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The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
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    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   43881   clinical trials with a EudraCT protocol, of which   7295   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
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    Summary
    EudraCT Number:2022-002579-12
    Sponsor's Protocol Code Number:CLL2222
    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:2022-11-14
    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 number2022-002579-12
    A.3Full title of the trial
    Front-Line Venetoclax and Obinutuzumab combination followed by Venetoclax or Venetoclax and Zanubrutinib combination in patients with residual disease: a minimal residual disease (MRD) tailored treatment for young patients with high risk CLL. A phase II multicenter study (VIS trial)
    Combinazione di venetoclax ed obinutuzumab come terapia di prima linea seguita da venetoclax oppure da venetoclax in associazione a zanubrutinib in caso di malattia residua: trattamento per pazienti giovani con leucemia linfatica cronica e caratteristiche genetiche prognosticamente sfavorevoli basato sulla malattia minima residua – Studio VIS
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    First-line combination of Bcl-2 inhibitor and monoclonal antibody followed by administration of Bcl-2 inhibitor alone or combination of Bcl-2 inhibitor with BTK inhibitor according to disease status of the young patient with high risk Chronic Lymphatic Leukemia
    Associazione di un inibitore di Bcl-2 e un anticorpo monoclonale in prima linea seguita dalla somministrazione del solo inibitore di Bcl-2 o dall'associazione dell'inibitore di Bcl-2 con un inibitore di BTK in base all'andamento della malattia del paziente giovane con Leucemia linfatica cronica ad alto rischio.
    A.3.2Name or abbreviated title of the trial where available
    VIS
    VIS
    A.4.1Sponsor's protocol code numberCLL2222
    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 SponsorFONDAZIONE GIMEMA (GRUPPO ITALIANO MALATTIE EMATOLOGICHE DELL' ADULTO) FRANCO MANDELLI ONLUS
    B.1.3.4CountryItaly
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportBeiGene
    B.4.2CountrySwitzerland
    B.4.1Name of organisation providing supportRoche
    B.4.2CountryItaly
    B.4.1Name of organisation providing supportFondazione GIMEMA Franco Mandelli Onlus
    B.4.2CountryItaly
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationFondazione GIMEMA Franco Mandelli Onlus
    B.5.2Functional name of contact pointCentro Dati
    B.5.3 Address:
    B.5.3.1Street AddressVia Casilina, 5
    B.5.3.2Town/ cityRoma
    B.5.3.3Post code00182
    B.5.3.4CountryItaly
    B.5.4Telephone number+390670390521
    B.5.5Fax number+390670390540
    B.5.6E-mailgimema@gimema.it
    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 nameGazyvaro 1000 mg
    D.3.2Product code [NA]
    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 INNObinutuzumab
    D.3.9.1CAS number 949142-50-1
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameObinutuzumab
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP 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 nameVenclyxto 10 mg
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Film-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 INNN-(5-(3,5-DIFLUOROBENZIL)-1H-INDAZOL-3-IL)-4-(4-METILPIPERAZIN-1-IL)-2-(TETRAIDRO-2H-PIRAN-4-ILAMINO)BENZAMIDE
    D.3.9.1CAS number 1257044-40-8
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameVenetoclax
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP 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 nameVenclyxto 50 mg
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Film-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 INNN-(5-(3,5-DIFLUOROBENZIL)-1H-INDAZOL-3-IL)-4-(4-METILPIPERAZIN-1-IL)-2-(TETRAIDRO-2H-PIRAN-4-ILAMINO)BENZAMIDE
    D.3.9.1CAS number 1257044-40-8
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameVenetoclax
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameVenclyxto 100 mg
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Film-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 INNN-(5-(3,5-DIFLUOROBENZIL)-1H-INDAZOL-3-IL)-4-(4-METILPIPERAZIN-1-IL)-2-(TETRAIDRO-2H-PIRAN-4-ILAMINO)BENZAMIDE
    D.3.9.1CAS number 1257044-40-8
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameVenetoclax
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 5
    D.1.2 and D.1.3IMP 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 nameBrukinsa
    D.3.2Product code [N.A.]
