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    Summary
    EudraCT Number:2022-003289-18
    Sponsor's Protocol Code Number:219369
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2023-01-16
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2022-003289-18
    A.3Full title of the trial
    A Phase 2, Single-Arm, Open-Label Study with Dostarlimab Monotherapy in Participants with Untreated Stage II/III dMMR/MSI-H Locally Advanced Rectal Cancer
    Estudio de fase II, de rama única, abierto, con dostarlimab en monoterapia en pacientes con cáncer de recto dMMR/MSI-H localmente avanzado en estadio II/III no tratado previamente.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Phase 2 Study of Dostarlimab in Untreated dMMR/MSI-H Locally Advanced Rectal Cancer
    Estudio de fase II de dostarlimab en pacientes con cáncer de recto dMMR/MSI-H localmente avanzado no tratado previamente
    A.3.2Name or abbreviated title of the trial where available
    Phase 2 Study of Dostarlimab in Untreated dMMR/MSI-H Locally Advanced Rectal Cancer
    A.4.1Sponsor's protocol code number219369
    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 SponsorGlaxoSmithKline Research & Development Limited
    B.1.3.4CountryUnited Kingdom
    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 supportGlaxoSmithKline Research & Development Ltd
    B.4.2CountryUnited Kingdom
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGlaxoSmithKline
    B.5.2Functional name of contact pointCentro de Información
    B.5.3 Address:
    B.5.3.1Street AddressC/Severo Ochoa, 2 (P.T.M.)
    B.5.3.2Town/ cityTres Cantos (Madrid)
    B.5.3.3Post code28760
    B.5.3.4CountrySpain
    B.5.4Telephone number+34902202700
    B.5.5Fax number+34918070479
    B.5.6E-mailes-ci@gsk.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 Jemperli
    D.2.1.1.2Name of the Marketing Authorisation holderGlaxoSmithKline (Ireland) Limited
    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 nameDostarlimab
    D.3.2Product code TSR-042, GSK4057190A
    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 INNDostarlimab
    D.3.9.1CAS number 2022215-59-2
    D.3.9.2Current sponsor codeGSK4057190A
    D.3.9.3Other descriptive nameDostarlimab (50 mg/mL) Solution for Intravenous Infusion
    D.3.9.4EV Substance CodeSUB195307
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.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
    Untreated Stage II/III dMMR/MSI-H locally advanced rectal cancer
    cáncer de recto dMMR/MSI-H localmente avanzado en estadio II/III no tratado previamente
    E.1.1.1Medical condition in easily understood language
    Rectal Cancer
    Cáncer de recto
    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 10038049
    E.1.2Term Rectal cancer stage II
    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 10038050
    E.1.2Term Rectal cancer stage III
    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 estimate the efficacy of dostarlimab in participants with Stage II/III (locally advanced) dMMR/MSI-H rectal cancer that has not been previously treated.
    Estimar la eficacia de dostarlimab en participantes con cáncer de recto dMMR/MSI-H en estadio II/III (localmente avanzado) que no han recibido tratamiento previo.
    E.2.2Secondary objectives of the trial
    - To further estimate the efficacy of dostarlimab in participants with Stage II/III (locally advanced) dMMR/MSI-H rectal cancer that has not been previously treated.
    - To assess the safety and tolerability of dostarlimab in participants with Stage II/III (locally advanced), dMMR/MSI-H rectal cancer that has not been previously treated.
    - To describe the PK of dostarlimab in participants with Stage II/III (locally advanced), dMMR/MSI-H rectal cancer that has not been previously treated.
    - To determine the immunogenicity of dostarlimab in participants with Stage II/III (locally advanced), dMMR/MSI-H rectal cancer that has not been previously treated.
    - Estimar adicionalmente la eficacia de dostarlimab en participantes con cáncer de recto dMMR/MSI-H en estadio II/III (localmente avanzado) que no han recibido tratamiento previo.
    - Evaluar la seguridad y la tolerabilidad de dostarlimab en participantes con cáncer de recto dMMR/MSI-H en estadio II/III (localmente avanzado) que no han recibido tratamiento previo.
    - Describir la FC de dostarlimab en participantes con cáncer de recto dMMR/
    MSI-H en estadio II/III (localmente avanzado) que no han recibido tratamiento previo.
    - Determinar la inmunogenicidad de dostarlimab en participantes con cáncer de recto dMMR/MSI-H en estadio II/III (localmente avanzado) que no han recibido tratamiento previo.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Inclusion criteria (Prescreening Period)
    - A Prescreening Period will only be available at sites/countries where local dMMR/MSI-H testing is not available. The Prescreening Period is not required for participants whose dMMR/MSI-H status has been previously determined. Prior to Screening, participants without must meet the Prescreening criteria below.
    *Age
    Is at least 18 years of age at the time of signing the ICF.
    *Type of participant and disease characteristics
    1. Has histologically confirmed Stage II to III (T3-T4, N0, or T any, N+), locally advanced rectal cancer.
    2. Has radiologically and endoscopically evaluable disease.

