Overview
Sponsor-declared trial summary
First-line treatment of participants with metastatic nonsmall cell lung cancer
1. To compare MK-3475A SC to pembrolizumab IV with respect to AUC 2. To compare MK-3475A SC to pembrolizumab IV with respect to steady-state Ctrough
Key facts
- Sponsor
- Merck Sharp & Dohme LLC
- Participant type
- Patients
- Age range
- 18-64 years, 65+ years
- Gender
- Male and Female
- Therapeutic area
- Diseases [C] - Neoplasms [C04]
- Trial duration
- 11 Apr 2023 → ongoing
- Decision date (initial)
- 2023-04-05
- Transition trial
- No
- Low-intervention
- No
- Rare-disease indication
- No
- Vulnerable population
- Yes
- Funding sources
- Merck Sharp & Dohme LLC
External identifiers
- EU CT number
- 2022-501506-36-00
- WHO UTN
- U1111-1280-9384
Trial design
CTIS Part I — objectives, methods, condition coding
Main objective
Scope: Safety, Pharmacokinetic
1. To compare MK-3475A SC to pembrolizumab IV with respect to AUC
2. To compare MK-3475A SC to pembrolizumab IV with respect to steady-state Ctrough
Secondary objectives 9
- To evaluate pembrolizumab exposure for MK-3475A SC relative to pembrolizumab IV
- To evaluate the development of circulating anti-pembrolizumab antibodies for MK-3475A SC and pembrolizumab IV
- To evaluate pembrolizumab Ctrough for MK-3475A SC relative to pembrolizumab IV
- To evaluate MK-3475A SC and pembrolizumab IV with respect to ORR per RECIST 1.1 as assessed by BICR
- To evaluate MK-3475A SC and pembrolizumab IV with respect to PFS per RECIST 1.1 as assessed by BICR
- To evaluate MK-3475A SC and pembrolizumab IV with respect to OS
- To evaluate MK-3475A SC and pembrolizumab IV with respect to DOR per RECIST 1.1 as assessed by BICR
- To evaluate the safety and tolerability of MK-3475A SC and pembrolizumab IV
- To evaluate the change from baseline in global health status/QoL for MK-3475A SC and pembrolizumab IV
Conditions and MedDRA coding
First-line treatment of participants with metastatic nonsmall cell lung cancer
| Version | Level | Code | Term | System organ class |
|---|---|---|---|---|
| 21.1 | PT | 10059515 | Non-small cell lung cancer metastatic | 100000004864 |
Regulatory references
- Scientific advice from competent authorities
- European Medicines Agency
- Plan to share IPD
- Yes
Eligibility criteria
Principal inclusion / exclusion criteria as submitted by sponsor
Inclusion criteria 3
- Has histologically or cytologically confirmed diagnosis of squamous or non-squamous Non-small Cell Lung Cancer (NSCLC)
- Must provide archival tumor tissue sample or newly obtained core, incisional, or excisional biopsy of a tumor lesion not previously irradiated
- Has a life expectancy of at least 3 months
Exclusion criteria 14
- Has a diagnosis of small cell lung cancer or, for mixed tumors, presence of small cell elements
- Has received prior systemic anticancer therapy for metastatic NSCLC
- Has received prior systemic anticancer therapy including investigational agents within 4 weeks before randomization
- Has received prior radiotherapy within 2 weeks of start of study intervention or has radiation-related toxicity requiring corticosteroids
- Has received radiation therapy to the lung (>30 Gray) within 6 months of start of study intervention
- Has received a live or live-attenuated vaccine within 30 days before the first dose of study intervention
- Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy
- Has a known additional malignancy that is progressing or has required active treatment within the past 3 years
- Has an active autoimmune disease that has required systemic treatment in past 2 years
- Has an active infection requiring systemic therapy
- Has a history of human immunodeficiency virus (HIV) infection
- Has a history of Hepatitis B or C