    D.3.4Pharmaceutical form Capsule, hard
    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 INN2-(4-phenoxyphenyl)-7-(1-prop-2-enoylpiperidin-4-yl)-4,5,6,7-tetrahydropyrazolo[1,5-a]pyrimidine-3-carboxamide
    D.3.9.1CAS number 1691249-45-2
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameZanubrutinib
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number80
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 6
    D.1.2 and D.1.3IMP 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 nameBactrim
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form 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 INNTRIMETOPRIM + SULFAMETOSSAZOLO *
    D.3.9.1CAS number 8064-90-2
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive namecotrimoxazol
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number160800
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 7
    D.1.2 and D.1.3IMP 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 nameLamivudina
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Film-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 INNLAMIVUDINA
    D.3.9.1CAS number 134678-17-4
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameLamivudine
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 8
    D.1.2 and D.1.3IMP 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 nameTrimeton
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Concentrate for solution for injection
    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 INNCLORFENAMINA MALEATO
    D.3.9.1CAS number 132-22-9
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameChlorpheniramine Maleate
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 9
    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 nameTachipirina
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form 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 INNPARACETAMOLO
    D.3.9.1CAS number 103-90-2
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameParacetamol, acetaminophen
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 10
    D.1.2 and D.1.3IMP 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 nameDecadron
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Solution for injection
    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 INNDESAMETASONE SODIO FOSFATO
    D.3.9.1CAS number 50-02-2
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive namedexamethasone
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number4
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 11
    D.1.2 and D.1.3IMP 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 nameAllopurinolo
    D.3.2Product code [NA]
    D.3.4Pharmaceutical form Buccal tablet
    D.3.4.1Specific paediatric formulation Yes
    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 INNALLOPURINOLO
    D.3.9.1CAS number 315-30-0
    D.3.9.2Current sponsor codeNA
    D.3.9.3Other descriptive nameAllopurinol
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number300
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Chronic Lymphocytic Leukemia
    Leucemia linfatica cronica
    E.1.1.1Medical condition in easily understood language
    Form of cancer characterized by the abnormal proliferation of a particular type of cells present in the blood (lymphocytes) with consequent accumulation in various parts of the body
    Forma di cancro caratterizzata dalla proliferazione abnorme di un particolare tipo di cellule presenti nel sangue (linfociti) con conseguente accumulo in varie parti del corpo
    E.1.1.2Therapeutic area Diseases [C] - Blood and lymphatic diseases [C15]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level LLT
    E.1.2Classification code 10008956
    E.1.2Term Chronic lymphatic leukaemia
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate in young CLL patients with an adverse biologic profile the following co-primary objectives:
    1. The benefit of front-line therapy with venetoclax and obinutuzumab (VenObi) in terms of rate of patients with uMRD by ASO-PCR in the PB and BM measured at the end of combination therapy (EOCT month 9).
    2. The benefit of adding Zanubrutinib to Venetoclax (VenZan) in terms of rate of patients with uMRD by ASO-PCR in the PB and BM in patients with residual disease at the EOCT with VenObi (month 21).
    L’obiettivo primario dello studio è quello di valutare in pazienti giovani con LLC con profilo biologico avverso i seguenti obiettivi co-primari:
    1. Il beneficio della terapia di prima linea con venetoclax e obinutuzumab (VenObi) in termini di tasso di pazienti con uMRD mediante ASO-PCR nel sangue periferico e nel midollo osseo misurata al termine della terapia di combinazione (EOCT mese 9).
    2. Il beneficio dell'aggiunta di zanubrutinib a venetoclax (VenZan) in termini di tasso di pazienti con uMRD mediante ASO-PCR nel sangue periferico e nel midollo osseo in pazienti con malattia residua alla fine della terapia (EOCT) con VenObi (EOT mese 21).