    Inclusion criteria (Screening Period)
    Participants are eligible to be included in the study only if all the following criteria apply:
    *Age
    1. Is at least 18 years of age at the time of signing the ICF.
    * Type of participant and disease characteristics
    2. Has histologically confirmed Stage II to III (T3-T4, N0, or T any, N+), locally advanced rectal cancer.
    3. Has radiologically and endoscopically evaluable disease.
    4. Has a tumor demonstrating the presence of either:
    a. dMMR status; MMR status must be assessed by IHC for MMR protein expression (MLH1, MSH2, MSH6, PMS2) where loss of 1 or more proteins indicates dMMR; MMR status may be determined either locally or by the
    central reference laboratory; or b. MSI-H phenotype as determined by polymerase chain reaction or by tissue next-generation sequencing; MSI-H may be determined either locally or by the central reference laboratory.
    NOTE: Participants who are known to have Lynch syndrome and have been found to carry a specific germline mutation in an MMR gene (MLH1, MSH2, MSH6, PMS2) are eligible to participate.
    5. Has an archival FFPE tissue sample that must be available and submitted to the central reference laboratory for testing at Screening. If no archival tissue is available, a fresh baseline biopsy will be required.
    *Sex and contraceptive/barrier requirements
    6. Is willing to use adequate contraception.
    • Contraceptive use by female participants should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
    Female participants:
    • A female participant is eligible to participate if she is not pregnant or breastfeeding, and 1 of the following conditions applies:
    • Is a WONCBP as defined in Appendix 4.
    OR
    • Is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of <1% per year), preferably with low user dependency, as described in Appendix 4, during the Intervention Period and for at least 120 days after the
    last dose of study intervention. The investigator should evaluate the potential for contraceptive method failure (e.g., noncompliance, recently initiated) in relationship to the first dose of study intervention.
    • A WOCBP must have a negative highly sensitive pregnancy test (urine or serum as required by local regulations) within 24 hours before the first dose of study intervention.
    • If a urine test cannot be confirmed as negative (e.g., an ambiguous result), a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive.
    • Additional requirements for pregnancy testing during and after study intervention as defined in Appendix 4.
    • The investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy.

    *Informed consent
    7. Is capable of giving signed informed consent as described in the protocol, including compliance with the requirements and restrictions listed in the ICF and in this
    protocol.

    * Performance status and organ function
    8. Has an ECOG performance status of 0 or 1.
    9. Has adequate organ function, as defined in Table 8. (NOTE: A complete blood count test should be obtained without transfusion or receipt of colony-stimulating factors within 2 weeks of obtaining the sample.)