- Has not adequately recovered from major surgery or has ongoing surgical complications
- Has a history of allogenic tissue/solid organ transplant
Endpoints
Primary and secondary outcome measures (English text)
Primary endpoints 2
- Area Under the Curve (AUC) of Pembrolizumab Measured After the First Dose
- Trough Concentration (Ctrough) of Pembrolizumab Measured at Steady State
Secondary endpoints 14
- Maximum Serum Concentration (Cmax) of Pembrolizumab Measured After the First Dose
- Trough Concentration (Ctrough) of Pembrolizumab Measured After the First Dose
- Area Under the Curve (AUC) of Pembrolizumab Measured at Steady State
- Maximum Serum Concentration (Cmax) of Pembrolizumab Measured at Steady State
- Number of Participants Who Test Positive for Anti-Drug Antibodies (ADAs) for Pembrolizumab
- Objective Response Rate (ORR) per Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1)
- Progression-free Survival (PFS) per Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1)
- Overall Survival (OS)
- Duration of Response (DOR) per Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1)
- Number of Participants Who Experienced at Least One Adverse Event (AE)
- Number of Participants Who Discontinued Study Treatment Due to an Adverse Event (AE)
- Change From Baseline in the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) Global Health Status/Quality of Life (GHS/QoL) Score-Items 29 and 30
- Change From Baseline in the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) Physical Functioning Score-Items 1 to 5
- Change From Baseline in the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) Role Functioning Score-Items 6 and 7
Investigational products
Investigational medicinal products (IMPs), comparators, placebo, auxiliary
Test 1
PRD9357633 · Product
- Active substance
- Pembrolizumab
- Pharmaceutical form
- SOLUTION FOR INJECTION
- Route of administration
- SUBCUTANEOUS
- Max daily dose
- 00 % (V/V) percent volume/volume
- Max total dose
- 00 % (V/V) percent volume/volume
- Max treatment duration
- 1 Week(s)
- Authorisation status
- Not Authorised
- MA holder
- MERCK & CO. INC.
- Paediatric formulation
- No
- Orphan designation
- No
Comparator 1
KEYTRUDA 25 mg/mL concentrate for solution for infusion
PRD4323105 · Product
- Active substance
- Pembrolizumab
- Substance synonyms
- Lambrolizumab, MK-3475, SCH-900475, ABP 234
- Pharmaceutical form
- SOLUTION FOR INFUSION
- Route of administration
- INTRAVENOUS
- Max daily dose
- 0 % percent
- Max total dose
- 00 % (V/V) percent volume/volume
- Max treatment duration
- 1 Week(s)
- Authorisation status
- Authorised
- ATC code
- L01FF02 — -
- Marketing authorisation
- EU/1/15/1024/002
- MA holder
- MERCK SHARP & DOHME BV
- MA country
- EU
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
Auxiliary 12
Pazenir 5 mg/ml powder for dispersion for infusion
PRD7328588 · Product
- Active substance
- Paclitaxel Albumin-Bound
- Substance synonyms
- PACLITAXEL ALBUMINE-BOUND
- Pharmaceutical form
- DISPERSION FOR INFUSION
- Route of administration
- INTRAVENOUS
- Max daily dose
- 100 mg/m2 milligram(s)/square meter
- Max total dose
- 100 mg/m2 milligram(s)/square meter
- Max treatment duration
- 12 Week(s)
- Authorisation status
- Authorised
- ATC code
- L01CD01 — PACLITAXEL
- Marketing authorisation
- EU/1/18/1317/001
- MA holder
- RATIOPHARM GMBH
- MA country
- EU
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
SUB09655MIG · Substance
- Active substance
- Pemetrexed
- Pharmaceutical form
- POWDER FOR CONCENTRATE FOR SOLUTION FOR INFUSION
- Route of administration
- INTRAVENOUS
- Max daily dose
- 500 mg/m2 milligram(s)/square meter
- Max total dose
- 500 mg/m2 milligram(s)/square meter
- Max treatment duration
