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| ID | Type | Description | Link |
|---|---|---|---|
| ISRCTN47153584 | Registry Identifier | International Clinical Trials Register Platform (ICTRP), WHO |
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| Name | Class |
|---|---|
| CIMAB (Cuba) | UNKNOWN |
| Laboratorio Elea Phoenix S.A. | INDUSTRY |
| Innogene Kalbiotech Pte. Ltd | INDUSTRY |
| Eurofarma Laboratorios S.A. |
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This is a prospective, randomized, open label, parallel-group, multicenter phase III study to evaluate the efficacy and safety of active specific immunotherapy with racotumomab plus best supportive care versus best supportive care in patients with advanced NSCLC who have achieved an Objective Response (Partial or Complete Response) or Stable Disease with standard first-line treatment. Also immunological parameters will be evaluated. Best supportive therapy will be administered to all patients in the study according to institutional standards and includes any subsequent onco-specific therapies. 1082 patients will be included in the study, with non-small cell lung cancer in stages IIIA (non-resectable), IIIB or IV.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Racotumomab plus Best Support Treatment | Experimental | Patients will receive Racotumomab and Best Support Treatment, which includes any further onco-specific therapy for progressive disease. |
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| Best Support Treatment | Active Comparator | Patients will receive best support treatment for advanced NSCLC including onco-specific therapies when disease progresses. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Racotumomab | Biological | Patients will receive best support treatment and vaccination with racotumomab. The vaccination schedule is as follows: 5 doses (1mg/mL each), intradermally, every 2 weeks (induction period) followed by monthly vaccinations until any criteria for discontinuation are met. If disease progression occurs and further onco-specific therapy is indicated, the patient will be able to continue in the study and vaccination will not be interrupted unless criteria for vaccine discontinuation are met. |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Survival | A comparison of survival in the subgroup of inoperable stage IIIA and dry IIIB will be performed in 757 (approximately 70% of the study population) | Until date of death or last censored observation, on average upto 17 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants with Adverse events as a measure of safety and tolerability | Safety will be evaluated at each study visit according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 3.0 and will include physical examination with vital signs, performance status as per the Eastern Cooperative Oncology Group scale(ECOG scale), laboratory tests and clinical history. |
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Inclusion Criteria:
Voluntarily signed informed consent.
Cytologic or histologically diagnosed NSCLC in stages IIIA (non-resectable) or IIIB or IV (TNM).
In continuous complete or partial remission or stable disease according to Response Evaluation Criteria in Solid Tumours (RECIST) after standard first-line treatment.
Imaging studies documenting the response to first-line therapy must be available for evaluation by the investigator.
Time lapse of 21 to 56 days between the end of onco-specific treatment and start of vaccination. Patients must have recovered from any acute toxicity produced by previous therapy.
Age greater than or equal to 18 years, either sex.
Eastern Cooperative Oncology Group performance status less than 2.
Adequate organ function, defined as follows:
8.1. Electrocardiogram (ECG) without significant anomalies, performed in the 7 days preceding entry
8.2. Haemoglobin greater than or equal to 90 g/L
8.3. Total white blood cell count (WBC) greater than or equal to 3.0 x 10^9/L
8.4. Absolute neutrophil count (ANC) greater than or equal to 1.5 x 10^9/L
8.5. Platelet count greater than 100 x 10^9/L
8.6. Total bilirubin less than or equal to 1.5 fold the maximum normal value at the place of evaluation or 2.5 fold the maximum normal value in case of liver metastases
8.7. Glutamic-oxaloacetic transaminase/aspartate aminotransferase (GOT/AST), and glutamic-pyruvic transaminase/alanine aminotransferase (GPT/ALT), less than or equal to 2.5 fold the maximum normal value at the place of evaluation (in case of liver metastasis, less than 5 fold the maximum normal value)
8.8. Creatinine less than or equal to 2 mg/dL (less than or equal to 176 µmol/L)
Known hepatitis B virus carriers who have liver function tests within the accepted limits are eligible
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Roberto Gomez, M.D. | Recombio S.L. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Instituto Médico CER | Quilmes | Buenos Aires | Argentina | |||
| Hospital Privado de Córdoba |
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| INDUSTRY |
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| Best Support Treatment | Other | Patients will receive best support treatment for advanced NSCLC as per each institution's standards, including onco-specific therapies when disease progresses. |
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| Until death, on average during 17 months |
| Progression Free Survival | Tumour evaluations will be performed every 2 months and evaluated as per Response Evaluation Criteria in Solid Tumors (RECIST). | From randomization until date of first documented progression of disease, assessed as per RECIST 1.0 during an expected average of 17 months |
| Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside | Baseline |
| Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside for Racotumomab Group | Month 3 |
| Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside for Racotumomab Group | Month 6 |
| Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside for Racotumomab Group | Month 9 |
| Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside for Racotumomab Group | Month 12 |
| Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside for Racotumomab Group | After the first year, every 3 months, on average for 17 months |
| Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay. | Baseline |
| Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay for Racotumomab Group. | Month 3 |
| Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay for Racotumomab Group. | Month 6 |
| Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay for Racotumomab Group. | Month 9 |
| Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay for Racotumomab Group. | Month 12 |
| Evaluation of the reactivity if the antibodies against X63 tumor line (mouse myeloma) for Racotumomab Group | Baseline |
| Evaluation of the reactivity if the antibodies against X63 tumor line (mouse yeloma) for Racotumomab Group | Month 3 |
| Evaluation of the reactivity if the antibodies against X63 tumor line (mouse myeloma) for Racotumomab Group | Month 6 |
| Evaluation of the reactivity if the antibodies against X63 tumor line (mouse myeloma) for Racotumomab Group | Month 9 |
| Evaluation of the reactivity if the antibodies against X63 tumor line (mouse myeloma) for Racotumomab Group | Month 12 |
| Evaluation of the reactivity if the antibodies against X63 tumor line (mouse myeloma) for Best Support Treatment Group | Baseline |
| Evaluation of the reactivity if the antibodies against X63 tumor line (mouse myeloma) for Best Support Treatment Group | Month 4 |
| Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside for Best Support Treatment Group | Baseline |
| Determination of IgM and IgG antibody titers against N-Glycolil-GM3 ganglioside for Best Support Treatment Group | Month 4 |
| Determination of gamma interferon by ELISPOT (enzyme-linked immunosorbent spot) assay for Best Support Treatment Group. | Month 4 |
| Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry. | Baseline |
| Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry in the Racotumomab Group. | Month 3 |
| Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry in the Racotumomab Group. | Month 6 |
| Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry in the Racotumomab Group. | Month 9 |
| Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry in the Racotumomab Group. | Month 12 |
| Determination of T supressor cell (Treg cell) frequency by immunostaining and flow cytometry in the Best Support Treatment Group. | Month 4 |
| Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available) | Baseline |
| Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available) in the Racotumomab Group. | Month 3 |
| Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available) in the Racotumomab Group. | Month 6 |
| Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available) in the Racotumomab Group. | Month 9 |
| Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available) in the Racotumomab Group. | Month 12 |
| Evaluation of the reactivity of the antibodies against the patients tumoral tissue (whenever samples are available) in the Best Support Treatment Group. | Month 4 |
| Measurement of pro-inflammatory and anti-inflammatory cytokines | Baseline |
| Measurement of pro-inflammatory and anti-inflammatory cytokines in the Racotumomab Group | Month 3 |
| Measurement of pro-inflammatory and anti-inflammatory cytokines in the Racotumomab Group | Month 6 |
| Measurement of pro-inflammatory and anti-inflammatory cytokines in the Racotumomab Group | Month 9 |
| Measurement of pro-inflammatory and anti-inflammatory cytokines in the Racotumomab Group | Month 12 |
| Measurement of pro-inflammatory and anti-inflammatory cytokines in the Best Support Treatment Group | Month 4 |
| Determination of anti-idiotypic IgG response | Baseline |
| Determination of anti-idiotypic IgG response in the Racotumomab Group. | Month 3 |
| Determination of anti-idiotypic IgG response in the Racotumomab Group. | Month 6 |
| Determination of anti-idiotypic IgG response in the Racotumomab Group. | Month 9 |
| Determination of anti-idiotypic IgG response in the Racotumomab Group. | Month 12 |
| Determination of anti-idiotypic IgG response in the Best Support Treatment Group. | Month 4 |
| Córdoba |
| Córdoba Province |
| Argentina |
| Instituto Oncológico de Córdoba | Córdoba | Córdoba Province | Argentina |
| Fundación COIR | Mendoza | Mendoza Province | Argentina |
| ISIS Clinica Especializada | Santa Fe | Santa Fe Province | Argentina |
| Policlínica Privada Instituto de Medicina Nuclear | Bahía Blanca | Argentina |
| Hospital Italiano | Córdoba | Argentina |
| Centro Oncológico de Rosario | Rosario | Argentina |
| CRIO - Centro Regional Integrado de Oncologia | Fortaleza | Ceará | Brazil |
| NOB - Nucleo de Oncologia da Bahia | Salvador | Estado de Bahia | Brazil |
| Hospital Universitário de Brasília | Brasília | Federal District | Brazil |
| Pro Onco - Centro de Tratamento Oncológico | Londrina | Paraná | Brazil |
| Hospital da Cidade de Passo Fundo | Passo Fundo | Rio Grande do Sul | Brazil |
| UPCO - Unidade de Pesquisas Clínicas em Oncologia | Pelotas | Rio Grande do Sul | Brazil |
| HCPA - Hospital de Clínicas de Porto Alegre | Porto Alegre | Rio Grande do Sul | Brazil |
| Hospital de Base de São José do Rio Preto | São José do Rio Preto | São Paulo | Brazil |
| Hospital Universitário de Brasília | Brasília - DF | Brazil |
| Centro de Oncologia do Parana | Curitiba | Brazil |
| CRIO - Centro Regional Integrado de Oncologia | Fortaleza - CE | Brazil |
| Hospital Amaral de Carvalho | Jaú | Brazil |
| Pro Onco - Centro de Tratamento Oncológico | Londrina - PR | Brazil |
| Centro Oncologico de Mogi das Cruzes | Mogi das Cruzes | Brazil |
| Liga Norte Riograndense Contra o Cancer | Natal | Brazil |
| Hospital da Cidade de Passo Fundo | Passo Fundo - RS | Brazil |
| UPCO - Unidade de Pesquisas Clínicas em Oncologia | Pelotas - RS | Brazil |
| Hospital Moinhos de Vento | Porto Alegre | Brazil |
| HCPA - Hospital de Clínicas de Porto Alegre | Porto Alegre - RS | Brazil |
| Oncologistas Associados | Rio de Janeiro | Brazil |
| NOB - Nucleo de Oncologia da Bahia | Salvador - BA | Brazil |
| Faculdade de Medicina do ABC | Santo André | Brazil |
| Hospital de Base de São José do Rio Preto | São José do Rio Preto | Brazil |
| GRAM - Grupo de Assistencia Medica e Prestacao de Servicos | São Paulo | Brazil |
| Hospital "Hermanos Ameijeiras" | Havana | Cuba |
| Hospital "Celestino Hernández Robau" | Provincia de Villa Clara | Cuba |
| Hospital Jose Ramon Lopez Tabranes | Versalles | Cuba |
| Dr Moewardi Hospital | Central Java | Indonesia |
| Persahabatan Hospital | Jakarta | Indonesia |
| RS Kanker 'Dharmais' | Jakarta | Indonesia |
| Dr Soetomo Hospital | Surabaya | Indonesia |
| Dr Sardjito Hospital | Yogyakarta | Indonesia |
| Perpetual Succour Hospital | Cebu City | Philippines |
| Veterans Memorial Medical Center | Manila | Philippines |
| Johns Hopkins Singapore International Medical Centre | Singapore | Singapore |
| Chiang Mai Hospital | Chiang Mai | Thailand |
| Khon Kaen Hospital, Division of Pulmonary and Critical Care Medicine | Khon Kaen | Thailand |
| Songklanagarind Hospital - HOCC-PSU | Songkhla | Thailand |
| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| D055752 | Small Cell Lung Carcinoma |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| C000590234 | racotumomab |
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