    For a full list of Exclusion criteria please refer to the Study Protocol Section 5.1 Inclusion Criteria pp58-61
    Criterios de inclusión (periodo de preselección)
    Habrá un periodo de preselección únicamente en centros/países en los que los análisis dMMR/MSI-H no estén disponibles. No se requiere un periodo de preselección en participantes cuyo estado dMMR/MSI-H haya sido determinado con anterioridad. Antes de la selección, los participantes sin este dato deben cumplir los criterios de preselección indicados a continuación. Para poder participar en el estudio, los sujetos deben cumplir todos los criterios de inclusión y exclusión tras completar el periodo de preselección.
    *Edad
    1. Al menos 18 años de edad en el momento de la firma del FCI.
    *Tipo de participantes y características de la enfermedad
    1. Confirmación histológica de cáncer de recto en estadio II a III (T3-T4, N0, o cualquier T, N+) localmente avanzado.
    2. Enfermedad radiológica y endoscópicamente evaluable.

    Criterios de inclusión (periodo de selección)
    Los participantes son elegibles para su inclusión en el estudio solo si cumplen todos los criterios dispuestos a continuación:
    *Edad
    1. Al menos 18 años de edad en el momento de la firma del FCI.
    Tipo de participantes y características de la enfermedad
    2. Confirmación histológica de cáncer de recto en estadio II a III (T3-T4, N0, o cualquier T, N+) localmente avanzado.
    3. Enfermedad radiológica y endoscópicamente evaluable.
    4. Tumor que demuestra la presencia de:
    a. Estado dMMR; el estado MMR debe evaluarse mediante IHQ para la expresión proteica MMR (MLH1, MSH2, MSH6, PMS2) de manera que la pérdida de 1 o más proteínas indica dMMR; el estado MMR se puede determinar localmente o utilizando el laboratorio de referencia central; o bien
    b. Fenotipo MSI-H conforme a lo determinado por la reacción en cadena de la polimerasa o mediante secuenciación tisular de nueva generación; MSI-H se puede determinar localmente o utilizando el laboratorio de referencia central.
    NOTA: Los pacientes que se sabe que padecen síndrome de Lynch y se ha descubierto que son portadores de una mutación específica de la línea germinal en el gen MMR (MLH1, MSH2, MSH6, PMS2) son elegibles para participar.
    5. Muestra tisular FFIP de archivo disponible que ha de presentarse en el laboratorio de referencia central para los análisis en el momento de la selección. En caso de no disponer de tejido de archivo, se deberá realizar una biopsia fresca al inicio.
    *Requisitos sobre el sexo y métodos anticonceptivos/de barrera
    6. Dispuesto a utilizar un método anticonceptivo adecuado.
    • El uso de anticonceptivos por las participantes de sexo femenino debe ser coherente con la normativa local sobre métodos anticonceptivos para participantes en estudios clínicos.
    Participantes femeninas:
    • Una paciente femenina es elegible para participar si no está embarazada o en periodo de lactancia y se cumple, al menos, una de las siguientes condiciones:
    • Es una MEF, tal y como se define en el Apéndice 4.
    O
    • Es una MEF que utiliza un método anticonceptivo de gran eficacia (con una tasa de fracaso < 1% al año), preferiblemente con una baja dependencia del usuario, tal y como se describe en el Apéndice 4, durante el periodo de tratamiento y al menos en los 120 días posteriores a la última dosis del tratamiento del estudio. El investigador debe evaluar la posibilidad de fracaso del método anticonceptivo (p. ej., falta de cumplimiento, inicio reciente) en relación con la primera dosis del tratamiento del estudio.
    • Una MEF debe presentar una prueba de embarazo de elevada sensibilidad con resultado negativo (en orina o suero según lo requerido por la normativa local) en las 24 horas antes de la primera dosis del tratamiento del estudio.
    • Si no se confirma el resultado negativo de la prueba en orina (p. ej., resultado ambiguo), se requerirá una prueba sérica de embarazo. En tales casos, la paciente no podrá participar si el resultado es positivo.
    • En el Apéndice 4 se exponen otros requisitos para las pruebas de embarazo durante y después del tratamiento del estudio.
    • El investigador es responsable de revisar el historial médico, antecedentes menstruales y actividad sexual reciente para reducir el riesgo de inclusión de una mujer con un embarazo no detectado precozmente.
    *Consentimiento informado
    7. Con capacidad para otorgar el consentimiento informado firmado conforme a lo descrito en el protocolo, incluyendo el cumplimiento con los requisitos y las restricciones dispuestas en el FCI y en este protocolo.
    *Estado funcional y función orgánica
    8. Estado funcional ECOG de 0 o 1.
    9. Función orgánica adecuada, conforme a lo descrito en la Tabla 8. (NOTA: Se debe obtener un hemograma completo sin transfusión o recepción de factores estimuladores de colonas en las 2 semanas tras la obtención de la muestra).
    Para una lista completa de los Criterio de Inclusión ver la Sección 5.1 del Protocolo del estudio.
    E.4Principal exclusion criteria
    Participants are excluded from the study if any of the following criteria
    * Medical conditions
    1. Has distant metastatic disease.
    2. Has received prior radiation therapy, systemic therapy, or surgery for management of rectal cancer. Note: Endoscopy guided biopsy is not considered surgery.
    3. Has a tumor that, in the investigator’s judgment, is causing symptomatic bowel obstruction or otherwise requires urgent/emergent local intervention.
    4. Has a known additional malignancy that progressed or required active treatment within the past 2 years. Exceptions include adequately treated superficial skin cancers, superficial bladder cancers, and other in situ cancers.
    5. Is immunocompromised in the opinion of the investigator.
    6. Has an active autoimmune disease that has required systemic treatment in the past 2 years (i.e., with use of disease-modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency)
    is not considered a form of systemic treatment.
    7. Is unable to undergo MRI.
    8. Has experienced any of the following with prior immunotherapy: any irAE of Grade ≥3, immune-related severe neurologic events of any grade (e.g., myasthenic syndrome/myasthenia gravis, encephalitis, Guillain-Barré Syndrome, or transverse myelitis), exfoliative dermatitis of any grade (Stevens-Johnson Syndrome, toxic epidermal necrolysis, or DRESS syndrome), or myocarditis of any grade. Non-clinically significant laboratory abnormalities are not exclusionary.

