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    Clinical Trial Results:
    A PHASE II, MULTICENTER, OPEN-LABEL TRIAL EVALUATING THE ACTIVITY AND TOLERABILITY OF ROMIDEPSIN (DEPSIPEPTIDE, FK228) IN PROGRESSIVE OR RELAPSED PERIPHERAL T-CELL LYMPHOMA FOLLOWING PRIOR SYSTEMIC THERAPY

    Summary
    EudraCT number
    2006-006228-21
    Trial protocol
    DE   CZ   FR   ES   SE   GB   IT  
    Global end of trial date
    17 May 2018

    Results information
    Results version number
    v1(current)
    This version publication date
    31 May 2019
    First version publication date
    31 May 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    GPI-06-0002
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00426764
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Celgene Corporation
    Sponsor organisation address
    86 Morris Avenue, Summit, NJ, United States, 07901
    Public contact
    Clinical Trial Disclosure, Celgene Corporation, ClinicalTrialDisclosure@celgene.com
    Scientific contact
    Jeffrey Jones, Celgene, 1 9086739686, jejones@celgene.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    17 May 2018
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    17 May 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this trial is to evaluate the activity of romidepsin in patients with progressive or relapsed PTCL following prior systemic therapy. The primary efficacy parameter is the rate of complete response, defined as the proportion of patients with complete response (CR) and unconfirmed complete response [CR(u)] according to the IWC for responses assessment for non-Hodgkin’s lymphomas (NHL).
    Protection of trial subjects
    This study was conducted in accordance with the guidelines of current Good Clinical Practice including the archiving of essential documents.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    19 Jun 2007
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 15
    Country: Number of subjects enrolled
    Ukraine: 1
    Country: Number of subjects enrolled
    Poland: 6
    Country: Number of subjects enrolled
    Spain: 10
    Country: Number of subjects enrolled
    Sweden: 2
    Country: Number of subjects enrolled
    United Kingdom: 1
    Country: Number of subjects enrolled
    Czech Republic: 3
    Country: Number of subjects enrolled
    France: 23
    Country: Number of subjects enrolled
    Germany: 9
    Country: Number of subjects enrolled
    United States: 61
    Worldwide total number of subjects
    131
    EEA total number of subjects
    54
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    81
    From 65 to 84 years
    50
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Screening tests were to be obtained within 2 weeks prior to study entry (defined as first dose of romidepsin, unless otherwise indicated).

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Romidepsin
    Arm description
    Subjects received romidepsin 14 mg/m^2 administered intravenously over 4 hours on Days 1, 8, and 15 of a 28-day cycle. Subjects continued on monthly cycles of romidepsin. The planned duration of study therapy was 6 cycles. Subjects who responded could continue beyond 6 cycles until disease progression or other withdrawal criteria were met. For subjects treated for 12 or more cycles, maintenance dosing (2 doses per cycle) was permitted.
    Arm type
    Experimental

    Investigational medicinal product name
    Romidepsin
    Investigational medicinal product code
    Other name
    ISTODAX, Depsipeptide, FK228
    Pharmaceutical forms
    Powder for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Romidepsin intravenously (through a vein) over 4 hours on Days 1, 8 and 15 of each 28-day cycle.

    Number of subjects in period 1
    Romidepsin
    Started
    131
    Discontinued Prior to or During Cycle 6
    98
    Discontinued at End of or After Cycle 6
    33
    Completed
    0
    Not completed
    131
         Physician decision
    6
         Adverse Event
    24
         Not Specfied
    1
         Death
    1
         Progressive Disease
    83
         Withdrawal by Patient
    4
         Other Reasons (Miscellaneous)
    10
         Compassionate Use
    1
         Protocol deviation
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Romidepsin
    Reporting group description
    Subjects received romidepsin 14 mg/m^2 administered intravenously over 4 hours on Days 1, 8, and 15 of a 28-day cycle. Subjects continued on monthly cycles of romidepsin. The planned duration of study therapy was 6 cycles. Subjects who responded could continue beyond 6 cycles until disease progression or other withdrawal criteria were met. For subjects treated for 12 or more cycles, maintenance dosing (2 doses per cycle) was permitted.

    Reporting group values
    Romidepsin Total
    Number of subjects
    131 131
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    59.4 ± 12.83 -
    Gender categorical
    Units: Subjects
        Female
    42 42
        Male
    89 89
    PTCL Subtype Based on Central Diagnosis
    ALK-1=anaplastic lymphoma kinase; ALCL=anaplastic large cell lymphoma
    Units: Subjects
        PTCL Unspecified (NOS)
    69 69
        Angioimmunoblastic T-cell lymphoma (AITL)
    27 27
        ALK-1 negative ALCL
    21 21
        Enteropathy-type T-cell lymphoma
    6 6
        Subcutaneous panniculitis-like T-cell lymphoma
    3 3
        ALK-1 positive ALCL
    1 1
        Cutaneous γδ T-cell lymphoma
    1 1
        Extranodal NK/T cell lymphoma nasal type
    1 1
        Transformed mycosis fungoides
    1 1
        Not in Subject Analysis Set
    1 1
    Race
    Units: Subjects
        White
    117 117
        Black
    7 7
        Asian
    3 3
        Other
    4 4
    Eastern Cooperative Oncology Group Performance Status [1]
    The ECOG scale is as follows: Grade 0: Fully active, able to carry on all pre-disease activities without restriction; Grade 1: Restricted in physically strenuous activity, ambulatory and able to carry out work of a light nature; Grade 2: Ambulatory and capable of all self-care but unable to work. Up and about more than 50% of waking hours; Grade 3: Capable of only limited self-care, confined to bed or chair > 50% of waking hours; Grade 4: Completely disabled. Cannot carry on any self-care. Confined to bed or Chair.
    Units: Subjects
        Grade 0
    46 46
        Grade 1
    67 67
        Grade 2
    17 17
        Missing
    1 1
    Body Surface Area (BSA)
    subjects with a Baseline measurement (n=128)
    Units: m^2
        arithmetic mean (standard deviation)
    1.84 ± 0.2348 -
    Duration of peripheral T-cell lymphoma (PTCL)
    Units: years
        arithmetic mean (standard deviation)
    2.268 ± 2.6654 -

    End points

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    End points reporting groups
    Reporting group title
    Romidepsin
    Reporting group description
    Subjects received romidepsin 14 mg/m^2 administered intravenously over 4 hours on Days 1, 8, and 15 of a 28-day cycle. Subjects continued on monthly cycles of romidepsin. The planned duration of study therapy was 6 cycles. Subjects who responded could continue beyond 6 cycles until disease progression or other withdrawal criteria were met. For subjects treated for 12 or more cycles, maintenance dosing (2 doses per cycle) was permitted.

    Subject analysis set title
    Histopathologically-Confirmed Population
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Subjects with central histologic confirmation of peripheral T-cell lymphoma (PTCL).

    Subject analysis set title
    Missing ECOG
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Subjects with a missing best on study ECOG performance score, who received romidepsin 14 mg/m^2 administered intravenously over 4 hours on Days 1, 8, and 15 of a 28-day cycle. Subjects continued on monthly cycles of romidepsin. The planned duration of study therapy was 6 cycles. Subjects who responded could continue beyond 6 cycles until disease progression or other withdrawal criteria were met. For subjects treated for 12 or more cycles, maintenance dosing (2 doses per cycle) was permitted.

    Subject analysis set title
    Best ECOG = 0
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Subjects with a best on study ECOG performance score of 0, who received romidepsin 14 mg/m^2 administered intravenously over 4 hours on Days 1, 8, and 15 of a 28-day cycle. Subjects continued on monthly cycles of romidepsin. The planned duration of study therapy was 6 cycles. Subjects who responded could continue beyond 6 cycles until disease progression or other withdrawal criteria were met. For subjects treated for 12 or more cycles, maintenance dosing (2 doses per cycle) was permitted.

    Subject analysis set title
    Best ECOG = 1
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Subjects with a best on study ECOG performance score of 1, who received romidepsin 14 mg/m^2 administered intravenously over 4 hours on Days 1, 8, and 15 of a 28-day cycle. Subjects continued on monthly cycles of romidepsin. The planned duration of study therapy was 6 cycles. Subjects who responded could continue beyond 6 cycles until disease progression or other withdrawal criteria were met. For subjects treated for 12 or more cycles, maintenance dosing (2 doses per cycle) was permitted.

    Subject analysis set title
    Best ECOG = 2
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Subjects with a best on study ECOG performance score of 2, who received romidepsin 14 mg/m^2 administered intravenously over 4 hours on Days 1, 8, and 15 of a 28-day cycle. Subjects continued on monthly cycles of romidepsin. The planned duration of study therapy was 6 cycles. Subjects who responded could continue beyond 6 cycles until disease progression or other withdrawal criteria were met. For subjects treated for 12 or more cycles, maintenance dosing (2 doses per cycle) was permitted.

    Subject analysis set title
    Best ECOG = 3
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Subjects with a best on study ECOG performance score of 3, who received romidepsin 14 mg/m^2 administered intravenously over 4 hours on Days 1, 8, and 15 of a 28-day cycle. Subjects continued on monthly cycles of romidepsin. The planned duration of study therapy was 6 cycles. Subjects who responded could continue beyond 6 cycles until disease progression or other withdrawal criteria were met. For subjects treated for 12 or more cycles, maintenance dosing (2 doses per cycle) was permitted.

    Subject analysis set title
    Best ECOG = 4
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Subjects with a best on study ECOG performance score of 4, who received romidepsin 14 mg/m^2 administered intravenously over 4 hours on Days 1, 8, and 15 of a 28-day cycle. Subjects continued on monthly cycles of romidepsin. The planned duration of study therapy was 6 cycles. Subjects who responded could continue beyond 6 cycles until disease progression or other withdrawal criteria were met. For subjects treated for 12 or more cycles, maintenance dosing (2 doses per cycle) was permitted.

    Primary: Percentage of Subjects With a Complete Response According to the International Workshop Response Criteria (IWC) for Non-Hodgkin's Lymphomas (NHL) Assessed by an Independent Review Committee

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    End point title
    Percentage of Subjects With a Complete Response According to the International Workshop Response Criteria (IWC) for Non-Hodgkin's Lymphomas (NHL) Assessed by an Independent Review Committee [1]
    End point description
    Complete Response (CR): >75% decrease in size aggregate of nodal index lesions (large and small), complete disappearance of extranodal and non-index lesions; total disappearance of clinical disease including skin involvement; disease-related signs and symptoms, normalization of biochemical abnormalities and reduction in size of spleen or liver so no longer palpable. Unconfirmed CR: all above criteria except all nodal index lesions must have regressed >75% in the sum of the product diameters (SPD) from baseline. Individual nodes previously confluent must have regressed by >75% in their SPD.
    End point type
    Primary
    End point timeframe
    Response was assessed after every 2 cycles of treatment and at completion of therapy, up until 30 September 2012 (data cutoff for analysis). Maximum duration on study was 1931 days.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive statistics are presented, per protocol.
    End point values
    Histopathologically-Confirmed Population
    Number of subjects analysed
    130
    Units: percentage of subjects
        number (confidence interval 95%)
    15.4 (9.7 to 22.8)
    No statistical analyses for this end point

    Secondary: Duration of Objective Disease Response

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    End point title
    Duration of Objective Disease Response
    End point description
    Duration of response was defined as the number of days from the date of the first disease response (Complete, Unconfirmed Complete or Partial Response) until the date of progression and was determined using Kaplan-Meier product-limit estimates. Progression was defined as: a ≥50% increase from the nadir in the individual sum of the products of the diameters of any index lesion; the reappearance of pathology, enlargement of liver/spleen, or unequivocal progression of non-measurable disease or appearance of any new lesions. Histopathologically-Confirmed Population with an objective response. Censoring for patients who did not have a date of progression was conducted based on last assessment reported for the patient.
    End point type
    Secondary
    End point timeframe
    Response was assessed after every 2 cycles of treatment and at completion of therapy, up until 30 September 2012 (data cutoff for analysis). Maximum duration on study was 1931 days.
    End point values
    Romidepsin Histopathologically-Confirmed Population
    Number of subjects analysed
    34
    34 [2]
    Units: days
        median (confidence interval 95%)
    999999 (353 to 999999)
    999999 (353 to 999999)
    Notes
    [2] - 999999=not estimable due to the low number of events
    No statistical analyses for this end point

    Secondary: Duration of Complete Disease Response

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    End point title
    Duration of Complete Disease Response
    End point description
    Duration of response was defined as the number of days from the date of the first disease response (Complete or Unconfirmed Complete) until the date of progression and was determined using Kaplan-Meier product-limit estimates. Progression was defined as: a ≥50% increase from the nadir in the individual sum of the products of the diameters of any index lesion; the reappearance of pathology, enlargement of liver/spleen, or unequivocal progression of non-measurable disease or appearance of any new lesions. Histopathologically-Confirmed Population with a complete response. Censoring for subjects who did not have a date of progression was conducted based on last assessment reported for the subject.
    End point type
    Secondary
    End point timeframe
    Response was assessed after every 2 cycles of treatment and at completion of therapy, up until 30 September 2012 (data cutoff for analysis). Maximum duration on study was 1931 days.
    End point values
    Romidepsin Histopathologically-Confirmed Population
    Number of subjects analysed
    20
    20 [3]
    Units: days
        median (confidence interval 95%)
    999999 (500 to 999999)
    999999 (500 to 999999)
    Notes
    [3] - 999999=not estimable due to the low number of events
    No statistical analyses for this end point

    Secondary: Percentage of Participants With Objective Disease Response

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    End point title
    Percentage of Participants With Objective Disease Response
    End point description
    Objective disease response was defined as patients with a Complete Response, Unconfirmed Complete Response or a Partial Response (PR) according to the IWC 1999 assessed by an independent review committee: CR, Cru defined above, PR defined as ≥50% decrease in size of 6 largest dominant nodes and/or nodal masses & extranodal index lesions and no increase of non-index lesions, liver, or spleen; no new sites of disease evident; skin lesions decreased by ≥50%.
    End point type
    Secondary
    End point timeframe
    Response was assessed after every 2 cycles of treatment and at completion of therapy, up until 30 September 2012 (data cutoff for analysis). Maximum duration on study was 1931 days.
    End point values
    Histopathologically-Confirmed Population
    Number of subjects analysed
    130
    Units: percentage of subjects
        number (confidence interval 90%)
    26.2 (18.8 to 34.6)
    No statistical analyses for this end point

    Secondary: Time to Disease Progression

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    End point title
    Time to Disease Progression
    End point description
    Time to progression (≥50% increase from the nadir in the individual sum of the products of the diameters of any index lesion; the reappearance of pathology, enlargement of liver/spleen, or unequivocal progression of non-measurable disease or appearance of any new lesions) was defined as the duration from the date of the first study drug dose to the date of relapse or progression as reported by the independent review committee and was determined using Kaplan-Meier product-limit estimates.
    End point type
    Secondary
    End point timeframe
    Response was assessed after every 2 cycles of treatment and at completion of therapy, up until 30 September 2012 (data cutoff for analysis). Maximum duration on study was 1931 days.
    End point values
    Histopathologically-Confirmed Population
    Number of subjects analysed
    130
    Units: days
        median (confidence interval 95%)
    182 (106 to 290)
    No statistical analyses for this end point

    Secondary: Change in Eastern Cooperative Oncology Group (ECOG) Performance Status

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    End point title
    Change in Eastern Cooperative Oncology Group (ECOG) Performance Status
    End point description
    The ECOG scale is as follows: Grade 0: Fully active, able to perform all pre-disease activities without restriction; Grade 1: Restricted in physically strenuous activity, ambulatory, able to carry out light work; Grade 2: Ambulatory and capable of all self-care but unable to work. Up and about more than 50% of waking hours; Grade 3: Capable of only limited self-care, confined to bed or chair > 50% of waking hours; Grade 4: Completely disabled. Cannot carry on any self-care. Confined to bed or chair. Data reported is the shift from Baseline ECOG score to best on-study assessment score.
    End point type
    Secondary
    End point timeframe
    From Baseline up until 30 September 2012 (data cutoff for analysis). Maximum duration on study was 1931 days.
    End point values
    Missing ECOG Best ECOG = 0 Best ECOG = 1 Best ECOG = 2 Best ECOG = 3 Best ECOG = 4
    Number of subjects analysed
    5
    40
    57
    19
    6
    4
    Units: subjects
        Missing Baseline ECOG Score
    1
    0
    0
    0
    0
    0
        Baseline ECOG Score = 0
    2
    26
    16
    1
    0
    1
        Baseline ECOG Score = 1
    1
    13
    35
    12
    4
    2
        Baseline ECOG Score = 2
    1
    1
    6
    6
    2
    1
        Baseline ECOG Score = 3
    0
    0
    0
    0
    0
    0
        Baseline ECOG Score = 4
    0
    0
    0
    0
    0
    0
    No statistical analyses for this end point

    Secondary: Number of Subjects With Treatment Emergent Adverse Events (TEAEs)

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    End point title
    Number of Subjects With Treatment Emergent Adverse Events (TEAEs)
    End point description
    An adverse event or experience (AE) is defined as any untoward medical occurrence, which does not necessarily have to have a causal relationship with this treatment. A serious AE is any untoward medical occurrence that at any dose: results in death; is life-threatening; requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; is a congenital anomaly/birth defect; is an important medical event or condition. Related AEs are defined as those considered by the Investigator to have a possible, probable, or very likely/certain relationship to the study drug. AEs were graded as mild (1), moderate (2), severe (3), life-threatening (4), or death (5). TEAEs occurred from the first dose of study medication through the end of the study (30 days post last dose) or any event that was present at baseline but worsened in intensity or was subsequently considered drug-related by the Investigator through end of study.
    End point type
    Secondary
    End point timeframe
    From first dose of study treatment until the final study visit, which occurred 30 days after receiving the last dose. Mean duration of treatment up until 30 September 2012 (data cutoff for analysis) was 169 days.
    End point values
    Romidepsin
    Number of subjects analysed
    131
    Units: subjects
        TEAE
    128
        ≥ Grade 3 TEAE
    89
        ≥ Grade 4 TEAE
    27
        Serious TEAE
    61
        TEAE Leading to Discontinuation
    25
        Deaths within 30 days of Last Dose
    8
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were reported and documented throughout the study from first dose of study treatment until the final study visit, which occurred 30 days after receiving the last dose. The mean duration of treatment was 210 days.
    Adverse event reporting additional description
    NOTE: events shown include data from 6 subjects who were ongoing in study treatment at the time of the last data cut-off (30-Sep-2012), which updated the mean duration of treatment from 196 to 210 days.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    Romidepsin
    Reporting group description
    Subjects received romidepsin 14 mg/m^2 administered intravenously over 4 hours on Days 1, 8, and 15 of a 28-day cycle. Subjects continued on monthly cycles of romidepsin.

    Serious adverse events
    Romidepsin
    Total subjects affected by serious adverse events
         subjects affected / exposed
    62 / 131 (47.33%)
         number of deaths (all causes)
    3
         number of deaths resulting from adverse events
    1
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Malignant melanoma
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Myelodysplastic syndrome
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Neoplasm malignant
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tumour flare
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Tumour pain
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    5 / 131 (3.82%)
         occurrences causally related to treatment / all
    3 / 5
         deaths causally related to treatment / all
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombosis
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Chest pain
         subjects affected / exposed
    3 / 131 (2.29%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Chills
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fatigue
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Multi-organ failure
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Oedema peripheral
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pain
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    11 / 131 (8.40%)
         occurrences causally related to treatment / all
    5 / 14
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Cytokine release syndrome
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypersensitivity
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    3 / 131 (2.29%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Hypoxia
         subjects affected / exposed
    2 / 131 (1.53%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    3 / 131 (2.29%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Mental status changes
         subjects affected / exposed
    2 / 131 (1.53%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Aspiration tracheal
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    C-reactive protein increased
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ejection fraction decreased
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Electrocardiogram QT prolonged
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Electrocardiogram T wave inversion
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Electrocardiogram repolarisation abnormality
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatic enzyme increased
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Liver function test abnormal
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Cardiogenic shock
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Subendocardial ischaemia
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Cerebrovascular accident
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Dizziness
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lethargy
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Polyneuropathy
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Somnolence
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    3 / 131 (2.29%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Anaemia haemolytic autoimmune
         subjects affected / exposed
    2 / 131 (1.53%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    4 / 131 (3.05%)
         occurrences causally related to treatment / all
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    Leukopenia
         subjects affected / exposed
    3 / 131 (2.29%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Neutropenia
         subjects affected / exposed
    3 / 131 (2.29%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Pancytopenia
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    2 / 131 (1.53%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Angle closure glaucoma
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    4 / 131 (3.05%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    2 / 131 (1.53%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric ulcer
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intussusception
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lower gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancreatitis
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Peritonitis
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    6 / 131 (4.58%)
         occurrences causally related to treatment / all
    4 / 6
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Hydronephrosis
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pelvi-ureteric obstruction
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Proteinuria
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal failure
         subjects affected / exposed
    2 / 131 (1.53%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Renal failure acute
         subjects affected / exposed
    2 / 131 (1.53%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Urinary retention
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Muscular weakness
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Periarthritis
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Tendon disorder
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Candida sepsis
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Catheter related infection
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cellulitis
         subjects affected / exposed
    5 / 131 (3.82%)
         occurrences causally related to treatment / all
    3 / 11
         deaths causally related to treatment / all
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infection
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oral candidiasis
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumocystis jiroveci pneumonia
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    7 / 131 (5.34%)
         occurrences causally related to treatment / all
    1 / 7
         deaths causally related to treatment / all
    0 / 2
    Respiratory tract infection
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    6 / 131 (4.58%)
         occurrences causally related to treatment / all
    2 / 6
         deaths causally related to treatment / all
    1 / 1
    Septic shock
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sinusitis
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Staphylococcal infection
         subjects affected / exposed
    2 / 131 (1.53%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    2 / 131 (1.53%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Viral upper respiratory tract infection
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    3 / 131 (2.29%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Failure to thrive
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypercalcaemia
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    2 / 131 (1.53%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Magnesium deficiency
