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    Clinical Trial Results:
    Cilengitide in subjects with newly diagnosed glioblastoma multiforme and unmethylated MGMT gene promoter - a multicenter, open-label Phase II study, investigating two cilengitide regimens in combination with standard treatment (temozolomide with concomitant radiation therapy, followed by temozolomide maintenance therapy) - CORE.

    Summary
    EudraCT number
    2008-004457-15
    Trial protocol
    CZ   IT   FR   HU   AT   ES  
    Global end of trial date
    01 Aug 2013

    Results information
    Results version number
    v2(current)
    This version publication date
    18 Sep 2017
    First version publication date
    26 Jul 2015
    Other versions
    v1
    Version creation reason
    • Correction of full data set
    Correction of full data set

    Trial information

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    Trial identification
    Sponsor protocol code
    EMD121974-012
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00813943
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Merck Serono
    Sponsor organisation address
    Frankfurter Str. 250, Darmstadt, Germany, 64293
    Public contact
    Communication Center, Merck KGaA , 49 6151725200, service@merckgroup.com
    Scientific contact
    Communication Center, Merck KGaA Communication Center, 49 6151725200, service@merckgroup.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
    01 Aug 2013
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    07 Feb 2013
    Global end of trial reached?
    Yes
    Global end of trial date
    01 Aug 2013
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To determine the safety and tolerability of a 5-day administration schedule of 2000 mg cilengitide given in combination with radiation therapy (RTX) and temozolomide (TMZ) standard treatment in the safety run-in part of the trial: To investigate the overall survival (OS) in subjects receiving 2 different regimens of 2000 mg cilengitide in combination with RTX and TMZ standard treatment in the randomized part of the trial:
    Protection of trial subjects
    In this trial highest medical and ethical standards were followed, in accordance with the principles laid down in the Declaration of Helsinki, and that are consistent with Good Clinical Practice and applicable regulations.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    06 Mar 2009
    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
    France: 20
    Country: Number of subjects enrolled
    Hungary: 13
    Country: Number of subjects enrolled
    Italy: 30
    Country: Number of subjects enrolled
    Czech Republic: 5
    Country: Number of subjects enrolled
    Poland: 49
    Country: Number of subjects enrolled
    Spain: 7
    Country: Number of subjects enrolled
    Austria: 3
    Country: Number of subjects enrolled
    Canada: 12
    Country: Number of subjects enrolled
    Serbia: 31
    Country: Number of subjects enrolled
    United States: 65
    Country: Number of subjects enrolled
    Korea, Democratic People's Republic of: 30
    Worldwide total number of subjects
    265
    EEA total number of subjects
    127
    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)
    218
    From 65 to 84 years
    47
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    First/last subject (informed consent): Mar 2009/Sep 2011. Clinical data cut-off: 07 Feb 2013, Study completion date: Aug 2013.

    Pre-assignment
    Screening details
    Enrolled: 294 screened for eligibility; 29 excluded (mainly due to non-fulfillment of inclusion or exclusion criteria), 265 subjects randomized.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Cilengitide (2-times weekly) + Temozolomide + Radiotherapy
    Arm description
    Cilengitide 2000 milligram (mg) twice weekly over 1 hour intravenous infusion from Weeks -1 to 77, Temozolomide (TMZ) 75 milligram per square meter [mg/m^2] intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and radiotherapy (RTX) at a dose of 2 Gray (Gy) per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason. Continuation of cilengitide treatment after Week 77 was optional in subjects without disease progression, If considered beneficial in the opinion of the Investigator.
    Arm type
    Experimental

    Investigational medicinal product name
    Cilengitide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Cilengitide 2000 milligram (mg) will be administered intravenously twice weekly over 1 hour infusion from Weeks -1 to 77 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason. If considered beneficial in the opinion of the Investigator, continuation of cilengitide treatment will be optional in subjects without disease progression and after Week 77 since start of treatment.

    Investigational medicinal product name
    Temozolomide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Temozolomide (TMZ) 75 milligram per square meter [mg/m^2] will be administered intravenously once daily from Week 1 to 6. From Week 11 onwards, TMZ will be given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 or until disease progression.

    Investigational medicinal product name
    Radiotherapy
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Radiopharmaceutical precursor, solution
    Routes of administration
    Route of administration not applicable
    Dosage and administration details
    Radiation therapy (RTX) at a dose of 2 gray (Gy) per fraction will be given once daily, 5 days per week from Week 1 to 6, total dose 60 Gy.

