A Study Comparing Abemaciclib Plus Temozolomide to Temozolomide Monotherapy in Children and Young Adults With High-grade Glioma Following Radiotherapy.

2022-502269-13-00 Protocol I3Y-MC-JPEH Therapeutic exploratory (Phase II) Ongoing, recruitment ended

Start 24 Sep 2024 · Status Ongoing, recruitment ended · 7 EU/EEA countries · 32 sites · Protocol I3Y-MC-JPEH

Overview

Sponsor-declared trial summary

Phase Therapeutic exploratory (Phase II)
Status Ongoing, recruitment ended
Participants planned 52
Countries 7
Sites 32

Glioma

The purpose of this study is to measure the benefit of adding abemaciclib to the chemotherapy, temozolomide, for newly diagnosed high-grade glioma following radiotherapy.

Key facts

Sponsor
Eli Lilly & Co.
Participant type
Pediatric, Patients
Age range
0-17 years, 18-64 years
Gender
Male and Female
Therapeutic area
Diseases [C] - Neoplasms [C04]
Trial duration
24 Sep 2024 → ongoing
Decision date (initial)
2024-08-06
Transition trial
No
Low-intervention
No
Rare-disease indication
Yes
Vulnerable population
Yes

External identifiers

EU CT number
2022-502269-13-00
WHO UTN
U1111-1289-0405

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Efficacy, Therapy, Pharmacokinetic, Safety

The purpose of this study is to measure the benefit of adding abemaciclib to the chemotherapy, temozolomide, for newly diagnosed high-grade glioma following radiotherapy.

Conditions and MedDRA coding

Glioma

Regulatory references

EMA paediatric investigation plan (PIP)
EMEA-002342-PIP02-18
Plan to share IPD
Yes
EU CT numberTitleSponsor
2023-506778-11-00 I3Y-MC-JPCS: A Phase 1b/2 Study of Abemaciclib in Combination with Irinotecan and Temozolomide (Part A) and Abemaciclib in Combination with Temozolomide (Part B) in Pediatric and Young Adult Patients with Relapsed/Refractory Solid Tumors and Abemaciclib in Combination with Dinutuximab, GM-CSF, Irinotecan, and Temozolomide in Pediatric and Young Adult Patients with Relapsed/Refractory Neuroblastoma (Part C). Eli Lilly & Co.

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 6

  1. Participants must:
  2. Have high-grade glioma
  3. Have had prior radiotherapy with or without temozolomide (patients less than 3 years old without prior radiotherapy may be eligible)
  4. Have recovered from major side effects of previous therapy and have adequate organ function and blood counts, as measured by lab tests
  5. Be able to swallow or have a feeding tube
  6. Be willing and able to follow study procedures, including frequent lab tests and tumor imaging

Exclusion criteria 6

  1. Participants must not:
  2. Have glioma that came back or started growing again after receiving treatment
  3. Have received other therapy for this cancer, except surgery and radiotherapy (with or without temozolomide)
  4. Have certain alterations in their tumor that can be treated with a different therapy
  5. Have acute infections or any serious medical conditions (other than this cancer)
  6. Be pregnant or breastfeeding

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Event Free Survival as Determined by Blinded Independent Review Committee

Investigational products

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

Test 3

Abemaciclib

PRD10495613 · Product

Active substance
Abemaciclib
Pharmaceutical form
TABLET
Route of administration
ORAL USE
Max daily dose
400 mg milligram(s)
Max total dose
0 mg milligram(s)
Max treatment duration
1 Month(s)
Authorisation status
Not Authorised
MA holder
ELI LILLY AND COMPANY LIMITED
Paediatric formulation
No
Orphan designation
No

Abemaciclib

PRD10495615 · Product

Active substance
Abemaciclib
Pharmaceutical form
GRANULES
Route of administration
ORAL USE
Max daily dose
400 mg milligram(s)
Max total dose
0 mg milligram(s)
Max treatment duration
1 Month(s)
Authorisation status
Not Authorised
MA holder
ELI LILLY AND COMPANY LIMITED
Paediatric formulation
Yes
Orphan designation
No

Verzenios 50 mg film-coated tablets

PRD6701098 · Product

Active substance
Abemaciclib
Substance synonyms
LY2835219
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
400 mg milligram(s)
Max total dose
0 mg milligram(s)
Max treatment duration
1 Month(s)
Authorisation status
Authorised
ATC code
L01EF03 — -
Marketing authorisation
EU/1/18/1307/001
MA holder
ELI LILLY NEDERLAND B.V.
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
Different primary packaging (bottles) than in marketing authorisation and clinical trial specific packaging and labeling.