    * Prior/concomitant therapy
    9. Is receiving any other anticancer or experimental therapy. No other experimental therapies (including but not limited to chemotherapy, radiation, hormonal treatment, antibody therapy, immunotherapy, gene therapy, vaccine therapy, or other experimental drugs) of any kind are permitted while the participant is receiving study intervention.
    10. Is receiving immunosuppressive medication.
    11. Has received systemic corticosteroids (>10 mg daily prednisone or equivalent) within 7 days of first dose of study intervention. Use of inhaled steroids, local injection of steroids, topical steroids, and steroidal eye drops are allowed.
    12. Has received any live vaccine within 30 days prior to enrollment. Vaccination against COVID-19 using vaccines that are authorized via the appropriate regulatory mechanisms (e.g., Emergency Use Authorization, Conditional Marketing Authorization, or Marketing Authorization Application) are not exclusionary. Note: mRNA and adenoviral-based COVID-19 vaccines are considered non-live. If a COVID-19 vaccine is administered at any time, the date of COVID-19 vaccination must be entered in the eCRF.
    13. Is considered, in investigator’s opinion, a poor medical risk due to a serious, uncontrolled medical disorder, non-malignant systemic disease, or active infection requiring systemic therapy. Specific examples include but are not limited to: uncontrolled major seizure disorder; unstable spinal cord compression; superior vena cava syndrome; or any psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study (including obtaining informed consent).

    *Diagnostic assessments and other criteria
    14. Has documented presence of HBsAg at Screening or within 3 months prior to first dose of study intervention.
    15. Has a positive HCV antibody test result at Screening or within 3 months prior to first dose of study intervention. NOTE: Participants with a positive HCV antibody test result due to prior resolved disease can be enrolled if a confirmatory negative HCV RNA test is obtained.
    16. Has a positive HCV RNA test result at Screening or within 3 months prior to the first dose of study intervention. NOTE: The HCV RNA test is optional and participants with negative HCV antibody test are not required to undergo HCV RNA testing as well.

    For a full list of Exclusion criteria please refer to the Study Protocol Section 5.2 Inclusion Criteria pp61-63
    Los participantes se excluirán del estudio si cumplen alguno de los siguientes criterios:
    * Afecciones médicas
    1. Enfermedad metastásica distante.
    2. Administración previa de radioterapia, tratamiento sistémico o cirugía para el cáncer de recto. Nota: Una biopsia guiada por endoscopia no se considera una cirugía.
    3. Presencia de un tumor que, a criterio del investigador, causa una obstrucción intestinal sintomática o requiere un tratamiento local urgente.
    4. Otra neoplasia maligna conocida que progresó o requirió tratamiento activo en los últimos 2 años. Entre las excepciones se incluyen cáncer cutáneo superficial tratado adecuadamente, cáncer de vejiga superficial y otros tipos de cáncer in situ.
    5. Sujeto inmunodeprimido conforme al juicio del investigador.
    6. Enfermedad autoinmunitaria activa que ha requerido tratamiento sistémico en los últimos 2 años (es decir, con el uso de agentes modificadores de la enfermedad, corticoesteroides o fármacos inmunosupresores). La terapia de sustitución (p. ej., con corticoesteroides fisiológicos, tiroxina o insulina para una insuficiencia adrenal o pituitaria) no se considera una forma de tratamiento sistémico.
    7. No puede someterse a una RM.
    8. Ha experimentado cualquiera de los siguientes con una inmunoterapia previa: cualquier AAir de grado ≥3, acontecimientos neurológicos graves inmunorrelacionados de cualquier grado (p. ej., síndrome miasténico/miastenia grave, encefalitis, síndrome de Guillain-Barré o mielitis transversa), dermatitis exfoliativa de cualquier grado (síndrome de Stevens-Johnson, necrólisis epidérmica tóxica o síndrome de DRESS), o miocarditis de cualquier grado. Las anomalías de laboratorio no clínicamente significativas no son motivo de exclusión.
    * Tratamiento previo/concomitante
    9. Recibe cualquier otro tratamiento frente al cáncer o experimental. No se permiten otras terapias experimentales (incluyendo, entre otras, quimioterapia, radiación, tratamiento hormonal, terapia con anticuerpos, inmunoterapia, tratamiento génico, administración de vacunas u otros fármacos experimentales) de cualquier tipo mientras el participante recibe el tratamiento del estudio.
    10. Recibe un tratamiento inmunosupresor.
    11. Ha recibido corticoesteroides sistémicos (> 10 mg al día de prednisona o equivalente) en los 7 días desde la primera dosis del tratamiento del estudio. Se permite el uso de corticoesteroides inhalados, inyección local de corticoesteroides, corticoesteroides tópicos y gotas oculares con corticoesteroides.
    12. Ha recibido una vacuna viva en los 30 días previos a la inclusión. La vacunación frente a la COVID-19 con vacunas autorizadas mediante los mecanismos normativos apropiados (p. ej., autorización de uso de urgencia, autorización para la comercialización condicional o solicitud de autorización de comercialización) no son motivo de exclusión. Nota: Las vacunas para la COVID-29 basadas en adenovirus y ARNm se consideran vacunas no vivas. Si se administra una vacuna frente a la COVID-19 en cualquier momento, la fecha de vacunación frente a esta afección debe incluirse en el CRDe.
    13. El investigador opina que supone un importante riesgo médico debido a un trastorno médico grave no controlado, enfermedad sistémica no maligna o infección activa que requiere tratamiento sistémico. Los ejemplos específicos incluyen, entre otros: trastorno convulsivo importante no controlado; compresión inestable de la médula espinal; síndrome de la vena cava superior o cualquier trastorno de abuso de sustancias o psiquiátrico que pueda interferir con la cooperación con los requisitos del estudio (incluso la obtención del consentimiento informado).
    *Evaluaciones diagnósticas y otros criterios
    14. Presencia documentada de HBsAg en la selección o en los 3 meses previos a la primera dosis del tratamiento del estudio.
    15. Resultado positivo en la prueba de anticuerpos del VHC en la selección o en los 3 meses antes de la primera dosis del tratamiento del estudio. NOTA: Los participantes con un resultado positivo en la prueba de anticuerpos del VHC debido a una enfermedad previa resuelta pueden participar si se obtiene un resultado negativo confirmatorio en la prueba del ARN del VHC.
    16. Resultado positivo en la prueba del ARN del VHC en la selección o en los 3 meses antes de la primera dosis del tratamiento del estudio. NOTA: La prueba del ARN del VHC es opcional y no es necesario que los participantes con un resultado negativo en la prueba de anticuerpos del VHC se sometan al análisis del ARN del VHC.

    Para una lista completa de los Criterio de Exclusion ver la Sección 5.2 del Protocolo del estudio.
    E.5 End points
    E.5.1Primary end point(s)
    cCR12 as assessed by ICR, defined as maintenance of cCR for 12 months. The 12-month period starts from the first disease assessment after last dose of study intervention that demonstrates cCR by ICR.
    RCc12 conforme a lo evaluado por RCI, que se define como el mantenimiento de la RCc durante 12 meses. El periodo de 12 meses se inicia en el momento de la primera evaluación de la enfermedad tras la última dosis del tratamiento del estudio que resulta en una RCc según la RCI
    E.5.1.1Timepoint(s) of evaluation of this end point
    - cCR12 as assessed by ICR, defined as maintenance of cCR for 12 months. The 12-month period starts from the first disease assessment after last dose of study intervention that demonstrates cCR by ICR.
    RCc12 conforme a lo evaluado por RCI, que se define como el mantenimiento de la RCc durante 12 meses. El periodo de 12 meses se inicia en el momento de la primera evaluación de la enfermedad tras la última dosis del tratamiento del estudio que resulta en una RCc según la RCI
    E.5.2Secondary end point(s)
    - cCR36 as assessed by ICR, defined as maintenance of cCR for 36 months. The 36-month period starts from the first disease assessment after last dose of study intervention that demonstrates cCR by ICR.

    - EFS3 as assessed by investigator assessment, defined as remaining alive and free of 1) disease progression precluding surgery, 2) local recurrence, and 3) distant recurrence, as assessed by investigator at 3 years from the first dose of study intervention.

    EFS by investigator assessment defined as time from the date of first dose of study intervention to any of the following events:
    1) progression of disease that precludes surgery, 2) local recurrence, 3) distant recurrence (all as assessed by the investigator), or 4) death due to any cause
    • cCR12 by investigator assessment
    • cCR36 by investigator assessment
    • ORR by ICR, defined as achieving a PR, nCR, or cCR at PIDA or at least 4 weeks but no longer than 8 weeks after PIDA for participants with nCR or iCR (PIDA 2)
    • ORR at PIDA by investigator assessment
    • TME at 3 years, defined as undergoing TME, either as primary management or for local recurrence
    • DSS, Disease-Specific Survival, defined as time from the date of first dose of study intervention to death due to disease under study
    • DSS5, defined as not dying due to disease under study at 5 years from the first dose of study intervention
    • OS, defined as time from first dose of study intervention to death from any cause
    • OS5, defined as being alive at 5 years from first dose of study intervention