    E.2.2Secondary objectives of the trial
    1) The benefit of front-line therapy with venetoclax and obinutuzumab (VenObi) in terms of rate of patients with uMRD by flow-cytometry at the end of combination therapy (EOCT month 9).
    2) The benefit of treatment with VenObi+Ven in terms of rate of patients with uMRD, L-MRD and H-MRD by:
    a) ASO-PCR
    b) Flow-cytometry.
    3) The benefit of treatment with VenObi+VenZan in terms of rate of patients with uMRD, L-MRD and H-MRD by:
    a) ASO-PCR
    b) Flow-cytometry
    4) Rate of patients with uMRD according to the baseline clinical and the biologic characteristics of CLL
    5) Progression Free Survival (PFS)
    6) Overall Survival (OS)
    7) Survival outcomes (OS and PFS) according to the:
    a) levels of MRD
    b) response
    c) treatment after VenObi
    d) the clinical and the biologic characteristics of CLL
    8) The benefits on the hematological improvement of treatment with VenObi+Ven or VenObi+VenZan.
    9) The toxicity profile of treatment.
    1. Il beneficio della terapia di prima linea con venetoclax e obinutuzumab (VenObi) in termini di tasso di pazienti con uMRD mediante citometria a flusso al termine della terapia di combinazione (EOCT mese 9).
    2. Il beneficio del trattamento con VenObi+Ven in termini di tasso di pazienti con uMRD, L-MRD e H-MRD mediante:
    a. ASO-PCR
    b. Citometria a flusso
    3. Il beneficio del trattamento con VenObi+VenZan in termini di tasso di pazienti con uMRD, L-MRD e H-MRD mediante:
    a. ASO-PCR
    b. Citometria a flusso
    4. Tasso di pazienti con uMRD in base alle caratteristiche cliniche basali e biologiche della LLC
    5. Sopravvivenza libera da progressione (PFS)
    6. Sopravvivenza globale (OS)
    7. Survival outcomes (OS e PFS) secondo:
    a. livelli di MRD
    b. risposta
    c. trattamento dopo VenObi
    d. caratteristiche cliniche e biologiche della LLC
    8. I benefici sul miglioramento ematologico del trattamento con VenObi+Ven o VenObi+VenZan
    9. Il profilo di tossicità del trattamento.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives

    Pharmacogenetics
    Version: 1.0
    Date: 18/07/1979
    Title: Translational research
    Objectives: To evaluate if and what extent an extensive biologic characterization at baseline may identify novel prognostic markers of MRD-negativity achievement

    Farmacogenetica
    Versione: 1.0
    Data: 18/07/1979
    Titolo: Ricerca Traslazionale
    Obiettivi: Valutare se la caratterizzazione biologica al basale possa identificare dei nuovi marcatori prognostici per il raggiungimento dell'MRD negatività
    E.3Principal inclusion criteria
    1. Patients older than18 years and 65 years or less.
    2. Diagnosis of CLL meeting the iwCLL 2018 criteria.
    3. Total CIRS <6, creatinine clearance >30 ml/min [Cockcroft-Gault]) and ECOG performance status of 0-1.
    4. No prior treatment.
    5. Patients with unmutated IGHV, and, or TP53 mutation assessed by an ERIC certified laboratory, and, or deletion 17p assessed by FISH analysis (Appendix N).
    6. Active disease meeting at least 1 of the iwCLL 2018 criteria for treatment requirement.
    7. Adequate hematologic parameters unless due to disease under study:
    • Absolute neutrophil count (ANC) =1.0 x 109/L unless neutropenia is clearly due to disease under study (per investigator discretion)
    • Platelet count = 75,000/mm3 - OR - Platelet count = 20,000/mm3 if thrombocytopenia is clearly due to disease under study (per investigator discretion)
    • Hemoglobin =9.0 g/dL unless anemia is clearly due to marrow involvement of CLL (per investigator discretion)
    8. Adequate renal and hepatic function, per laboratory reference range at Screening as follows:
    • AST/SGOT, ALT/SGPT =2.0 x ULN
    • Total bilirubin =1.5 x ULN unless considered secondary to Gilbert’s syndrome, in which case =3 x ULN