- 150 Week(s)
- Authorisation status
- Authorised
- ATC code
- - — -
- Marketing authorisation
- -
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
SUB09583MIG · Substance
- Active substance
- Paclitaxel
- Pharmaceutical form
- CONCENTRATE FOR SOLUTION FOR INFUSION
- Route of administration
- INTRAVENOUS
- Max daily dose
- 200 mg/m2 milligram(s)/square meter
- Max total dose
- 200 mg/m2 milligram(s)/square meter
- Max treatment duration
- 12 Week(s)
- Authorisation status
- Authorised
- ATC code
- - — -
- Marketing authorisation
- -
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
Paclitaxel EVER Pharma 6 mg/ml Konzentrat zur Herstellung einer Infusionslösung
PRD6187383 · Product
- Active substance
- Paclitaxel
- Pharmaceutical form
- SOLUTION FOR INFUSION
- Route of administration
- INTRAVENOUS
- Max daily dose
- 200 mg/m2 milligram(s)/square meter
- Max total dose
- 200 mg/m2 milligram(s)/square meter
- Max treatment duration
- 12 Week(s)
- Authorisation status
- Authorised
- ATC code
- L01CD01 — PACLITAXEL
- Marketing authorisation
- 96558.00.00
- MA holder
- EVER VALINJECT GMBH
- MA country
- Germany
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
ALIMTA 500 mg powder for concentrate for solution for infusion
PRD2433080 · Product
- Active substance
- Pemetrexed
- Pharmaceutical form
- SOLUTION FOR INFUSION
- Route of administration
- INTRAVENOUS
- Max daily dose
- 500 mg/m2 milligram(s)/square meter
- Max total dose
- 500 mg/m2 milligram(s)/square meter
- Max treatment duration
- 150 Week(s)
- Authorisation status
- Authorised
- ATC code
- L01BA04 — -
- Marketing authorisation
- EU/1/04/290/001
- MA holder
- ELI LILLY NEDERLAND B.V.
- MA country
- Iceland
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
SUB127678 · Substance
- Active substance
- Paclitaxel Albumin-Bound
- Pharmaceutical form
- DISPERSION FOR INFUSION
- Route of administration
- INTRAVENOUS
- Max daily dose
- 100 mg/m2 milligram(s)/square meter
- Max total dose
- 100 mg/m2 milligram(s)/square meter
- Max treatment duration
- 12 Week(s)
- Authorisation status
- Authorised
- ATC code
- - — -
- Marketing authorisation
- -
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
SCP180112 · ATC
- Active substance
- Glatiramer Acetate
- Substance synonyms
- COPOLYMER-1
- Route of administration
- INTRAVENOUS INFUSION
- Max daily dose
- 0 % (V/V) percent volume/volume
- Max total dose
- 0 % (V/V) percent volume/volume
- Max treatment duration
- 1 Day(s)
- Authorisation status
- Authorised
- ATC code
- L03AA13 — PEGFILGRASTIM
- Marketing authorisation
- -
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
SUB06614MIG · Substance
- Active substance
- Carboplatin
- Pharmaceutical form
- SOLUTION FOR INFUSION
- Route of administration
- INTRAVENOUS
- Max daily dose
- 6 Other
- Max total dose
- 6 Other
- Max treatment duration
- 12 Week(s)
- Authorisation status
- Authorised
- ATC code
- - — -
- Marketing authorisation
- -
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
Carboplatin Kabi 10 mg/ml Konzentrat zur Herstellung einer Infusionslösung
PRD669106 · Product
- Active substance
- Carboplatin
- Pharmaceutical form
- SOLUTION FOR INFUSION
- Route of administration
- INTRAVENOUS
- Max daily dose
- 6 Other
- Max total dose
- 6 Other
- Max treatment duration
- 12 Week(s)
- Authorisation status
- Authorised
- ATC code
- L01XA02 — CARBOPLATIN
- Marketing authorisation
- 84223.00.00
- MA holder
- FRESENIUS KABI DEUTSCHLAND GMBH
- MA country
- Germany
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
Cisplatin Teva® 1 mg/ml Konzentrat zur Herstellung einer Infusionslösung
PRD662245 · Product
- Active substance
- Cisplatin
- Pharmaceutical form
- INJECTION
- Route of administration
- INTRAVENOUS
