 109/L y hemoglobina ≥9,0 g/dl según los resultados analíticos locales.
    c. Función renal: aclaramiento de creatinina estimado ≥20 ml/min, calculado utilizando la fórmula convencional local, según proceda.
    9. En opinión del investigador, cada paciente debe:
    a. Tener una esperanza de vida de al menos 12 semanas, y
    b. Ser capaz de recibir el tratamiento en investigación.
    10. Las mujeres en estado premenopáusico y con posiblidad de quedarse embarazadas deben presentar una prueba de embarazo negativa (prueba de detección de β-gonadotropina coriónica humana) antes de la administración de la primera dosis del fármaco en estudio. Las participantes en edad fértil deben aceptar utilizar métodos anticonceptivos de alta eficacia durante el transcurso del estudio y en los 90 días posteriores a la administración de la última dosis del fármaco en estudio.
    11. Dar su consentimiento informado por escrito de conformidad con las directrices federales, locales e institucionales antes de la realización del primer procedimiento de selección.
    E.4Principal exclusion criteria
    1. Has any uterine sarcomas (carcinosarcomas – not excluded), clear cell or small cell carcinoma with neuroendocrine differentiation
    2. Received a blood or platelet transfusion during the 2 weeks prior to C1D1. Patients’ hemoglobin must be assessed within 2 weeks of screening and at least 1 week post transfusion.
    3. Concurrent systemic steroid therapy higher than physiologic dose (>10 mg/day of prednisone or equivalent). Systemic steroid therapy as pre-medication for taxane is allowed.
    4. Insufficient time since or not recovered from procedures or anti-cancer therapy, defined as:
    • Not recovered from major surgery ≤28 days prior to Day 1 dosing. Minor procedures, such as biopsies, dental work, or placement of a port or intravenous (IV) line for infusion are permitted
    5. Having ongoing clinically significant anti-cancer therapy-related toxicities CTCAE Grade >1, with the exception of alopecia. In specific cases, patients whose toxicity has stabilized or with Grade 2 non-hematologic toxicities can be allowed following documented approval by the Sponsor’s Medical Monitor
    6. Palliative radiotherapy within 14 days of the intended C1D1. Palliative radiotherapy may be permitted for symptomatic control of pain from bone metastases, provided that the radiotherapy does not involve target lesions, and the reason for the radiotherapy does not reflect evidence of disease progression
    7. Any gastrointestinal dysfunctions that could interfere with the absorption of selinexor (e.g., bowel obstruction, inability to swallow tablets, malabsorption syndrome, unresolved nausea, vomiting, diarrhea CTCAE v 5.0 > grade 1)
    8. Patients unable to tolerate two forms of antiemetics for at least 2 cycles will not be eligible for the trial.
    9. Active, ongoing or uncontrolled active infection requiring parenteral antibiotics, antivirals, or antifungals within 1 week of screening
    10. Serious psychiatric or medical condition that could interfere with participation in the study or in the opinion of the Investigator would make study involvement unreasonably hazardous
    11. Previous treatment with an XPO1 inhibitor
    12. Stable disease or PD on the post-chemotherapy scan or clinical evidence of progression prior to randomization.
    13. Patients who received any systemic anticancer therapy including investigational agents ≤3 weeks (or ≤5 half-lives of the drug [whichever is shorter]) prior to C1D1.
    14. Major injuries or surgery within 14 days prior to C1D1 and/or planned major surgery during the on-treatment study period
    15. Other malignant disease with disease-free ≤ 3 years except: curatively treated carcinoma in situ of the cervix, basal cell carcinoma of the skin, or ductal carcinoma in situ (DCIS) of the breast
    16. History of allergic reactions attributed to compounds of similar chemical or biologic composition to selinexor, or other agents used in the study
    17. Active brain metastases (e.g., stable for <8 weeks, no adequate previous treatment with radiotherapy and/or surgery, symptomatic, requiring treatment with anti-convulsant therapy. Corticoid therapy is allowed if administered as stable dose for at least 1 month before randomization).
    18. Females who are pregnant or lactating
    19. Any other life-threatening illness, active medical condition, organ system dysfunction, or serious active psychiatric issue which, in the Investigator's opinion, could compromise the patient’s safety or the patient’s ability to remain compliant with study procedures.
    1. Padecer cualquier tipo de sarcoma uterino (no se excluyen los carcinosarcomas), sarcoma de células claras o carcinoma microcítico con diferenciación neuroendocrina.