Comparator 1

Temozolomide

SCP131007 · ATC

Active substance
Temozolomide
Route of administration
ORAL USE
Max daily dose
200 mg/m2 milligram(s)/sq. meter
Max total dose
28600 mg milligram(s)
Max treatment duration
12 Month(s)
Authorisation status
Authorised
ATC code
L01AX03 — TEMOZOLOMIDE
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Eli Lilly & Co.

Sponsor organisation
Eli Lilly & Co.
Address
1 Lilly Corporate Center
City
Indianapolis
Postcode
46285-0001
Country
United States

Scientific contact point

Organisation
Eli Lilly & Co.
Contact name
Lilly Clinical Trials information desk

Public contact point

Organisation
Eli Lilly & Co.
Contact name
Lilly Clinical Trials information desk

Third parties 8

OrganisationCity, countryDuties
Jumo Health USA Inc.
ORG-100044054
New Haven, United States Other
Greenphire LLC
ORG-100041621
King Of Prussia, United States Other
Altasciences Compagnie Inc.
ORG-100037610
Laval, Canada Laboratory analysis
Icon Clinical Research Limited
ORG-100008322
Dublin 18, Ireland On site monitoring, Code 10, Code 11, Code 12, Code 13, Other, Other, Code 2, Laboratory analysis, Code 5, Data management, E-data capture
RWS Life Sciences Inc.
ORG-100042348
East Hartford, United States Other
PPD Development L.P.
ORG-100011560
Wilmington, United States Code 10
Labcorp Early Development Laboratories Inc.
ORG-100012865
Indianapolis, United States Laboratory analysis
Q2 Solutions LLC
ORG-100017000
Ithaca, United States Laboratory analysis

Locations

7 EU/EEA countries · 32 investigational sites

By country

CountryMS statusPlanned subjectsSites
Belgium Ongoing, recruitment ended 3 4
Denmark Ongoing, recruitment ended 2 1
France Ongoing, recruitment ended 6 8
Italy Ongoing, recruitment ended 8 7
Netherlands Ongoing, recruitment ended 2 1
Romania Ongoing, recruitment ended 2 2
Spain Ongoing, recruitment ended 7 9
Rest of world
Japan, United States, Australia
22

Investigational sites

Belgium

4 sites · Ongoing, recruitment ended
Centre Hospitalier Regional De La Citadelle
Pediatric hemato-oncology department, Boulevard Du Douzieme De Ligne 1, 4000, Liege
UZ Leuven
Pediatric hemato-oncology department, Herestraat 49, 3000, Leuven
Universitair Ziekenhuis Gent
Pediatric hemato- oncology department, Corneel Heymanslaan 10, 9000, Gent
Cliniques Universitaires Saint-Luc
Pediatric hemato-oncology department, Hippokrateslaan 10, Batiment 54, Sint-Lambrechts-Woluwe

Denmark

1 site · Ongoing, recruitment ended
Rigshospitalet
Department of Paediatrics and Adolescent Medicine, Blegdamsvej 9, 2100, Copenhagen Oe

France

8 sites · Ongoing, recruitment ended
Institut Curie
SIREDO(Soins, Innovation, Recherche, en oncologie de l’Enfant, de l’aDOlescent et de l’adulte jeune), 26 Rue D Ulm, 75005, Paris
Centre Leon Berard
IHOPe (Institute of Hematology and Pediatric Oncology), 28 Rue Laennec, 69008, Lyon
Centre Oscar Lambret
Pediatric unit, oncology department, 3 Rue Frederic Combemale, 59000, Lille
CHRU De Nancy
Paediatric onco-haematology unit, Rue Du Morvan, 54500, Vandoeuvre Les Nancy
Institut Gustave Roussy
Children and adolescent oncology, 114 Rue Edouard Vaillant, 94800, Villejuif
Centre Hospitalier Universitaire De Bordeaux
Paediatric onco-haematology unit, Place Amelie Raba Leon, 33000, Bordeaux
Centre Hospitalier Regional De Marseille
Service d’immunologie, hématologie et oncologie pédiatrique, 264 Rue Saint Pierre, 13005, Marseille
Centre Hospitalier Universitaire D'Angers
Pediatric Oncology, 4 Rue Larrey, 49100, Angers