    9. QT-interval corrected according to Fridericia’s formula (QTcF) =450 milliseconds (ms).
    10. For females of childbearing potential, a negative serum pregnancy test within 7 days of study treatment.
    11. For female patients of childbearing potential, agreement to use highly effective form(s) of contraception (i.e., one that results in a low failure rate [<1% per year] when used consistently and correctly) or remain abstinent (refrain from heterosexual intercourse) during the treatment period and to continue its use for 90 days after the last dose of zanubrutinib AND 30 days after the last dose of venetoclax AND for 18 months after the last dose of obinutuzumab (whichever date is later). For men with a female partner of childbearing potential or a pregnant female partner: agreement to remain abstinent (refrain from heterosexual intercourse) or use a condom during the treatment period and to continue its use for 90 days after the last dose of zanubrutinib, or venetoclax AND for 18 months after the last dose of obinutuzumab (whichever date is later).
    12. A signed informed consent document indicating that they understand the purpose of and the procedures required for the study, including biomarkers, and are willing to participate in the study.
    13. Ability and willingness to comply with the requirements of the study protocol.
    1. Età compresa tra i 18 e i 65 anni
    2. Diagnosi di LLC in accordo ai criteri iwCLL 2018
    3. CIRS <6, Clearance della creatinina > 30 ml/min [Cockcroft-Gault] e ECOG performance status 0-1
    4. Nessun trattamento precedente
    5. Pazienti con IGHV non mutata e/o mutazione TP53 valutata da un laboratorio certificato ERIC e,
    o delezione 17p valutata mediante analisi FISH
    6. Malattia attiva che soddisfa almeno 1 dei criteri iwCLL 2018 per la necessità di trattamento
    7. Parametri ematologici adeguati a meno che non dovuti alla malattia:
    • Conta assoluta dei neutrofili (ANC) =1,0 x 109/L a meno che la neutropenia non sia chiaramente dovuta alla malattia in studio (a discrezione dello sperimentatore)
    • Conta piastrinica = 75.000/mm3 - o - Conta piastrinica = 20.000/mm3 se la trombocitopenia è chiaramente dovuta a malattia in studio (a discrezione dello sperimentatore)
    • L'emoglobina =9,0 g/dL a meno che l'anemia non sia chiaramente dovuta al coinvolgimento midollare della LLC (a discrezione dello sperimentatore)
    8. Adeguata funzionalità renale ed epatica, in base ai valori di riferimento di laboratorio allo screening come segue:
    • AST/SGOT, ALT/SGPT =2.0 x ULN
    • Bilirubina totale =1,5 x ULN a meno che non sia considerata secondaria alla sindrome di Gilbert, nel qual caso =3 x ULN
    9. Intervallo QT corretto secondo la formula di Fridericia (QTcF) =450 millisecondi (ms).
    10. Per donne potenzialmente fertili, un test di gravidanza sierico negativo entro 7 giorni dal trattamento.
    11. Per donne potenzialmente fertili, utilizzo di metodi contraccettivi altamente efficaci (es.contraccettivo con un basso tasso di fallimento [<1% all'anno] quando usato in modo coerente e corretto) o astinenza (astenersi da rapporti eterosessuali) durante il periodo di trattamento e per 90 giorni dopo l'ultima dose di zanubrutinib e per 30 giorni dopo l'ultima dose di venetoclax eper 18 mesi dopo l'ultima dose di obinutuzumab (a seconda di quale sia la data ultima). Per gli uomini con una partner femminile in età fertile o una partner femminile in gravidanza: astinenza (astenersi dal rapporto eterosessuale) o utilizzo di un preservativo durante il periodo di
    trattamento e per 90 giorni dopo l'ultima dose di zanubrutinib, o venetoclax e per 18 mesi dopo l'ultima dose di obinutuzumab (a seconda di quale data sia ultima).