- Max daily dose
- 75 mg/m2 milligram(s)/sq. meter
- Max total dose
- 75 mg/m2 milligram(s)/square meter
- Max treatment duration
- 12 Week(s)
- Authorisation status
- Authorised
- ATC code
- L01XA01 — CISPLATIN
- Marketing authorisation
- 71983.00.00
- MA holder
- TEVA GMBH
- MA country
- Germany
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
SUB07483MIG · Substance
- Active substance
- Cisplatin
- Pharmaceutical form
- CONCENTRATE FOR SOLUTION FOR INFUSION
- Route of administration
- INTRAVENOUS
- Max daily dose
- 75 mg/m2 milligram(s)/square meter
- Max total dose
- 75 mg/m2 milligram(s)/square meter
- Max treatment duration
- 12 Week(s)
- Authorisation status
- Authorised
- ATC code
- - — -
- Marketing authorisation
- -
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
SCP147553 · ATC
- Active substance
- Filgrastim
- Substance synonyms
- NT100H, FILGRASTIM (GENETICAL RECOMBINATION)
- Route of administration
- INTRAVENOUS INFUSION
- Max daily dose
- 0 % (V/V) percent volume/volume
- Max total dose
- 0 % (V/V) percent volume/volume
- Max treatment duration
- 1 Day(s)
- Authorisation status
- Authorised
- ATC code
- L03AA02 — FILGRASTIM
- Marketing authorisation
- -
- Paediatric formulation
- No
- Orphan designation
- No
- Modified vs. Marketing Authorisation
- No
Sponsors and contacts
Sponsor organisations, regulatory contacts, third parties
Merck Sharp & Dohme LLC
- Sponsor organisation
- Merck Sharp & Dohme LLC
- Address
- 126 East Lincoln Avenue
- City
- Rahway
- Postcode
- 07065-4607
- Country
- United States
Scientific contact point
- Organisation
- Merck Sharp & Dohme LLC
- Contact name
- Jianda Yuan
Public contact point
- Organisation
- Merck Sharp & Dohme LLC
- Contact name
- Jianda Yuan
Third parties 9
| Organisation | City, country | Duties |
|---|---|---|
| Signant Health Management Limited ORG-100040504
|
London, United Kingdom | Other |
| Bioclinica Inc. ORG-100033079
|
Princeton, United States | Other |
| Syneos Health Clinique Inc. ORG-100028348
|
Quebec, Canada | Other |
| Parexel International Corporation ORG-100007310
|
Auburndale, United States | Other |
| Hematogenix Laboratory Services LLC ORG-100040020
|
Tinley Park, United States | Other |
| Q Squared Solutions LLC. ORL-000008178
|
Valencia, United States | Laboratory analysis |
| Almac Clinical Technologies LLC ORG-100043036
|
Souderton, United States | Interactive response technologies (IRT) |
| PPD Development LP ORG-100011560
|
Richmond, United States | Other |
| Greenphire LLC ORG-100041621
|
King Of Prussia, United States | Other |
Locations
5 EU/EEA countries · 18 investigational sites
By country
| Country | MS status | Planned subjects | Sites |
|---|---|---|---|
| France | Ended | 2 | 3 |
| Hungary | Ongoing, recruitment ended | 33 | 5 |
| Poland | Ongoing, recruitment ended | 22 | 2 |
| Romania | Ongoing, recruitment ended | 30 | 4 |
| Spain | Ongoing, recruitment ended | 13 | 4 |
| Rest of world
South Africa, Japan, Turkey, Chile, Thailand, United States, Brazil, Guatemala, Taiwan, China, Argentina
|
— | 293 | — |
Investigational sites
Country notifications
Trial-start, recruitment-start, end and early-termination notifications submitted per Member State
| Country | Trial start | Trial end | Recruitment start | Recruitment end | Early termination |
|---|---|---|---|---|---|
| France | 2023-06-27 | 2025-05-04 | 2023-08-08 | 2023-12-08 | |
| Hungary | 2023-05-08 | 2023-05-09 | 2023-12-08 | ||
| Poland | 2023-05-04 | 2023-05-09 | 2023-12-08 | ||
| Romania | 2023-05-04 | 2023-05-04 | 2023-12-08 | ||
| Spain | 2023-04-11 | 2023-04-26 | 2023-12-08 |
Results and documents
Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial
Documents 53 files
Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.
