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    Clinical Trial Results:
    A randomized phase III study of standard treatment +/- enoxaparin in small cell lung cancer.

    Summary
    EudraCT number
    2007-006033-14
    Trial protocol
    SE   DK  
    Global end of trial date
    05 May 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Jul 2021
    First version publication date
    22 Jul 2021
    Other versions
    Summary report(s)
    Publication. Annals of Oncology

    Trial information

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    Trial identification
    Sponsor protocol code
    Version 10
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00717938
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Lund University Hospital
    Sponsor organisation address
    Getingevägen 4, Lund, Sweden, 221 85
    Public contact
    Jan Sundberg, Lund University Hospital, +46 46 17 70 34, jan.sundberg@skane.se
    Scientific contact
    Lars Ek, Lund University Hospital, +46 46 17 10 00, l.ek@icloud.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
    05 May 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    05 May 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    05 May 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective with the study was to evaluate treatment with chemotherapy with a platinum- and a topoisomeras inhibitor containing regimen versus treatment with the same chemotherapy with addition of low molecular weight heparin, in this case enoxaparin, comparing overall survival.
    Protection of trial subjects
    The study treatment (enoxaparin) was stopped permanently if one of the following occured: • In case of major bleeding, defined as a decrease in Hemoglobin > 20g/L or that leads to transfusion of two or more units of red blood cells. • Any bleeding intracranially. • If the patient developed deep venous thrombosis, pulmonary embolism or any other absolute indication for anticoagulant therapy such as LMWH or warfarine. • If a persistant decrease in platelets (< 50 x10 9/L) is observed and can not be explained by the chemotherapy, HIT (heparin induced thrombocytopenia) must be considered. • Any other reason at investigators discretion. • All patients undergone physical examination every third week.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    02 Apr 2008
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Sweden: 345
    Country: Number of subjects enrolled
    Denmark: 13
    Country: Number of subjects enrolled
    Canada: 32
    Worldwide total number of subjects
    390
    EEA total number of subjects
    358
    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)
    152
    From 65 to 84 years
    236
    85 years and over
    2

    Subject disposition

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    Recruitment
    Recruitment details
    Patients with newly diagnosed small cell lung cancer, suitable for chemotherapy treatment containing cisplatinum and a topoisemerasinhibitor for 4-6 cycles were screened for inclusion in the trial. Included patients were randomised between standard treatment (control arm, arm A) or chemotherapy with addition of enoxaparin, experimental arm.

    Pre-assignment
    Screening details
    Patients were screened for normal coagulation status, before entering the trial.

    Pre-assignment period milestones
    Number of subjects started
    390
    Number of subjects completed
    390

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Arm A (control arm)
    Arm description
    Standard chemotherapy including platinum- and a topoisomerase inhibitor for 4-6 cycles (cycle length 21 days), investigators choice, control arm.
    Arm type
    Active comparator

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solvent for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Was given every third week at a dose of 75 mg/m2.

    Investigational medicinal product name
    Karboplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Was given every third week at a dose of AUC 5.

    Investigational medicinal product name
    Irinotekan
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Was given every third week at a dose of 175 mg/m2.

    Investigational medicinal product name
    Etoposide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Was given every third week at a dose of 100 mg/m2.

    Investigational medicinal product name
    Etoposide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Was given every third week at a dose of 100 mg/m2.

    Investigational medicinal product name
    Topotekan
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Was given every third week at a dose of 1.5 mg/m2.

    Arm title
    Arm B (experimental arm)
    Arm description
    Standard chemotherapy including platinum- and a topoisomerase inhibitor for 4-6 cycles (cycle length 21 days), investigators choice, control arm, plus the addition of enoxaparine, 1 mg/kilogram bodyweigt, given daily subcutaneously during chemotherapy treatment.
    Arm type
    Experimental

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solvent for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Was given every third week at a dose of 75 mg/m2.

    Investigational medicinal product name
    Karboplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Was given every third week at a dose of AUC 5.

    Investigational medicinal product name
    Irinotekan
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Was given every third week at a dose of 175 mg/m2.

    Investigational medicinal product name
    Etoposide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Was given every third week at a dose of 100 mg/m2.

    Investigational medicinal product name
    Etoposide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Was given every third week at a dose of 100 mg/m2.

    Investigational medicinal product name
    Topotekan
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Was given every third week at a dose of 1.5 mg/m2.

    Investigational medicinal product name
    Klexane
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Was given in thde experimental arm once daily during chemotherpt, at a dose of 1 mg/kg bodyweight.

    Number of subjects in period 1
    Arm A (control arm) Arm B (experimental arm)
    Started
    195
    195
    Completed
    195
    195

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Arm A (control arm)
    Reporting group description
    Standard chemotherapy including platinum- and a topoisomerase inhibitor for 4-6 cycles (cycle length 21 days), investigators choice, control arm.

    Reporting group title
    Arm B (experimental arm)
    Reporting group description
    Standard chemotherapy including platinum- and a topoisomerase inhibitor for 4-6 cycles (cycle length 21 days), investigators choice, control arm, plus the addition of enoxaparine, 1 mg/kilogram bodyweigt, given daily subcutaneously during chemotherapy treatment.

    Reporting group values
    Arm A (control arm) Arm B (experimental arm) Total
    Number of subjects
    195 195 390
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    73 75 148
        From 65-84 years
    121 120 241
        85 years and over
    1 0 1
    Age continuous
    Units: years
        median (full range (min-max))
    68 (62 to 73) 68 (62 to 73) -
    Gender categorical
    Units: Subjects
        Female
    115 113 228
        Male
    80 82 162
    Subject analysis sets

    Subject analysis set title
    Overall trial
    Subject analysis set type
    Per protocol
    Subject analysis set description
    Overall survival was evaluated at time from randomisation to death of any cause.

    Subject analysis sets values
    Overall trial
    Number of subjects
    390
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    148
        From 65-84 years
    241
        85 years and over
    1
    Age continuous
    Units: years
        median (full range (min-max))
    68 (62 to 73)
    Gender categorical
    Units: Subjects
        Female
    228
        Male
    162

    End points

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    End points reporting groups
    Reporting group title
    Arm A (control arm)
    Reporting group description
    Standard chemotherapy including platinum- and a topoisomerase inhibitor for 4-6 cycles (cycle length 21 days), investigators choice, control arm.

    Reporting group title
    Arm B (experimental arm)
    Reporting group description
    Standard chemotherapy including platinum- and a topoisomerase inhibitor for 4-6 cycles (cycle length 21 days), investigators choice, control arm, plus the addition of enoxaparine, 1 mg/kilogram bodyweigt, given daily subcutaneously during chemotherapy treatment.

    Subject analysis set title
    Overall trial
    Subject analysis set type
    Per protocol
    Subject analysis set description
    Overall survival was evaluated at time from randomisation to death of any cause.

    Primary: Overall survival

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    End point title
    Overall survival
    End point description
    End point type
    Primary
    End point timeframe
    Survival duration is measured from the date of randomization to the date of death from any cause.
    End point values
    Arm A (control arm) Arm B (experimental arm) Overall trial
    Number of subjects analysed
    195
    195
    390
    Units: Months
        number (confidence interval 0.75%)
    195 (190 to 200)
    195 (190 to 200)
    390 (380 to 400)
    Statistical analysis title
    Survival analysis
    Comparison groups
    Arm A (control arm) v Arm B (experimental arm)
    Number of subjects included in analysis
    390
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.05
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -
         upper limit
    -

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From the day the patient was randomized in the trial until 30 days after last treatment.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE
    Dictionary version
    3.0
    Reporting groups
    Reporting group title
    All patients
    Reporting group description
    -

    Serious adverse events
    All patients
    Total subjects affected by serious adverse events
         subjects affected / exposed
    163 / 390 (41.79%)
         number of deaths (all causes)
    28
         number of deaths resulting from adverse events
    0
    Vascular disorders
    Bleeding
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 2
    Brain infarction
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac infarction
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombosis
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Detoriation general condition
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 2
    Fatigue
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Fever
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Pain
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnea
         subjects affected / exposed
    6 / 390 (1.54%)
         occurrences causally related to treatment / all
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    Pleural infection
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Obstructive lung disease
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    Pulmonary embolism
         subjects affected / exposed
    5 / 390 (1.28%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 2
    Respiratory failure
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences causally related to treatment / all
    0 / 377
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Increased creatinine
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Glucose increased
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypercalcemia
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypocalcemia
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypomagnesemia
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyponatremia
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Fracture
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac arrhythmia
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Headache
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Neuropathy
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Seizure
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anemia
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    16 / 390 (4.10%)
         occurrences causally related to treatment / all
    2 / 16
         deaths causally related to treatment / all
    2 / 2
    Hematemesis
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myelodysplastic syndrome unclassifiable
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Neutropenia
         subjects affected / exposed
    8 / 390 (2.05%)
         occurrences causally related to treatment / all
    1 / 8
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    4 / 390 (1.03%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Colon perforation
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Constipation
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Diarrhéa
         subjects affected / exposed
    10 / 390 (2.56%)
         occurrences causally related to treatment / all
    0 / 10
         deaths causally related to treatment / all
    0 / 0
    Esophagitis
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    8 / 390 (2.05%)
         occurrences causally related to treatment / all
    0 / 8
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Urinary retention
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Muscle weakness
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Infection
         subjects affected / exposed
    45 / 390 (11.54%)
         occurrences causally related to treatment / all
    0 / 45
         deaths causally related to treatment / all
    0 / 9
    Cystitis
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Herpesencephalitis
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Septic infection
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    1 / 1
    Pneumonia
         subjects affected / exposed
    4 / 390 (1.03%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 2
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    All patients
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    109 / 390 (27.95%)
    Vascular disorders
    Bleeding
         subjects affected / exposed
    4 / 390 (1.03%)
         occurrences all number
    4
    Pulmonary embolus
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Hypertension
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Hypotension
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Thrombosis
         subjects affected / exposed
    10 / 390 (2.56%)
         occurrences all number
    10
    Haematoma
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    4 / 390 (1.03%)
         occurrences all number
    4
    Chills
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Fatigue
         subjects affected / exposed
    5 / 390 (1.28%)
         occurrences all number
    5
    Fever
         subjects affected / exposed
    8 / 390 (2.05%)
         occurrences all number
    8
    Immune system disorders
    Allergy
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Pulmonary bleeding
         subjects affected / exposed
    11 / 390 (2.82%)
         occurrences all number
    11
    Bronkitis
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Coagh
         subjects affected / exposed
    7 / 390 (1.79%)
         occurrences all number
    7
    Dyspnea
         subjects affected / exposed
    16 / 390 (4.10%)
         occurrences all number
    16
    Pulmonary emphysema
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Epistaxis
         subjects affected / exposed
    9 / 390 (2.31%)
         occurrences all number
    9
    Haemoptysis
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Hypoxia
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Pulmonary infiltrates
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Voice changes
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    5 / 390 (1.28%)
         occurrences all number
    5
    Depression
         subjects affected / exposed
    6 / 390 (1.54%)
         occurrences all number
    6
    Hallucinations
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Insomnia
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences all number
    3
    Somnolence
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Investigations
    Creatinine increased
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences all number
    3
    Blood glucose increased
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Hypercalcemia
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Hypocalcemia
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Hypokalemia
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences all number
    3
    Hypomagnesemia
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences all number
    3
    Hyponatremia
         subjects affected / exposed
    10 / 390 (2.56%)
         occurrences all number
    10
    Increased ALAT
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Weight loss
         subjects affected / exposed
    7 / 390 (1.79%)
         occurrences all number
    7
    Injury, poisoning and procedural complications
    Dental injury
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Atrial fibrillation
         subjects affected / exposed
    4 / 390 (1.03%)
         occurrences all number
    4
    Cardiac arrest
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Cardiac arrythmia
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Cardiac failure
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Cardiac infarction
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Tachycardia
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Nervous system disorders
    Cerebral infarction
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Neuropathia
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Dizziness
         subjects affected / exposed
    9 / 390 (2.31%)
         occurrences all number
    9
    Headache
         subjects affected / exposed
    15 / 390 (3.85%)
         occurrences all number
    15
    Restless legs
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Seizure
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Speech impairment
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Syncope
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Transitorisk ischemisk attack
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Anemia
         subjects affected / exposed
    21 / 390 (5.38%)
         occurrences all number
    21
    Thrombocytopenia
         subjects affected / exposed
    13 / 390 (3.33%)
         occurrences all number
    13
    Ear and labyrinth disorders
    Decreased hearing
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences all number
    3
    Eye disorders
    Blurred vision
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Diplopia
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Dry eyes
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Eye pain
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Iritis
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    5 / 390 (1.28%)
         occurrences all number
    5
    Bleeding from ulcus ventriculi
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Rectal bleeding
         subjects affected / exposed
    3 / 390 (0.77%)
         occurrences all number
    3
    Colon rupture
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Constipation
         subjects affected / exposed
    10 / 390 (2.56%)
         occurrences all number
    10
    Diarréa
         subjects affected / exposed
    20 / 390 (5.13%)
         occurrences all number
    20
    Dysphagia
         subjects affected / exposed
    10 / 390 (2.56%)
         occurrences all number
    10
    Eosophagitis
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Epigastralgia
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Esophagitis
         subjects affected / exposed
    8 / 390 (2.05%)
         occurrences all number
    8
    Flatulence
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Fracture
         subjects affected / exposed
    5 / 390 (1.28%)
         occurrences all number
    5
    Gastritis
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Gastroenteritis
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Gastrointestinal bleeding
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Vomiting
         subjects affected / exposed
    10 / 390 (2.56%)
         occurrences all number
    10
    Stomatitis
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Taste alteration
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Bruising
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Dry skin
         subjects affected / exposed
    2 / 390 (0.51%)
         occurrences all number
    2
    Ecchymosis
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Pruritus
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Rash
         subjects affected / exposed
    6 / 390 (1.54%)
         occurrences all number
    6
    Urticaria
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Renal and urinary disorders
    Urinary urgency
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Musculoskeletal pain
         subjects affected / exposed
    19 / 390 (4.87%)
         occurrences all number
    19
    Back pain
         subjects affected / exposed
    7 / 390 (1.79%)
         occurrences all number
    7
    Cramps
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Hallux valgus
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Muscular weakness
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Infections and infestations
    Infection
         subjects affected / exposed
    13 / 390 (3.33%)
         occurrences all number
    13
    Caliciinfection
         subjects affected / exposed
    4 / 390 (1.03%)
         occurrences all number
    4
    Cystitis
         subjects affected / exposed
    6 / 390 (1.54%)
         occurrences all number
    6
    Epydidemitis
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Herpes zoster
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Respiratory tract infection
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Urinary tract infection
         subjects affected / exposed
    8 / 390 (2.05%)
         occurrences all number
    8
    Viral syndrome
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    1 / 390 (0.26%)
         occurrences all number
    1

    More information

    Close Top of page

    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    20 Mar 2009
    Addition of a substudy, in which analysis of circulating tumour cells in peripheral blood was performed. Participation in this substudy was not mandatory for the patient. A special written informed concent form was signed by the patient if he/she was willing to participate. Addition of a new site.
    15 Oct 2012
    Extended risk-benefit description

    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

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/29106448
    For support, Contact us.
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    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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