E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Metastatic Pancreatic Ductal Adenocarcinoma (mPDAC) |
Adenocarcinoma Ductal Pancreático Metastásico (ADPm) |
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E.1.1.1 | Medical condition in easily understood language |
Pancreatic Cancer |
Cáncer de Páncreas |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10033599 |
E.1.2 | Term | Pancreatic adenocarcinoma metastatic |
E.1.2 | System Organ Class | 100000004864 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the disease control rate (DCR) by RECIST v1.1 in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel. |
Evaluar la tasa de control de la enfermedad (TCE) según RECIST v1.1 en pacientes con ADPm tratados en 1L con TTFields concomitantes con atezolizumab, gemcitabina y nab-paclitaxel. |
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E.2.2 | Secondary objectives of the trial |
To evaluate the overall survival (OS) and 1-year survival rate in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel. To evaluate the safety and tolerability profile of TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel in patients with 1L mPDAC. To evaluate the progression free survival (PFS) by RECIST v1.1 in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel. To evaluate the objective response rate (ORR) by RECIST v1.1 in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel. To evaluate the PFS rate at 6 months (PFS6) in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel. To evaluate the duration of response (DOR) by RECIST v1.1 in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel. |
Evaluar: - la supervivencia global (SG) en pacientes con ADPm tratados en 1L con TTFields concomitantes con atezolizumab, gemcitabina y nab-paclitaxel (A, G y N-p). - la supervivencia sin progresión (SSP) según RECIST-v1.1 en pacientes con ADPm tratados en 1L con TTFields concomitantes con A, G y N-p. - la tasa de supervivencia al año en pacientes con ADPm tratados en 1L con TTFields concomitantes con A, G y N-p. - la tasa de respuesta objetiva (TRO) según RECIST v1.1 en pacientes con ADPm tratados en 1L con TTFields concomitantes con A, G y N-p. - la SSP a los 6 meses (SSP6) en pacientes con ADPm tratados en 1L con TTFields concomitantes con A, G y N-p. -la duración de la respuesta (DdR) según RECIST v1.1 en pacientes con ADPm tratados en 1L con TTFields concomitantes con A, G y N-p. - el perfil de seguridad y tolerabilidad de los TTFields concomitantes con atezolizumab, gemcitabina y nab-paclitaxel en pacientes con ADPm tratados en 1L. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Signed Informed Consent Form - 18 years of age and older - ECOG performance status of 0-1 - Histologically or cytologically confirmed de-novo diagnosis of metastatic pancreatic ductal adenocarcinoma - No prior treatment for PDAC - Life expectancy equal to or greater than 3 months - Measurable disease in the abdomen, as defined by RECIST v1.1 - Preferably, tumor accessible for tissue collection. Consent to provide blood and tumor tissue for exploratory study is highly encouraged - Amenable and assigned by the investigator to receive therapy with gemcitabine and nab- paclitaxel - Adequate hematologic and end-organ function - Able to operate the NovoTTF-200T device |
- Firmar el documento de consentimiento informado - Tener al menos 18 años - Tener un estado funcional del ECOG de 0 o 1. - Tener un diagnóstico de adenocarcinoma ductal pancreático metastásico confirmado de novo confirmado histológica o citológicamente. - No haber tenido tratamiento anterior contra el ADP. - Tener una esperanza de vida de al menos 3 meses. - Presentar enfermedad mensurable en el abdomen, según definición de los RECIST v1.1. - Presentar preferiblemente un tumor accesible para la obtención de tejidos. Se recomienda encarecidamente que se consienta facilitar muestras de sangre y tejido tumoral para el estudio exploratorio. - Ser tributarios y que el investigador les haya asignado a recibir terapia con gemcitabina y nab-paclitaxel. - Presentar un funcionamiento hemático y del órgano afectado adecuado - Ser capaz de utilizar el dispositivo NovoTTF-200T de manera independiente o con la ayuda de un cuidador. |
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E.4 | Principal exclusion criteria |
- Symptomatic, untreated, or actively progressing CNS metastases - History of leptomeningeal disease - Uncontrolled tumor-related pain - Active or history of autoimmune disease - Severe infection within 4 weeks prior to initiation of study treatment - History of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins - Any other disease, metabolic dysfunction, physical examination finding, or clinical laboratory finding that contraindicates the use of an investigational drug or device, may affect the interpretation of the results, or may render the patient at high risk from treatment complications - Concurrent anti-tumor therapy beyond gemcitabine and nab-paclitaxel - Implantable electronic medical devices in the torso, such as pacemakers. |
