Section to complete information about primary and secondary outcomes including. It includes the metric or method of measurement used and, the time point for every outcome.
Primary outcome(s):
Stage 1:
- Proportion of patients with serious adverse events with a causal relationship (definite, very probable or probable) with the immunomodulator VSSPs. An adverse event will be evaluated as serious with an intensity greater than 4 (AE that threatens or incapacitates and AE that causes death) following the criteria of intensity, seriousness and causality, according to the CTCAE v5 classification. Measurement time: iteratively and in each administration of the product, for 2 years.
Stage 2:
- Overall survival at 2 years. The time elapsed from the inclusion of the patient in the study until the patient's death will be measured, regardless of the cause or until the date of the latest news by clinical history. Measurement time: at 12 and 24 months, for 2 years.
Key secondary outcomes:
- Type of AE. The presented EA will be described. Measurement time: iteratively and in each administration of the product, for 2 years.
- Duration of the EA. It will be evaluated by the start and end dates of the adverse event. Measurement time: iteratively and in each administration of the product, for 2 years.
- AE severity. It will be classified as Serious/Serious or Not Applicable (NP) when the AE is Not Serious/Not Serious. Measurement time: iteratively and in each administration of the product, for 2 years.
- Intensity of the AE. It will be classified according to the Common Toxicity Criteria (CTCAE) version 5.0 of the US National Cancer Institute. It includes the following categories: Mild, Moderate, Severe, AE that threatens or incapacitates and AE that causes death. Measurement time: iteratively and in each administration of the product, for 2 years.
- Causal relationship. It will be classified as: Definitive, Very Likely, Probable, Possible, Unrelated, Unknown. Measurement time: iteratively and in each administration of the product, for 2 years.
- Attitude followed before the appearance of the AE. It includes the following categories: no change, dose modification, temporary or permanent interruption of study treatment. Measurement time: iteratively and in each administration of the product, for 2 years.
- Results of the EA. It includes the following categories: recovered, improved, persists, sequelae. Measurement time: iteratively and in each administration of the product, for 2 years.
- Evaluation of the percentage and absolute number in the population of peripheral blood mononuclear cells (PBMC) of MDSC, Lymphocytes, dendritic cells, regulatory T cells, monocytes by flow cytometry. Measurement of Arginase I, S100A8/A9 and HMGB1 levels in the serum (ELISA). Evaluation of the proliferation of T lymphocytes within the PBMC. Measurement time: days 0, 21, 28, 1 week before and 1 week after month 6, and months 12, 18 and 24.
- Objective answer. Response to treatment will be assessed using the Response Evaluation Criteria in Solid Tumors (RECIST version 1.1) and classified as Complete Response (CR), Partial Response (PR), Stable Disease (EE) or Progressive Disease (PD). Measurement time: 4 weeks after the last dose on day 28 (month 2 of treatment) and at months 6, 9, 12 and 24.
- Duration of response. (Defined in days, as the time from the date the patient achieves a response to study treatment (CR/PR) to objective disease progression or death.) measurement time: up to 24 months
progression-free survival. (Time that elapses from the start of treatment to the date that is considered, by the results of the imaging tests, the progression of the disease or death from any cause). Measuring time: up to 24 months
- Quality of life. (It will be measured by the QLQ-C30 survey). measurement time: before treatment, at month 6, 12 and 24.