A Phase III Randomised Study to Evaluate Dato-DXd and Durvalumab Injections Before and After Surgery for the Treatment of Adult Patients with Breast Cancer

2023-505928-59-00 Protocol D926QC00001 Therapeutic confirmatory (Phase III) Ongoing, recruitment ended

Start 15 Apr 2024 · Status Ongoing, recruitment ended · 9 EU/EEA countries · 84 sites · Protocol D926QC00001

Overview

Sponsor-declared trial summary

Phase Therapeutic confirmatory (Phase III)
Status Ongoing, recruitment ended
Participants planned 1,900
Countries 9
Sites 84

Triple Negative or Hormone Receptor low/HER2-negative Breast Cancer

To demonstrate superiority of neoadjuvant Dato-DXd plus durvalumab followed by adjuvant durvalumab with or without chemotherapy relative to neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab with or without chemotherapy in participants with previously untreated TNBC or hormone receptor-low/H…

Key facts

Sponsor
Astrazeneca AB
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Neoplasms [C04]
Trial duration
15 Apr 2024 → ongoing
Decision date (initial)
2024-03-25
Transition trial
No
Low-intervention
No
Rare-disease indication
No
Vulnerable population
Yes
Funding sources
AstraZeneca AB

External identifiers

EU CT number
2023-505928-59-00
ClinicalTrials.gov
NCT06112379

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Efficacy, Safety, Therapy, Pharmacokinetic

To demonstrate superiority of neoadjuvant Dato-DXd plus durvalumab followed by adjuvant durvalumab with or without chemotherapy relative to neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab with or without chemotherapy in participants with previously untreated TNBC or hormone receptor-low/HER2-negative breast cancer, by investigator assessment of EFS.

Secondary objectives 3

  1. Key Secondary:To demonstrate superiority of neoadjuvant Dato-DXd plus durvalumab followed by adjuvant durvalumab with or without chemotherapy relative to neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab with or without chemotherapy in participants with previously untreated TNBC or hormone receptor-low/HER2-negative breast cancer, by central assessment of pCR.
  2. Key Secondary: To demonstrate superiority of neoadjuvant Dato-DXd plus durvalumab followed by adjuvant durvalumab with or without chemotherapy relative to neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab with or without chemotherapy in participants with previously untreated TNBC or hormone receptor-low/HER2-negative breast cancer, by assessment of OS.
  3. To assess effectiveness of neoadjuvant Dato-DXd plus durvalumab followed by adjuvant durvalumab with or without chemotherapy relative to neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab with or without chemotherapy in participants with previously untreated TNBC or hormone receptor low/HER2-negative breast cancer, by assessment of DDFS.

Conditions and MedDRA coding

Triple Negative or Hormone Receptor low/HER2-negative Breast Cancer

VersionLevelCodeTermSystem organ class
20.0 SOC 10029104 Neoplasms benign malignant and unspecified (incl cysts and polyps) 2
20.0 PT 10075566 Triple negative breast cancer 100000004864

Regulatory references

Scientific advice from competent authorities
European Medicines Agency, Food And Drug Administration
Plan to share IPD
Yes
IPD plan description
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal Vivli.org. All requests will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared. AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA PhRMA Data Sharing Principles. When a request has been approved AstraZeneca will provide access to the anonymized individual patient-level data via secure research environment https://vivli.org/. Signed Data Usage Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information.

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 1

  1. Participant must be ≥ 18 years, at the time of signing the ICF. - Histologically confirmed Stage II or III unilateral or bilateral primary invasive TNBC or hormone receptor-low/HER2-negative breast cancer - ECOG PS of 0 or 1 - Provision of acceptable tumour sample - Adequate bone marrow reserve and organ function - Contraceptive use by males or females should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies; and in alignment with protocol requirements.

Exclusion criteria 1

  1. History of any prior invasive breast malignancy - History of another primary malignancy except for non-breast malignancy treated with curative intent with no known active disease within 5 years before randomisation - Evidence of distant disease. - Clinically significant corneal disease. - Has active or uncontrolled hepatitis B or C virus. - Known HIV infection that is not well controlled. - Uncontrolled infection requiring i.v. antibiotics, antivirals or antifungals - Known to have active tuberculosis infection - Mean resting corrected QTcF interval > 470 ms obtained from ECG - Uncontrolled or significant cardiac disease. - History of non-infectious ILD/pneumonitis - Has severe pulmonary function compromise - Any prior or concurrent surgery, radiotherapy or any systemic anticancer therapy for TNBC or hormone receptor-low/HER2-negative breast cancer - For females only: is pregnant (confirmed with positive serum pregnancy test) or breastfeeding, or planning to become pregnant. - Female participants should refrain from breastfeeding from enrolment throughout the study and for at least 7 months after last dose of study intervention, or as dictated by local PI for SoC if longer. - Concurrent use of systemic hormone replacement therapy or oral hormonal contraception

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Endpoint Event free survival (EFS) is defined as the time from the date of randomisation until the date of the first occurrence of any of the following events: disease progression precluding surgery, disease recurrence (local, regional, distant, or contralateral), second primary invasive cancer (other than squamous or basal cell skin cancer), or relapse from prior malignancy, or death by any cause (in the absence of recurrence).

Secondary endpoints 3

  1. Key Secondary: pathological complete response (pCR) rate is defined as the proportion of participants who have no evidence by haematoxylin and eosin staining of residual invasive disease or lymphovascular invasion at the time of definitive surgery in the complete resected breast specimen and all sampled regional lymph nodes (ypT0/Tis ypN0) by blinded central evaluation following completion of neoadjuvant systemic therapy per AJCC staging criteria (edition 8).
  2. Key secondary- overall survival (OS) is defined as the time from the date of randomisation until the date of death due to any cause.
  3. Distant disease-free survival (DDFS) is defined as the time from the date of randomisation until the date of the first occurrence of any of the following events: distant metastasis, occurrence of second primary invasive cancer (other than squamous or basal cell skin cancer), relapse from prior malignancy or death by any cause (in the absence of recurrence).

Investigational products

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

Test 2

Datopotamab deruxtecan

PRD9684738 · Product

Active substance
Datopotamab Deruxtecan
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg/kg milligram(s)/kilogram
Max total dose
00 mg/kg milligram(s)/kilogram
Max treatment duration
9999999 Month(s)
Authorisation status
Not Authorised
MA holder
DAIICHI SANKYO, INC.
Paediatric formulation
No
Orphan designation
No

IMFINZI 50 mg/mL concentrate for solution for infusion.

PRD6651398 · Product

Active substance
Durvalumab
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
L01XC28 — -
Marketing authorisation
EU/1/18/1322/001
MA holder
ASTRAZENECA AB
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Comparator 13

Capecitabine

SUB12474MIG · Substance

Active substance
Capecitabine
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
00 mg/m2 milligram(s)/sq. meter
Max total dose
00 mg/m2 milligram(s)/sq. meter
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Capecitabine

SUB12474MIG · Substance

Active substance
Capecitabine
Pharmaceutical form
FILM COATED TABLET
Route of administration
ORAL USE
Max daily dose
00 mg/m2 milligram(s)/sq. meter
Max total dose
00 mg/m2 milligram(s)/sq. meter
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Epirubicin

SUB06571MIG · Substance

Active substance
Epirubicin
Pharmaceutical form
CONCENTRATE FOR SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg/m2 milligram(s)/sq. meter
Max total dose
00 mg/m2 milligram(s)/sq. meter
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Carboplatin

SUB06614MIG · Substance

Active substance
Carboplatin
Pharmaceutical form
CONCENTRATE FOR SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg/ml milligram(s)/millilitre
Max total dose
00 mg/ml milligram(s)/millilitre
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Cyclophosphamide

SUB06859MIG · Substance

Active substance
Cyclophosphamide
Pharmaceutical form
POWDER FOR SOLUTION FOR INJECTION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg/m2 milligram(s)/sq. meter
Max total dose
00 mg/m2 milligram(s)/sq. meter
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Cyclophosphamide

SUB06859MIG · Substance

Active substance
Cyclophosphamide
Pharmaceutical form
POWDER FOR SOLUTION FOR INJECTION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg/m2 milligram(s)/square meter
Max total dose
00 mg/m2 milligram(s)/sq. meter
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Cyclophosphamide

SUB06859MIG · Substance

Active substance
Cyclophosphamide
Pharmaceutical form
POWDER FOR SOLUTION FOR INJECTION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg/m2 milligram(s)/sq. meter
Max total dose
00 mg/m2 milligram(s)/sq. meter
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Cyclophosphamide

SUB06859MIG · Substance

Active substance
Cyclophosphamide
Pharmaceutical form
POWDER FOR SOLUTION FOR INJECTION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg/m2 milligram(s)/square meter
Max total dose
00 mg/m2 milligram(s)/square meter
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Lynparza 150 mg film-coated tablets

PRD6152224 · Product

Active substance
Olaparib
Substance synonyms
AZD-2281, AZD2281
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
L01XX46 — -
Marketing authorisation
EU/1/14/959/004
MA holder
ASTRAZENECA AB
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
Lynparza 150 mg film-coated tablet is identical to the IMP except that it has commercial deboss/marking. The IMP (used in this study) is unmarked and packed in HDPE bottles rather than the commercial blister pack to facilitate blinding in placebo controlled studies.

Lynparza 100 mg film-coated tablets

PRD6163466 · Product

Active substance
Olaparib
Substance synonyms
AZD-2281, AZD2281
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
L01XX46 — -
Marketing authorisation
EU/1/14/959/003
MA holder
ASTRAZENECA AB
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
Lynparza 100 mg Tablet is identical to the IMP except that that it has a yellow film coat due to the deletion of a small amount of iron oxide, and has a commercial deboss/marking. The IMP has a green film coat, is unmarked and is supplied in an HDPE bottle rather than the commercial blister pack to facilitate blinding in placebo controlled studies.