- Presentar metástasis sintomática, no tratada o con progresión activa en el sistema nervioso central (SNC). - Presentar antecedentes de carcinomatosis leptomeníngea. - Presentar dolor incontrolado relacionado con el tumor. - Tener enfermedad inmunitaria activa o antecedentes de enfermedad inmunitaria - Presentar una infección grave en las 4 semanas anteriores al inicio del tratamiento del estudio - Tener antecedentes de reacciones alérgicas, anafilácticas o de otro tipo de hipersensibilidad de carácter grave a los anticuerpos quiméricos o humanizados o a las proteínas de fusión - Cualquier otra enfermedad, disfunción metabólica, hallazgo en exploración física o hallazgo clínico de laboratorio que contraindique el uso de un medicamento o producto en investigación puede afectar a la interpretación de los resultados o exponer al paciente a un alto riesgo de complicaciones derivadas del tratamiento. - Recibir terapia antineoplásica concurrente aparte de gemcitabina y nab-paclitaxel. - Llevar dispositivos médicos electrónicos implantables en el tronco, por ejemplo, un marcapasos. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Disease control rate (DCR) by RECIST v1.1 in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel, measured as the proportion of patients with stable disease for at least 16 weeks or confirmed PR or CR. |
Tasa de control de la enfermedad (TCE) según RECIST v1.1 en pacientes con ADPm tratados en 1L con TTFields concomitantes con atezolizumab, gemcitabina y nab-paclitaxel, medida por el porcentaje de pacientes con enfermedad estable (EE) durante un mínimo de 16 semanas o con respuesta parcial (RP) o respuesta completa (RC) confirmadas. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Stable disease for at least 16 weeks, or confirmed PR or CR. |
Enfermedad estable (EE) durante un mínimo de 16 semanas o con respuesta parcial (RP) o respuesta completa (RC) confirmadas. |
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E.5.2 | Secondary end point(s) |
• Overall survival (OS) in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel, measured as the period between the time of treatment initiation and the time of death. • Progression free survival (PFS) by RECIST v1.1 in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel, measured from the time of treatment initiation. • 1-year survival rate in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel, measured as the proportion of patients alive one year after treatment initiation. • Objective response rate (ORR) by RECIST v1.1 in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel, measured as the proportion of patients with partial or complete response between the time of treatment initiation and the time of death. • Progression free survival rate at 6 months (PFS6) by RECIST v1.1 in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel, defined as the proportion of patients who are alive and are progression free six months after treatment initiation. • Duration of response (DOR) by RECIST v1.1 in patients with 1L mPDAC treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel, measured as the time from the first occurance of a documented objective response to disease progression or death from any cause (whichever occurs first). • Toxicity profile in 1L mPDAC patients treated with TTFields concomitant with atezolizumab, gemcitabine and nab-paclitaxel, measured by the rate of patients with treatment-emergent adverse events (based on CTCAE V5.0). |
• Supervivencia global (SG) en pacientes con ADPm tratados en 1L con TTFields concomitantes con atezolizumab, gemcitabina y nab-paclitaxel, medida según el periodo transcurrido entre el momento de inicio del tratamiento y el momento de la muerte. • Supervivencia sin progresión (SSP) según RECIST-v1.1 en pacientes con ADPm tratados en 1L con TTFields concomitantes con atezolizumab, gemcitabina y nab-paclitaxel, medida desde el momento de inicio del tratamiento. • Tasa de supervivencia al año en pacientes con ADPm tratados en 1L con TTFields concomitantes con atezolizumab, gemcitabina y nab-paclitaxel medida por el porcentaje de pacientes vivos un año después del inicio del tratamiento. • Tasa de respuesta objetiva (TRO) según RECIST v1.1 en pacientes con ADPm tratados en 1L con TTFields concomitantes con atezolizumab, gemcitabina y nab-paclitaxel, medida por el porcentaje de pacientes con RP o RC entre el momento de inicio del tratamiento y el momento de la muerte. • Supervivencia sin progresión a los 6 meses (SSP6) según RECIST v1.1 en pacientes con ADPm tratados en 1L con TTFields concomitantes con atezolizumab, gemcitabina y nab-paclitaxel, definida como el porcentaje de pacientes vivos y sin progresión seis meses después del inicio del tratamiento. • Duración de la respuesta (DdR) según RECIST v1.1 en pacientes con ADPm tratados en 1L con TTFields concomitantes con atezolizumab, gemcitabina y nab-paclitaxel, definida como el tiempo transcurrido entre la primera aparición de una respuesta objetiva confirmada y la progresión de la enfermedad o la muerte por cualquier causa (lo que suceda primero). • Perfil de toxicidad en pacientes con ADPm tratados en 1L con TTFields concomitantes con atezolizumab, gemcitabina y nab-paclitaxel, medido por la tasa de pacientes con acontecimientos adversos surgidos durante el tratamiento (a partir de los Criterios terminológicos comunes para acontecimientos adversos, CTCAE, versión 5.0). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
As stated in E.5.2. |
Como se indica en E.5.2. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 15 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Switzerland |
Czechia |
Germany |
Hungary |
Spain |
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E.8.7 | Trial 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
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LPLV |
Última visita del último sujeto |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |