EX-10.13 11 d693633dex1013.htm EX-10.13 EX-10.13

Exhibit 10.13

 

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SERVICE AGREEMENT

FOR A CLINICAL STUDY CONDUCT

concluded on 16 December 2013 (“Effective Date”) in Warsaw by and between:

KCR S.A. (Polish joint-stock company) with its registered office in Warsaw at 6 Postępu Str., 02-676 Warsaw, Poland, entered in the register of entrepreneurs kept by the District Court for the Capital City of Warsaw in Warsaw, 13th Commercial Division of the National Court Register, under number 0000289542, tax identification number NIP: 521-31-69-665, share capital (covered in total): PLN 700,000.00, hereinafter referred to as “CRO”, represented by Mr. Mike Jagielski – President of the Management Board and Ms. Anna Baran – Vice President of the Management Board,

and

Vascular Biogenics Ltd., its principal place of business at 6 Jonathan Netanyahu Street, Or Yehuda, Israel 60376 hereinafter referred to as “Sponsor”, represented by Prof. Dror Harats—Chief Executive Officer,

hereinafter jointly referred to as „the Parties” and individually as a “Party”.

Whereas:

 

  a) Sponsor intends to conduct a clinical study of the investigational medicinal product VB-201 [„Investigational Medicinal Product”] entitled “A Randomized, Double-Blind, Dose-Ranging, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Oral VB-201 in Patients with Moderate to Severe Plaque Psoriasis” [„Study”] according to the protocol number VB-201-079 [“Protocol”] on the territory of Poland,

 

  b) Legal Representative of the Sponsor is SCIderm GmbH, a company organized and existing under the laws of Federal Republic of Germany, entered in the Trade Register maintained by the District Court in Hamburg, under the number HRB 93824 with its registered office at Drehbahn 1-3, 20354 Hamburg, Germany,

 

  c) Sponsor wishes to engage CRO to provide services connected with the conduct of the Study as defined herein,

 

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  d) fulfillment of CRO’s obligations resulting from this agreement is included in the scope of CRO’s business activity and CRO has an experience in providing services of similar nature as described herein, including the fact that CRO employs qualified employees in order to perform such obligations.

Now then, the Parties agree to conclude the agreement as follows [„Agreement”]:

§ 1. Subject of the Agreement

 

1. Sponsor hereby entrusts CRO with performance of activities connected with the conduct of the Study as defined in Attachment No. 1 hereto (Scope of Services), hereinafter referred to as „Services”, and CRO hereby accepts such entrusted responsibilities.

 

2. Services shall be performed within the timelines indicated in Attachment No. 2. Parties declare that these timelines shall be deemed as a forecast only and may be changed due to reasons which are not attributable to the CRO. In case of necessity to provide Services within different timelines than those anticipated in Attachment No. 2 for reasons not attributable to CRO, Sponsor waives its right to bring any claims against CRO for an untimely provision of Services.

§ 2. Manner of Providing Services

 

1. CRO shall perform its responsibilities, in the scope indicated in the Agreement, with due diligence and in compliance with laws and regulations in force applicable in the countries where the Services will be performed, guidelines of Good Manufacturing Practice, Good Laboratory Practice, Good Clinical Practice, ICH GCP in a version applicable during the term of the Study conduct, in compliance with the Agreement and a valid version of the Protocol, constituting Attachment No. 3 to the Agreement, CRO’s SOPs listed in Attachment No. 4 and any written instructions of the Sponsor.

 

2.

The CRO represents and warrants that it has obtained, and will maintain throughout the term of this Agreement, all governmental or regulatory approvals, licenses, registrations and insurances that may be required to complete the Study, and that it has full right, power and authority to perform its obligations hereunder and to grant the rights set forth herein. During the term of this Agreement the CRO shall not conduct any other trial which, at the CRO’s

 

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  discretion, would adversely affect the ability of the CRO to perform their obligations under this Agreement.

 

3. In order to perform Services, CRO undertakes an obligation to appoint from among its employees only persons with appropriate knowledge, experience and qualifications necessary to perform Services, and who have bound by confidentiality undertakings according to this Agreement.

 

4. The CRO certifies that it has not and will not use in any capacity in connection with this Agreement the services of any individual, corporation, partnership, or association which has been debarred, excluded, or disqualified from participation in clinical investigations under any applicable laws, regulations, or guidance. In the event that the CRO receives notice of the debarment or threatened debarment, exclusion or disqualification or threatened disqualification, of any individual, corporation, partnership or association providing services to the CRO, which relate to its activities under this Agreement, the CRO shall notify the Sponsor immediately.

 

5. If the Sponsor raises any objections regarding provision of Services by a particular CRO employee, the Sponsor shall notify CRO of that fact in writing and may request replacement of such employee solely due to material and reasonable objections against his/her work or behavior. CRO shall appoint a new employee with appropriate qualifications and experience in the shortest possible time.

 

6. Sponsor shall have the right to reject any Services that it deems in nonconformance with the Protocol or the Agreement. Sponsor shall provide CRO with written notification of the deficiency or non-conformance and, within thirty (30) days of receipt of such written notification, CRO shall correct the deficiency or non-conformance at CRO’s expense.

 

7. During the term of the Agreement and subject to the prior approval of the Sponsor (e-mail form is acceptable), CRO may entrust a third party, such as sites, investigators, and other relevant sub-contractors (“Sub-contractors”) with performance of all or some of the Services while observing due diligence in this choice, provided that such Sub-contractors are made aware of and acknowledge the obligations applicable to such Sub-contractors according to this Agreement including without limitation confidentiality, Intellectual property rights and publications. The CRO shall ensure, and shall at all times remain jointly and severally responsible and liable, for the compliance of such Sub-contractors with the terms of this Agreement. For the avoidance of doubt, the Parties agree that this section shall not release

 

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  the Sponsor or the investigators from liability for the Study conduct according to provisions of law in force.

 

8. CRO acknowledge that the Sponsor may entrust third parties with performance of services, which are related to the Study but are not included in the Services, which shall be provided by the CRO. A list of such third parties attached hereto as Attachment 5 or as shall be amended by the Sponsor from time to time. CRO warrants that (i) it will fully cooperate with such third parties according to the Sponsor’s written instructions as necessary to the conduct of the Study and (ii) it will be obligated by the relevant written instructions imposed by such third parties as shall be presented to the CRO by such third party or the Sponsor.

 

9. CRO warrants that the assumptions underlying each Attachment and/or timeline have been arrived at in good faith by CRO, based upon its experience and professional judgment. In the event the CRO or Sponsor requests to amend the Services, timelines or budget for a Study, the Parties agree to negotiate in good faith a written change order signed by the duly authorized representatives of the Parties.

 

10. Both Sponsor and CRO shall carry, at its sole expense, with financially sound and reputable insurers, an insurance coverage with respect to the conduct of its business.

§ 3. Sponsor’s responsibilities

Sponsor undertakes an obligation in particular to:

 

  a) provide CRO with all information in its possession about the Investigational Medicinal Product necessary for the conduct of the Study,

 

  b) keep CRO informed on an ongoing basis about any new findings concerning safety of the Investigational Medicinal Product,

 

  c) supply CRO with the Investigational Medicinal Product manufactured in compliance with Good Manufacturing Practice, adequately packed and labeled,

 

  d) supply CRO with documentation necessary for conduct of the Study, including the valid version of the Protocol, Investigator’s Brochure and the Case Report Forms (CRF),

 

  e) conclude insurance agreement on third party liability of the Sponsor and investigators for damages related to the conduct of the Study, in compliance with laws in force and provide CRO with a valid copy of the insurance policy confirming conclusion of such agreement,

 

  f) notify CRO immediately of any suspension of the Study or withdrawal of the approval for the conduct of the Study,

 

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  g) perform other responsibilities not assigned to the CRO and necessary for the conduct of the Study.

§ 4. Audits and inspections

 

1. On Sponsor’s reasonable request, CRO shall, at any time, provide the Sponsor with information on the status of the Services performed. In particular, the Sponsor may request CRO to prepare an activity report on the Services performed by CRO.

 

2. During the term of the Agreement, CRO undertakes an obligation to allow the Sponsor and any competent authorities and national, foreign and international bodies or organizations responsible for registration of medicinal products and supervision, audit or inspection of clinical studies to conduct an audit, control or inspection of the Study as well as to access the records related to the Study conduct, and to monitor and audit the activities of the investigators and members of the study teams during the Study (including inspection and audit of the facilities and procedures used in the Study by the investigators and the study teams, as well as the equipment, data registration method and storing the records), and to enable both Sponsor and any national, foreign and international bodies or organizations responsible for registration of medicinal products and supervision or inspection of clinical studies to obtain any and all information on the conduct of the Study.

 

3. CRO shall notify Sponsor if any competent authorities and national, foreign and international bodies or organizations responsible for registration of medicinal products and supervision, audit or inspection of clinical studies inform CRO about any scheduled, or begin an unscheduled inspection of any study site, CRO or bioethics committee. CRO shall immediately provide the Sponsor with any correspondence and/or communication related to a notification, conduct and results of an audit or inspection and shall inform the Sponsor of the measures to be taken following finding and recommendations of such inspection and audits and their results.

 

4. Sponsor agrees to cover the costs of CRO’s employees involvement in an audit, control or inspection based on real time spent on such activities according to the rates described in Attachment No. 6.

 

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§ 5. Remuneration

 

1. For execution of all obligations resulting from the Agreement by CRO, Sponsor undertakes an obligation to pay remuneration as well as reimburse costs and expenses as defined in net amounts in Attachment No. 6. Due VAT shall be added to the above fee.

 

2. The Sponsor is obliged to make payments within 30 days from the receipt of a VAT invoice from CRO and provided that the CRO has provided upon the execution of this Agreement a Certificate of Residency from its Tax Authorities. If it is necessary to convert one currency into another, it shall be calculated by CRO on the basis of a current foreign exchange selling rate of the Polish National Bank announced on the date of the VAT invoice issuance.

 

3. The remuneration shall be calculated and paid on a monthly basis for the time committed to or a type of Services provided in a given month within 30 days from the delivery of the invoice issued by CRO to the Sponsor. CRO shall be entitled to issue and deliver a VAT invoice beginning with the last day of a given month for the amount covering time or type of Services performed in such month.

 

4. On Sponsor’s request, CRO shall submit a list of Services performed in a given month, including a timesheet of persons providing Services with a detailed description of activities performed.

 

5. The Sponsor shall reimburse CRO:

 

  a) for any costs incurred by CRO in connection with conclusion of the Agreement and providing the Services hereunder—so called “pass through costs”, including in particular costs of telephone connections, faxes, internet, courier and mail services, accommodation and travel expenses of persons appointed to perform Services, which will be incurred in connection with the execution of the Agreement. These expenses will be invoiced on a monthly basis and presented to the Sponsor with a detailed list.

 

  b) for any costs related to use of CRO company cars for business travels to and from study sites indicated by the Sponsor,

 

  c) for any other costs necessary for the proper conduct of the Study provided that such expenses have been pre-approved by the Sponsor.

 

6.

Specification of expected costs and expenses (so called „pass through costs”) is included in Attachment No. 6 hereto. In case if costs, expenses or a scope of Services connected with the conduct of the Study appear to be higher than those anticipated on the Agreement date, the Sponsor undertakes an obligation to cover these costs and reimburse CRO for expenses incurred

 

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  in relation to the execution of the Agreement provided that such expenses have been pre-approved by the Sponsor.

 

7. When CRO is in charge of investigators, sites, Study subject or IRB/EC fees or expenses payment or reimbursement, estimated or known amounts for such payments/reimbursements will be invoiced to the Sponsor, before paying such fees or expenses. The CRO has no obligation to advance funds and make these payments unless and until the funds are received from the Sponsor. If Sponsor does not provide funds in time to enable CRO to make timely payments, Sponsor agrees to be liable for and to reimburse CRO for any interest and other charges, costs, fees and expenses incurred by CRO because of such late payment. Any excess funds paid to CRO for such fees and expenses shall be refunded to Sponsor at the end of the Study or sooner, upon Sponsor’s request.

 

8. Sponsor is obliged to reimburse CRO for the costs and expenses incurred by CRO in relation to the execution of the Agreement within 30 days from the receipt of relevant documentary evidence supporting such costs and expenses from CRO.

 

9. Payment of the remuneration and reimbursement of costs incurred by CRO shall be made by a transfer to CRO bank account indicated on the invoice.

 

10. CRO rates included in the budget in Attachment 6 shall automatically increase each calendar year beginning from January 1, 2015 for the next 12 month period, according to year inflation rate published by Eurostat, the Statistical Office of the European Communities. The Parties agree that increase of rates shall be effective from the beginning of calendar year regardless of the date of publishing year inflation rate by Eurostat.

§ 6. Confidentiality

 

1. The CRO shall keep confidential any and all information and data concerning Sponsor`s business or its activities (including reports and information as well as all clinical data about the Study or its progress produced by the CRO or the sites within the framework of this Agreement), or information obtained that may come to the knowledge of the CRO, its personnel or appointed representatives during or in connection with the execution of this Agreement including without limitation third party confidential information received by the Sponsor (“Sponsor’s Confidential Information”). For the avoidance of any doubt, the Protocol, the Investigational Medicinal Product, the Study results, and the Inventions (as defined below) shall be considered the Sponsor’s Confidential Information.

 

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2. Sponsor shall keep confidential any and all information and data concerning the CRO`s business or its activities (including information produced by Sponsor within the framework of this Agreement) or information obtained that may come to the knowledge of Sponsor, its personnel or appointed representatives during or in connection with the execution of this Agreement, and is not considered Sponsor’s Confidential Information.

 

3. Parties undertake an obligation to keep strictly confidential any confidential information or data which came into possession of the other Party in any manner, were delivered or otherwise disclosed to the other Party in connection with the Agreement. Parties may use and make the above mentioned information available solely for the purpose of the execution of the Agreement.

 

4. The above provision does not apply to information which the receiving Party can demonstrate that:

 

  a) is known to the receiving Party at the moment of its disclosure,

 

  b) is publicly accessible at the time of its disclosure to the receiving Party or it becomes later publicly accessible without the Party’s fault,

 

  c) may be disclosed upon the other Party’s consent expressed in writing otherwise being void,

 

  d) was disclosed to the receiving Party by a third party that was not obliged to keep it confidential or

 

  e) is disclosed by virtue of laws in force.

 

5. If confidential information needs to be disclosed to a third party for the purpose of performance hereof, the Sponsor or CRO, prior to making any such disclosure, will cause such third party to undertake the confidentiality and non-use obligations in writing at least to the extent applicable to themselves under the Agreement. Any publication of data from the Study or oral presentations on an individual basis with respect to the Study data shall be subject to the Sponsor’s prior review and approval. The Sponsor is entitled at its sole discretion to delay or reject of such publication due to Sponsor’s business or operational reasons.

§ 7. Personal data processing

 

1.

Sponsor undertakes to observe the provisions of Personal Data Protection Act of 29th of August 1997 (uniform text: Journal of Laws from 2002, No. 101, position 926 with later changes) as well as secondary regulations, regarding personal data of CRO’s employees, contractors and other individuals (such as employees of CRO’s contractors), provided by CRO to Sponsor, in

 

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  the scope of performance the obligations under the Agreement. The personal data of the CRO’s employees, contractors and other individuals will be processed by Sponsor on grounds of their consent or justified purposes of a data controller. However, for the purposes of processing by Sponsor of the personal data of the CRO’s employees or contractors in relation to the execution of obligations of CRO as an employer, CRO entrusts Sponsor with the processing of such personal data in accordance with the Agreement.

 

2. Sponsor appoints CRO as its representative within the meaning of article 31a of the Personal Data Protection Act.

 

3. The scope of the entrusted personal data includes the following categories: names, surnames, addresses, contact details, professional experience, current and past position, education, skills. Sponsor undertakes to process the personal data by collecting, recording, storing, deleting compiling, amending, transferring in paper form and by electronic means.

 

4. Sponsor cannot use entrusted personal data for any other purpose or in any other manner than necessary to execute the Agreement. Sponsor is also obliged neither to disclose nor to pass on the personal data to any entity without prior written CRO’s consent.

 

5. Sponsor is liable for the damages caused to CRO or any third party in the result of personal data processing against the Agreement by Sponsor or under its responsibility.

 

6. When the Agreement is finished/terminated/expired, Sponsor is obliged to finish personal data processing, return or destroy all received documents and their copies, and return all received electronic data mediums to CRO.

 

7. Sponsor entrusts CRO with the processing of personal data of the investigators and the members of study teams for the purposes of the performance of activities connected with the conduct of the Study. The scope of the entrusted personal data includes the following categories: names, surnames, addresses, place of work, telephone numbers, e-mail addresses, bank account numbers, PESEL numbers, tax identification numbers, professional experience, current and past position, education. CRO undertakes to process the personal data by collecting, recording, storing, deleting, compiling, amending, transferring in paper form and by electronic means. Sponsor hereby authorizes CRO to subcontract the processing of the personal data to a further data processor as shall be agreed in advance by the Sponsor.

 

8. CRO undertakes to observe the provisions of the Personal Data Protection Act and the secondary regulations. CRO cannot use the entrusted personal data for any other purpose or in any other manner than necessary to execute the Agreement.

 

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9. In relations between CRO and Sponsor acting as data controllers / data processors towards each other, the following rules shall apply accordingly:

 

  a) the data processor is hereby obliged, prior to commencing the processing of the personal data and afterwards, during the term of this Agreement, to apply any technical and organizational measures that will ensure the security of the personal data being processed, as set forth in the Personal Data Protection Act and the secondary regulations, and any legislation that will supplement and/or replace them in the future; in particular, it should secure the personal data against access by unauthorized persons, its removal by unauthorized persons, and against it being damaged or destroyed;

 

  b) the data processor shall be obliged to ensure supervision of the following: when and by whom the personal data has been entered into the data filing system and to whom the data has been transferred;

 

  c) the data processor undertakes to preserve the confidentiality of the personal data entrusted to it under this Agreement;

 

  d) only persons who were authorized by the data processor shall be allowed to carry out the processing of personal data;

 

  e) the data processor shall be obliged to take all necessary steps to ensure that the persons referred to in point (d) of this clause keep the personal data and the methods of their protection confidential;

 

  f) the data processor shall immediately inform the data controller of any instance of any breach, whatsoever, of the security of the personal data entrusted to the data processor and processed under this Agreement;

 

  g) the data processor shall grant the data controller, at its request, any necessary information concerning all personal data processed by the data processor;

 

  h) the data controller shall have the right to conduct inspections as to whether the data processor is observing the principles of processing the personal data specified in the Personal Data Protection Act, the secondary regulations and this Agreement, by accessing and inspecting any premises where the personal data is processed, as well as the documents, equipment and IT systems relating to the personal data processing;

 

  i)

the data controller shall be entitled to review whether the above principles of the processing of the personal data are being observed and as such the data controller’s representatives will be entitled to demand that the data processor’s representatives provide to the data controller

 

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  the necessary information concerning the way in which the data processor processes the personal data contained in the data filing system;

 

  j) any inspection of whether the above principles of the personal data processing are being observed may only take place after the data controller has notified the data processor of the intention of carrying out such an inspection at least two days in advance of the date of the commencement of the inspection, and has indicated in writing the persons designated to carry out the inspection; an inspection may be exercised by the data controller at the location where the personal data are being processed – between the hours of 9 a.m. and 4 p.m. on any business day;

 

  k) following the inspection, the data controller may draw up recommendations concerning the improvement of the quality of the safeguarding of the personal data, as well as the means of its processing by the data processor and the means of remedying any identified irregularities, which the data processor is obliged to immediately remedy not later than 30 days after the data controller’s notification of its observations;

 

  l) upon the expiry or termination of this Agreement the data processor shall be obliged to transfer the personal data to the data controller or delete all the personal data, within seven days of receiving the data controller’s instruction; the deletion of the personal data shall be understood as the erasing of the personal data, or their modification in such a way that the identity of the persons to whom the data refers cannot be established.

§ 8. Intellectual property

 

1. The Parties acknowledge that all rights to materials, Investigational Medicinal Product, data bases, notes, analyses, lists, studies or any other documents, as well as names and graphic signs made available to CRO by the Sponsor in any manner whatsoever, shall remain the property of the Sponsor and CRO shall not acquire any rights thereto, except for the right of use thereof during execution of the Agreement for the purpose of conducting the Study in the manner permitted by the Sponsor.

 

2.

Inventions or discoveries whether or not patentable, processes, trade secrets, data, improvements, and/or patents relating to the Investigational Medicinal Product or otherwise arising from the Study, conceived, generated, developed or first reduced to practice, as the case may be, during the term of this Agreement (hereinafter called “Inventions”), either by the CRO,

 

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  its employees, sites, investigator or any other Sub-contractors related to this Agreement shall be the property of the Sponsor.

 

3. The CRO its employees, sites, investigator or any other Sub-contractors will promptly inform Sponsor of any Invention or discovery arising from the Study, and assign its rights in relation to all intellectual property rights and know how, and provide reasonable assistance to the Sponsor in filing or prosecuting intellectual property rights, at the expense of the Sponsor.

§ 9. Duration of the Agreement and its termination

 

1. The Agreement is concluded for a specified period of time and shall be valid from the Effective Date until the termination of the Study unless any circumstances indicated below should occur.

 

2. Each Party has a right to terminate the Agreement with immediate effect in case of a material breach by the other Party of the obligations resulting from the Agreement if a default is not cured within 30 (thirty) days from the date of delivery of a written notice on the discovered breach to the other Party.

 

3. The Sponsor has a right to terminate the Agreement upon 90 days’ written notice without giving cause and CRO has a right to terminate the Agreement upon 120 days’ written notice without giving cause.

 

4. Upon receipt of the notice of termination of the Agreement from the Sponsor by CRO or dispatch of the same to the Sponsor by CRO, CRO shall make all possible efforts to terminate or transfer further conduct of any unfinished Services as soon as possible, according to the Sponsor’s instructions. In such a case, CRO shall cease to provide Services or undertake further obligations in connection with the Services unless Parties agreed otherwise in writing.

 

5. The Sponsor undertakes an obligation to reimburse CRO for all necessary and actual costs connected with the termination or expiration of the Agreement as well as to pay CRO due remuneration, in particular to reimburse CRO for any expenses incurred (so called „pass through costs”) or to be incurred in relation to provision of the Services from which CRO cannot withdraw. Promptly after the date of the Agreement termination or expiration, CRO shall issue an invoice for the above costs and expenses to the Sponsor.

 

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§ 10. Non-Solicitation Clause

 

1. The Sponsor undertakes an obligation that it shall not employ any employee of the CRO, in its own enterprise or in any company under its control, during the term of the Agreement and for the period of 2 years from the date of termination or expiry hereof.

 

2. In the event of employing the above mentioned persons, the Sponsor shall be obliged to pay a contractual fine in the amount of Euro 50 000 (say: fifty thousands) per each person employed within 7 days from the receipt of the call for payment. Payment of contractual fine shall not deprive CRO of its right to claim damages exceeding the amount of the contractual fine reserved.

§ 11. Final provisions

 

1. Neither Party shall be liable to the other Party in connection with this Agreement for any indirect, consequential (including without limitation lost profits), incidental, special or punitive damages.

 

2. CRO shall not bear any liability connected with the Investigational Medicinal Product, including liability for administering the Investigational Medicinal Product. CRO’s liability due to negligence, non-adherence to professional standards or breach of the Agreement shall be limited to the double amount of the remuneration (CRO fee) received.

 

3. Sponsor shall defend, indemnify, and hold harmless CRO, its affiliates and their respective directors, officers, employees, consultants, sub-contractors, independent contractors, and agents from and against any and all losses, claims (including third party claims), actions, damages, liabilities, awards, costs and expenses (including reasonable legal counsel fees and expenses), whether joint or several, relating to or arising from or in connection with this Agreement or the Services contemplated herein, including but not limited to, the Study, test, specifications, compound, device, placebo or Investigational Medicinal Product, potential product or procedure performed or administered as a result of the Protocol and this Agreement or any litigation, investigation or other proceeding relating to any of the foregoing, unless as a result of CRO’s its affiliates and their respective directors, officers, employees, consultants, sub-contractors, independent contractors, and agents negligence, non-adherence to professional standards or breach of the Agreement.

 

4. CRO shall defend, indemnify, and hold harmless Sponsor, its affiliates and its and their respective directors, officers, employees, and agents from and against any and all losses, claims (including third party claims), actions, damages, liabilities, costs and expenses (including

 

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  reasonable legal counsel fees and expenses) (“Sponsor Losses”) but only to the extent such Sponsor Losses are related to or arise from or in connection with CRO’s negligence, non-adherence to professional standards or breach of this Agreement, except to the extent that such Sponsor Losses arise from (i) the negligence or reckless or willful act or omission of Sponsor, its affiliates or its and their respective directors, officers, employees, contractors or agents; or (ii) any breach of this Agreement by Sponsor, its affiliates, or its and their respective directors, officers, employees, contractors or agents.

 

5. The Party seeking indemnity will give the indemnifying party prompt written notice (within 15 days knowledge) of any matter upon which such indemnified party intends to base a claim for indemnification (an “Indemnity Claim”). The indemnified party shall have the right to participate jointly with the indemnifying party, at its own expense, in the defense, settlement or other disposition of any Indemnity Claim.

 

6. In no event shall either Party be liable to the other in case of not being able to perform its obligations hereunder due to a natural disaster, general strike, war, riots, fire, order of the authorities or any other unforeseeable and unpreventable circumstances, provided that such Party unable to perform its obligation will do its best effort to fulfill its obligations. The Party affected by such circumstances shall immediately notify the other Party of this fact in writing, providing any relevant information regarding the matter.

 

7. No Party may assign any rights or obligations resulting from the Agreement to any third party without prior written consent of the other Party.

 

8. Any representations of the Parties as specified herein shall be made in writing, otherwise null and void.

 

9. Except for cases expressly indicated in the Agreement, all statements, notices, calls etc. connected with the Agreement must be delivered to the addresses of the Parties defined in the preamble hereof, otherwise void and ineffective. Either Party should notify the other of the change of its address in accordance with this paragraph. Such notice shall be deemed properly served by the Party after its receipt by the addressee. All and any notices and statements sent thus far in connection with this Agreement to the addresses given above shall be deemed as served effectively.

 

10. Provisions of § 4, § 6, § 8 and § 10 of the Agreement shall remain in force despite its expiry or termination for any reason.

 

11.

For the avoidance of doubt, this Agreement and the Protocol may only be amended by the agreement in writing of duly authorized signatories of Sponsor and CRO, otherwise being null

 

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  and void. Changes in the Protocol may imply changes in the total course of the Study (costs, time-lines etc.).

 

12. If any one or more provisions of this Agreement shall be found to be illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby.

 

13. The Agreement and any matters connected herewith shall be governed by the laws of England, excluding its rules for choice of law. Any dispute relating to or arising in connection with this Agreement, which is not settled within a reasonable time, shall be finally settled under the Rules of Arbitration of the International Chamber of Commerce (“ICC”) by one arbitrator appointed in accordance with the said rules. The award shall be final and binding and enforceable in any court of competent jurisdiction. The arbitration shall be held in London, United Kingdom, in English language.

 

14. The Agreement has been drawn up in two identical counterparts, one counterpart for each of the Parties.

 

CRO:    Sponsor:
Anna Baran /s/ Anna Baran    /s/ Amos Ron
Mike Jagielski /s/ Mike Jagielski    Vascular Biogenics Ltd.
   Amos Ron
   January 1, 2014

 

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Attachment No. 1

Scope of Services:

Part A

Study Assumptions

 

STUDY ASSUMPTIONS

Number of countries involved

   1

COUNTRIES INVOLVED

   Poland

CRA staff involved

   3

STUDY SITES

   10

PATIENTS ENROLLED (# of expected)

   50

NUMBER OF PATIENT’s VISITs IN SITE DURING THE STUDY

   9

PLANNED NUMBER OF PAYMENTS FOR PI AND SITES DURING THE STUDY

   3

 

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Attachment No. 1

Scope of Services:

Part B

Division of Responsibilities CRO—Sponsor

 

     KCR    VBL
Ltd.
  

Comments

STUDY INITIATION         
Protocol development       X   
Protocol review    X    X    KCR to review the draft of study protocol and provide VBL with comments.
Protocol approval       X   
Protocol printing    X      
Protocol distribution to sites    X      
Preparation of amendments       X   
CRF design and development (e CRF)       X   
CRF review & approval       X   
Preparation of master Informed Consent (IC) and Patient Information Sheet (PIS)       X   
Revision and translation of Informed Consent and Patient Information Sheet according to local Ethical Committee requirements    X      
Final approval of country specific IC and PIS       X    Based on back translation of local of Informed Consent and Patient Information Sheet. Approval process according to KCR SOP.
Monitoring Plan development    X      
Monitoring Plan approval       X   
Recruitment Plan development    X      
Trial Master File Set-up    X      
Distribution of Site Documents    X      
Randomization schedule preparation    X      

 

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     KCR    VBL
Ltd.
  

Comments

REGULATORY / ETHICS COMMITTEE SUBMISSIONS         
Preparation of the documentation for Ethics Committees    X    X   

VBL to provide:

- Investigator’s Brochure

- IMPD

- CRF

- Insurance certificate

- Patient related scales/diaries

- Certificate of analysis

- Drug label

- Manufacturing authorisation

- GMP certificate

KCR to provide VBL with country specific requirements regarding submission and to prepare submission package.

Submission of the documentation for Ethics Committees and follow up until authorisation    X      
Preparation of the documentation for Regulatory Authorities    X    X   

VBL to provide:

- Investigator’s Brochure

- IMPD

- CRF

- Insurance certificate

- Patient rated scales/diaries - Certificate of analysis

   X    X   

- Drug label

- Manufacturing authorisation

- GMP certificate

KCR to provide VBL with country specific requirements regarding submission and to prepare submission package.

Submission of the documentation for Regulatory Authorities and follow up until authorisation    X      

 

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     KCR    VBL
Ltd.
  

Comments

TRANSLATIONS         
Translations    X       Relevant for patient-related documents, labels, Power of Attorney
SITE RECRUITMENT AND INITIATION         
Investigator’s Site Identification    X      
Investigator’s Site Selection    X      
Final Site Selection    X    X   

KCR to provide VBL with pre-study visit reports and lists of recommended sites in all selected countries.

VBL to approve selected sites.

Conduct Site Selection Visits    X      
Negotiate Investigators/Sites Contracts    X      
Final Approval for Investigators/Sites Contracts       X   
Signature on Investigators/Sites Contracts    X      
Regulatory Documents collection & review    X      
Conduct Site Initiation Visits    X      
INVESTIGATOR MEETING         
Investigator’s Meeting Planning    X      
Investigator’s Meeting Preparation    X    X   

VBL to present:

- VB-201: Scientific Background

- Phase I/II Experience & Development Plan

- Study Design & Objectives

- Protocol Overview

- Eligibility Criteria

- Study Specific Procedures

- Study Assessment Scales

KCR to present:

- Communication Plan

- Timelines & Recruitment Strategies

- ICH GCP Refreshment

Investigator’s Meeting Attendance    X    X   

 

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     KCR    VBL
Ltd.
  

Comments

STUDY DRUG MANAGEMENT/CENTRAL LABORATORY MANAGEMENT         
Clinical Trial Supply Logistics Management       X   
Packaging and labeling of study medication       X   
Distribution of study medication to sites       X   
Destruction of unused supplies       X   
Randomization list management       X   
Central Laboratory Supplies and Logistic Set-up/Courier Management       X    By VBL subcontractor.
Central Laboratory Management       X    VBL subcontractor to manage the central laboratory.
STUDY MONITORING         
Conduct Site Monitoring Visits    X      
Communication with Sites    X      
Monitoring visit reports preparation and review    X      
Monitoring visit reports final approval       X   
S.D.V.: (100% of patients, 100% of key study parameters)    X      
Periodic Regulatory Document Collection / Updates (Investigator’s Master File management)    X      
Data review/correction on all CRF’s    X      
Resolution of Queries with Sites    X      
SAE Reconciliation with Sites    X      
Conduct Site Close-out / Termination Visits    X      
Drug accountability during study and final drug record reconciliation    X      
End of Study Notification to Regulatory Agencies/ECs    X      

 

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     KCR    VBL
Ltd.
  

Comments

CLINICAL STUDY MANAGEMENT         
Maintain Central Trial Master File    X      
Fortnightly enrolment updates and Weekly Status Reports to Sponsor    X      
Administered Investigator’s Payments    X       KCR will be responsible for bank transfers.
Prepare and Distribute Newsletter (if applicable)       X   
Central File Archiving       X   
Clinical Team Communication    X       KCR to provide Communication Plan.
MEDICAL MONITORING         
Development of Medical Monitoring Plan       X   
Provide Medical Oversight to CRO Project Team       X   
Medical Communication/Consultation with Sites       X   
Patient Eligibility - Medical Review       X   
Review Safety Data Listing       X   
Review CRFs for safety/efficacy       X   
Review Safety Laboratory Data       X   
Review of Data Management Coding       X   
Review of Data Management SAE reconciliation       X   
Organization of Data Safety Monitoring Board Meeting       X   
SAFETY MONITORING         
Safety Plan Preparation       X   
SAE Reporting Procedure and Database Set-up       X   
Receipt & Review of Initial SAE Report from Site    X      
Tracking /Analyzing SAE Report       X   
Entering SAE into Database       X   
Writing SAE Narrative       X   
Expectedness Judgment for SAE & Regulatory Reporting Assessment       X   
Final Medical and Regulatory Judgment       X   
Preparing Annual Report for Competent Authority in EU (inc. safety update)       X   
Reporting Expedited SAEs to Regulatory Authorities       X   
Reporting Expedited SAEs to Investigators and EC    X      
Ongoing SAE File Maintenance       X   

 

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     KCR    VBL
Ltd.
  

Comments

DATA MANAGEMENT         
Preparation of Data Management Documentation such as Data Management Plan, Data Review Plan, Data Handling Guiding       X   
EDC collector development       X   
Data Review, Query Generation       X   
Query Resolution    X      
Import of Electronic (Laboratory) Data       X    By VBL subcontractor
Reconciliation of SAEs       X   
Provision of data extracts during study to support interim analyses       X   
Documentation Maintenance       X   
Archiving of EDC tool, Archiving of Data Management Material       X   
STATISTICS AND REPORTING         
Development of Statistical Analysis Plan       X   
Final Approval for Statistical Analysis Plan       X   
Creation of Analysis Dataset (Statistical analysis of the dataset)       X   
Programming of Tables, Figures and Listings       X   
PK parameters calculation       X   
Development of interim and final Integrated Statistical/Clinical Report in conformity to ICH guideline and CTD       X   
Review of final Integrated Statistical/Clinical Report in conformity to ICH guideline and CTD       X   
Final Approval for clinical Study Report       X   
Writing of SAE and AE Discontinuation Narratives       X   
AUDITS         
Conduct of GCP Audits of Investigator’s Sites    X      
Conduct of Quality Assurance Audit of Database       X   
PROJECT MANAGEMENT         
Management of the study team    X      
Communication with study sponsor and vendors    X      
Coordination of start-up activities, realization phase and closure    X      
Oversees the regulatory document collection and submission process.    X      
Control and track the budget monthly and cumulative realization    X      
Preparation of Risk Management Plan and/or Contingency Plan, if required    X      
CONTRACTS AND PAYMENTS         
Preparation of study contracts    X      
Signature and payments    X    X   
Payment of Ethics Committees’ fees    X      

 

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Attachment No. 2

Timelines

STUDY TIMELINES

 

[***]      [***]   

 

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Protocol VB-201-079    VB-201

 

Attachment No. 3

Study Protocol

CLINICAL PROTOCOL

 

Title:    A Randomized, Double-Blind, Dose-Ranging, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Oral VB-201 in Patients with Moderate to Severe Plaque Psoriasis
Protocol No.    VB-201-079
Eudra CT No.:    2012-002763-10
Investigational    VB-201
Product:   
Indication:    Plaque Psoriasis
Development    2
Phase:   
Sponsor:    Vascular Biogenics Ltd.
   6 Jonathan Netanyahu St.
   Or Yehuda, Israel 60376
   Phone: 972-3-6346450
   Fax: 972-3-6346449
Version:    2.2 (Poland and Israel only)
Date:    December 2, 2013

CONFIDENTIAL

This document contains proprietary and confidential information of VBL. Acceptance of this document constitutes agreement by the recipient that no previously unpublished information contained herein will be published or disclosed without the prior written approval of Vascular Biogenics Limited with the exception that this document may be disclosed to study personnel under your supervision who need to know the contents for conducting the study and appropriate Institutional Review Boards (IRBs)/Ethics Committees (IEC) under the condition that the personnel have agreed to keep this information confidential. The foregoing shall not apply to disclosure required by governmental regulations or laws, however, VBL shall be promptly notified of any such disclosure.

 

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Protocol VB-201-079    VB-201

 

AUTHOR SIGNATURE PAGE

The undersigned have written, reviewed and approved the following protocol:

 

Ron Goldblum, MD   

/s/ Ron Goldblum

  

02 DEC 2013

Medical Monitor    Signature    Date
Vascular Biogenics Ltd      
Naamit Sher, PhD   

/s/ Naamit Sher

  

3 Dec 2013

Vice President    Signature    Date
Drug Development & RA      
Vascular Biogenics Ltd      

 

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Protocol VB-201-079    VB-201

 

CONFIDENTIALITY AND INVESTIGATOR STATEMENT

Vascular Biogenics Limited

Clinical Research Protocol

VB-201-079

The information contained in this document and all information provided to you related to VB-201 (“drug”) are the confidential and proprietary information of Vascular Biogenics Limited (Sponsor) and except as may be required by federal, state or local laws or regulations, may not be disclosed to others without prior written permission of Sponsor. The Principal Investigator may, however, disclose such information to supervised individuals working on the Drug, provided such individuals agree to be bound to maintain the confidentiality of such Drug information.

I agree to abide by the statement of confidentiality.

I agree to conduct the study according to this protocol and have read and agree to comply with the Investigator’s Responsibilities. Any changes in procedure will only be made if necessary to protect the safety, rights, or welfare of subjects.

I agree to comply with the current International Conference on Harmonisation (ICH) Guideline on Good Clinical Practice (GCP), applicable laws and regulations, and the Declaration of Helsinki.

I agree to conduct the Study in person or to supervise the Study.

I agree to ensure that all who assist me in the conduct of the Study have access to the Study protocol and any amendments and are aware of their obligations.

 

  

 

Principal Investigator    Date (dd/mmm/yyyy)
Printed Name:   

 

Institution:   

 

Address:   

 

 

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Protocol VB-201-079    VB-201

 

TABLE OF CONTENTS

 

1.0    STUDY SYNOPSIS      31   
2.0    LIST OF ABBREVIATIONS      44   
3.0    INTRODUCTION      46   
   3.1    Psoriasis: Pathophysiology and Unmet Medical Need      46   
   3.2    Name and description of the investigational product      46   
   3.3    Summary of findings from nonclinical studies relevant to the trial      46   
   3.4    Summary of findings from clinical studies      48   
      3.4.1     VB-201 Phase I Studies      48   
      3.4.2     VB-201 Phase II studies      48   
   3.5    Rationale for Route of Administration, Pharmaceutical Form, Dosage, Dosage Regimen and Treatment Period      50   
   3.6    Rationale for the PASI 50 Endpoint      50   
   3.7    Rationale for the Use of Placebo      51   
4.0    OBJECTIVES      52   
   4.1    Safety Objective      52   
   4.2    Efficacy Objective      52   
   4.3    Exploratory Biomarker      52   
5.0    INVESTIGATIONAL PLAN      52   
   5.1    Study Design      52   
   5.2    Number of Patients      52   
   5.3    Subject Selection      54   
      5.3.1     Inclusion Criteria      54   
      5.3.2     Exclusion Criteria      54   
   5.4    Subject Screening and Randomization      56   
   5.5    Duration of Participation      56   
   5.6    Protocol Amendments      56   
   5.7    Withdrawal Criteria      56   
   5.8    Study/Study Site Termination      57   
6.0    STUDY DRUG      57   
   6.1    Formulation, Packaging, and Labeling      57   
   6.2    Storage and Handling      58   
   6.3    Accountability      58   

 

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Protocol VB-201-079    VB-201

 

   6.4    Access to Blinded Treatment      58   
   6.5    Administration of Study Drug      59   
      6.5.1     Dosage      59   
      6.5.2     Assignment of Treatment Cartons      60   
      6.5.3     Compliance      60   
7.0    PRIOR AND CONCOMITANT MEDICATION      60   
8.0    OUTCOME MEASURES      61   
   8.1    Efficacy Assessments      61   
   8.2    Safety Assessments      64   
      8.2.1     Physical Examination Assessments      64   
      8.2.2     Clinical Laboratory & Other Safety Assessments      64   
      8.2.3     Population Pharmacokinetics      65   
                   8.2.3.1     Blood and Urine Samples      66   
                   8.2.3.2     Risk Assessment      66   
      8.2.4     Study Withdrawals      66   
      8.2.5     Adverse Events and Serious Adverse Events      66   
   8.3    Exploratory Assessments      66   
      8.3.1     Inflammatory Related Biomarkers      67   
9.0    SCHEDULE OF STUDY ASSESSMENTS      67   
   9.1    Screening Visit      67   
   9.2    Baseline      67   
   9.3    Week 2      68   
   9.4    Week 4, 8, 12      69   
   9.5    Week 16      69   
   9.6    Week 20      70   
   9.7    Week 24/ Early Termination      70   
   9.8    Week 28      71   
10.0    ADVERSE EVENTS      71   
   10.1    Definition of Adverse Event      71   
   10.2    Definition of Serious Adverse Event      72   
   10.3    Reporting and Documentation      73   
   10.4    Patient Stopping Rules      74   
   10.5    Pregnancy      75   
11.0    STATISTICAL CONSIDERATIONS      75   

 

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Protocol VB-201-079    VB-201

 

   11.1    Statistical Methods      75   
      11.1.1    Comparisons of Interest      75   
      11.1.2    Sample Size Determination      75   
      11.1.3    Subject Population/Data Sets To Be Evaluated      75   
                    11.1.3.1       Modified Intent-To-Treat (MITT) Population      75   
                    11.1.3.2       Per-Protocol Population      76   
                    11.1.3.3       Safety Population      76   
      11.1.4    Randomization      76   
   11.2    Statistical Analyses      76   
      11.2.1    Subject Disposition      77   
      11.2.2    Demography      77   
      11.2.3    Efficacy Analysis      77   
                    11.2.3.1       Primary Efficacy Endpoints      77   
                    11.2.3.2       Secondary Efficacy Endpoints
     78   
                    11.2.3.3       Tertiary Endpoints      79   
      11.2.4    Safety Analysis      80   
                    11.2.4.1       Adverse Events      80   
                    11.2.4.2       Laboratory Parameters      80   
                    11.2.4.3       Vital Signs      81   
                    11.2.4.4       Withdrawals      81   
                    11.2.4.5       Deaths      81   
                    11.2.4.6       Dropouts      81   
      11.2.5    Concomitant Medications      81   
12.0    DATA RECORDING, MONITORING, AND RETENTION      81   
   12.1    Source Documents      81   
   12.2    Case Report Forms (CRFs)      81   
   12.3    Record Retention      81   
   12.4    Monitoring Requirements      82   
   12.5    Subject Confidentiality      82   
13.0    ETHICS      83   
   13.1    Ethical Conduct of the Study      83   
   13.2    Local Regulatory Approval      83   
   13.3    Ethics Committee Approval      84   
   13.4    Subject Information and Informed Consent      84   

 

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Protocol VB-201-079    VB-201

 

14.0         PUBLICATION

     85   

15.0         LIST OF APPENDICES

     85   

16.0         REFERENCES

     87   
LIST OF TABLES   

Table 1: Schedule of Procedures for VB-201-079 (Psoriasis)

     42   

Table 2. Composition of the patient identification number

     53   

Table 3. Composition of the randomization number

     53   

Table 4. VB-201 Drug Distribution

     59   

Table 5. Clinical Assessments Relating to Efficacy

     62   

Table 6. Physical Examination Assessments Relating to Safety

     64   

Table 7. Clinical Laboratory & Other Assessments Relating to Safety

     65   

Table 8. Population Pharmacokinetics

     66   

Table 9. Clinical Laboratory for Exploratory Assessments

     66   

 

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1.0         STUDY SYNOPSIS

 

Title of Study:    A Randomized, Double-Blind, Dose-Ranging, Placebo- Controlled Study to Evaluate the Efficacy and Safety of Oral VB-201 in Patients with Moderate to Severe Plaque Psoriasis
Sponsor:    VBL
Phase:    Phase 2
Patient Population:    Male or female patients >18 to <75 of age with moderate to severe, stable, active plaque Psoriasis Vulgaris affecting between 10% to 30% of the body surface and with a Psoriasis Area and Severity Index (PASI) score of 10 to 20
Efficacy Objective:    To examine the effect of treatment with two different doses of VB-201 compared to placebo for 16 weeks and 24 weeks on measures of disease activity in patients with psoriasis.
Safety Objective:    To examine the safety and tolerability of up to 24 weeks’ treatment with VB-201 vs. placebo in patients with psoriasis.
Study Design:    [***]

 

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Protocol VB-201-079    VB-201

 

Dosage Regimen and Treatment Groups    [***]
Investigative Product Name and Description    [***]
Number of Subjects:    ;[***]
Duration of Participation:    [***]

 

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Protocol VB-201-079    VB-201

 

Eligibility Criteria Inclusion Criteria    [***]
Exclusion Criteria    [***]

 

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Protocol VB-201-079    VB-201

 

   4. [***]

 

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Protocol VB-201-079    VB-201

 

   [***]
Concomitant    [***]

 

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Protocol VB-201-079    VB-201

 

Medications:       [***]
Safety Endpoints:       [***]
Stage 1 Primary Efficacy Endpoint:       [***]
Stage 1 Secondary Endpoints:    1.    [***]

 

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Protocol VB-201-079    VB-201

 

      [***]
Stage 1 Tertiary Endpoints:    1.    [***]

 

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Protocol VB-201-079    VB-201

 

Stage 2 Primary Efficacy Endpoint:       [***]

 

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Stage 2 Secondary

Endpoints:

   1.    [***]

Stage 2 Tertiary

Endpoints:

   1.    [***]

 

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Protocol VB-201-079    VB-201

 

   4.    [***]
Compliance Measures       [***]
Study Conduct       [***]
Statistical Methods       [***]

 

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Rationale for Number of Subjects:           [***]

 

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Protocol VB-201-079    VB-201

 

Table 1: Schedule of Procedures for VB-201-079 (Psoriasis)

 

Evaluation    [***]     [***]   [***]   [***]   [***]   [***]   [***]   [***]
           STAGE 1   STAGE 2

Study Day

     [ ***]    [***]   [***]   [***]   [***]   [***]   [***]   [***]

Assessment Window (±Days)

       [***]   [***]   [***]   [***]   [***]   [***]

Informed Consent

     X                 

Inclusion/ Exclusion Criteria

     X      X            

[***]

     X                 

[***]

     X1      X       X     X  

[***]

     X      X       X     X  

[***]

     X      X     X   X   X   X   (X)3

[***]

     X     X   X   X   X  

[***]

     X     X4   X     X  

[***]

     X            X     X  

[***]

     X5      X6       X     X  

[***]

     X      X7     X   X   X   X   X

[***]

     X     X   X   X    

[***]

         X   X   X   X  

[***]

         X   X   X   X  

[***]

     X      X   X   X   X   X   X   X

[***]

     X   X   X   X   X   X   X

[***]8

     X      X     X   X   X   X   X

[***]

     X       X     X  

[***]

     X       X     X   X

 

1  [***]

 

VBL

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Figure 1. STUDY DIAGRAM

 

LOGO

 

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2.0 LIST OF ABBREVIATIONS

 

Abbreviation/ Acronym

  

Definition

AE    Adverse Event
ALT    Alanine transaminase
ANCOVA    Analysis of Covariance
AST    Aspartate transaminase
BSA    Body Surface Area
BUN    Blood Urea Nitrogen
CFR    Code of Federal Regulations
CRA    Clinical Research Associate
CRF    Case Report Form
CRO    Contract Research Organization
DLQI    Dermatology Life Quality Index
DSM-LV-TR    Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
ECG    Electrocardiogram
eCRF    Electronic Case Report Form
EDC    Electronic Data Capture
ET    Early Termination
FDA    Food and Drug Administration
GCP    Good Clinical Practice
GGT    Gamma Glutamyl Transferase
Hb    Hemoglobin
HIPAA    Health Insurance Portability and Accountability Act
HIV    Human Immunodeficiency Virus
ICH    International Conference on Harmonization
IEC    Independent Ethics Committee
IL    Interleukin
IRB    Institutional Review Board
IUD    Intrauterine Device
IVRS / IWRS    Interactive Voice Response System/Interactive Web Response
LOCF    Last Observation Carried Forward
MCH    Mean Corpuscular Hemoglobin
MCHC    Mean Corpuscular Hemoglobin Concentration
MCV    Mean Corpuscular Volume

 

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Abbreviation/ Acronym

  

Definition

MedDRA    Medical Dictionary for Regulatory Activities
MITT    Modified Intent-To-Treat
PASI    Psoriasis Area and Severity Index
PBMC    Peripheral Blood Mononuclear Cells
PGA    Physician Global Assessment
PIF    Pregnancy Information Form
PK    Pharmacokinetics
PO    By Mouth
QD    Once Daily
RBC    Red Blood Cell
SAE    Serious Adverse Event
SUSAR    Suspected Unexpected Serious Adverse Reaction
TNF-a    Tumor Necrosis Factor-a
ULN    Upper Limit of Normal
URI    Upper Respiratory Infection
UTI    Urinary Tract Infection
VAS    Visual Analogue Scale
VBL    Vascular Biogenics Ltd.
WBC    White Blood Cell
WHO    World Health Organization

 

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3.0 INTRODUCTION

 

  3.1 Psoriasis: Pathophysiology and Unmet Medical Need

Psoriasis is a life-long, immune-mediated inflammatory skin disease of unknown etiology, affecting up to 3% of the general population, with rates varying among geographic areas and races.1 Over 80% of patients have chronic plaque psoriasis, characterized by recurrent exacerbations and remissions of thickened, erythematous, scaly patches of skin that can occur anywhere on the body.

Psoriatic symptoms can cause physical discomfort (pain and pruritus), and when combined with the psychological effects of the disease often interfere with everyday activities and negatively impact a patient’s quality of life.2,3 While there are many available treatments, these agents each have limited efficacy and/or significant side effects. Thus, there remains a significant unmet need for a therapy that will provide high continuous efficacy and improved safety profile.

It is currently believed that environmental factors, including microorganisms, instigate a cascade of events which lead to psoriasis initiation. 4 Once encountered by microbial components, toll-like receptors (TLR) expressed on keratinocytes and dermal dendritic cells mediate the secretion of pro-inflammatory cytokines such as IL-6, IL-1, IL-12 and IL-23.5,6 These cytokines induce the generation of Th1 and Th17 cells which promote psoriasis pathogenesis.7,8,9

Vascular Biogenics Ltd (VBL) has developed a small molecule, VB-201 (formerly known as CI-201 as seen in some of the figures) a new class of compounds, oxidized phospholipid analogs (lecinoxoids). VB-201 was found to inhibit TLR signaling restricted to TLR2 and TLR4, an effect attributed to its binding to TLR2 and CD14. Consequently, when activated using TLR4 and TLR2 agonists in the presence of VB-201, antigen presenting cells showed impaired production of the Th1 and Th17- polarizing cytokines IL-12(p40) and IL-6 respectively.

Given the putative TLR complicity in psoriasis, VB-201 has the potential to be an orally active drug for treating psoriasis.

The current study is designed to test safety, efficacy, and tolerability of an oral preparation of VB-201 in patients with chronic plaque psoriasis.

 

  3.2 Name and description of the investigational product

[***]

 

  3.3 Summary of findings from nonclinical studies relevant to the trial

[***]

 

VBL

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[***]

5) [***]

[***]

 

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3.4 Summary of findings from clinical studies

 

3.4.1 VB-201 Phase I Studies

[***]

 

3.4.2 VB-201 Phase II studies

VB-201 was further used in two Phase II clinical trials:

1. [***]

 

VBL

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[***]

2. VB-201-030: [***]

 

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[***]

 

3.5 Rationale for Route of Administration, Pharmaceutical Form, Dosage, Dosage Regimen and Treatment Period

[***]

 

3.6 Rationale for the PASI 50 Endpoint

[***]

 

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[***]

 

3.7 Rationale for the Use of Placebo

[***]

 

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[***]

 

4.0 OBJECTIVES

 

  4.1 Safety Objective

 

    To examine the safety and tolerability of up to 24 weeks’ treatment with VB-201 or placebo in patients with psoriasis.

 

  4.2 Efficacy Objective

 

    Stage 1: To examine the effect of treatment with two different doses of VB-201 compared to placebo (initial 16 weeks) on measures of disease activity in patients with psoriasis.

 

    Stage 2: To examine the effect of treatment with two different doses of VB-201 compared to placebo (24 weeks) on measures of disease activity in patients with psoriasis.

 

  4.3 Exploratory Biomarker

 

    [***]

 

5.0 INVESTIGATIONAL PLAN

 

  5.1 Study Design

[***]

 

  5.2 Number of Patients

[***]

 

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[***]

Table 2. Composition of the patient identification number

 

    

Combined site number

    

Letter

  

Country number

  

Site number

  

Patient number

S    Germany    01    Site numbers will be assigned in an ascending order: 01, 02, 03, 04…   

Patient numbers will be assigned in an

ascending order: 01, 02, 03, 04,…

   Spain    02      
   Israel    03      
   Poland    04      

The 7-digit randomization number is a combination of the letter R (1 digit), the combined site number (4 digits), consisting of the country number (2 digits) and the site number (2 digits) and the patient number (2 digits). The site number is identical to the site number of the patient identification number. Patient numbers of the randomization number will start with 51 to ensure clear distinction from patient identification numbers. Example: R010151 is the site number 0101 and the patient number 51. Refer to Table 3 below.

Table 3. Composition of the randomization number

 

    

Combined site number

    

Letter

  

Country number

  

Site number

  

Patient number

R    Germany    01   

Site numbers will be assigned in an ascending order: 01, 02, 03, 04…

   Patient numbers will be assigned in an ascending order: 51, 52, 53, 54,…
   Spain    02      
   Israel    03      
   Poland    04      

 

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  5.3 Subject Selection

 

5.3.1 Inclusion Criteria

[***]

 

5.3.2 Exclusion Criteria

Patients who meet ANY of the following criteria will be excluded from participation in this study:

1. [***]

 

VBL

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  [***]

 

12 [***]

 

VBL

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[***]

 

5.4 Subject Screening and Randomization

[***]

 

5.5 Duration of Participation

[***]

 

5.6 Protocol Amendments

[***]

 

5.7 Withdrawal Criteria

[***]

 

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[***]

 

5.8 Study/Study Site Termination

[***]

 

6.0 STUDY DRUG

 

6.1 Formulation, Packaging, and Labeling

[***]

 

VBL

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[***]

 

  6.2 Storage and Handling

The study drug should be stored on site at room temperature, in a secured location with access limited to authorized personnel. All boxes of study drug, both used and unused, must be saved for a drug audit by the Sponsor clinical monitor or an assigned designee. Once dispensed to the study subjects the study drug should be stored at room temperature. Subjects should be instructed on the proper storage methods and conditions.

 

  6.3 Accountability

Study drug (VB-201 and placebo) will be supplied by the Sponsor. It is the responsibility of the Principal Investigator to supervise accurate monitoring of the receipt, storage, dispensing, and accounting of all study drug according to accepted medical and pharmaceutical practice.

Copies of all invoices of study drug shipments must be retained. Accurate, original site records of study drug inventory and dispensing must be maintained using the forms provided. All shipment, accountability, and dispensing records must be made available for inspection by the Sponsor or the designated CRO upon request.

Each site must keep all used and unused cartons in their original kit packaging until the Study Monitor either arranges return to the distribution center or gives instruction on their disposal. If any unused cartons remain at the end of the study, they will be accounted for at the Site Close-Out Visit in the presence of the Study Monitor, who will provide instructions on their disposal. If the Study Monitor directs the site to dispose of study drug or empty blister packs, disposal should be according to the institution standard operating procedures and all applicable local and national regulations.

 

6.4 Access to Blinded Treatment

A subject’s treatment assignment should only be unblinded when knowledge of the treatment is essential for the further management of the subject. Unblinding for any other reason will be considered a protocol violation.

 

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The Principal Investigator should make every effort to contact either the CRO or the Sponsor before unblinding any subject’s treatment assignment, but must do so within one working day after the event and must document the unblinding in the subject’s source documentation.

The identity of the treatment group assigned to subjects can be provided, in an emergency only, by the centralized randomization system via the CRO. The Principal Investigator or his/her designee is responsible for ensuring that the instructions on how to perform a code break are stored safely, that their location is known, and that access is readily available to the relevant staff in case of an emergency. A separate Sponsor representative who is not involved with the study will also have access to unblinding information if required.

The CRO’s safety officer will report SUSARs on the Sponsor’s behalf and will break the blind for SUSAR reporting.

 

6.5 Administration of Study Drug

 

6.5.1 Dosage

[***]

Table 4. VB-201 Drug Distribution

 

VBL

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Treatment Group

  

Carton AM

  

Carton PM

[***]    [***]    [***]

Subjects will be instructed to take 2 capsules from the morning blister (white) pack at breakfast time with food and 2 capsules from the evening blister (silver) pack at dinner time with food every day for up to 24 weeks.

Each carton will be labeled to meet regional regulatory requirements. All capsules will be identical in appearance. There is no provision under this protocol for dose adjustments by the Investigator.

 

6.5.2 Assignment of Treatment Cartons

At each visit, the Investigator or designee will first assess the subject to confirm eligibility to continue to receive study drug. After eligibility is confirmed, study medication with the appropriate subject number can be distributed to the subject [***]

 

6.5.3 Compliance

[***]

 

7.0 PRIOR AND CONCOMITANT MEDICATION

[***]

 

VBL

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[***]

 

8.0 OUTCOME MEASURES

 

  8.1 Efficacy Assessments

[***]

 

VBL

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Table 5. Clinical Assessments Relating to Efficacy

 

Assessment

  

Study Visit

  

Description

[***]    [***]    [***]

 

VBL

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Table 5. Clinical Assessments Relating to Efficacy (cont.)

 

Assessment

  

Study Visit

  

Description

[***]    [***]    [***]

W-week, D-day, ET-early termination

[***]

 

VBL

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Plaque Photography

[***]

 

  8.2 Safety Assessments

 

8.2.1 Physical Examination Assessments

The physical exam assessments relating to safety to be performed during the study are described in Table 6.

Table 6. Physical Examination Assessments Relating to Safety

 

Assessment

  

Study Visit

  

Description

[***]    [***]    [***]

W-week, D-day, ET-early termination

 

8.2.2 Clinical Laboratory & Other Safety Assessments

The clinical laboratory and other tests relating to safety to be performed during the study are described in Table 7.

 

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Table 7. Clinical Laboratory & Other Assessments Relating to Safety

 

Assessment

  

Study Visit

  

Description

[***]    [***]    [***]

W-week, D-day, ET-early termination

 

* If values are abnormal at the Week 24/ET visit, they should be repeated at the Week 28 visit to ensure values have returned to within normal limits.

 

8.2.3 Population Pharmacokinetics

Blood collected for trough levels of VB-201 during the study are described in Table 8:

 

VBL

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Table 8. Population Pharmacokinetics

 

Assessment

  

Study Visit

  

Description

[***]    [***]    [***]

 

8.2.3.1 Blood and Urine Samples

[***]

 

8.2.3.2 Risk Assessment

[***]

 

8.2.4 Study Withdrawals

[***]

 

8.2.5 Adverse Events and Serious Adverse Events

Adverse events and serious adverse events (SAEs) are discussed in detail in Section 9.

 

  8.3 Exploratory Assessments

The clinical laboratory and other tests relating to exploratory assessments to be performed during the study are described in Table 9:

Table 9. Clinical Laboratory for Exploratory Assessments

 

Assessment

  

Study Visit

  

Description

[***]    [***]    [***]

D- day, W-week, ET-early termination

 

VBL

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8.3.1 Inflammatory Related Biomarkers

[***]

 

9.0 SCHEDULE OF STUDY ASSESSMENTS

[***]

 

  9.1 Screening Visit

[***]

 

  9.2 Baseline

[***]

 

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    [***]

NOTE: [***]

 

  9.3 Week [***]

Each subject will be contacted by telephone at Week [***] and the following will be performed:

 

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    [***]

 

  9.4 Week [***]

Each of the following assessments will be performed on Week, [***]

 

    [***]

 

  9.5 Week [***]

Each of the following assessments will be performed on Week [***]:

 

    [***]

 

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    [***]

 

  9.6 Week [***]

Each of the following assessments will be performed on Week [***]

 

    [***]

 

  9.7 Week [***]

Each of the following assessments will be performed at Week [***] or, if a subject discontinues early from the study:

 

    [***]

 

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    [***]

 

9.8 Week [***]

Patients who complete the Week [***] and those who discontinue early from the study will return to the clinic on Week [***] after their last study medication dose if the subject discontinued early from the study, for a follow-up evaluation and the following assessments:

 

    [***]

 

10.0 Adverse Events

 

  10.1 Definition of Adverse Event

[***]

 

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[***]

Severity Assessment

[***]

Causality Assessment

[***]

 

10.2 Definition of Serious Adverse Event

[***]

 

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    [***]

 

10.3 Reporting and Documentation

The Investigator must report all directly observed AEs and all spontaneously reported AEs. At each visit the Investigator will ask the subject a nonspecific question (e.g., “Have you noticed anything different since your last visit?”) to assess whether any AEs have been experienced since the last report or visit. AEs will be identified and documented on the AE page of the CRF in appropriate medical terminology. Details of the event must include severity, relationship to study drug, duration, action taken, and outcome.

The action(s) taken regarding the AE are classified as follows:

Treatment for event

 

    None

 

    Concomitant medication given or changed

 

    Hospitalization

 

    Others

 

    Unknown (only applicable if patient has been lost to follow up).

Action taken with study medication

 

    None

 

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    Temporary discontinuation

 

    Permanent discontinuation

 

    Unknown (only applicable if patient has been lost to follow up).

The outcome of the AE is classified as follows

 

    Recovered

 

    Recovered with sequelae

 

    Not recovered

 

    Death

 

    Unknown (only applicable if patient has been lost to follow up).

Furthermore it must be stated if the study was discontinued permanently for patient (yes, no) due to the AE/ SAE

The Principal Investigator is responsible for evaluating all AEs, obtaining supporting documents, and determining that documentation of the event is adequate. The Principal Investigator may delegate these duties to Sub-investigators and must assure that these Sub-investigators are qualified to perform these duties under the supervision of the Principal Investigator.

In the event that a subject is withdrawn from the study because of an AE, it must be recorded on the CRF. The subject should be followed and treated by the Investigator until the AE has resolved or a new chronic baseline has been established.

Any SAE, whether or not considered related to the study drug, must be reported immediately (within 24 hours) upon learning of the event (See Study Manual). The Investigator or his designee should complete the study-specific SAE Report Form. Investigators should not wait to collect additional information that fully documents the event before notifying VBL or its designee of an SAE. Contact numbers for reporting SAEs and events of concern will be provided prior to the start of the study.

It is the responsibility of the Investigator to report SAEs to their IRB/IEC according to the standard operating procedures and policies of the IRB or EC. At a minimum, events identified by the Sponsor to require expedited reporting as serious, unexpected, and possibly related to study drug must be brought to the attention of the responsible IRB/IEC. Adequate documentation must be provided to VBL or its designee that the IRB or EC was properly notified.

 

10.4 Patient Stopping Rules

The following stopping rules will be utilized in this study:

 

  1. [***]

 

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  2. [***]

Subjects who permanently discontinue study medication shall return for an Early Termination visit and subsequently for a final safety visit 4 weeks from the last dose.

 

10.5 Pregnancy

[***]

 

11.0 STATISTICAL CONSIDERATIONS

 

  11.1 Statistical Methods

 

11.1.1 Comparisons of Interest

[***]

 

11.1.2 Sample Size Determination

[***]

 

11.1.3 Subject Population/Data Sets To Be Evaluated

 

11.1.3.1   Modified Intent-To-Treat (MITT) Population

[***]

 

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[***]

 

11.1.3.2 Per-Protocol Population

[***]

 

11.1.3.3 Safety Population

[***]

 

11.1.4 Randomization

[***]

 

11.2 Statistical Analyses

[***]

 

 

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11.2.1 Subject Disposition

[***]

 

11.2.2 Demography

[***]

 

11.2.3 Efficacy Analysis

[***]

 

11.2.3.1 Primary Efficacy Endpoints

 

11.2.3.1.1 Stage 1 Primary Efficacy Endpoints

[***]

 

11.2.3.1.2 Stage 2 Primary Efficacy Endpoints

[***]

 

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11.2.3.2 Secondary Efficacy Endpoints

 

11.2.3.2.1  Stage 1 Secondary Efficacy Endpoints

[***]

 

11.2.3.2.2  Stage 2 Secondary Efficacy Endpoints

[***]

 

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  3. [***]

 

11.2.3.3 Tertiary Endpoints

 

11.2.3.3.1  Stage 1 Tertiary Endpoints

[***]

 

  4. [***]

 

11.2.3.3.2  Stage 2 Tertiary Endpoints

[***]

 

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[***]

 

11.2.4 Safety Analysis

[***]

 

11.2.4.1 Adverse Events

[***]

 

11.2.4.2 Laboratory Parameters

[***]

 

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11.2.4.3 Vital Signs

[***]

 

11.2.4.4 Withdrawals

[***]

11.2.4.5 Deaths

All deaths will be listed.

 

11.2.4.6 Dropouts

Dropout rates due to rescue intervention in each of the VB-201 groups will be compared to the placebo group using Fisher’s exact test.

 

11.2.5 Concomitant Medications

[***]

 

12.0 DATA RECORDING, MONITORING, AND RETENTION

 

  12.1 Source Documents

Source records are original documents, data, and records (e.g., medical records, raw data collection forms, pharmacy dispensing records, recorded data from automated instruments, laboratory data) that are relevant to the clinical trial. The Investigator will prepare and maintain adequate and accurate source documents. These documents are designed to record all observations and other pertinent data for each subject enrolled in this clinical trial. Source records must be adequate to reconstruct all data transcribed onto the Case Report Forms (CRFs).

 

12.2 Case Report Forms (CRFs)

All data will be recorded on electronic data capture (EDC) system CRFs provided by the Sponsor or its designee. All electronic case report forms (eCRFs) should be completed by designated study personnel in a timely fashion.

All missing data must be explained in the subject’s source record. All eCRFs must be reviewed and verified by the investigator for accuracy, completeness, legibility, and timeliness of reporting to the Sponsor.

 

12.3 Record Retention

Investigators are required to maintain all study documentation, informed consent forms and subject information sheets and adequate records for the receipt and disposition of all study drugs in a secure and safe facility.

 

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Essential documents must be retained for at least 2 years following the FDA or other regulatory approval date of the drug, or until two years after the drug investigational program is discontinued unless a longer period is required by applicable law or regulation. Only the Sponsor can notify an Investigator when any records may be discarded. If the investigator wishes to assign responsibility for the study records to another party or have them moved to another location, the Sponsor must be notified in advance. When the study documents no longer need to be retained, it is the responsibility of the Sponsor to inform the investigator/institution. Subject identity information will be maintained for 15 years unless a longer period is required by applicable law or regulation.

 

12.4 Monitoring Requirements

Following pre-qualification and initiation of the study site, periodic monitoring visits will be made by the Sponsor or its designated representative. The investigator must provide sufficient space and allocate sufficient time for the monitor to inspect subject source records, case report forms, drug accountability records, and regulatory documents.

The study monitor is responsible for visiting the study site at regular intervals to verify the following:

 

    The rights and well-being of human Patients are protected;

 

    The reported data are accurate, complete, and verifiable from source documents;

 

    The conduct of the trial is in compliance with the currently approved protocol, amendment(s), International Conference on Harmonisation (ICH) Good Clinical Practices (GCP), U.S. Food and Drug Administration (FDA) Code of Federal Regulations (CFR), and any other applicable national and local regulatory requirements.

The study monitor should have access to subject medical records and other study-related records needed to verify the entries in the database.

The Investigator must make study data accessible to the study monitor, the Sponsor, authorized representatives of the Sponsor (e.g., CRO), and Regulatory Agencies/Competent Authorities upon request.

 

12.5 Subject Confidentiality

The Investigator must ensure that the subject’s anonymity is maintained. On the CRFs or other documents submitted to the Sponsor and/or designated CRO, Patients should be identified by a Subject Identification number and/or randomization number.

Documents that are not for submission to the Sponsor and/or designated CRO (e.g., signed informed consent forms and subject information sheets) should be kept in strict confidence by the Investigator in compliance with Federal regulations/ICH GCP Guidelines. It is required that the Investigator and institution permit authorized representatives of the company, of the regulatory agency, and the IRB/IEC direct access to review the subject’s original medical records for verification of study-related procedures and data.

Direct access includes examining, analyzing, verifying, and reproducing any records and reports that are important to the evaluation of the study. The Investigator is obligated to inform the subject that his/her study-related records will be reviewed by the above named

 

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representatives, although the confidentiality of his/her records will be maintained as much as reasonably possible.

For the purposes of the study, only the data set forth in this protocol (including the CRFs) will be obtained regarding participating Patients (whether screen failures or enrolled Patients). Such data shall:

 

    be processed in accordance with this Protocol or as otherwise instructed by the Sponsor;

 

    be processed solely for the purposes of the study and in the manner specified in this Protocol;

 

    not be processed in any manner incompatible with the purposes of the study;

 

    be accurate, up to date and corrected to address any inaccuracies or omissions;

 

    be maintained (as specified in this Protocol/using reasonable measures) to protect against accidental or unlawful destruction, accidental loss or damage, alteration, unauthorized disclosure or access and against other unauthorized or unlawful forms of processing;

 

    not be disclosed to any third party without the Sponsor’s prior written consent; and

 

    be maintained as detailed in Section 12.3 unless a longer period is required by applicable laws or regulations.

Any reasonably requested assistance shall be provided to assist the Sponsor to enable it to comply with any data-related notification obligations under applicable laws or regulations. In the US, conduct of this study will comply with all provisions of HIPAA. The Sponsor shall be promptly informed of any communication received from a study subject regarding the data collected about him/her in connection with the study.

 

13.0 ETHICS

 

  13.1 Ethical Conduct of the Study

The study will be conducted in accordance with applicable national and international laws and regulations, the ICH-GCP guideline and the ethics principles that have their origins in the Declaration of Helsinki. The protocol and the proposed informed consent form have to been reviewed and approved by a properly constituted Independent Ethics Committee (IEC/IRB) before study start at a particular study site. Prior to study start, the principal investigator is required to sign the protocol signature page (page 3 of this study protocol) confirming his agreement to conduct the study in accordance with these documents and all of the instructions and procedures found in this protocol and to give access to all relevant data and records to monitors, auditors, IRBs/IECs, and regulatory authorities as required.

 

13.2 Local Regulatory Approval

The Sponsor or the CRO will supply the Competent Authorities of each participating country with a dossier containing the required pharmacological, toxicological and pharmaceutical data on the compound, so as to obtain import and study approval. The study will not start in that country until this has been obtained where appropriate.

 

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13.3 Ethics Committee Approval

The Principal Investigator at each site is responsible for obtaining Institutional Review Board (IRB) or Independent Ethics Committee (IEC), approval for the protocol, informed consent form/ information sheet, and any advertisements to recruit Patients before being implemented at the investigative site. Written approval of these documents must be obtained from the committee before any subject is enrolled at a center.

The Principal Investigator is also responsible for the following interactions with the IRB/IEC:

 

    Obtaining IRB/IEC approval for any protocol amendments and informed consent form revisions before implementing the changes;

 

    Providing the IRB/IEC with any required information before or during the study;

 

    Submitting progress reports to the IRB/IEC, as required, during the conduct of the study; requesting re-review and approval of the study, as needed; providing copies of all IRB/IEC re-approvals and relevant communication to the CRO or the Sponsor;

 

    Notifying the IRB/IEC of all serious and unexpected AEs related to the study drug reported by the Sponsor or the CRO, as required. Documentation of this notification should be retained.

 

13.4 Subject Information and Informed Consent

No investigator may involve a human being as a subject in research unless the Investigator has obtained the legally effective informed consent of the subject or the subject’s legally authorized representative. An Investigator shall seek such consent only under circumstances that provide the prospective subject or the subject’s legally authorized representative sufficient opportunity to consider whether or not to participate, and that minimize the possibility of coercion or undue influence. The information that is given to the subject or the representative shall be in a language understandable to the subject or representative.

The Sponsor or its designated representative will provide the Investigator with a sample consent form. Local and/or institutional requirements may require disclosure of additional information in the informed consent. Any changes to the consent form must be submitted to the sponsor or its designated representative for approval prior to submission to the IRB/IEC. The IRB/IEC must review the consent form for approval/favorable opinion, and a copy of the approved consent form must be submitted to the Sponsor or its designated representative prior to initiation of the study.

Before implementing any study procedure, informed consent shall be documented by the use of an IRB/IEC approved written consent form signed and dated by the subject or the subject’s legally authorized representative at the time of consent. A copy of the signed informed consent will be given to the subject or the subject’s legally authorized representative. The original signed consent must be maintained by the Investigator and available for inspection by the Sponsor, its designated representative, or regulatory authority at any time.

 

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14.0 PUBLICATION

The Sponsor recognizes the importance of communicating clinical study data and therefore it is the intent of the Sponsor to publish the results of this trial, the details of which will be provided in the Clinical Study Agreement.

 

15.0 LIST OF APPENDICES

Appendix A: ELEMENTS OF THE PSORIASIS AREA AND SEVERITY INDEX (PASI)

 

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Appendix A: ELEMENTS OF THE PSORIASIS AREA AND SEVERITY INDEX (PASI)

 

    

 

 

    

Head

  

Upper Extremities

  

Trunk

  

Lower extremities

[***]            
[***]            
[***]            
[***]            
[***]            
[***]            
[***]    [***]    [***]    [***]    [***]
[***]            

[***]

 

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16.0 REFERENCES

 

1. Krueger GG, Duvic M. Epidemiology of psoriasis: clinical issues. J Invest Dermatol. 1994;102(6):14S-8S.

 

2. Kimball AB, Jacobson C, Weiss S, et al. The psychosocial burden of psoriasis. Am J Clin Dermatol. 2005;6(6):383-92.

 

3. Russo PA, Ilchef R, Cooper AJ. Psychiatric morbidity in psoriasis: a review. Australas J Dermatol. 2004;45(3):155-9.

 

4. Nestle FO, Kaplan DH, Barker J. Mechanisms of Disease: Psoriasis. N Engl J Med 2009 Jul;361:496-509.

 

5. Nestle FO, Di Meglio P, Qin JZ. Skin immune sentinels in health and disease. Nature Reviews Immunology 2009
Oct;9:679-690.

 

6. Di Meglio P, Perera GK, Nestle FO. The Multitasking Organ: Recent Insights into Skin Immune Function. Immunity 2011 Dec;35: 857-869.

 

7. Austin LM, Ozawa M, Kikuchi T, et al. The majority of epidermal T cells in Psoriasis vulgaris lesions can produce type 1 cytokines, interferon-gamma, interleukin-2, and tumor necrosis factor-alpha, defining TC1 (cytotoxic T lymphocyte) and TH1 effector populations: a type 1 differentiation bias is also measured in circulating blood T cells in psoriatic patients. J Invest Dermatol. 1999 Nov;113(5):752-9.

 

8. Schlaak JF, Buslau M, Jochum W, et al. T cells involved in psoriasis vulgaris belong to the Th1 subset. J Invest Dermatol. 1994 Feb;102(2):145-9.

 

9. Fitch E, Harper E, Skorcheva I, et al. A. Pathophysiology of psoriasis: recent advances on IL-23 and Th17 cytokines. Curr Rheumatol Rep. 2007 Dec;9(6):461- 7.