Doxorubicin

SUB06391MIG · Substance

Active substance
Doxorubicin
Pharmaceutical form
CONCENTRATE FOR SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg/m2 milligram(s)/sq. meter
Max total dose
00 mg/m2 milligram(s)/sq. meter
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Pembrolizumab

SUB167136 · Substance

Active substance
Pembrolizumab
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Paclitaxel

SUB09583MIG · Substance

Active substance
Paclitaxel
Pharmaceutical form
CONCENTRATE FOR SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg/m2 milligram(s)/sq. meter
Max total dose
00 mg/m2 milligram(s)/sq. meter
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Auxiliary 5

Infliximab

SUB02681MIG · Substance

Active substance
Infliximab
Pharmaceutical form
POWDER FOR CONCENTRATE FOR SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS USE
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Mycophenolate Mofetil

SUB03360MIG · Substance

Active substance
Mycophenolate Mofetil
Pharmaceutical form
CAPSULE, HARD
Route of administration
ORAL USE
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Mycophenolate Mofetil

SUB03360MIG · Substance

Active substance
Mycophenolate Mofetil
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Mycophenolate Mofetil

SUB03360MIG · Substance

Active substance
Mycophenolate Mofetil
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL USE
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Mycophenolate Mofetil

SUB03360MIG · Substance

Active substance
Mycophenolate Mofetil
Pharmaceutical form
HARD CAPSULES
Route of administration
ORAL USE
Max daily dose
00 mg milligram(s)
Max total dose
00 mg milligram(s)
Max treatment duration
9999999 Month(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Astrazeneca AB

Sponsor organisation
Astrazeneca AB
Address
Astraallen Gartuna, Karlebyhus Byggnad 674 Karlebyhus Byggnad 674
City
Sodertalje
Postcode
151 85
Country
Sweden

Scientific contact point

Organisation
Astrazeneca AB
Contact name
AstraZeneca Clinical Study Information Center

Public contact point

Organisation
Astrazeneca AB
Contact name
AstraZeneca Clinical Study Information Center

Locations

9 EU/EEA countries · 84 investigational sites

By country

CountryMS statusPlanned subjectsSites
Austria Ongoing, recruitment ended 40 4
Belgium Ongoing, recruitment ended 50 6
Bulgaria Ongoing, recruitment ended 11 2
France Ongoing, recruitment ended 70 13
Germany Ongoing, recruitment ended 127 23
Hungary Ongoing, recruitment ended 24 6
Italy Ongoing, recruitment ended 72 12
Poland Ongoing, recruitment ended 41 9
Spain Ongoing, recruitment ended 66 9
Rest of world
United Kingdom, Turkey, Thailand, Vietnam, China, India, Korea, Republic of, Taiwan, Canada, Australia, Singapore, United States, Malaysia, Hong Kong, Switzerland, Brazil, Japan
1,399

Investigational sites

Austria

4 sites · Ongoing, recruitment ended
Medizinische Universitaet Innsbruck
University Clinic for Gynaecology and Obstetrics, Anichstrasse 35, 6020, Innsbruck
SCRI CCCIT Ges.m.b.H.
Abteilung für Innere Medizin III, Muellner Hauptstrasse 48, 5020, Salzburg
Ordensklinikum Linz GmbH
Medical Oncology and Hematology, Seilerstaette 4, 4010, Linz
Vorarlberger Krankenhaus-Betriebsgesellschaft mbH
Internal Medicine II at LKH Rankweil, Carinagasse 47, 6800, Feldkirch

Belgium

6 sites · Ongoing, recruitment ended
Universitair Ziekenhuis Gent
Medical Oncology, Corneel Heymanslaan 10, 9000, Gent
Hopital De Libramont
Oncology, Avenue De Houffalize 35, 6800, Libramont-Chevigny
UZ Leuven
Medical Oncology, Herestraat 49, 3000, Leuven
Ziekenhuis Aan De Stroom
Medical Oncology, Oosterveldlaan 24, 2610, Antwerp
Algemeen Ziekenhuis Klina
Oncology Hematology, Augustijnslei 100, 2930, Brasschaat
Grand Hopital De Charleroi
Oncology & Hematology, Rue Du Campus Des Viviers 1, 6060, Charleroi

Bulgaria

2 sites · Ongoing, recruitment ended
University Specialized Hospital For Active Treatment In Oncology EAD
Clinic of medical oncology, Ulitsa Plovdivsko Pole 6, 1756, Sofiya
Mbal Za Zhensko Zdrave Nadezhda OOD
Clinic of medical oncology, Blaga Vest Street 3, 1330, Sofia

France

13 sites · Ongoing, recruitment ended
Institut Regional Du Cancer De Montpellier
Medical Oncology, 208 Avenue Des Apothicaires, 34298, Montpellier Cedex 5
Polyclinique De Limoges
Medical Oncology, 18 Rue Du General Catroux, 87039, Limoges Cedex I
Institut Universitaire Du Cancer Toulouse-Oncopole
Medical Oncology, 1 Avenue Irene Joliot Curie, 31100, Toulouse
Institut Paoli-Calmettes
Medical Oncology, 232 Boulevard De Sainte Marguerite, Bp 156, Marseille
Centre Jean Perrin
Medical Oncology, 58 Rue Montalembert, 63000, Clermont-Ferrand
Centre Hospitalier De La Cote Basque
Oncology, 13 Avenue Interne Jacques Loeb, 64100, Bayonne
Institut Gustave Roussy
Medical Oncology, 114 Rue Edouard Vaillant, 94800, Villejuif
Institut Sainte Catherine
Medical Oncology, 250 Chemin De Baigne Pieds, 84000, Avignon
Hopital Saint Louis
Medical Oncology, 1 Avenue Claude Vellefaux, 75010, Paris
Institut De Cancerologie De Lorraine
Medical Oncology, 6 Avenue De Bourgogne, Cs 30519, Vandoeuvre Les Nancy Cedex
Centre Antoine Lacassagne
Medical Oncology, 33 Avenue De Valombrose, 06189, Nice Cedex 2
Centre Francois Baclesse
Medical Oncology, 3 Avenue Du General Harris, Cs 45026, Caen Cedex 5
Institut Godinot
Medical Oncology, 1 Rue Du General Koenig, 51100, Reims