    12. Firma del consenso informato in cui viene indicato che i pazienti comprendono lo scopo e le procedure richieste per lo studio, compresi i biomarcatori, e sono disposti a partecipare allo studio.
    13. Capacità e disponibilità a rispettare i requisiti del protocollo di studio
    E.4Principal exclusion criteria
    1. Any significant concurrent, uncontrolled medical condition or organ system dysfunction and laboratory abnormality or psychiatric disease, which, in the investigator's opinion, could compromise the subject's safety or put the study outcomes at undue risk or prevent the subject from signing the informed consent form.
    2. Known active histological transformation from CLL to an aggressive lymphoma (i.e., Richter’s transformation or pro-lymphocytic leukemia).
    3. Known central nervous system involvement.
    4. Active malignancy or systemic therapy for another malignancy within 3 years
    Except:
    • Malignancies surgically treated with curative intent and with no known active disease present for = 3 years before randomization
    • Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease
    • Adequately treated cervical carcinoma in situ without evidence of disease
    • Surgically/adequately treated low grade, early stage localized prostate cancer without evidence of disease
    5. Co-morbidities:
    • Uncontrolled autoimmune hemolytic anemia or thrombocytopenia
    • Any uncontrolled illness that, in the opinion of the investigator, would preclude administration of study therapy.
    • History of stroke or intracranial hemorrhage within 180 days before first dose of study drug.
    • History of severe bleeding disorder or history of spontaneous bleeding requiring blood transfusion or other medical intervention due to thrombocytopenia or inherited or acquired bleeding disorders due to deficiency or functional abnormality of any coagulation proteins.
    • History of significant cardiovascular disease, defined as: a. Congestive heart failure greater than New York Heart Association (NYHA) class II according to the NYHA functional classification. b. Unstable angina or myocardial infarction with 6 months of enrollment. c. Serious cardiac arrhythmia or clinically significant ECG abnormality: corrected QT wave (QTcF) > 480 msec based on the Fridericia's formula or other ECG abnormalities including second-degree atrioventricular block type II, third-degree atrioventricular block. Participants who have a pacemaker will be allowed on study despite ECG abnormalities or the inability to calculate the QTc.
    • Known active bacterial, viral, fungal, mycobacterial, parasitic, or other infection (excluding fungal infections of nail beds) at study enrollment, or any major episode of infection requiring treatment with IV antibiotics or hospitalization (relating to the completion of the course of antibiotics) within 4 weeks prior to Cycle 1, Day 1.
    • History of tuberculosis within the last five years or recent exposure to tuberculosis equal to or less than 6 months.
    • History of progressive multifocal leukoencephalopathy (PML).
    • History of HIV infection or active hepatitis B (chronic or acute) or hepatitis C infection:
    I. Patients with occult or prior HBV infection (defined as positive total hepatitis B core antibody [HBcAb] and negative HBsAg) may be included if HBV DNA is undetectable. These patients must be willing to take appropriate anti-viral prophylaxis as indicated and undergo monthly DNA testing.
    II. Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction (PCR) is negative for HCV RNA.
    • Inadequate renal function: CrCl < 30 mL/min.
    • Clinically significant history of liver disease, including viral or other hepatitis, current alcohol abuse, or cirrhosis.
    • History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies or known sensitivity or allergy to murine products.
    • Known intolerance or hypersensitivity to any of the components of the therapeutic regimen.
    • Receipt of live-virus vaccines within 28 days prior to the initiation of study treatment or need for live-virus vaccines at any time during study treatment.
    • Prior major surgical procedure within 4 weeks of study, or anticipation of need for a major surgical procedure during the course of the study.
    • Known condition or other clinical situation that would affect oral absorption.
    • Psychiatric illness/social situations that would interfere with study compliance.
    • Inability to swallow a large number of tablets.
