An early access study of ivosidenib in patients with a pretreated locally advanced or metastatic cholangiocarcinoma

2022-501463-40-00 Protocol DIM-95031-002 Therapeutic confirmatory (Phase III) Not authorised

Status Not authorised · 4 EU/EEA countries · 17 sites · Protocol DIM-95031-002

Overview

Sponsor-declared trial summary

Phase Therapeutic confirmatory (Phase III)
Status Not authorised
Participants planned 109
Countries 4
Sites 17

Locally Advanced or Metastatic Cholangiocarcinoma

Safety of ivosidenib in patients with pretreated locally advanced or metastatic CCA

Key facts

Sponsor
Servier Affaires Medicales
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Neoplasms [C04]
Decision date (initial)
2023-02-20
Transition trial
No
Low-intervention
No
Rare-disease indication
Yes
Vulnerable population
Yes
Funding sources
SERVIER AFFAIRES MÉDICALES

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Pharmacoeconomic, Safety, Efficacy, Others, Pharmacogenomic

Safety of ivosidenib in patients with pretreated locally advanced or metastatic CCA

Secondary objectives 3

  1. • Efficacy in daily clinical practice
  2. • Quality of life (HRQOL)
  3. • Utilization of medical resources

Conditions and MedDRA coding

Locally Advanced or Metastatic Cholangiocarcinoma

VersionLevelCodeTermSystem organ class
20.0 PT 10008593 Cholangiocarcinoma 100000004864

Study design 1 period

#TitleAllocationBlindingRoles blindedArms
1 Treatment Period
Patients can remain on ivosidenib study treatment as long as there is a clinical benefit for the patients as assessed by the investigator, until unacceptable toxicity occurs, or until ivosidenib is available via medical prescription at the patient’s site or can be accessed from an alternative source.
Not Applicable None Test: Ivosidenib 500 mg once daily (QD)

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 11

  1. 1. Be ≥18 years of age
  2. 2. Have a histopathological diagnosis of CCA consistent with nonresectable or metastatic CCA and are not eligible for curative-intent resection, transplantation, or ablative therapies
  3. 3. Have documented IDH1 R132C, R132L, R132G, R132H, or R132S gene-mutated disease based on a local validated biomolecular profiling method
  4. 4. Have documented locally advanced or metastatic CCA following at least 1 prior line of systemic therapy
  5. 5. Have an ECOG PS score of 0 or 1
  6. 6. Have recovered from toxicities associated with prior anticancer therapy to baseline or have stabilized under medical management
  7. 7. Have adequate bone marrow function as described in the protocol.
  8. 8. Have adequate hepatic function as described in the protocol.
  9. 9. Have adequate renal function as described in the protocol.
  10. 10. Be able to understand and willing to sign the informed consent form (ICF) and to comply with the study procedures.
  11. 11. Willingness to comply with contraception guidelines of this study.

Exclusion criteria 16

  1. 1. Received a prior IDH1 inhibitor
  2. 2. Had a prior transplantation
  3. 3. Received systemic anticancer therapy <2 weeks prior to first dose of study treatment on C1D1, immune based anticancer therapy <4 weeks prior to C1D1, or an investigational agent <5 half-lives of this agent prior to C1D1
  4. 4. Received radiotherapy to metastatic sites of disease <2 weeks prior to C1D1
  5. 5. Underwent hepatic radiation, chemoembolization, and radiofrequency ablation <4 weeks prior to C1D1
  6. 6. Have known symptomatic brain metastases requiring steroids.
  7. 7. Have a history of another primary cancer, with the exception of: a) curatively resected non-melanoma skin cancer; b) curatively treated cervical carcinoma in situ; or c) other primary solid or liquid tumor with no known active disease present that, in the opinion of the Investigator, will not affect patient outcome in the setting of current CCA diagnosis.
  8. 8. Underwent major surgery <4 weeks prior to C1D1 or have not recovered from post-surgery toxicities
  9. 9. Are pregnant or breastfeeding
  10. 10. Are taking known strong cytochrome P450 (CYP) 3A4 inducers or inhibitors or sensitive CYP3A4 substrate medications, unless they can be transferred to other medications.
  11. 11. Are taking P-glycoprotein (P-gp) transporter-sensitive substrate medications or inhibitors unless they can be transferred to other medications.
  12. 12. Have an active infection requiring systemic anti-infective therapy or with an unexplained fever >38.5°C within 7 days of Day 1.
  13. 13. Have any known hypersensitivity to any of the components of ivosidenib
  14. 14. Have significant active cardiac disease within 6 months prior to the start of study treatment.
  15. 15. Have known active hepatitis B (HBV) or hepatitis C (HCV) infections, known positive human immunodeficiency virus (HIV) antibody results, or acquired immunodeficiency syndrome (AIDS) related illness.
  16. 16. Have any gastrointestinal medical condition which would limit ingestion or gastrointestinal absorption according to investigator’s judgment

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. AEs, serious AEs (SAEs), AEs of special interest (AESIs), AEs leading to discontinuation or death, safety laboratory parameters, 12-lead ECG, vital signs, Eastern Cooperative Oncology Group (ECOG) performance status (PS)