    Arm title
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy
    Arm description
    Cilengitide 2000 mg 5-times weekly over 1 hour intravenous infusion from Weeks -1 to 77, TMZ 75 mg/m^2 intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and RTX at a dose of 2 Gy per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason. Continuation of cilengitide treatment after Week 77 was optional in subjects without disease progression, If considered beneficial in the opinion of the Investigator.
    Arm type
    Experimental

    Investigational medicinal product name
    Cilengitide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Cilengitide 2000 mg 5-times weekly over 1 hour intravenous infusion from Weeks -1 to 77

    Investigational medicinal product name
    Temozolomide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    TMZ 75 mg/m^2 intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34.

    Investigational medicinal product name
    Radiotherapy
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Radiopharmaceutical precursor, solution
    Routes of administration
    Route of administration not applicable
    Dosage and administration details
    RTX at a dose of 2 Gy per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason.

    Arm title
    Temozolomide + Radiotherapy
    Arm description
    TMZ 75 mg/m^2 administered intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and RTX at a dose of 2 Gy per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason.
    Arm type
    Active comparator

    Investigational medicinal product name
    Cilengitide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    TMZ 75 mg/m^2 administered intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34.

    Investigational medicinal product name
    Radiotherapy
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Radiopharmaceutical precursor, solution
    Routes of administration
    Intravenous use
    Dosage and administration details
    RTX at a dose of 2 Gy per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason.

    Number of subjects in period 1
    Cilengitide (2-times weekly) + Temozolomide + Radiotherapy Cilengitide (5-times weekly) + Temozolomide + Radiotherapy Temozolomide + Radiotherapy
    Started
    88
    88
    89
    Completed
    83
    83
    86
    Not completed
    5
    5
    3
         Ongoing at cut-off date
    5
    5
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Cilengitide (2-times weekly) + Temozolomide + Radiotherapy
    Reporting group description
    Cilengitide 2000 milligram (mg) twice weekly over 1 hour intravenous infusion from Weeks -1 to 77, Temozolomide (TMZ) 75 milligram per square meter [mg/m^2] intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and radiotherapy (RTX) at a dose of 2 Gray (Gy) per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason. Continuation of cilengitide treatment after Week 77 was optional in subjects without disease progression, If considered beneficial in the opinion of the Investigator.

    Reporting group title
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy
    Reporting group description
    Cilengitide 2000 mg 5-times weekly over 1 hour intravenous infusion from Weeks -1 to 77, TMZ 75 mg/m^2 intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and RTX at a dose of 2 Gy per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason. Continuation of cilengitide treatment after Week 77 was optional in subjects without disease progression, If considered beneficial in the opinion of the Investigator.

    Reporting group title
    Temozolomide + Radiotherapy
    Reporting group description
    TMZ 75 mg/m^2 administered intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and RTX at a dose of 2 Gy per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason.

    Reporting group values
    Cilengitide (2-times weekly) + Temozolomide + Radiotherapy Cilengitide (5-times weekly) + Temozolomide + Radiotherapy Temozolomide + Radiotherapy Total
    Number of subjects
    88 88 89 265
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    54.6 ± 9.63 55.2 ± 10.44 54.5 ± 11.64 -
    Gender categorical
    Units: Subjects
        Female
    38 38 34 110
        Male
    50 50 55 155

    End points

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    End points reporting groups
    Reporting group title
    Cilengitide (2-times weekly) + Temozolomide + Radiotherapy
    Reporting group description
    Cilengitide 2000 milligram (mg) twice weekly over 1 hour intravenous infusion from Weeks -1 to 77, Temozolomide (TMZ) 75 milligram per square meter [mg/m^2] intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and radiotherapy (RTX) at a dose of 2 Gray (Gy) per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason. Continuation of cilengitide treatment after Week 77 was optional in subjects without disease progression, If considered beneficial in the opinion of the Investigator.

    Reporting group title
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy
    Reporting group description
    Cilengitide 2000 mg 5-times weekly over 1 hour intravenous infusion from Weeks -1 to 77, TMZ 75 mg/m^2 intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and RTX at a dose of 2 Gy per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason. Continuation of cilengitide treatment after Week 77 was optional in subjects without disease progression, If considered beneficial in the opinion of the Investigator.

    Reporting group title
    Temozolomide + Radiotherapy
    Reporting group description
    TMZ 75 mg/m^2 administered intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and RTX at a dose of 2 Gy per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason.

    Subject analysis set title
    Safety Analysis Set (SAF)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Safety population included all subjects who received any dose of study treatment that is Cilengitide, Temozolomide or Radiotherapy. 1 subject who was randomized to cilengitide 5-times weekly, but who actually received Cilengitide 2-times weekly was allocated to the cilengitide 2-times weekly treatment group for the safety population.

    Subject analysis set title
    Cilengitide (2-times weekly) + Temozolomide + Radiotherapy-SAF
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Cilengitide 2000 milligram (mg) twice weekly over 1 hour intravenous infusion from Weeks -1 to 77, Temozolomide (TMZ) 75 milligram per square meter [mg/m^2] intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and radiotherapy (RTX) at a dose of 2 Gray (Gy) per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason. Continuation of cilengitide treatment after Week 77 was optional in subjects without disease progression, If considered beneficial in the opinion of the Investigator.

    Subject analysis set title
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy-SAF
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Cilengitide 2000 mg 5-times weekly over 1 hour intravenous infusion from Weeks -1 to 77, TMZ 75 mg/m^2 intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and RTX at a dose of 2 Gy per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason. Continuation of cilengitide treatment after Week 77 was optional in subjects without disease progression, If considered beneficial in the opinion of the Investigator.

    Subject analysis set title
    Temozolomide + Radiotherapy-SAF
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    TMZ 75 mg/m^2 administered intravenously once daily from Weeks 1 to 6, from Week 11 onward, TMZ was given as maintenance treatment at a dose of 150-200 mg/m^2 for consecutive 5 days every 4 weeks until Week 34 and RTX at a dose of 2 Gy per fraction once daily, 5 days per week from Weeks 1 to 6 or until occurrence of progressive disease, unacceptable toxicity, or withdrawal for any other reason. Safety population included all subjects who received any dose of study treatment that is Cilengitide, Temozolomide or Radiotherapy. 1 subject who was randomized to cilengitide 5-times weekly, but who actually received Cilengitide 2-times weekly was allocated to the cilengitide 2-times weekly treatment group for the safety population.

    Primary: Overall survival (OS) time

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    End point title
    Overall survival (OS) time
    End point description
    The OS time was defined as the time (in months) from randomization to death or last day known to be alive. Subjects without event were censored at the last date known to be alive or at the clinical cut-off date, whatever was earlier. ITT population included all the participants who were randomized to study treatment.
    End point type
    Primary
    End point timeframe
    Time from randomization to death or last day known to be alive, reported between day of first subject randomized, that was, Jun 2009 until cut-off date, (07 Feb 2013)
    End point values
    Cilengitide (2-times weekly) + Temozolomide + Radiotherapy Cilengitide (5-times weekly) + Temozolomide + Radiotherapy Temozolomide + Radiotherapy
    Number of subjects analysed
    88
    88
    89
    Units: Months
        median (confidence interval 95%)
    16.3 (13.2 to 18.1)
    14.5 (12.6 to 16.5)
    13.4 (12.2 to 14.3)
    Statistical analysis title
    Statistical Analysis 1 for Overall Survival Time
    Comparison groups
    Temozolomide + Radiotherapy v Cilengitide (2-times weekly) + Temozolomide + Radiotherapy
    Number of subjects included in analysis
    177
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0328
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.686
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.484
         upper limit
    0.972
    Statistical analysis title
    Statistical Analysis 2 for Overall Survival Time
    Comparison groups
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy v Temozolomide + Radiotherapy
    Number of subjects included in analysis
    177
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.3771
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.858
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.612
         upper limit
    1.204

    Secondary: Progression free survival (PFS) time - investigator and independent read

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    End point title
    Progression free survival (PFS) time - investigator and independent read
    End point description
    The PFS time was defined as the duration from randomization to either first observation of progressive disease (PD) or occurrence of death due to any cause. Investigator read was the assessment of all imaging by the treating physician at the local trial site. Independent Read was the assessment of all imaging centrally by an Independent Review Committee (IRC). ITT population included all the participants who were randomized to study treatment.
    End point type
    Secondary
    End point timeframe
    Time from randomization to disease progression, death or last tumor assessment, reported between day of first subject randomized, that was, Jun 2009 until cut-off date, (07 Feb 2013).
    End point values
    Cilengitide (2-times weekly) + Temozolomide + Radiotherapy Cilengitide (5-times weekly) + Temozolomide + Radiotherapy Temozolomide + Radiotherapy
    Number of subjects analysed
    88
    88
    89
    Units: Months
    median (confidence interval 95%)
        PFS Time: Independent read
    5.6 (3.6 to 5.9)
    5.9 (4.2 to 7.6)
    4.1 (3.7 to 4.7)
        PFS Time: Investigator read
    6.4 (4.2 to 7.9)
    7.5 (5.9 to 8.2)
    6 (4.1 to 7.7)
    No statistical analyses for this end point