         subjects affected / exposed
    1 / 131 (0.76%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tumour lysis syndrome
         subjects affected / exposed
    2 / 131 (1.53%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Romidepsin
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    124 / 131 (94.66%)
    Vascular disorders
    Hypotension
         subjects affected / exposed
    10 / 131 (7.63%)
         occurrences all number
    13
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    22 / 131 (16.79%)
         occurrences all number
    42
    Chest pain
         subjects affected / exposed
    8 / 131 (6.11%)
         occurrences all number
    14
    Chills
         subjects affected / exposed
    14 / 131 (10.69%)
         occurrences all number
    22
    Fatigue
         subjects affected / exposed
    53 / 131 (40.46%)
         occurrences all number
    120
    Oedema
         subjects affected / exposed
    7 / 131 (5.34%)
         occurrences all number
    10
    Oedema peripheral
         subjects affected / exposed
    13 / 131 (9.92%)
         occurrences all number
    23
    Pain
         subjects affected / exposed
    10 / 131 (7.63%)
         occurrences all number
    12
    Pyrexia
         subjects affected / exposed
    44 / 131 (33.59%)
         occurrences all number
    75
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    24 / 131 (18.32%)
         occurrences all number
    36
    Dyspnoea
         subjects affected / exposed
    16 / 131 (12.21%)
         occurrences all number
    21
    Oropharyngeal pain
         subjects affected / exposed
    8 / 131 (6.11%)
         occurrences all number
    11
    Rhinorrhoea
         subjects affected / exposed
    8 / 131 (6.11%)
         occurrences all number
    8
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    9 / 131 (6.87%)
         occurrences all number
    9
    Insomnia
         subjects affected / exposed
    9 / 131 (6.87%)
         occurrences all number
    9
    Investigations
    Weight decreased
         subjects affected / exposed
    14 / 131 (10.69%)
         occurrences all number
    15
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    13 / 131 (9.92%)
         occurrences all number
    17
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    10 / 131 (7.63%)
         occurrences all number
    27
    Dysgeusia
         subjects affected / exposed
    27 / 131 (20.61%)
         occurrences all number
    39
    Headache
         subjects affected / exposed
    19 / 131 (14.50%)
         occurrences all number
    35
    Lethargy
         subjects affected / exposed
    8 / 131 (6.11%)
         occurrences all number
    9
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    32 / 131 (24.43%)
         occurrences all number
    84
    Leukopenia
         subjects affected / exposed
    15 / 131 (11.45%)
         occurrences all number
    28
    Neutropenia
         subjects affected / exposed
    37 / 131 (28.24%)
         occurrences all number
    90
    Thrombocytopenia
         subjects affected / exposed
    53 / 131 (40.46%)
         occurrences all number
    181
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    15 / 131 (11.45%)
         occurrences all number
    24
    Abdominal pain upper
         subjects affected / exposed
    9 / 131 (6.87%)
         occurrences all number
    11
    Constipation
         subjects affected / exposed
    39 / 131 (29.77%)
         occurrences all number
    65
    Diarrhoea
         subjects affected / exposed
    46 / 131 (35.11%)
         occurrences all number
    84
    Dyspepsia
         subjects affected / exposed
    12 / 131 (9.16%)
         occurrences all number
    14
    Nausea
         subjects affected / exposed
    76 / 131 (58.02%)
         occurrences all number
    246
    Stomatitis
         subjects affected / exposed
    14 / 131 (10.69%)
         occurrences all number
    36
    Vomiting
         subjects affected / exposed
    48 / 131 (36.64%)
         occurrences all number
    127
    Skin and subcutaneous tissue disorders
    Dry skin
         subjects affected / exposed
    8 / 131 (6.11%)
         occurrences all number
    8
    Night sweats
         subjects affected / exposed
    9 / 131 (6.87%)
         occurrences all number
    9
    Pruritus
         subjects affected / exposed
    12 / 131 (9.16%)
         occurrences all number
    13
    Rash
         subjects affected / exposed
    11 / 131 (8.40%)
         occurrences all number
    14
    Skin lesion
         subjects affected / exposed
    11 / 131 (8.40%)
         occurrences all number
    11
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    7 / 131 (5.34%)
         occurrences all number
    10
    Back pain
         subjects affected / exposed
    9 / 131 (6.87%)
         occurrences all number
    13
    Muscle spasms
         subjects affected / exposed
    12 / 131 (9.16%)
         occurrences all number
    14
    Myalgia
         subjects affected / exposed
    8 / 131 (6.11%)
         occurrences all number
    34
    Pain in extremity
         subjects affected / exposed
    7 / 131 (5.34%)
         occurrences all number
    8
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    7 / 131 (5.34%)
         occurrences all number
    10
    Oral candidiasis
         subjects affected / exposed
    7 / 131 (5.34%)
         occurrences all number
    8
    Upper respiratory tract infection
         subjects affected / exposed
    12 / 131 (9.16%)
         occurrences all number
    19
    Urinary tract infection
         subjects affected / exposed
    7 / 131 (5.34%)
         occurrences all number
    9
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    38 / 131 (29.01%)
         occurrences all number
    54
    Decreased appetite
         subjects affected / exposed
    12 / 131 (9.16%)
         occurrences all number
    16
    Hypokalaemia
         subjects affected / exposed
    14 / 131 (10.69%)
         occurrences all number
    17
    Hypomagnesaemia
         subjects affected / exposed
    9 / 131 (6.87%)
         occurrences all number
    11

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    14 Sep 2011
    Amendment provided for a reduced treatment and disease assessment schedule for patients on long-term therapy. Specifically, patients who continued maintenance dosing beyond Cycle 12 were to receive at least 2 doses per cycle through at least Cycle 24 and must have remained at this regimen for a minimum of 6 months prior to reduction to 1 dose per cycle. For patients who remained on study for more than 36 months (3 years), disease assessments could be reduced from every 2 cycles to every 4 cycles. For all patients, disease assessments were to be conducted at the time of study discontinuation or whenever progression of disease was suspected by clinical findings.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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