    6. Concomitant medications and drug interactions:
    • Patients who are on treatment with the following agents within 7 days prior to treatment:
    Strong CYP3A inhibitors such as fluconazole, ketoconazole, and clarithromycin Strong CYP3A inducers such as rifampin, carbamazepine and strong inhibitors or inducers of CYP2C8, CYP2C9 and CYP2C19. The same applied for moderate inhibitors or inducers of CYP3A
    Requires warfarin, marcumar, or phenprocoumon (due to potential drug-drug interactions that may potentially increase the exposure of warfarin or phenprocoumon)
    • Prior anti-CD20 monoclonal antibody therapy for non-malignant indication
    6. Females who are currently pregnant or breastfeeding.
    7. Participation in a separate investigational therapeutic study unless authorized by PI
    1.Qualsiasi significativa condizione medica concomitante e incontrollata o disfunzione del sistema d'organo e anomalia di laboratorio o malattia psichiatrica, che, a parere del PI, potrebbe compromettere la sicurezza del soggetto o mettere a rischio indebito i risultati dello studio o impedire al soggetto di firmare il modulo di consenso informato
    2.Trasformazione istologica attiva nota da LLC a linfoma aggressivo(trasformazione di Richter o leucemia pro-linfocitica)
    3.Coinvolgimento noto del SNC
    4.Neoplasia attiva o terapia sistemica per un altro tumore maligno entro 3anni
    Eccetto
    •Tumori maligni trattati chirurgicamente con intento curativo e senza malattia attiva nota presente per=3 anni prima dell’arruolamento
    •Cancro della pelle non-melanoma adeguatamente trattato o lentigo maligna senza evidenza di malattia
    •Carcinoma della cervice in situ adeguatamente trattato senza evidenza di malattia
    •Carcinoma prostatico localizzato di basso grado e in fase iniziale chirurgicamente/adeguatamente trattato senza evidenza di malattia
    5.Comorbilità
    •Anemia emolitica autoimmune incontrollata o trombocitopenia
    •Qualsiasi malattia incontrollata che, a giudizio dello sperimentatore, precluderebbe la somministrazione della terapia di studio
    •Storia di ictus o emorragia intracranica entro 180gg prima della 1°dose del farmaco in studio
    •Storia di grave disturbo emorragico o storia di sanguinamento spontaneo che richiede trasfusione di sangue o altro intervento medico a causa di trombocitopenia o disturbi emorragici ereditari o acquisiti a causa di
    carenza o anomalia funzionale di qualsiasi proteina della coagulazione
    •Storia di malattia cardiovascolare significativa, definita
    a)Insufficienza cardiaca congestizia > della classe II secondo la classificaz. funzionale della NYHA
    b)Angina instabile o infarto miocardico nei 6 mesi che precedono l’arruolamento
    c)Aritmia cardiaca grave o anomalia ECG clinicamente significativa:QTcF>480 msec in base alla formula di Fridericia o altre anomalie dell'ECG tra cui blocco atrioventricolare di 2°grado di tipo II blocco atrioventricolare di 3°grado. I partecipanti che hanno pacemaker saranno ammessi allo studio nonostante le anomalie dell'ECG o l'incapacità di calcolare il QTc
    •Infezione batterica, virale, fungina, micobatterica, parassitaria o di altro tipo(escluse le infezioni fungine dei letti ungueali)nota all'arruolamento nello studio o qualsiasi episodio importante di infezione che richieda un trattamento con antibiotici per via endovenosa o il ricovero in ospedale(relativo al completamento del ciclo di antibiotici)entro 4settimane prima del ciclo1, giorno1
    •Storia di tubercolosi negli ultimi 5anni o recente esposizione alla tubercolosi pari o inferiore a 6mesi
    •Storia di leucoencefalopatia multifocale progressiva