    2. Haber recibido una transfusión de sangre o plaquetas en las 2 semanas previas al C1D1. Deberán evaluarse los niveles de hemoglobina de las pacientes en las 2 semanas previas a la selección y al menos 1 semana después de la transfusión.
    3. Tratamiento esteroideo sistémico concurrente administrado a una dosis superior a la fisiológica (>10 mg/día de prednisona o un equivalente). Se permite el tratamiento esteroideo sistémico como premedicación para la quimioterapia con taxanos.
    4. Plazo insuficiente o falta de recuperación desde la realización de procedimientos o la administración del tratamiento antineoplásico, definidos como:
    • Falta de recuperación de un procedimiento quirúrgico mayor efectuado ≤28 días antes de la administración de la dosis del día 1. Se permite la realización de procedimientos menores, como biopsias, intervenciones odontológicas o la colocación de un catéter o una vía intravenosa para la infusión.
    5. Presentar toxicidades actuales relacionadas con el tratamiento antineoplásico de trascendencia clínica (grado CTCAE >1), a excepción de la alopecia. En casos específicos, las pacientes que presenten una toxicidad estable o una toxicidad no hematológica de grado 2 podrán participar en el estudio tras recibir la aprobación documentada del monitor médico designado por el promotor.
    6. Haber recibido radioterapia paliativa en los 14 días previos a la fecha prevista del C1D1. Podría permitirse la radioterapia paliativa con fines de control sintomático del dolor causado por metástasis óseas, siempre y cuando este tratamiento no se dirija frente a las lesiones diana y que el motivo de su administración no incluya la existencia de pruebas de progresión de la enfermedad.
    7. Padecer cualquier trastorno gastrointestinal que podría interferir con la absorción del selinexor (p. ej., obstrucción intestinal, incapacidad para tragar los comprimidos, síndrome de malabsorción, náuseas, vómitos o diarrea de grado CTCAE v5.0 >1).
    8. Ser incapaz de tolerar dos formulaciones de antieméticos durante un mínimo de 2 ciclos.
    9. Presentar una infección activa actual o no controlada que requiera la administración de antibióticos, antivirales o antifúngicos por vía parenteral en la semana previa a la selección.
    10. Padecer una afección psiquiátrica o médica grave que pudiese interferir con la participación de la paciente en el estudio o que, en opinión del investigador, provocaría que su participación en el estudio fuese excesivamente peligrosa.
    11. Haber recibido tratamiento previo con un inhibidor de XPO1.
    12. Presentar signos de una enfermedad estable o PE en una prueba de imagen realizada tras completar la quimioterapia o pruebas clínicas de progresión de la enfermedad antes de la aleatorización.
    13. Haber recibido cualquier tratamiento antineoplásico sistémico, incluidos agentes en investigación, ≤3 semanas (o ≤5 semividas del fármaco [lo que ocurra antes]) antes del C1D1.
    14. Presentar una lesión importante o haberse sometido a un procedimiento quirúrgico mayor en los 14 días previos al C1D1 o tener previsto someterse a un procedimiento quirúrgico mayor durante el período de tratamiento del estudio.
    15. Haber presentado y haberse recuperado de otra enfermedad neoplásica ≤3 años antes del estudio, a excepción del carcinoma cervical in situ tratado con fines curativos, carcinoma basocelular de la piel o carcinoma ductal in situ de las mamas.
    16. Tener antecedentes de reacciones alérgicas atribuidas a compuestos con una composición química o biológica similar a la del selinexor, o a otros agentes utilizados en este estudio.
    17. Presentar metástasis cerebrales activas (p. ej., estables durante <8 semanas, sin un tratamiento previo adecuado con radioterapia o cirugía, sintomáticas y con requerimientos de tratamiento anticonvulsivo. Se permite el tratamiento con corticoesteroides si este se administró a una dosis estable durante al menos 1 mes antes de la aleatorización).