 

10. Vascular Biogenics Ltd. VB-201 Investigator’s Brochure Version 13. Internal archive; 2012.

 

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CLINICAL PROTOCOL

 

  Title:    A Randomized, Double-Blind, Dose-Ranging, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Oral VB-201 in Patients with Moderate to Severe Plaque Psoriasis
  Protocol No.    VB-201-079
  Eudra CT No.:    2012-002763-10
  Investigational Product:    VB-201
  Indication:    Plaque Psoriasis
  Development Phase:    2
  Sponsor:    Vascular Biogenics Ltd.
     6 Jonathan Netanyahu St.
     Or Yehuda, Israel 60376
     Phone: 972-3-6346450
     Fax: 972-3-6346449
  Version:    2.2 (Poland and Israel only)
  Date:    December 2, 2013

CONFIDENTIAL

This document contains proprietary and confidential information of VBL. Acceptance of this document constitutes agreement by the recipient that no previously unpublished information contained herein will be published or disclosed without the prior written approval of Vascular Biogenics Limited with the exception that this document may be disclosed to study personnel under your supervision who need to know the contents for conducting the study and appropriate Institutional Review Boards (IRBs)ZEthics Committees (1EC) under the condition that the personnel have agreed to keep this information confidential. The foregoing shall not apply to disclosure required by governmental regulations or laws, however, VBL shall be promptly notified of any such disclosure.

 

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Attachment No. 4

List of SOPs applicable for the Study conduct

KCR SOP AND ASSOCIATED FORMS AND TEMPLATES

 

     Version    Effective date  

101.1 MED. Feasibility process

   5      06 Dec 11   

Associated Forms And Templates:

101.1 MED. 01 Short Feasibility Worksheet

   2      08 Mar 10   

101.1 MED. 02 Feasibility Questionnaire

   3      06 Dec 11   

101.1 MED. 03 Feasibility Results

   2      08 Mar 10   

101.1 MED. 04 Thank You Letter

   1      06 Dec 11   

102.1 MED. Regulatory Submission for Clinical Study Application

   4      13 Dec 12   

102.3 MED. Updating Clinical Study Documentation

   2      13 Aug 12   

102.5 MED. Management of Regulatory Process

   2      13 Aug 12   

103.1 MED. Pre-Study Visit

   2      21 Feb 11   

Associated Forms And Templates:

     

103.1 MED. 01 Confirmation Pre-study Letter

   2      21 Feb 11   

103.1 MED. 02 Pre-study Visit Checklist

   2      21 Feb 11   

103.1 MED. 03 Pre-study Visit Report

   2      21 Feb 11   

103.1 MED. 04 Follow-up Pre-study Visit Letter

   2      21 Feb 11   

103.1 MED. 05 Site Selection Summary

   2      21 Feb 11   

103.1 MED. 06 Site Selection letter

   2      21 Feb 11   

103.1 MED. 07 Site Exclusion Letter

   2      21 Feb 11   

103.1 MED. 08 Declaration on Facilities

103.1 MED. 09 Curriculum Vitae form

103.1 MED. 10 Contact Data Form

103.1 MED. 11 Pre-study Visit Agenda

   2

3

2

1

    

 

 

 

21 Feb 11

21 Jun 11

21 Feb 11

21 Feb 11

  

  

  

  

104.1 MED. Informed Consent Form

   3      10 Nov 11   

Associated Forms And Templates:

     

104.1 MED. 01 Informed Consent Form Approval Process

   2      10 Nov 11   

104.1 MED. 02 Informed Consent Form Checklist

   2      10 Nov 11   

104.1 MED. 03 Patient Information and Informed Consent Form Version Log

   2      10 Nov 11   

104.1 MED. 04 Informed Consent Form local adjustment

   3      10 Nov 11   

 

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105.1 MED. Initiation Visit

   2      04 Mar 11   

Associated Forms And Templates:

     

105.1 MED. 01 Confirmation Initiation Visit Letter

   2      04 Mar 11   

105.1 MED. 02 Site Initiation Visit Checklist

   2      04 Mar 11   

105.1 MED. 03 IMP Release Form

   2      04 Mar 11   

105.1 MED. 04 Site Green Light Approval

   2      04 Mar 11   

105.1 MED. 05 Site Initiation Visit Report

   2      04 Mar 11   

105.1 MED. 06 Delegation of Responsibilities Log

   2      04 Mar 11   

105.1 MED. 07 Site Visit Log

   2      04 Mar 11   

105.1 MED. 08 Subject Identification Log

   3      04 Mar 11   

105.1 MED. 09 Subject Screening and Randomization Log

   3      04 Mar 11   

105.1 MED. 10 Follow-up Site Initiation Visit Letter

   2      04 Mar 11   

105.1 MED. 11 Financial Disclosure Form

   2      04 Mar 11   

105.1 MED. 12 Subject pre-screening Log

   2      04 Mar 11   

105.1 MED. 13 Site Initiation Visit Agenda

   2      22 Jan 13   

105.1 MED. 14 List of Site Initiation Visit Activities

   1      04 Mar 11   

105.1 MED. 15 Consent to Processing Personal Data

   1      02 Jun 11   

105.1 MED. 16 Instruction on How to Manage Consent for Personal Data in Clinical Operation Department

   1      27 Aug 12   

106.1 MED. Monitoring Visit

   2      18 Apr 11   

Associated Forms And Templates:

     

106.1 MED. 01 Confirmation Monitoring Visit Letter

   2      18 Apr 11   

106.1 MED. 02 Monitoring Visit Report

   3      18 Apr 11   

106.1 MED. 03 Contact Report

   2      18 Apr 11   

106.1 MED. 04 Subject Visit Status

   2      18 Apr 11   

106.1 MED. 05 Note to File

   3      18 Apr 11   

106.1 MED. 06 Follow-up Monitoring Visit Letter

   2      18 Apr 11   

106.1 MED. 07 Monitoring Visit and Reporting Plan

   2      18 Apr 11   

106.1 MED. 08 Data Clarification Form

106.1 MED. 09 Site Personal Training Log

106.1 MED. 10 Confidentiality Violation Log

   1

1

1

    

 

 

18 Jul 11

26 Jun 12

26 Jun 12

  

  

  

106.2 MED. Taking Over The Study

   3      31 May 13   

Associated Forms And Templates:

     

106.2 MED. 01 CRA Site Take-Over Checklist

   5      31 May 13   

106.2 MED. 02 CTA Take-Over Checklist

   2      31 May 13   

106.3 MED. Co-Monitoring Visit

   2      25 Jul 11   

106.3 MED. 02 Co-monitoring Visit Report: Quality Control Assessment

   2      25 Jul 11   

106.4 MED. Reporting Protocol Deviations

   2      10 Aug 10   

Associated Forms And Templates:

     

106.4 MED. 01 Protocol deviation report

106.4 MED. 02 Protocol Deviation Cumulative List

   2

1

    

 

10 Aug 10

10 Aug 10

  

  

107.1 MED. Close-out Visit

   3      29 Dec 11   

 

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Associated Forms And Templates:

     

107.1 MED. 01 Confirmation Close-out Visit Letter

   2      30 Apr 11   

107.1 MED. 02 Close out Visits Plan

   2      30 Apr 11   

107.1 MED. 03 Close out Visit Checklist

   2      30 Apr 11   

107.1 MED. 04 Close out Visit Report

   2      30 Apr 11   

107.1 MED. 05 Record Retention Form

   2      30 Apr 11   

107.1 MED. 06 Site Close out Assessment

   2      30 Apr 11   

107.1 MED. 07 Follow-up Close out Visit Letter

   2      30 Apr 11   

108.1 MED. Translation

 

Associated Forms And Templates:

108.1 MED. 01 Translation Certificate

   3

3

    

 

19 Sep 11

19 Sep 11

  

  

109.1 MED. Clinial Trial Documents

   4      16 Sep 13   

Associated Forms And Templates:

     

109.1 MED 01 Essential Documents

   4      16 Sep 13   

109.3 MED. Trial Master File

   1      16 Sep 13   

Associated Forms And Templates:

     

109.2 MED. 01 Trial Maser File Table of Content

   1      16 Sep 13   

109.2 MED. 02 Trial Maser File and Shadow File Review Form

109.2 MED. 03 TMF Transfer Form

109 3 MED 04 Study Documentation Management Form

   1

1

1

    

 

 

16 Sep 13

16 Sep 13

16 Sep 13

  

  

  

109.5 MED. Investigator’s File

   1      16 Sep 13   

Associated Forms And Templates:

     

109.5 MED. 01 Investigator’s File Table of Content

   1      16 Sep 13   

109.5 MED. Electronic Study Folder and Shadow File

 

109.7 MED.01 Shadow File Coordinators Log

109.7 MED.02 Electronic Folder Names

109.7 MED.03 Example of Electronic Study Folder and Shadow File Structure

   1

1

1

1

    

 

 

 

16 Sep 13

16 Sep 13

16 Sep 13

16 Sep 13

  

  

  

  

110.1 MED. Clinical Supplies

   3      16 Sep 13   

Associated Forms And Templates:

     

110.1 MED. 01 Temperature Log

   3      16 Sep 13   

110.1 MED. 02 Clinical Supply Shipment Management Log

   3      16 Sep 13   

110.1 MED. 03 Clinical Supply Accountability Form

   3      16 Sep 13   

110.1 MED. 04 Re-labelling Report

   3      16 Sep 13   

110.1 MED. 05 Investigational product RECALL form

   3      16 Sep 13   

110.1 MED. 06 Investigational product RETURN form

   3      16 Sep 13   

110.1 MED. 07 Clinical Supply Destruction Report

110.1 MED.08 Site Investigational Product Accountability Log

   3

1

    

 

16 Sep 13

16 Sep 13

  

  

111.1 MED. Clinical Trial Materials

   2      30 Sep 13   

Associated Forms And Templates:

     

111.1 MED.01 Trial Supply Shipment Form

   4      30 Sep 13   

111.1 MED.02 Controlled Copy Distribution Log

   3      30 Sep 13   

111.1 MED.03 Frozen Samples storage log

   3      30 Sep 13   

111.1 MED.04 Investigator’s Brochure Acknowledgement of Receipt

   2      30 Sep 13   

 

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112.1 MED. Serious Adverse Event Reporting

     3         08 Mar 13   

Associated Forms And Templates:

     

112.1 MED. 01 SAE Pregnancy Report Form

     3         08 Mar 13   

112.2 MED. Distribution of SUSAR reports

     2         15 Sep 11   

Associated Forms And Templates:

     

112.2 MED. 01 SUSAR Reports Tracking Log

     2         15 Sep 11   

112.5 MED. Safety Management Principles

     1         16 Sep 2013   

114.1 MED. Insurance in Clinical Trial

 

Associated Forms And Templates:

114.1 MED. 01 Questionnaire for Insurance Purposes

    

 

3

3

  

  

    

 

15 Apr 13

15 Apr 13

  

  

116.1 MED. Clinical Study Report

     3         28 Jun 13   

Associated Forms And Templates:

     

116.1MED. 01 Clinical Study Report Tracking Log

     3         28 Jun 13   

117.1 MED. Archiving Study Files

     3         09 Sep 13   

Associated Forms And Templates:

     

117.1 MED. 01 Archiving Facility Log

     3         09 Sep 13   

117.1 MED. 02 Archiving Coordinator Log

     2         09 Sep 13   

117.1 MED. 03 Archiving Coordinator Backup Log

     2         09 Sep 13   

117.1 MED. 04 Archiving Coordinator Take Over

     2         09 Sep 13   

117.1 MED. 05 Post Study Checklist

     3         09 Sep 13   

117.1 MED. 06 Content of Archived Box

     2         09 Sep 13   

117.1 MED. 07 List of Archived Studies

     2         09 Sep 13   

117.1 MED. 08 Retrieve from Archives Request

     2         09 Sep 13   

117.1 MED. 09 Confirmation of Destruction

     2         09 Sep 13   

117.1 MED. 10 Inventory of Archiving Boxes

     2         09 Sep 13   

117.1 MED. 11 Inventory of Archiving Locking Seals

     2         09 Sep 13   

117.1 MED. 12 Content of Archiving File

     2         09 Sep 13   

117.3 MED Management of Electronic Correspondence

     1         29 Mar 13   

121.1 MED. Contracts with Investigators and Investigational Sites

     4         01 Feb 10   

Associated Forms And Templates:

121.1 MED. 01 Bilateral contract (investigator)

121.1 MED. 02 Bilateral contract (centre)

    

 

4

4

  

  

    

 

08 Aug 11

08 Aug 11

  

  

121.1 MED. 03 Tripartite contract (investigator & centre)

121.1 MED. 04 Bilateral contract (investigator-coordinator)

121.1 MED. 06 Lend agreement (investigator)

121.1 MED. 07 Lend agreement (centre)

121.1 MED. 08 Service agreement (contractor with team)

    

 

 

 

 

4

4

2

2

2

  

  

  

  

  

    

 

 

 

 