    •Storia di infezione da HIV o epatiteB attiva(cronica o acuta)o infezione da epatiteC:
    1.I pazienti con infezione occulta o precedente da HBV(definiti come HBcAb+ e HBsAg-)possono essere inclusi se l'HBV DNA non è rilevabile. Questi pazienti devono essere disposti a ricevere un'appropriata profilassi antivirale come indicato e sottoporsi a test mensili del DNA
    2.I pazienti positivi all'anticorpo dell’HCV sono eleggibili solo se la PCR è negativa per l'HCV RNA
    •Funzionalità renale inadeguata:CrCl<30 ml/min
    •Storia clinicamente significativa di malattia epatica, tra cui epatite virale o altro tipo,attuale abuso di alcol o cirrosiù•Storia di gravi reazioni allergiche o anafilattiche ad Ab monoclonali umanizzati o murini o sensibilità nota o allergia ai prodotti murini
    •Intolleranza nota o ipersensibilità a uno dei componenti del regime terapeutico
    •Ricezione di vaccini a virus vivo entro 28gg prima dell'inizio del trattamento in studio o necessità di vaccini a virus vivo in qualsiasi momento durante il trattamento in studio
    •Precedente procedura chirurgica entro 4settimane dallo studio, o anticipazione della necessità di una procedura chirurgica maggiore durante il corso dello studio
    •Condizione nota o altra situazione clinica che potrebbe influenzare l'assorbimento orale
    •Malattia psichiatrica/condizioni sociali che interferirebbero con la conformità allo studio
    •Incapacità di deglutire un gran numero di compresse
    6.Farmaci concomitanti e interazioni farmacologiche:
    •Pazienti in trattamento con i seguenti agenti entro 7gg prima del trattamento:
    Forti inibitori del CYP3A come fluconazolo, ketoconazolo e claritromicina. Forti induttori del CYP3A come rifampicina, carbamazepina e forti inibitori o induttori di CYP2C8, CYP2C9 e CYP2C19.Lo stesso vale per
    inibitori o induttori moderati del CYP3A. Richiede warfarin, marcumar o fenprocumone (a causa di potenziali interazioni farmaco-farmaco che possono potenzialmente aumentare l'esposizione di warfarin o fenprocumone)
    •Precedente terapia con Ab monoclonali anti-CD20 per il trattamento di patologie non maligne
    7.Donne attualmente incinte o che allattano
    8.Partecipazione ad altro studio terapeutico sperimentale, salvo autoriz.del PI
    E.5 End points
    E.5.1Primary end point(s)
    To evaluate in young CLL patients with an adverse biologic profile:
    1. The benefit of front-line therapy with Venetoclax and Obinutuzumab (VenObi) in terms of rate of patients with uMRD by ASO-PCR in the PB and BM measured at the end of combination therapy (EOCT month 9).
    2. The benefit of adding Zanubrutinib to Venetoclax (VenZan) in terms of rate of patients with uMRD by ASO-PCR in the PB and BM in patients with residual disease at the EOCT with VenObi (month 21).
    Valutare nel paziente giovane CLL con un profilo biologico avverso:
    1. il beneficio della terapia di prima linea con Venetoclax e Obinutuzumab (VenObi) in termini di percentuale di pazienti con malattia minima residua non rilevabile (ASO-PCR) nel sangue periferico e nel midollo osseo misurata al termine della terapia di associazione (mese 9).
    2. il beneficio dell'aggiunta di Zanubrutinib a Venetoclax (VenZan) in termini di percentuale di pazienti con malattia minima residua non rilevabile (ASO-PCR) nel sangue periferico e nel midollo osseo misurata al termine di VenObi (mese 21).
    E.5.1.1Timepoint(s) of evaluation of this end point
    Month 9 and month 21
    Mese 9 e mese 21
    E.5.2Secondary end point(s)
    1. The benefit of front-line therapy with Venetoclax and Obinutuzumab (VenObi) in terms of rate of patients with uMRD by flow-cytometry in the PB and BM measured at the end of combination therapy (EOCT month 9).