| Type | Title | Version |
|---|---|---|
| Clinical study report (for publication) | m5351-pd77v01mk3475a-p-app1611-protocol | 1 |
| Clinical study report (for publication) | m5351-pd77v01mk3475a-p-app1612-crf | 1 |
| Clinical study report (for publication) | m5351-pd77v01mk3475a-p-app1619-sap | 1 |
| Clinical study report (for publication) | m5351-pd77v01mk3475a-p-csr-body | 1 |
| Protocol (for publication) | D1 _Protocol_2022-501506-36-00_for pub | 03R |
| Protocol (for publication) | D1_Protocol_2022-501506-36-00_for pub | 00R |
| Protocol (for publication) | D1_PSP_for pub | 01R |
| Protocol (for publication) | D4_Copyright statement_EN_SM12_for pub | 04DEC2024 |
| Recruitment arrangements (for publication) | K_Recruitment Arrangements and Informed Consent Procedure_HUN_for publication | 12Nov2022 |
| Recruitment arrangements (for publication) | K1_Recruitment Arrangements and Informed Consent Procedure_ESP_Spanish_for publication | 21OCT2022 |
| Recruitment arrangements (for publication) | K1_Recruitment Arrangements and Informed Consent Procedure_FRA_French_for publication | 03MAY2023 |
| Recruitment arrangements (for publication) | K1_Recruitment Arrangements and Informed Consent Procedure_POL_Polish English_for publication | 27OCT2022 |
| Recruitment arrangements (for publication) | K1_Recruitment Arrangements and Informed Consent Procedure_ROU_Romanian_for publication | 24Nov2022 |
| Recruitment arrangements (for publication) | K2_Recruitment Doc Brochure_FRA_FR_for pub | 00.1 |
| Subject information and informed consent form (for publication) | L_ICF_Optional nursing_HUN_Hungarian_for publication | 0.00R |
| Subject information and informed consent form (for publication) | L1_ICF_FBR consent_ESP_Spanish_for publication | 18NOV2022 |
| Subject information and informed consent form (for publication) | L1_ICF_FBR consent_FRA_French_for publication | 0-00 |
| Subject information and informed consent form (for publication) | L1_ICF_FBR consent_HUN_Hungarian_for publication | 16NOV2022 |
| Subject information and informed consent form (for publication) | L1_ICF_FBR consent_POL_Polish_for publication | 0.00 |
| Subject information and informed consent form (for publication) | L1_ICF_FBR consent_ROU_EN_for pub | 0.00 |
| Subject information and informed consent form (for publication) | L1_ICF_FBR consent_ROU_RO_for pub | 0.00 |
| Subject information and informed consent form (for publication) | L1_ICF_Genetic consent_HUN_Hungarian_for publication | 16NOV2022 |
| Subject information and informed consent form (for publication) | L1_ICF_Main addendum disease progression_ESP_Spanish_for publication | 18NOV2022 |
| Subject information and informed consent form (for publication) | L1_ICF_Main addendum disease progression_FRA_for publication | 22NOV2022 |
| Subject information and informed consent form (for publication) | L1_ICF_Main addendum disease progression_HUN_Hungarian_for publication | 16NOV2022 |
| Subject information and informed consent form (for publication) | L1_ICF_Main addendum disease progression_POL_PL_SM10_for pub | 00 |
| Subject information and informed consent form (for publication) | L1_ICF_Main addendum disease progression_ROU_English_for publication | 23NOV2022 |
| Subject information and informed consent form (for publication) | L1_ICF_Main addendum disease progression_ROU_Romanian_for publication | 23NOV2022 |
| Subject information and informed consent form (for publication) | L1_ICF_Main addendum_ROU_EN_for pub | 1 |
| Subject information and informed consent form (for publication) | L1_ICF_Main addendum_ROU_RO_for pub | 0.00 |
| Subject information and informed consent form (for publication) | L1_ICF_Main consent_ESP_ES_SM12_for pub | AM03v3.02R |