Italy

7 sites · Ongoing, recruitment ended
Istituto Oncologico Veneto
Medical Oncology 1 Unit, Via Gattamelata 64, 35128, Padova
Bambino Gesu Childrens Hospital
Neuro-Oncology Unit, Piazza Sant'Onofrio 4, 00165, Rome
Fondazione IRCCS Istituto Nazionale Dei Tumori
Pediatric Oncology Unit, Via Giacomo Venezian 1, 20133, Milan
Azienda Ospedaliera Universitaria Citta Della Salute E Della Scienza Di Torino
SC Pediatric Oncoematology, Piazza Polonia 94, 10126, Turin
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
UO Oncologia Pediatrica, Largo Francesco Vito 1, 00168, Rome
L’Azienda Ospedaliera Di Rilievo Nazionale Santobono-Pausilipon
UOSD Neuroncology, Via Posillipo 226, 80123, Naples
IRCCS Istituto Giannina Gaslini
Department of Hemato-Oncology, Via Gerolamo Gaslini 5, 16147, Genoa

Netherlands

1 site · Ongoing, recruitment ended
Prinses Maxima Centrum voor Kinderoncologie B.V.
Neuro-oncology, Heidelberglaan 25, 3584 CS, Utrecht

Romania

2 sites · Ongoing, recruitment ended
Institute Of Oncology Prof. Dr. Ion Chiricuta Cluj-Napoca
Sectia Oncopediatrie, Strada Republicii 34-36, 400015, Cluj-Napoca
Institutul Oncologic Prof. Dr. Alexandru Trestioreanu Bucuresti
Sectia Oncologie Pediatrica, Soseaua Fundeni 252, 022328, Bucharest

Spain

9 sites · Ongoing, recruitment ended
Hospital Universitari Vall D Hebron
Servei d’Oncologia i Hematologia Pediatrica, Passeig De La Vall D'Hebron 119-129, 08035, Barcelona
Hospital Universitario Y Politecnico La Fe
Unidad Oncohematología Pediátrica, Avenida De Fernando Abril Martorell 106, 46026, Valencia
Hospital Universitario Reina Sofia
Servicio de Pediatría, Avenida Menendez Pidal S/n, 14004, Cordoba
Hospital Universitario Hm Monteprincipe
Pediatric Oncology Unit, Avenida De Monteprincipe 25, 28660, Boadilla Del Monte
Hospital Infantil Universitario Nino Jesus
Servicio de Onco-Hematología Pediátrica, Avenida Menendez Pelayo 65, 28009, Madrid
Hospital Universitario La Paz
Hemato-Oncología Pediátrica y TPH, Paseo De La Castellana 261, 28046, Madrid
University Clinical Hospital Virgen De La Arrixaca
Oncología pediatrica, Carretera Madrid-Cartagena S/N, El Palmar, Murcia
Sant Joan De Deu Barcelona Hospital
Unidad de Neuro-Oncología, Passeig De Sant Joan De Deu 2, 08950, Esplugues De Llobregat
University Hospital Virgen Del Rocio S.L.
Oncología pediatrica, Avenida De Manuel Siurot S/n, 41013, Sevilla

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Belgium 2025-01-28 2025-09-04 2026-01-14
Denmark 2025-03-24 2025-06-13 2026-01-14
France 2024-10-03 2025-02-24 2026-01-14
Italy 2024-10-02 2025-04-03 2026-01-14
Netherlands 2025-05-27 2025-06-20 2026-01-14
Romania 2025-04-23 2025-08-05 2026-01-14
Spain 2024-09-24 2024-10-25 2026-01-14

