| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
| Treatment of bone metastases in subjects with advanced cancer excluding breast and prostate cancer  or multiple myeloma | 
 
 
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| MedDRA Classification | 
| E.1.2 Medical condition or disease under investigation | 
| E.1.2 | Version  | 6.1 | 
 
| E.1.2 | Level  | PT | 
 
| E.1.2 | Classification code  | 10027452 | 
 
 
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| E.1.3 | Condition being studied is a rare disease  |  No  | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial  | 
| To determine if denosumab is non-inferior to zoledronic acid with respect to the first on-study occurrence of a skeletal related event  SRE  in subjects with advanced cancers and bone metastases | 
 
 
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| E.2.2 | Secondary objectives of the trial  | 
| To determine if denosumab is superior to zoledronic acid with respect to the first on-study SRE To determine if denosumab is superior to zoledronic acid with respect to the first-and-subsequent on-study SRE  multiple event analysis  To compare the treatment effect of denosumab with zoledronic acid on pain To compare the treatment effect of denosumab with zoledronic acid on the first on-study use of radiation to bone To assess the safety and tolerability of denosumab compared with zoledronic acid | 
 
 
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| E.2.3 | Trial contains a sub-study  |  Information not present in EudraCT  | 
| E.3 | Principal inclusion criteria  | 
|   adult with histologically or cytologically confirmed advanced cancers including solid tumors, multiple myeloma, and lymphoma   current or prior radiographic  ie, x-ray, computer tomography  CT , or magnetic resonance imaging  MRI   evidence of at least 1 bone metastasis  or bone lesion from multiple myeloma    Eastern Cooperative Oncology Group  ECOG  performance status of 0, 1, or 2  adequate organ function as defined by the following criteria    56256;  56451; serum aspartate aminotransferase  AST    8804; 5 x upper limit of normal  ULN    56256;  56451; serum alanine aminotransferase  ALT    8804; 5 x ULN   56256;  56451; serum total bilirubin   8804; 2 x ULN   56256;  56451; creatinine clearance  Cockcroft-Gault    8805; 30 mL/min   56256;  56451; albumin-adjusted serum calcium   8805; 2.0 mmol/L  8.0 mg/dL  and   8804; 2.9 mmol/L  11.5 mg/dL    Before any study-specific procedure is performed, the appropriate written informed consent must be obtained | 
 
 
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| E.4 | Principal exclusion criteria | 
|   diagnosis of breast or prostate cancer   current or prior IV bisphosphonate administration   current or prior oral bisphosphonate for the treatment of bone metastasis / osteolytic lesion   planned radiation therapy or surgery to bone   prior administration of denosumab   known brain metastases   life expectancy less than 6 months   prior history or current evidence of osteonecrosis/osteomyelitis of the jaw   active dental or jaw condition which requires oral surgery   non-healed dental/oral surgery   planned invasive dental procedure over the course of the study   evidence of any of the following conditions per subject self report or medical chart review   any other prior malignancy  other than basal cell carcinoma or in situ cervical cancer  with active disease within 3 years before randomization   56256;  56451; known infection with human immunodeficiency virus   56256;  56451; active infection with Hepatitis B virus or Hepatitis C virus  any organic or psychiatric disorder that, in the opinion of the investigator, might prevent the subject from completing the study or interfere with the interpretation of the study results   thirty days or less since receiving an investigational product or device  ie, does not have marketing authorization  in another clinical trial   pregnant or breast feeding women   subject with reproductive potential who will not agree to use effective contraception  as defined by the principal investigator or designee    56256;  56451; known sensitivity to any of the products to be administered during the study  eg, zoledronic acid, mammalian derived products, calcium or vitamin D | 
 
 
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| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| time to the first on-study SRE  non-inferiority  | 
 
 
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| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis |  No  | 
| E.6.2 | Prophylaxis |  No  | 
| E.6.3 | Therapy |  No  | 
| E.6.4 | Safety |  Yes  | 
| E.6.5 | Efficacy |  Yes  | 
| E.6.6 | Pharmacokinetic |  Yes  | 
| E.6.7 | Pharmacodynamic |  Yes  | 
| E.6.8 | Bioequivalence |  Information not present in EudraCT  | 
| E.6.9 | Dose response |  No  | 
| E.6.10 | Pharmacogenetic |  Information not present in EudraCT  | 
| E.6.11 | Pharmacogenomic |  No  | 
| E.6.12 | Pharmacoeconomic |  No  | 
| E.6.13 | Others |  Information not present in EudraCT  | 
| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) |  No  | 
| E.7.1.1 | First administration to humans |  No  | 
| E.7.1.2 | Bioequivalence study |  No  | 
| E.7.1.3 | Other |  No  | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) |  No  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  Yes  | 
| E.7.4 | Therapeutic use (Phase IV) |  No  | 
| E.8 Design of the trial | 
| E.8.1 | Controlled |  Yes  | 
| E.8.1.1 | Randomised |  Yes  | 
| E.8.1.2 | Open |  No  | 
| E.8.1.3 | Single blind |  No  | 
| E.8.1.4 | Double blind  |  Yes  | 
| E.8.1.5 | Parallel group |  Yes  | 
| E.8.1.6 | Cross over  |  No  | 
| E.8.1.7 | Other |  No  | 
| E.8.2 |  Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) |  Yes  | 
| E.8.2.2 | Placebo  |  Yes  | 
| E.8.2.3 | Other |  No  | 
| E.8.3 | 
                                The trial involves single site in the Member State concerned
                             |  No  | 
| E.8.4 |  The trial involves multiple sites in the Member State concerned  |  Yes  | 
| E.8.5 | The trial involves multiple Member States |  Yes  | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.1 | Trial being conducted both within and outside the EEA |  Yes  | 
| E.8.6.2 | Trial being conducted completely outside of the EEA |  Information not present in EudraCT  | 
| E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned | 
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| E.8.7 | Trial has a data monitoring committee |  Information not present in EudraCT  | 
| E.8.8 | 
                        Definition of the end of the trial and justification where it is not the last
                        visit of the last subject undergoing the trial
                     |  | 
| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 2 | 
| E.8.9.1 | In the Member State concerned months | 0 | 
| E.8.9.1 | In the Member State concerned days |  | 
| E.8.9.2 | In all countries concerned by the trial years | 2 | 
| E.8.9.2 | In all countries concerned by the trial months | 0 |