| Subject information and informed consent form (for publication) | L1_ICF_Main consent_FRA_FR_SM10_for pub | AM02v2.01R |
| Subject information and informed consent form (for publication) | L1_ICF_Main consent_HUN_HU_SM12_for pub | AM03v3.02R |
| Subject information and informed consent form (for publication) | L1_ICF_Main consent_POL_PL_SM12_for pub | AM03v3.02R |
| Subject information and informed consent form (for publication) | L1_ICF_Main consent_ROU_EN_SM12_for pub | AM03v3.02 |
| Subject information and informed consent form (for publication) | L1_ICF_Main consent_ROU_RO_SM12_for pub | AM03v3.02 |
| Subject information and informed consent form (for publication) | L1_ICF_Optional nursing_ESP_Spanish_for publication | 0.00R |
| Subject information and informed consent form (for publication) | L1_ICF_Optional nursing_ESP_Spanish_for publication_ | 29NOV2022 |
| Subject information and informed consent form (for publication) | L1_ICF_Optional nursing_FRA_French_for publication | 0.00 |
| Subject information and informed consent form (for publication) | L1_ICF_Optional nursing_POL_Polish_for publication | 0.00 |
| Subject information and informed consent form (for publication) | L1_ICF_Optional pregnant partner_HUN_Hungarian_for publication | 17NOV2022 |
| Subject information and informed consent form (for publication) | L1_ICF_Optional_add reimbursement_ROU_EN_SM10_for pub | 01 |
| Subject information and informed consent form (for publication) | L1_ICF_Optional_add reimbursement_ROU_RO_SM10_for pub | 01 |
| Subject information and informed consent form (for publication) | L1_ICF_Optional_nursing_ROU_EN_for pub | 0.00 |
| Subject information and informed consent form (for publication) | L1_ICF_Optional_nursing_ROU_RO_for pub | 0.00R |
| Subject information and informed consent form (for publication) | L1_Patient ID Card_HUN_HU_for pub | 2 |
| Synopsis of the protocol (for publication) | D1_PPLS_2022-501506-36_ESP_ES_for pub | 2.0 |
| Synopsis of the protocol (for publication) | D1_PPLS_2022-501506-36_for pub | 2.0 |
| Synopsis of the protocol (for publication) | D1_PPLS_2022-501506-36_FRA_FR_for pub | 2.0 |
| Synopsis of the protocol (for publication) | D1_PPLS_2022-501506-36_HUN_HU_for pub | 2.0 |
| Synopsis of the protocol (for publication) | D1_PPLS_2022-501506-36_POL_PL_for pub | 2.0 |
| Synopsis of the protocol (for publication) | D1_PPLS_2022-501506-36_ROU_RO_for pub | 2.0 |
| Synopsis of the protocol (for publication) | D1_Protocol Scientific Synopsis_2022-501506-36_ROU_EN_for pub | outofscope |
Application history
11 submissions — initial application plus substantial / non-substantial modifications
| # | Type | Code | Submitted | Reference MS | Conclusion | Decision date |
|---|---|---|---|---|---|---|
| 1 | INITIAL | IN | 2022-11-30 | Spain | Acceptable 2023-04-04
|
2023-04-04 |
| 2 | SUBSTANTIAL MODIFICATION | SM-1 | 2023-05-11 | Spain | Acceptable 2023-06-21
|
2023-06-21 |
| 3 | SUBSTANTIAL MODIFICATION | SM-2 | 2023-11-22 | Spain | Acceptable 2024-01-30
|
2024-01-30 |
| 4 | SUBSTANTIAL MODIFICATION | SM-8 | 2024-03-07 | Spain | Acceptable 2024-05-10
|
2024-05-10 |
| 5 | SUBSTANTIAL MODIFICATION | SM-9 | 2024-06-25 | Spain | Acceptable 2024-08-06
|
2024-08-06 |
| 6 | SUBSTANTIAL MODIFICATION | SM-10 | 2024-12-16 | Spain | Acceptable 2025-03-03
|
2025-03-04 |
| 7 | NON SUBSTANTIAL MODIFICATION | NSM-2 | 2025-04-02 | Spain | Acceptable 2025-03-03
|
2025-04-02 |
| 8 | SUBSTANTIAL MODIFICATION | SM-11 | 2025-04-08 | Acceptable | 2025-05-17 | |
| 9 | NON SUBSTANTIAL MODIFICATION | NSM-3 | 2025-06-10 | Spain | Acceptable | 2025-06-10 |
| 10 | NON SUBSTANTIAL MODIFICATION | NSM-4 | 2025-08-20 | Spain | Acceptable | 2025-08-20 |
| 11 | SUBSTANTIAL MODIFICATION | SM-12 | 2025-12-05 | Spain | Acceptable 2026-02-25
|
2026-02-26 |