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 111 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol_2022-502269-13-00_FP a
Protocol (for publication) D4_Patient Facing Documentation Statement_FP 1.0
Recruitment arrangements (for publication) K1_ICF and Patient Recruitment Procedure_FP 2.0
Recruitment arrangements (for publication) K1_Recruit-ICF process_FP 2.0
Recruitment arrangements (for publication) K1_Recruit-ICF process_FP 1.0
Recruitment arrangements (for publication) K1_Recruit-ICF process_FP 1.0
Recruitment arrangements (for publication) K1_Recruit-ICF process_FP 2.0
Recruitment arrangements (for publication) K1_Recruit-ICF process_Placeholder_FP N/A
Recruitment arrangements (for publication) K1_Recruitment arrangements_FP 1.1
Recruitment arrangements (for publication) K2_Appointment Reminder Card_en_FP 1.0
Recruitment arrangements (for publication) K2_Appointment Reminder Card_ro_FP 1.0
Recruitment arrangements (for publication) K2_Brochure_en_FP 1.0
Recruitment arrangements (for publication) K2_Brochure_en_FP 1.0
Recruitment arrangements (for publication) K2_Brochure_FP 1.0
Recruitment arrangements (for publication) K2_Brochure_FP 1.1
Recruitment arrangements (for publication) K2_Brochure_FP 1.0
Recruitment arrangements (for publication) K2_Brochure_FP 1.0
Recruitment arrangements (for publication) K2_Brochure_FP 1.0
Recruitment arrangements (for publication) K2_Brochure_fr_FP 1.0
Recruitment arrangements (for publication) K2_Brochure_nl_FP 1.0
Recruitment arrangements (for publication) K2_Brochure_ro_FP 1.0
Recruitment arrangements (for publication) K2_HCP Letter_en_FP 1.0
Recruitment arrangements (for publication) K2_HCP Letter_ro_FP 1.0
Recruitment arrangements (for publication) K2_HCP_FS_en_FP 1.0
Recruitment arrangements (for publication) K2_HCP_FS_ro_FP 1.0
Recruitment arrangements (for publication) K2_Lay synopsis for website_PMC_FP N/A
Recruitment arrangements (for publication) K2_Patient Letter_en_FP 1.0
Recruitment arrangements (for publication) K2_Patient letter_en_FP 1.0
Recruitment arrangements (for publication) K2_Patient Letter_FP 1.0
Recruitment arrangements (for publication) K2_Patient Letter_FP 1.0
Recruitment arrangements (for publication) K2_Patient Letter_FP 1.0
Recruitment arrangements (for publication) K2_Patient Letter_FP 1.0
Recruitment arrangements (for publication) K2_Patient letter_fr_FP 1.0
Recruitment arrangements (for publication) K2_Patient letter_nl_FP 1.0
Recruitment arrangements (for publication) K2_Patient Letter_ro_FP 1.0
Recruitment arrangements (for publication) K2_Poster_en_FP 1.0
Recruitment arrangements (for publication) K2_Poster_en_FP 1.0
Recruitment arrangements (for publication) K2_Poster_FP 1.0
Recruitment arrangements (for publication) K2_Poster_FP 1.0
Recruitment arrangements (for publication) K2_Poster_FP 1.0
Recruitment arrangements (for publication) K2_Poster_FP 1.0
Recruitment arrangements (for publication) K2_Poster_fr_FP 1.0
Recruitment arrangements (for publication) K2_Poster_nl_FP 1.0
Recruitment arrangements (for publication) K2_Poster_ro_FP 1.0
Recruitment arrangements (for publication) K2_Study Visit Guide_FP 1.0
Recruitment arrangements (for publication) K2_SVG_en_FP 1.0
Recruitment arrangements (for publication) K2_SVG_ro_FP 1.0
Subject information and informed consent form (for publication) L1_SIS-ICF Parental-Adult Main_sponsor statement_FP 1.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Adult and Parent Privacy_FP 4.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Adult_FP 4.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent 12-14y_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent 12-17 years_FP 4.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent 15-17y_FP 5.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent 2-6 years_FP 2.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent 6-11_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent 7-11 years_FP 2.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent older 12-AoM_FP 2.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent Older Age_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent older_en_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent older_en_FP 6.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent older_fr_FP 6.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent older_nl_FP 6.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent older_ro_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent younger age_FP 2.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent Younger Age_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent younger_en_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent younger_en_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent younger_fr_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent younger_nl_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Assent younger_ro_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Consent 12-16_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Greenphire Notice_en_FP 10.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Greenphire Notice_fr_FP 10.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Greenphire Notice_nl_FP 10.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Greenphire_FP 2.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Main 16plus_FP 2.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Main_FP 5.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Optional Biopsy_FP 1.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Parent_FP 4.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Parent_FP 4.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Parental Guardian_FP 5.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Parental Optional Biopsy_FP 1.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Parental-Adult Main_en_FP 4.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Parental-Adult Main_en_FP 10.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Parental-Adult Main_FP 1.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Parental-Adult Main_FP 3.1
Subject information and informed consent form (for publication) L1_SIS-ICF_Parental-Adult Main_FP 4.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Parental-Adult Main_fr_FP 10.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Parental-Adult Main_nl_FP 10.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Parental-Adult Main_ro_FP 4.0
Subject information and informed consent form (for publication) L1_SIS-ICF_PP_en_FP 4.0
Subject information and informed consent form (for publication) L1_SIS-ICF_PP_FP 2.1
Subject information and informed consent form (for publication) L1_SIS-ICF_PP_fr_FP 4.0
Subject information and informed consent form (for publication) L1_SIS-ICF_PP_nl_FP 4.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Preg Partner_en_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Preg Partner_FP 2.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Preg Partner_FP 2.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Preg Partner_ro_FP 3.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Pregnant Partner and Participant_FP 2.0
Subject information and informed consent form (for publication) L1_SIS-ICF_Pregnant Partner_FP 3.0
Subject information and informed consent form (for publication) L2_Parent PoA_FP 1
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC_temozolomide_FP 1.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_BE_de_2022-502269-13-00_FP a
Synopsis of the protocol (for publication) D1_Protocol Synopsis_BE_fr_2022-502269-13-00_FP a
Synopsis of the protocol (for publication) D1_Protocol Synopsis_BE_nl_2022-502269-13-00_FP a
Synopsis of the protocol (for publication) D1_Protocol Synopsis_EN_2022-502269-13-00_FP a
Synopsis of the protocol (for publication) D1_Protocol Synopsis_ES_es_2022-502269-13-00_FP a
Synopsis of the protocol (for publication) D1_Protocol Synopsis_FR_fr_2022-502269-13-00_FP a
Synopsis of the protocol (for publication) D1_Protocol Synopsis_IT_it_2022-502269-13-00_FP a
Synopsis of the protocol (for publication) D1_Protocol Synopsis_NL_nl_2022-502269-13-00_FP a
Synopsis of the protocol (for publication) D1_Protocol Synopsis_RO_ro_2022-502269-13-00_FP a