    2. The benefit of treatment with VenObi+Ven in terms of rate of patients with uMRD, L-MRD and H-MRD in the PB and BM at month 15, 21, 27, 33, 36 by:
    a. ASO-PCR
    b. Flow-cytometry
    3. The benefit of treatment with VenObi+VenZan in terms of rate of patients with uMRD, L-MRD and H-MRD in the PB and BM at month 15, 21, 27, 33, 36 by:
    a. ASO-PCR
    b. Flow-cytometry
    4. Rate of patients with uMRD according to the clinical and the biologic characteristics of CLL
    5. Progression Free Survival (PFS) at 36 months
    6. Overall Survival (OS) at 36 months
    7. Survival outcomes (OS and PFS) estimates at 36 months according to the:
    a. levels of MRD (uMRD, L-MRD, H-MRD);
    b. response (CR, PR, stable disease);
    c. treatment (Ven-Obi+Ven or VenObi+VenZan);
    d. the clinical and the biologic characteristics of CLL (CD38, CD49d, IGHV, FISH profile, mutations of TP53, NOTCH1, BIRC3, SF3B1)
    8. The benefit of treatment with VenObi+Ven or VenObi+VenZan on the improvement of Hb value, granulocyte, and platelet counts and immunoglobulin levels.
    9. The toxicity profile of treatment in terms of AE/SAE.
    1. ll beneficio della terapia di prima linea con Venetoclax e Obinutuzumab (VenObi) in termini di percentuale di pazienti con malattia minima residua non rilevabile (citometria a flusso) nel sangue periferico e nel midollo osseo misurata al termine della terapia di associazione (mese 9).
    2. Il beneficio del trattamento con VenObi+Ven in termini di percentuale di pazienti con malattia minima residua non rilevabile, bassa malattia minima residua e alta malattia minima residua nel sangue periferico e nel midollo osseo al mese 15, 21, 27, 33, 36 tramite:
    a. ASO-PCR
    b. citometria a flusso
    3. Il beneficio del trattamento con VenObi+VenZan termini di percentuale di pazienti con malattia minima residua non rilevabile, bassa malattia minima residua e alta malattia minima residua nel sangue periferico e nel midollo osseo al mese 15, 21, 27, 33, 36 tramite:
    a. ASO-PCR
    b. citometria a flusso
    4. Percentuale di pazienti con malattia minima residua non rilevabile secondo le caratteristiche cliniche e biologiche della CLL
    5. Progression Free Survival (PFS) a 36 mesi
    6. Overall Survival (OS) a 36 mesi
    7. Outcome di sopravvivenza (OS e PFS) stimati a 36 mesi secondo:
    a. livelli di MRD (non rilevabile, bassa, alta);
    b. risposta (CR, PR, malattia stabile);
    c. trattamento (Ven-Obi+Ven o VenObi+VenZan);
    d. le caratteristiche cliniche e biologiche della CLL (CD38, CD49d, IGHV, profilo FISH, mutazioni di TP53, NOTCH1, BIRC3, SF3B1)
    8. Il beneficio del trattamento con VenObi+Ven o VenObi+VenZan sul miglioramento del valore di emoglobina, granulociti e conta piastrinica e sui livelli di immunoglobuline.
    9. Il profilo di tossicità del trattamento in termini di AE/SAE
    E.5.2.1Timepoint(s) of evaluation of this end point
    During and at the end of the study
    Durante e al termine dello studio
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    E.8.1.2Open No
    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) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial1
    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 concerned41
    E.8.5The trial involves multiple Member States No
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    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 years4
    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: 74
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 4
    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 state78
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 78
    F.4.2.2In the whole clinical trial 78
    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)
    Patients will be followed as normal clinical practice.
    I pazienti continueranno ad essere seguiti secondo le norme previste dalla buona pratica clinica.
    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 Fondazione GIMEMA
    G.4.3.4Network Country Italy
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2023-04-04
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2022-12-07
    P. End of Trial
    P.End of Trial StatusOngoing
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