    18. Estar embarazada o en período de lactancia.
    19. Padecer cualquier otra enfermedad potencialmente mortal, una afección médica activa, una disfunción de un aparato o sistema, o un trastorno psiquiátrico activo grave que, en opinión del investigador, podría comprometer la seguridad de la paciente o su capacidad para cumplir los procedimientos del estudio
    E.5 End points
    E.5.1Primary end point(s)
    Investigator assessed PFS per Response Evaluation Criteria in Solid Tumors (RECIST)
    v1.1 in the ITT population (tumor protein 53 wild-type [TP53 wt] by central next generation
    sequencing [NGS] testing)
    Supervivencia libre de progresión (SLP), evaluada por el investigador según los Criterios de Evaluación de la Respuesta en Tumores Sólidos (RECIST) v1.1, en la población de análisis por IDT (ausencia de mutaciones en la proteína supresora de tumores p53, determinada mediante un estudio de secuenciación de nueva generación [NGS])
    E.5.1.1Timepoint(s) of evaluation of this end point
    July 2024
    Julio de 2024
    E.5.2Secondary end point(s)
    • OS
    • The safety and tolerability of study drug (selinexor and placebo) will be evaluated
    based on adverse event (AE) reports, physical examination results (including vital signs), and clinical laboratory results by means of the occurrence, nature, and severity of AEs via
    Common Terminology Criteria for Adverse Events (CTCAE) v. 5.0
    • TFST
    • TSST
    • Time from randomization until the second progression event (PFS2) or death due to any
    cause, whichever occurs first
    • PFS, as assessed by a BICR, per RECIST v1.1
    • European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life
    Questionnaire EuroQol-5 Dimensions-5 Levels (EQ-5D-5L)
    - SG
    - Se evaluarán la seguridad y la tolerabilidad del fármaco en estudio (selinexor o placebo) en función de las notificaciones de acontecimientos adversos (AA), los hallazgos en las exploración física (incluida la medición de las constantes vitales) y los resultados de las pruebas analíticas según la incidencia, la naturaleza y la gravedad de los AA determinada de acuerdo a la versión 5.0 de los criterios comunes de terminología para acontecimientos adversos (CTCAE v5.0)
    - TPTP
    - TSTP
    - Tiempo transcurrido entre la aleatorización y el segundo episodio de progresión (SSP2) o la muerte por cualquier causa, lo que ocurra antes
    - SLP, según lo evaluado en una ECIE con base en los criterios RECIST v1.1
    - Cuestionario EuroQol de cinco dimensiones y cinco niveles para medir la calidad de vida relacionada con la salud (EQ-5D-5L, por su sigla en inglés) de la Organización Europea para la Investigación y el Tratamiento del Cáncer (EORTC, por su sigla en inglés)
    E.5.2.1Timepoint(s) of evaluation of this end point
    August 2025
    Agosto de 2025
    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 Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    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 No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    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 concerned10
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA50
    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
    Canada
    Israel
    United States
    Spain
    Czechia
    Germany
    Italy
    Belgium
    Hungary
    Ireland
    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
    End of study will be approximately 3 years after the last patient is enrolled into the study, when the last patient in the study has withdrawn consent, has been withdrawn from the study by the Investigator, has died, or has been lost to follow-up, whichever occurs first.
    El final del estudio será aproximadamente 3 años después de la inclusión del último paciente en el estudio, cuando el último paciente del estudio haya retirado su consentimiento, haya sido retirado del estudio por el investigador, haya fallecido o se haya perdido el seguimiento, lo que ocurra primero.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years5
    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 years5
    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: 160
    F.1.3Elderly (>=65 years) No
    F.1.3.1Number of subjects for this age range: 60
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male No
    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 state30
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 90
    F.4.2.2In the whole clinical trial 220
    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)
    After the trial, the patients will receive the standard of care follow-up and/or treatment of this condition.
    Después del ensayo, los pacientes continuarán en seguimiento y/o tratamiento estándar de esta enfermedad.
    G. Investigator Networks to be involved in the Trial
    G.4 Investigator Network to be involved in the Trial: 1
    G.4.1Name of Organisation MITO (Multicenter Italian trials in Ovarian Cancer)
    G.4.3.4Network Country Italy
    G.4 Investigator Network to be involved in the Trial: 2
    G.4.1Name of Organisation GEICO (Grupo Español de Investigación de Cáncer de
    G.4.3.4Network Country Spain
    G.4 Investigator Network to be involved in the Trial: 3
    G.4.1Name of Organisation NOGGO (North-Eastern-German Society of
    G.4.3.4Network Country Germany
    G.4 Investigator Network to be involved in the Trial: 4
    G.4.1Name of Organisation CEEGOG
    G.4.3.4Network Country Czechia
    G.4 Investigator Network to be involved in the Trial: 5
    G.4.1Name of Organisation UZLEUVEN/BGOG
    G.4.3.4Network Country Belgium
    G.4 Investigator Network to be involved in the Trial: 6
    G.4.1Name of Organisation MaNGO group, Istituto di Ricerche Farmacologiche Mario Negri IRCCS
    G.4 Investigator Network to be involved in the Trial: 7
    G.4.1Name of Organisation Cancer Trials Ireland
    G.4.3.4Network Country Ireland
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2023-03-15
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2023-03-09
    P. End of Trial
    P.End of Trial StatusOngoing
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