Application history

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

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-04-29 Spain Acceptable
2024-08-05
2024-08-05
2 SUBSTANTIAL MODIFICATION SM-5 2024-09-05 Spain Acceptable
2024-11-11
2024-11-13
3 SUBSTANTIAL MODIFICATION SM-6 2024-12-05 Spain Acceptable 2025-01-16
4 SUBSEQUENT ADDITION OF MSC APP-4 2024-12-06 Acceptable
2024-11-11
2025-02-21
5 SUBSEQUENT ADDITION OF MSC APP-5 2024-12-06 Acceptable
2024-11-11
2025-03-17
6 SUBSTANTIAL MODIFICATION SM-7 2024-12-10 Acceptable 2025-03-14
7 SUBSTANTIAL MODIFICATION SM-8 2024-12-11 Acceptable 2024-12-20
8 SUBSTANTIAL MODIFICATION SM-9 2024-12-13 Acceptable 2025-02-03
9 SUBSEQUENT ADDITION OF MSC APP-9 2025-01-30 Acceptable
2024-11-11
2025-04-24
10 SUBSTANTIAL MODIFICATION SM-10 2025-05-15 Spain Acceptable
2025-06-23
2025-06-26
11 SUBSTANTIAL MODIFICATION SM-11 2025-11-26 Acceptable 2026-02-25
12 SUBSTANTIAL MODIFICATION SM-12 2025-11-26 Acceptable 2026-01-16
13 NON SUBSTANTIAL MODIFICATION NSM-1 2026-03-25 Spain Acceptable 2026-03-25
14 SUBSTANTIAL MODIFICATION SM-13 2026-04-15 Spain Acceptable 2026-05-15