08 Aug 11

08 Aug 11

08 Aug 11

08 Aug 11

08 Aug 11

  

  

  

  

  

121.1 MED. 09 Service agreement (single contractor)

121.1 MED. 10 Bilateral contract (investigator) – MD

121.1 MED. 11 Bilateral contract (centre) – MD

    

 

 

2

2

2

  

  

  

    

 

 

08 Aug 11

08 Aug 11

08 Aug 11

  

  

  

121.1 MED. 12Tripartite contract (investigator & centre) – MD

     2         08 Aug 11   

 

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121.1 MED. 13 Bilateral contract (investigator-coordinator) – MD

     2         08 Aug 11   

122.1 MED. Confidentiality Agreements and Confidentiality Obligation

     3         14 Mar 11   

Associated Forms And Templates:

122.1 MED. 01 CA general unilateral (investigator—centre)

122.1 MED. 02 CA study specific unilateral (investigator—centre)

122.1 MED. 03 CA general unilateral (sponsor—contractor—other)

122.1 MED. 04 CA study specific unilateral (sponsor—contractor—other)

122.1 MED. 05 CA general mutual (sponsor—contractor—other)

122.1 MED. 06 CO in feasibility only (investigator)

122.1 MED. 07 CA/CO explanatory notice

    

 

 

 

 

 

 

2

2

2

2

2

3

2

  

  

  

  

  

  

  

    

 

 

 

 

 

 

15 Feb 11

15 Feb 11

15 Feb 11

15 Feb 11

15 Feb 11

15 Feb 11

01 Mar 11

  

  

  

  

  

  

  

123.1 MED. Principles of drawing contracts and master service agreements

     2         28 Mar 11   

Associated Forms And Templates:

123.1 MED. 01 KCR Group Contract Template:

        Master Service Agreement

123.1 MED. 02 KCR Group Contract Template:

        Service Agreement for a clinical study conduct

    

 

2

1

  

  

    

 

28 Mar 11

20 Oct 08

  

  

124.1 MED. Fraud and Misconduct

     3         11 Feb 13   

125.1 MED. Purchases Within a Project

     1         25 Jul 11   

127.1 MED. Legislation in Clinical Trials

     2         31 Jul 13   

127.3 MED Regulatory Intelligence

 

Associated Forms And Templates:

127.3 MED.01 Regulatory Intelligence Responsibilities

    

 

1

1

  

  

    

 

28 Dec 12

28 Dec 12

  

  

128.1 MED. Communication with Subcontractor

 

Associated Forms And Templates:

128.1 MED. 01 Subcontractor Tracking Log

    

 

 

1

 

1

  

 

  

    

 

 

01 Sep 11

 

01 Sep 11

  

 

  

129.1 MED. Annual Progress Report to Competent Authorities

     2         30 Sep 11   

Associated Forms And Templates:

     

129.1 MED. 01 Annual Progress Report Template

     2         30 Sep 11   

130.1 MED. Preparing Monitoring Plan

     1         25 Nov 11   

Associated Forms And Templates:

     

130.1 MED. 01 Monitoring Plan

     1         25 Nov 11   

131.1 MED. Communication Plan

 

Associated Forms And Templates:

     1         30 Apr 12   

131.1 MED. 01 Communication GLOBAL Contact List

     1         30 Apr 12   

131.1 MED. 02 Communication COUNTRY Contact List

     1         30 Apr 12   

131.1 MED. 03 Communication VENDOR Contact List

     1         30 Apr 12   

131.1 MED. 04 Study Team Delegation Log

     1         30 Apr 12   

 

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131.1 MED 05 Communication Plan

   1      30 Apr 12   

132.1 MED. Unbliding

   1      28 Aug 12   

Associated Forms And Templates:

     

132.1 MED. 01 Unblinding Contact List

   1      28 Aug 12   

132.1 MED. 02 Unblinding Report

   1      28 Aug 12   

132.2 MED. 03 Unblinding Listing

   1      28 Aug 12   

134.1.MED Principal Investigator Change

 

   1      04 Apr 13   

Associated Forms And Templates:

     

134 1 MED 01 Principal Investigator Change Checklist 131.1. MED. 03 134

1 MED 02 Letter to Competent Authorities About Principal Investigator Change

   1

1

    

 

04 Apr 13

04 Apr 13

  

  

 

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Attachment No. 5

List of third parties engaged by the Sponsor for the conduct of the Study

 

  a. Legal representative (SCIderm GmbH): CRO shall undertake the following obligation, and shall indemnify the sponsor for any damage in case it will breach such obligation: notify immediately SCIderm GmbH and the Sponsor of any untoward occurrences, including serious breaches of the protocol, GCP or regulations, occurring in the clinical trial.

 

  b. Data Management: CRO shall act according to the procedures, as shall be determined for this clinical trial.

 

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Attachment No. 6

Study Budget

Specification of anticipated costs and expenses

 

Ref.
#

  

Service

   Job
position
     Unit
Cost
(€)
     Quantity
of hours
units
     Total     

KCR Notes / Comments

A    MEDICAL WRITING               [***]       [***]
B    STUDY FAMILIARIZATION & TRAINING               [***]      
B.1    Kick-off Meeting—attendance      [***]         [***]         [***]         [***]       [***]
B.3    Monitors training (therapeutic)      [***]         [***]         [***]         [***]       [***]
B.4    Monitors training (therapeutic)      [***]         [***]         [***]         [***]       [***]
B.5    Investigator’s meeting—attendance and travel      [***]         [***]         [***]         [***]       [***]
B.6    Investigator’s meeting—attendance and travel      [***]         [***]         [***]         [***]       [***]
B.11    Investigator’s meeting—attendance and travel      [***]         [***]         [***]         [***]       [***]
B.12    Investigator’s meeting—prepare presentation      [***]         [***]         [***]         [***]       [***]
B.13    Investigator’s meeting organization      [***]         [***]         [***]         [***]       [***]
B.14    Familiarization with study documentation, SOPs and study specifics      [***]         [***]         [***]         [***]       [***]
C    SITE MANAGEMENT IN HOUSE (including site payments)               [***]      
C.1    Site contacts over phone and written communication      [***]         [***]         [***]         [***]       [***]
C.2    CRF off site management      [***]         [***]         [***]         [***]       [***]
C.3    Resolve issues & queries      [***]         [***]         [***]         [***]       [***]
C.4    Administer investigators grants      [***]         [***]         [***]         [***]       [***]

 

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                  [***]
C.5    Collect Pre-Study/Regulatory Documentation from sites and Sponsor      [***]         [***]         [***]         [***]       [***]
D    STUDY ADMINISTRATION & DOCUMENT MANAGEMENT               [***]      
D.1    Set up study Trial Master Files      [***]         [***]         [***]         [***]       [***]
D.2    Create Investigator Binders      [***]         [***]         [***]         [***]       [***]
D.3    Maintain & update study Trial Master Files and project specific files      [***]         [***]         [***]         [***]       [***]
D.4    Archive, retain or return Study Documentation      [***]         [***]         [***]         [***]       [***]
E    STUDY AUTHORIZATION & CONTRACTS               [***]      
E.1    Develop local Informed Consent Form      [***]         [***]         [***]         [***]       [***]
E.2    Develop local Informed Consent Form      [***]         [***]         [***]         [***]       [***]
E.3    Coordinate translation/preparation process (protocol synopsis, drug labels, back translation)      [***]         [***]         [***]         [***]       [***]
E.4    Translation and country adaptation of drug labels      [***]         [***]         [***]         [***]       [***]
E.5    Development of project specific contract template      [***]         [***]         [***]         [***]       [***]
E.6    Preparing countries specific contract templates from the project specific template      [***]         [***]         [***]         [***]       [***]
E.7    Negotiate Investigator Budget & CSA (+ 2nd for hospital authorities)      [***]         [***]         [***]         [***]       [***]
E.8    Negotiate Investigator Budget & CSA (+ 2nd for hospital authorities)      [***]         [***]         [***]         [***]       [***]
E.9    Development of Authorization Letters      [***]         [***]         [***]         [***]       [***]
E.10    Initial submission to CA and EC      [***]         [***]         [***]         [***]       [***]

 

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E.11    Initial submission to CA and EC      [***]         [***]         [***]         [***]       [***]
E.12    Regulatory maintenance—administrative amendments      [***]         [***]         [***]         [***]       [***]
E.13    Regulatory maintenance—substantial amendments      [***]         [***]         [***]         [***]      

[***]

E.14    Project Management—Regulatory Affairs      [***]         [***]         [***]         [***]      

[***]

E.15    Regulatory Manager—Teleconferences      [***]         [***]         [***]         [***]       [***]
E.16    Insurance arrangement      [***]         [***]         [***]         [***]       [***]
F    SITE SELECTION ACTIVITIES               [***]      
F.1    Identify Investigative Sites      [***]         [***]         [***]         [***]      

[***]

F.2    Site Selection Visits—visits      [***]         [***]         [***]         [***]       [***]
F.3    Site Selection Visits—travelling      [***]         [***]         [***]         [***]       [***]
G    MONITORING               [***]      
G.1    Site Initiation Visits—visits      [***]         [***]         [***]         [***]       [***]
G.2    Site Initiation Visits—travelling      [***]         [***]         [***]         [***]       [***]
G.3    Interim Monitoring Visits—visits      [***]         [***]         [***]         [***]       [***]
G.4    Interim Monitoring Visits—travelling      [***]         [***]         [***]         [***]       [***]
G.5    Site Close-out Visits—visits      [***]         [***]         [***]         [***]       [***]
G.6    Site Close-out Visits—travelling      [***]         [***]         [***]         [***]       [***]
H    MEDICAL MONITORING               [***]       [***]
I    SAFETY REPORTING               [***]       [***]
J    DATA MANAGEMENT               [***]       [***]
K    PROJECT MANAGEMENT               [***]      
K.1    Project management      [***]         [***]         [***]         [***]       [***]

 

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                  [***]
  K.3       Internal team meetings—COPM participation      [***]         [***]         [***]         [***]       [***]
  K.5       Internal team meetings—CRAs participation      [***]         [***]         [***]         [***]       [***]
  K.6       Verification of monitoring reports      [***]         [***]         [***]         [***]       [***]
  L       QUALITY ASSURANCE SERVICES               [***]      
  L.1       Quality assurance services—Clinical management      [***]         [***]         [***]         [***]       [***]
  CRO TOTAL            [***]         [***]      
      

ESTIMATED PASS THROUGH COSTS (this
is rough estimation of the majority costs which
should be taken into account and not directly
paid by Sponsor)

          Unit
Cost
(€)
     Quantity
of units
     Total       
  1       Regulatory costs               [***]      
  1.1       Ethics Committee fees + RA fee            [***]         [***]       [***]
  1.2       Custom clearance               [***]       [***]
  1.3       Insurance               [***]       [***]
  2       Travel costs               [***]      

 

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  2.1       CRA Travel (hotels, tickets, allowances)         [***]         [***]         [***]       [***]
  2.2       QAD Travel (hotels, tickets, allowances)         [***]         [***]         [***]       [***]
  2.3       Investigator Meetings travel and hotel costs (per attendee)         [***]         [***]         [***]       [***]
  2.4       Patients travel costs         [***]         [***]         [***]       [***]
  3       Administration               [***]      
  3.1       Copies / duplication (binding and photocopies included)         [***]         [***]         [***]       [***]
  3.2       Courier / shipment         [***]         [***]         [***]       [***]
  3.3       Telephone / fax         [***]         [***]         [***]       [***]
  4       Translation               [***]      
  4.1       Translation of study documents         [***]         [***]         [***]       [***]
  5.       Other costs               [***]      
  5.1       Overnight stay               [***]       [***]
  PASS-THROUGH COSTS TOTAL               [***]      
      

SERVICE PROVIDERS COSTS

        Unit
Cost
(€)
     Quantity
of units
     Total       
  1       Central Laboratory               [***]      
  2       Data Management               [***]      
  3       Drug Supply               [***]      
  4       IVRS               [***]      
  5       Statistical Analysis and CSR               [***]      
  SERVICE PROVIDORS COSTS TOTAL               [***]      

 

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INVESTIGATORS FEES

        Unit
Cost
(€)
     Quantity
of units
     Total       
  1                     [***]      
  1.1       Investigators fee         [***]         [***]         [***]       [***]
  1.2       Country study co-ordinator fees         [***]         [***]         [***]       [***]
  1.3       Investigators fee (screen failures)         [***]         [***]         [***]       [***]
  1.4       Start-up fees (Polish sites)         [***]         [***]         [***]       [***]
  1.5       Archiving fees (Polish sites)         [***]         [***]         [***]       [***]
  INVESTIGATORS FEES TOTAL               [***]      
  TOTAL CRO FEES      

[***]

  TOTAL PASS THROUGH COSTS      

[***]

  TOTAL VENDORS COSTS      

[***]

  TOTAL INVESTIGATORS FEES      

[***]

 

PROJECT GRAND TOTAL

  

   [***]

 

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