    - Frequency and severity of AEs, SAEs, irAEs, and AEs leading to death or discontinuation of study intervention
    - Serum concentrations and PK parameters (C-EOI and Ctrough) for dostarlimab
    - Incidence of ADA against dostarlimab
    - RCc36 conforme a lo evaluado por RCI, que se define como el mantenimiento de la RCc durante 36 meses. El periodo de 36 meses se inicia en el momento de la primera evaluación de la enfermedad tras la última dosis del tratamiento del estudio que resulta en una RCc según la RCI.
    - SLA3 según la evaluación del investigador, que se define como permanecer con vida y sin 1) progresión de la enfermedad que impide la cirugía, 2) recurrencia local, y 3) recurrencia distante, conforme a lo evaluado por el investigador al cabo de 3 años desde la primera dosis del tratamiento del estudio.
    - SLA según la evaluación del investigador, que se define como el tiempo desde la fecha de la primera dosis del tratamiento del estudio hasta cualquiera de los siguientes acontecimientos: 1) progresión de la enfermedad que impide la cirugía, 2) recurrencia local, 3) recurrencia distante (todo conforme a lo evaluado por el investigador), o 4) muerte por cualquier causa
    - RCc12 según la evaluación del investigador
    - RCc36 según la evaluación del investigador
    - TRO según la RCI, que se define como el logro de una RP, RCcc o RCc en PIDA o un mínimo de 4 semanas y un máximo de 8 semanas después de la PIDA en participantes con RCcc o RCi (PIDA 2)
    - TRO en PIDA según la evaluación del investigador
    - EMT a los 3 años, que se define como EMT en curso, como tratamiento principal o para la recurrencia local
    - SEE, supervivencia específica de la enfermedad, que se define como el tiempo desde la fecha de la primera dosis del tratamiento del estudio hasta la muerte causada por la enfermedad en estudio
    - SEE5, que se define como el no fallecimiento a causa de la enfermedad en estudio a los 5 años desde la primera dosis del tratamiento del estudio
    - SG, que se define como el tiempo desde la primera dosis del tratamiento del estudio hasta la muerte por cualquier causa
    - SG5, que se define como permanecer con vida al cabo de 5 años desde la primera dosis del tratamiento del estudio

    - Frecuencia y gravedad de AA, AAG, AAir y AA que producen la muerte o dan lugar a la suspensión del tratamiento del estudio
    - Concentraciones séricas y parámetros FC (C-FDI y Cmín) para dostarlimab
    - Incidencia de AAF frente a dostarlimab
    E.5.2.1Timepoint(s) of evaluation of this end point
    - cCR36 as assessed by ICR, defined as maintenance of cCR for 36 months. The 36-month period starts from the first disease assessment after last dose of study intervention that demonstrates cCR by ICR.
    - EFS3 as assessed by investigator assessment, defined as remaining alive and free of 1) disease progression precluding surgery, 2) local recurrence, and 3) distant recurrence, as assessed by investigator at 3 years from the first dose of study intervention.
    -ORR by ICR, defined as achieving a PR, nCR, or cCR at PIDA or at least 4 weeks but no longer than 8 weeks after PIDA for participants with nCR or iCR (PIDA 2)
    -TME at 3 years, defined as undergoing TME, either as primary management or for local recurrence
    Please refer Table 6 in Protocol Page No. 51
    - RCc36 conforme a lo evaluado por RCI, que se define como el mantenimiento de la RCc durante 36 meses. El periodo de 36 meses se inicia en el momento de la primera evaluación de la enfermedad tras la última dosis del tratamiento del estudio que resulta en una RCc según la RCI.
    - SLA3 según la evaluación del investigador, que se define como permanecer con vida y sin 1) progresión de la enfermedad que impide la cirugía, 2) recurrencia local, y 3) recurrencia distante, conforme a lo evaluado por el investigador al cabo de 3 años desde la primera dosis del tratamiento del estudio.

    ver Tabla 6 del Protocolo
    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 Yes
    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 Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    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 concerned21
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA24
    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
    Japan
    Korea, Republic of
    United States
    France
    Netherlands
    Spain
    Germany
    Italy
    United Kingdom
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    LVLS
    utima visita del último paciente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years6
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days18
    E.8.9.2In all countries concerned by the trial years6
    E.8.9.2In all countries concerned by the trial months6
    E.8.9.2In all countries concerned by the trial days18
    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: 50
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 50
    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 state12
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 61
    F.4.2.2In the whole clinical trial 100
    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)
    None
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2023-03-14
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2023-03-02
    P. End of Trial
    P.End of Trial StatusOngoing
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