Germany

23 sites · Ongoing, recruitment ended
Agaplesion Frankfurter Diakonie Kliniken gGmbH
Gynaekologisches Krebszentrum, Wilhelm-Epstein-Strasse 4, Bockenheim, Frankfurt Am Main
Medizinische Hochschule Hannover
Gynaekologische Onkologie, Carl-Neuberg-Strasse 1, Gross Buchholz, Hanover
Haematologie-Onkologie im Zentrum MVZ GmbH
na, Halderstrasse 29, Innenstadt, Augsburg
University Medical Center Hamburg-Eppendorf
Klinik und Poliklinik für Gynaekologie, Martinistrasse 52, Eppendorf, Hamburg
KEM I Evang. Kliniken Essen-Mitte gGmbH
Klinik fuer Frauenheilkunde Brustzentrum, Henricistrasse 92, Huttrop, Essen
HELIOS Klinikum Berlin-Buch GmbH
Geburtshilfe und Gynaekologie, Schwanebecker Chaussee 50, Buch, Berlin
Ulm University
Klinik fuer Frauenheilkunde und Geburtshilfe, Prittwitzstrasse 43, Mitte, Ulm
Universitaetsklinikum Carl Gustav Carus Dresden an der Technischen Universitaet Dresden AöR
Klinik und Poliklinik fuer Frauenheilkunde und Geburtshilfe, Fetscherstrasse 74, Johannstadt-Nord, Dresden
Medical Center - University Of Freiburg
Klinik fuer Frauenheilkunde, Hugstetter Strasse 55, Stuehlinger, Freiburg Im Breisgau
Universitat Heidelberg
Gynaekologische Onkologie, Theodor-Kutzer-Ufer 1-3, Wohlgelegen, Mannheim
Universitaetsklinikum Muenster AöR
"Klinik und Poliklinik fuer Frauenheilkunde und Geburtshilfe Brustzentrum", Albert-Schweitzer-Campus 1, Sentrup, Muenster
Praxis Fuer Interdisziplinaere Onkologie And Haematologie GbR
na, Wirthstrasse 11c, Landwasser, Freiburg Im Breisgau
Diakovere Krankenhaus gGmbH
Frauenklinik, Schwemannstrasse 17-19, Kirchrode, Hanover
Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz KöR
Klinik und Poliklinik fuer Geburtshilfe und Frauengesundheit, Langenbeckstrasse 1, Oberstadt, Mainz
Universitaetsklinikum Erlangen AöR
Frauenklinik, Universitaetsstrasse 21-23, Innenstadt, Erlangen
Klinikum Mutterhaus der Borromaeerinnen gGmbH
Gynaekologie und Geburtshilfe, Feldstrasse 16, Innenstadt, Trier
Vivantes MVZ GmbH
"Klinik fuer Innere Medizin Haematologie und Onkologie", Dieffenbachstrasse 1, Kreuzberg, Berlin
Klinikum der Technischen Universitaet Muenchen (TUM Klinikum)
Klinik und Poliklinik fuer Frauenheilkunde, Ismaninger Strasse 22, Au-Haidhausen, Munich
Klinikum Esslingen GmbH
Klinik fuer Frauenheilkunde und Geburtshilfe, Hirschlandstrasse 97, Oberesslingen, Esslingen Am Neckar
Staedtisches Klinikum Dessau
Klinik fuer Frauenheilkunde und Geburtshilfe, Auenweg 38, Alten, Dessau-Rosslau
Universitaetsklinikum Schleswig-Holstein
"Klinik fuer Gynaekologie und Geburtshilfe Frauenheilkunde", Arnold-Heller-Strasse 3, Brunswik, Kiel
Universitaetsklinikum Heidelberg AöR
Nationales Centrum für Tumorerkrankungen, Im Neuenheimer Feld 460, Neuenheim, Heidelberg
Rotkreuzklinikum Muenchen gGmbH
Gynaekologie, Taxisstrasse 3, Neuhausen-Nymphenburg, Munich

Hungary

6 sites · Ongoing, recruitment ended
Tolna Varmegyei Balassa Janos Korhaz
Onkológiai Osztály, Beri Balogh Adam Utca 5-7, 7100, Szekszard
Borsod-Abauj-Zemplen Varmegyei Koezponti Korhaz Es Egyetemi Oktatokorhaz
Klinikai Onkológiai és Sugárterápiás Centrum, Szentpeteri Kapu 72-76, 3526, Miskolc
Szabolcs-Szatmar-Bereg Varmegyei Oktatokorhaz
Onkoradiológiai Osztály, Szent Istvan Utca 68, 4400, Nyiregyhaza
Szent Lazar Megyei Korhaz
Onkológiai Centrum, Fuleki Ut 54-56, 3100, Salgotarjan
Orszagos Onkologiai Intezet
Mellkasi és Hasüregi Daganatok és Klinikai Farmakológiai Osztály "Kemoterápia B", Rath Gyorgy Utca 7-9, Kerulet, Budapest XII
Bacs-Kiskun Varmegyei Oktatokorhaz
Onkoradiológiai Központ, Nyiri Ut 38, 6000, Kecskemet

Italy

12 sites · Ongoing, recruitment ended
Istituto Oncologico Veneto
Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Via Gattamelata 64, 35128, Padova
Ospedale Generale Provinciale Di Macerata
Dipartimento di Specialità Mediche-UOC Oncologia, Via Santa Lucia 2, 62100, Macerata
Azienda Sanitaria Universitaria Friuli Centrale
Oncologia, Piazzale Santa Maria Della Misericordia 15, 33100, Udine
Azienda Ospedaliera Universitaria Citta' Della Salute E Della Scienza Di Torino
Divisione di Oncologia, Corso Spezia 60, 10126, Turin
Pia Fondazione Di Culto E Religione Card G Panico
Oncologia, Via Pio X 4, 73039, Tricase
Azienda Unita Sanitaria Locale Toscana Nord Ovest
Divisione di Oncologia, Via Filippo Francesconi 556, 55100, Lucca
Azienda USL Toscana Centro
Divisione di Oncologia, Viale Giovanni Boccaccio 16, 50053, Empoli
IRCCS Istituto Nazionale Tumori Fondazione Pascale
Divisione di Oncologia, Via Mariano Semmola 52, 80131, Naples
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Scienze della Salute della donna, del bambino e di sanità pubblica, Largo Francesco Vito 1, 00168, Rome
Ospedale San Raffaele S.r.l.
Oncologia Medica, Via Olgettina 60, 20132, Milan
Humanitas Research Hospital
Unità Operativa di Oncologia ed Ematologia, Via Alessandro Manzoni 56, 20089, Rozzano
Azienda Ospedaliero Universitaria Di Modena
Oncologia ed Ematologia, Largo Del Pozzo 71, 41124, Modena

Poland

9 sites · Ongoing, recruitment ended
Bialostockie Centrum Onkologii Im. Marii Sklodowskiej-Curie W Bialymstoku
Oddzial Onkologii Klinicznej Im. Dr Ewy Pileckiej z Pododzialem Chemioterapii Dziennej, Ul. Ogrodowa 12, 15-027, Bialystok
Uniwersyteckie Centrum Kliniczne
Klinika Onkologii I Radioterapii, Ul. Mariana Smoluchowskiego 17, 80-214, Gdansk
Narodowy Instytut Onkologii Im. Marii Sklodowskiej-Curie Panstwowy Instytut Badawczy
Klinika Nowotworow Piersi i Chirurgii Rekonstrukcyjnej, Ul. Wilhelma Konrada Roentgena 5, 02-781, Warsaw
Szpitale Pomorskie Sp. z o.o.
Oddział Onkologii I Radioterapii, Onkologia Kliniczna, Ul. Powstania Styczniowego 1, 81-519, Gdynia
Instytut Centrum Zdrowia Matki Polki
Klinika Onkologii, Ul. Rzgowska 281/289, 93-338, Lodz
Samodzielny Publiczny Zaklad Opieki Zdrowotnej Szpital Uniwersytecki W Krakowie
Oddzial Kliniczny Onkologii oraz Poradnia Onkologiczna, Ul. Mikolaja Kopernika 50, 31-501, Cracow
Specjalistyczny Szpital Onkologiczny Nu-Med Sp. z o.o.
Oddzial Onkologii Klinicznej, Ul. Jana Pawla II 35, 97-200, Tomaszow Mazowiecki
Dolnoslaskie Centrum Onkologii Pulmonologii I Hematologii
Breast Unit, Pl. Ludwika Hirszfelda 12, 53-413, Wroclaw
Centrum Onkologii Im. Prof. Franciszka Lukaszczyka W Bydgoszczy
Ambulatorium Chemioterapii, Ul. Izabeli Romanowskiej 2, 85-796, Bydgoszcz

Spain

9 sites · Ongoing, recruitment ended
Hospital Clinico Universitario Lozano Blesa
Oncology, Avenida De San Juan Bosco 15, 50009, Zaragoza
Institut Catala D'oncologia
Oncology, Avinguda De La Gran Via De L'hospitalet 199-203, 08908, L'hospitalet De Llobregat
Hospital Universitario Virgen De La Macarena
Oncology, Avenida Del Doctor Fedriani 3, 41009, Sevilla
Hospital Clinic De Barcelona
Oncology, Calle Villarroel 170, 08036, Barcelona
Complexo Hospitalario Universitario De Santiago
Oncology, Calle Choupana Da S/n, 15706, Santiago De Compostela
Hospital Universitario Ramon Y Cajal
Oncology, Carretera Del Colmenar Viejo Km 9 100, Por El Pardo, Madrid
Hospital Universitario Clinico San Cecilio
Oncology, Avenida Del Conocimiento S/n, Poligono Industrial De Ciencias De La Salud, Granada
Hospital Beata Maria Ana
Oncology, Calle Del Doctor Esquerdo No. 83, 28007, Madrid
Hospital Universitari Vall D Hebron
Oncology, Edificio Materno-Infantil, Passeig De La Vall D'hebron 119-129, Barcelona

Country notifications

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

Country Trial startTrial end Recruitment startRecruitment end Early termination
Austria 2024-04-15 2024-04-17 2025-07-16
Belgium 2024-04-15 2024-04-23 2025-07-03
Bulgaria 2024-04-19 2024-05-09 2025-06-20
France 2024-04-15 2024-04-23 2025-07-11
Germany 2024-04-15 2024-04-17 2025-06-27
Hungary 2024-05-17 2024-05-23 2025-06-12
Italy 2024-04-24 2024-04-29 2025-06-26
Poland 2024-04-15 2024-04-18 2025-05-06
Spain 2024-04-15 2024-04-16 2025-07-03

Oversight and notifications

Regulatory notifications under CTR Articles 38, 52, 53, 54 and 77

Temporary halts 7 · Art. 38 CTR

Temporary halt TH-41050

Halt date
2024-06-20
Member states concerned
France
Publication date
2024-08-14
Reason
Medicinal Product related
Explanation
Due to enrolment that has greatly exceeded the initial recruitment projections for this study, the Sponsor is facing limitations in the supply of investigational products (IP) supplied centrally, namely Dato-DXd, durvalumab and some standard of care chemotherapy agents. To manage the supply limitations the Sponsor is aiming to control the recruitment rate by putting limiting the number of new patients that can be screened per site/country each month. This requires that recruitment is temporarily stopped when the country limit is reached and restarted in a later month (see also separate letter attached).
Follow-up measures
See separate letter attached
Benefit-risk balance changed
No
Treatment stopped
No

Temporary halt TH-41060

Halt date
2024-06-17
Member states concerned
Spain
Publication date
2024-08-14
Reason
Medicinal Product related
Explanation
Due to enrolment that has greatly exceeded the initial recruitment projections for this study, the Sponsor is facing limitations in the supply of investigational products (IP) supplied centrally, namely Dato-DXd, durvalumab and some standard of care chemotherapy agents. To manage the supply limitations the Sponsor is aiming to control the recruitment rate by putting limiting the number of new patients that can be screened per site/country each month. This requires that recruitment is temporarily stopped when the country limit is reached and restarted in a later month (see also separate letter attached).
Follow-up measures
See separate letter attached
Benefit-risk balance changed
No
Treatment stopped
No

Temporary halt TH-41053

Halt date
2024-06-12
Member states concerned
Germany
Publication date
2024-08-14
Reason
Medicinal Product related
Explanation
Due to enrolment that has greatly exceeded the initial recruitment projections for this study, the Sponsor is facing limitations in the supply of investigational products (IP) supplied centrally, namely Dato-DXd, durvalumab and some standard of care chemotherapy agents. To manage the supply limitations the Sponsor is aiming to control the recruitment rate by putting limiting the number of new patients that can be screened per site/country each month. This requires that recruitment is temporarily stopped when the country limit is reached and restarted in a later month (see also separate letter attached).
Follow-up measures
See separate letter attached
Benefit-risk balance changed
No
Treatment stopped
No

Temporary halt TH-41055

Halt date
2024-06-20
Member states concerned
Italy
Publication date
2024-08-14
Reason
Medicinal Product related
Explanation
Due to enrolment that has greatly exceeded the initial recruitment projections for this study, the Sponsor is facing limitations in the supply of investigational products (IP) supplied centrally, namely Dato-DXd, durvalumab and some standard of care chemotherapy agents. To manage the supply limitations the Sponsor is aiming to control the recruitment rate by putting limiting the number of new patients that can be screened per site/country each month. This requires that recruitment is temporarily stopped when the country limit is reached and restarted in a later month (see also separate letter attached).
Follow-up measures
See separate letter attached
Benefit-risk balance changed
No
Treatment stopped
No

Temporary halt TH-41057

Halt date
2024-06-24
Member states concerned
Poland
Publication date
2024-08-14
Reason
Medicinal Product related
Explanation
Due to enrolment that has greatly exceeded the initial recruitment projections for this study, the Sponsor is facing limitations in the supply of investigational products (IP) supplied centrally, namely Dato-DXd, durvalumab and some standard of care chemotherapy agents. To manage the supply limitations the Sponsor is aiming to control the recruitment rate by putting limiting the number of new patients that can be screened per site/country each month. This requires that recruitment is temporarily stopped when the country limit is reached and restarted in a later month (see also separate letter attached).
Follow-up measures
See separate letter attached
Benefit-risk balance changed
No
Treatment stopped
No

Temporary halt TH-41046

Halt date
2024-07-18
Member states concerned
Bulgaria
Publication date
2024-08-14
Reason
Medicinal Product related
Explanation
Due to enrolment that has greatly exceeded the initial recruitment projections for this study, the Sponsor is facing limitations in the supply of investigational products (IP) supplied centrally, namely Dato-DXd, durvalumab and some standard of care chemotherapy agents. To manage the supply limitations the Sponsor is aiming to control the recruitment rate by putting limiting the number of new patients that can be screened per site/country each month. This requires that recruitment is temporarily stopped when the country limit is reached and restarted in a later month (see also separate letter attached).
Follow-up measures
See separate letter attached
Benefit-risk balance changed
No
Treatment stopped
No

Temporary halt TH-41048

Halt date
2024-06-11
Member states concerned
Hungary
Publication date
2024-08-14
Reason
Medicinal Product related
Explanation
Due to enrolment that has greatly exceeded the initial recruitment projections for this study, the Sponsor is facing limitations in the supply of investigational products (IP) supplied centrally, namely Dato-DXd, durvalumab and some standard of care chemotherapy agents. To manage the supply limitations the Sponsor is aiming to control the recruitment rate by putting limiting the number of new patients that can be screened per site/country each month. This requires that recruitment is temporarily stopped when the country limit is reached and restarted in a later month (see also separate letter attached).
Follow-up measures
See separate letter attached
Benefit-risk balance changed
No
Treatment stopped
No

Results and documents

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

Documents 100 files

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

TypeTitleVersion
Protocol (for publication) D1_Protocol_redacted 4.0
Recruitment arrangements (for publication) K1_ Recruitment arrangements_Austria 1.0
Recruitment arrangements (for publication) K1_ Recruitment arrangements_Germany N/A
Recruitment arrangements (for publication) K1_ Recruitment arrangements_PL 2
Recruitment arrangements (for publication) K1_Pamphlet_Dutch_redacted 1
Recruitment arrangements (for publication) K1_Pamphlet_French_redacted 1
Recruitment arrangements (for publication) K1_Patient Study Guide_Dutch_redacted 2.0
Recruitment arrangements (for publication) K1_Patient Study Guide_French_redacted 2.0
Recruitment arrangements (for publication) K1_Recruitment arrangements 1
Recruitment arrangements (for publication) K1_Recruitment arrangements 1
Recruitment arrangements (for publication) K1_Recruitment arrangements 1
Recruitment arrangements (for publication) K1_Recruitment arrangements 1
Recruitment arrangements (for publication) K1_Recruitment arrangements 2.0
Recruitment arrangements (for publication) K1_Recruitment Material_Poster_Dutch 1
Recruitment arrangements (for publication) K1_Recruitment Material_Poster_French 1
Recruitment arrangements (for publication) K2 Recruitment material Pamphlet_HU_Redacted 1
Recruitment arrangements (for publication) K2_Patient Pamphlet_redacted 1.0
Recruitment arrangements (for publication) K2_Patient PSG Guide_redacted 2.0
Recruitment arrangements (for publication) K2_Patient Recruitment Pamphlet_redacted 1
Recruitment arrangements (for publication) K2_Patient Recruitment Patient Guide_redacted 2.0
Recruitment arrangements (for publication) K2_Patient Recruitment Poster 1.0
Recruitment arrangements (for publication) K2_Patient Recruitment Poster 1
Recruitment arrangements (for publication) K2_Patient Recruitment Poster_FR 1
Recruitment arrangements (for publication) K2_Recruitment material_Pamphlet PL_Redacted 1
Recruitment arrangements (for publication) K2_Recruitment material_Patient Recruitment Pamphlet_redacted 1
Recruitment arrangements (for publication) K2_Recruitment material_Patient Recruitment Poster 1
Recruitment arrangements (for publication) K2_Recruitment material_Patient Study Guide PL_Redacted 2.0
Recruitment arrangements (for publication) K2_Recruitment material_Patient Study Guide_Redacted 2.0
Recruitment arrangements (for publication) K2_Recruitment material_Patient Study Guide_Redacted 2.0
Recruitment arrangements (for publication) K2_Recruitment material_Poster PL 1
Recruitment arrangements (for publication) K2_Recruitment material_Recruitment Pamphlet_Redacted 1
Recruitment arrangements (for publication) K2_Recruitment material_Recruitment Poster 1
Subject information and informed consent form (for publication) L1_ SIS and ICF Adult PL_Redacted 5.0
Subject information and informed consent form (for publication) L1_ SIS and ICF Adults_BE_Dutch_redacted 3.0
Subject information and informed consent form (for publication) L1_ SIS and ICF Adults_BE_English_redacted 3.0
Subject information and informed consent form (for publication) L1_ SIS and ICF Adults_BE_French_redacted 3.0
Subject information and informed consent form (for publication) L1_ SIS and ICF optional genetic PL 1
Subject information and informed consent form (for publication) L1_ SIS and ICF Pregnant partner_BE_Dutch_clean 1
Subject information and informed consent form (for publication) L1_ SIS and ICF Pregnant partner_BE_English_clean 1
Subject information and informed consent form (for publication) L1_ SIS and ICF Pregnant partner_BE_French_clean 1
Subject information and informed consent form (for publication) L1_ SIS and ICF pregnant partners PL 1
Subject information and informed consent form (for publication) L1_List of the submitted HU ICFs N/A
Subject information and informed consent form (for publication) L1_Optional Genetic Research Information and ICF 1
Subject information and informed consent form (for publication) L1_Optional Genetic Research Information and ICF_Master 1
Subject information and informed consent form (for publication) L1_Pregnant partner ICF 1
Subject information and informed consent form (for publication) L1_Pregnant partner ICF_Master 1
Subject information and informed consent form (for publication) L1_Research Study Consent Summary 1
Subject information and informed consent form (for publication) L1_Research Study Consent Summary_Master 1
Subject information and informed consent form (for publication) L1_SIS and Data privacy_redacted 4.0
Subject information and informed consent form (for publication) L1_SIS and ICF Adult Subjects_redacted 5.0
Subject information and informed consent form (for publication) L1_SIS and ICF Adults Austria_redacted 5.0
Subject information and informed consent form (for publication) L1_SIS and ICF adults_redacted 5.0