Secondary endpoints 5

  1. • Response to treatment based on tumor assessments by the investigator according to local clinical practice o Progression-free survival (PFS) o Overall survival (OS) o Duration of response (DOR) o Time to response (TTR)
  2. • HRQOL as assessed by the validated European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Cholangiocarcinoma and Gallbladder Cancer Module (QLQ-BIL21)
  3. • Health economic outcomes as assessed by the 5 level EuroQol 5-dimensional questionnaire (EQ-5D-5L)
  4. • Proportion of days at home or hospital
  5. • Concomitant medications

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Ivosidenib

SUB189254 · Substance

Active substance
Ivosidenib
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL
Max daily dose
500 mg milligram(s)
Max total dose
500 mg milligram(s)
Max treatment duration
24 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
Yes
Orphan designation number
EU/3/18/1994
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Servier Affaires Medicales

Sponsor organisation
Servier Affaires Medicales
Address
35 Rue De Verdun
City
Suresnes Cedex
Postcode
92284
Country
France

Scientific contact point

Organisation
Servier Affaires Medicales
Contact name
Evidence Generation Lead

Public contact point

Organisation
Servier Affaires Medicales
Contact name
Evidence Generation Lead

Third parties 7

OrganisationCity, countryDuties
Suvoda LLC
ORG-100043523
Conshohocken, United States Interactive response technologies (IRT)
Medidata Solutions Inc.
ORG-100016256
New York, United States E-data capture
Syneos Health Netherlands B.V.
ORG-100013861
Amsterdam, Netherlands On site monitoring, Code 11, Code 12, Code 13, Code 2, Code 5, Data management, Code 8
Azenta Germany GmbH
ORG-100039257
Griesheim, Germany Other, Laboratory analysis
Umotif Limited
ORG-100043353
London, United Kingdom Other
Pharmaceutical Product Development LLC
ORG-100016999
Highland Heights, United States Other, Laboratory analysis
PPD International Holdings LLC
ORG-100007655
Zaventem, Belgium Other

Locations

4 EU/EEA countries · 17 investigational sites

By country

CountryMS statusPlanned subjectsSites
Austria Not authorised 13 5
Germany Not authorised 30 7
Netherlands Not authorised 12 3
Sweden Not authorised 10 2
Rest of world
United Kingdom, Australia
44

Investigational sites

Austria

5 sites · Not authorised
Ordensklinikum Linz GmbH
Barmherzige Schwestern, Seilerstätte 4, 4020, Linz
Medical University Of Vienna
Department of Medicine I, Division of Oncology, Waehringer Guertel 18-20, Alsergrund, Vienna
SCRI – CCCIT Ges.m.b.H.
III MedDept with Hematology_MedOncology_Hemostaseology_InfDiseases and Rheumatology_OncologicCenter, Muellner Hauptstrasse 48, 5020, Salzburg
Medizinische Universitaet Innsbruck
University Hospital for Internal Medicine I, Anichstraße 35, 6020, Innsbruck
Medical University Of Graz
Dept. of Internal Medicine, Division of Oncology, Auenbruggerplatz 2, 8036, Graz

Germany

7 sites · Not authorised
Klinikum der Universitat Munchen AöR
Medizinische Klinik und Poliklinik III Campus Großhadern, Marchioninistraße 15, Hadern, Munich
Universitaetsklinikum Duesseldorf AöR
Klinik für Gastroenterologie, Hepatologie und Infektiologie, Moorenstraße 5, Bilk, Düsseldorf
Medical Center - University Of Freiburg
Klinik für Innere Medizin II Gastroenterologie, Hepatologie, Infektiologie & Endokrinologie, Hugstetter Strasse 55, Stuehlinger, Freiburg Im Breisgau
Goethe University Frankfurt
Department of Internal Medicine I, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main
Technische Universitat Dresden
Medizinische Klinik und Poliklinik I Bereich Klinische Studien, Fetscherstrasse 74, Johannstadt-Nord, Dresden
Medizinische Hochschule Hannover
Zentrum Innere Medizin Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Carl-Neuberg-Strasse 1, Gross Buchholz, Hanover
Charite Universitatsmedizin Berlin KöR
Division of Oncology/Hematology/Tumorimmunology, Charitéplatz 1, Mitte, Berlin

Netherlands

3 sites · Not authorised
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Oncology, Dr. Molewaterplein 40, 3015 GD, Rotterdam
Maastricht University
Oncology, P Debyelaan 25, 6229 HX, Maastricht
Amsterdam UMC
Oncology, De Boelelaan 1117, 1081 HV, Amsterdam

Sweden

2 sites · Not authorised
Karolinska University Hospital
Tema Cancer, Medical Unit Upper Abdomen C1:77, Halsovagen, Flemingsberg, Huddinge
Sahlgrenska University Hospital-Vastra Gotalandsregionen
Oncology, Bla Straket 5, 413 46, Goteborg

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2022-10-11 Austria Not acceptable
2023-02-13
2023-02-16