Subject information and informed consent form (for publication) L1_SIS and ICF Bio Sample Research Addendum Information and Consent Form 1
Subject information and informed consent form (for publication) L1_SIS and ICF for Optional Genetic Research 1
Subject information and informed consent form (for publication) L1_SIS and ICF for Pregnant Partners 2.0
Subject information and informed consent form (for publication) L1_SIS and ICF Future Research Austria_redacted 4.0
Subject information and informed consent form (for publication) L1_SIS and ICF Future Research Germany_redacted 2.0
Subject information and informed consent form (for publication) L1_SIS and ICF Genetic Austria 2.0
Subject information and informed consent form (for publication) L1_SIS and ICF Genetic Germany_redacted 1
Subject information and informed consent form (for publication) L1_SIS and ICF Main with optional genetic research_redacted 4.0
Subject information and informed consent form (for publication) L1_SIS and ICF main_HU_Redacted 4.0
Subject information and informed consent form (for publication) L1_SIS and ICF optional future_HU_Redacted 3.0
Subject information and informed consent form (for publication) L1_SIS and ICF optional genetic_HU 2.0
Subject information and informed consent form (for publication) L1_SIS and ICF Pregnant Partner_FR 1
Subject information and informed consent form (for publication) L1_SIS and ICF pregnant partner_HU_Redacted 2.0
Subject information and informed consent form (for publication) L1_SIS and ICF summary_HU 1
Subject information and informed consent form (for publication) L1_SIS and ICF_Adult subject ICF_Redacted 5.1
Subject information and informed consent form (for publication) L1_SIS and ICF_Future research ICF_Redacted 4.1 ES
Subject information and informed consent form (for publication) L1_SIS and ICF_Genetic ICF 1
Subject information and informed consent form (for publication) L1_SIS and ICF_Pregnant partners ICF 1
Subject information and informed consent form (for publication) L1_SIS and ICF_Research Study Consent Summary 1
Subject information and informed consent form (for publication) L1_Site-specific data of the planned clinical trial sites_Austria_redacted 2.0
Subject information and informed consent form (for publication) L1_Study information and informed consent form_Master_Redacted 2
Subject information and informed consent form (for publication) L1_Study information and informed consent form_Redacted 4.0
Subject information and informed consent form (for publication) L2_Other subject information material_Patient Poster 1
Subject information and informed consent form (for publication) L2_Other subject information material_Patient Recruitment Pamphlet_Redacted 1.0
Subject information and informed consent form (for publication) L2_Other subject information material_Patient Study Guide_Redacted 2.0
Subject information and informed consent form (for publication) L2_Patient card HU 3.0
Summary of Product Characteristics (SmPC) (for publication) E2_Summary of Products Characteristics Carboplatin RSI 2
Summary of Product Characteristics (SmPC) (for publication) E2_Summary of Products Characteristics Doxorubicin RSI 2
Summary of Product Characteristics (SmPC) (for publication) E2_Summary of Products Characteristics Epirubicin RSI 3
Summary of Product Characteristics (SmPC) (for publication) E2_Summary of Products Characteristics Pembrolizumab RSI 3
Summary of Product Characteristics (SmPC) (for publication) G2_Summary of Products Characteristics Capecitabine RSI N/A
Summary of Product Characteristics (SmPC) (for publication) G2_Summary of Products Characteristics Cyclophosphamide RSI N/A
Summary of Product Characteristics (SmPC) (for publication) G2_Summary of Products Characteristics Paclitaxel RSI N/A
Synopsis of the protocol (for publication) D1_Protocol Synopsis HU_redacted 3.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_BE_Dutch 2023 505928 59_redacted 4.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_BE_French 2023 505928 59_redacted 4.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_BE_German 2023 505928 59_redacted 4.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_ES_Lay language_Redacted 4.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_IT_2023-505928-59-00_redacted 3.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_IT_Lay language_2023-505928-59-00_Redacted 4.0
Synopsis of the protocol (for publication) D1_Protocol synopsis_lay language_PL_Redacted 4.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_lay language_redacted 4.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_lay person_redacted 4.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_LL_HU_redacted 3.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_redacted 2.0
Synopsis of the protocol (for publication) D1_Protocol Synopsis_redacted 4.0
Synopsis of the protocol (for publication) D2_Protocol Lay language synopsis Bulgaria 2023-505928-59-00_Redacted 4.0
Synopsis of the protocol (for publication) D2_Protocol Scientific synopsis Bulgaria 2023-505928-59-00_Redacted 3.0

Application history

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

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2023-11-17 Spain Acceptable
2024-03-12
2024-03-12
2 SUBSTANTIAL MODIFICATION SM-1 2024-11-13 Spain Acceptable
2025-02-12
2025-02-12
3 SUBSTANTIAL MODIFICATION SM-2 2025-03-25 Acceptable 2025-04-22
4 SUBSTANTIAL MODIFICATION SM-3 2025-05-30 Spain Acceptable
2025-07-14
2025-07-14
5 SUBSTANTIAL MODIFICATION SM-5 2025-11-07 Spain Acceptable
2026-02-06
2026-02-09
6 NON SUBSTANTIAL MODIFICATION NSM-1 2026-03-10 Acceptable
2026-02-06
2026-03-10
7 NON SUBSTANTIAL MODIFICATION NSM-3 2026-04-23 Acceptable
2026-02-06
2026-04-23