    Secondary: Maximum observed plasma concentration (Cmax)

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    End point title
    Maximum observed plasma concentration (Cmax) [1]
    End point description
    The Cmax for cilengitide was calculated by non-compartmental analysis using the computer program WinNonlin, Version 6.2. Cilengitide plasma concentrations were determined after dosing on Day 1 (single dose) and Day 5 (repeated doses) of Week 1.
    End point type
    Secondary
    End point timeframe
    Days 1 and 5 of Week 1
    Notes
    [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Only "Cilengitide (5-times) + Temozolomide + Radiotherapy" group was analyzed for this outcome measure as per planned analysis
    End point values
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy
    Number of subjects analysed
    11 [2]
    Units: nanogram per milliliter
    arithmetic mean (standard deviation)
        Day 1
    108527 ± 27197
        Day 5
    150873 ± 97220
    Notes
    [2] - N' (number of participants analyzed) signifies those participants who were evaluable for this OM
    No statistical analyses for this end point

    Secondary: Time to maximum plasma concentration (Tmax) and terminal elimination half-life (t1/2)

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    End point title
    Time to maximum plasma concentration (Tmax) and terminal elimination half-life (t1/2) [3]
    End point description
    The Tmax and t1/2 for cilengitide were calculated by non-compartmental analysis using the computer program WinNonlin, Version 6.2. Cilengitide plasma concentrations were determined after dosing on Day 1 (single dose) and Day 5 (repeated doses) of Week 1.
    End point type
    Secondary
    End point timeframe
    Days 1 and 5 of Week 1
    Notes
    [3] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Only "Cilengitide (5-times) + Temozolomide + Radiotherapy" group was analyzed for this outcome measure as per planned analysis
    End point values
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy
    Number of subjects analysed
    11 [4]
    Units: hours
    arithmetic mean (standard deviation)
        Tmax: Day 1 (Single dose)
    0.97 ± 0.34
        Tmax: Day 5 (Repeated doses)
    1.17 ± 0.34
        t1/2: Day 1 (Single dose)
    2.38 ± 0.8
        t1/2: Day 5 (Repeated doses)
    2.44 ± 0.8
    Notes
    [4] - N' (number of participants analyzed) signifies those participants who were evaluable for this OM
    No statistical analyses for this end point

    Secondary: Area under the plasma concentration-time curve from time 0 to infinity (AUC [0-infinity]) and area under the plasma concentration-time curve from time 0 to 24 hours (AUC [0-24])

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    End point title
    Area under the plasma concentration-time curve from time 0 to infinity (AUC [0-infinity]) and area under the plasma concentration-time curve from time 0 to 24 hours (AUC [0-24]) [5]
    End point description
    The AUC (0-infinity) and AUC (0-24) for cilengitide were calculated by non-compartmental analysis using the computer program WinNonlin, Version 6.2. Cilengitide plasma concentrations were determined after dosing on Day 1 (single dose) and Day 5 (repeated doses) of Week 1.
    End point type
    Secondary
    End point timeframe
    Days 1 and 5 of Week 1
    Notes
    [5] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Only "Cilengitide (5-times) + Temozolomide + Radiotherapy" group was analyzed for this outcome measure as per planned analysis
    End point values
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy
    Number of subjects analysed
    11 [6]
    Units: hour*ng/mL
    arithmetic mean (standard deviation)
        AUC (0-infinity): Day 1 (Single dose)
    280944 ± 75720
        AUC (0-infinity): Day 5 (Repeated Doses)
    335263 ± 105435
        AUC (0-24): Day 1 (Single dose)
    269941 ± 82850
        AUC (0-24): Day 5 (Repeated doses)
    316137 ± 110425
    Notes
    [6] - N' (number of participants analyzed) signifies those participants who were evaluable for this OM
    No statistical analyses for this end point

    Secondary: Plasma concentration at pre-dose (Cpre) and plasma concentration at end of infusion (CT)

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    End point title
    Plasma concentration at pre-dose (Cpre) and plasma concentration at end of infusion (CT) [7]
    End point description
    The Cpre and CT for cilengitide were calculated by non-compartmental analysis using the computer program WinNonlin, Version 6.2. Cilengitide plasma concentrations were determined after dosing on Day 1 (single dose) and Day 5 (repeated doses) of Week 1
    End point type
    Secondary
    End point timeframe
    Days 1 and 5 of Week 1
    Notes
    [7] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Only "Cilengitide (5-times) + Temozolomide + Radiotherapy" group was analyzed for this outcome measure as per planned analysis
    End point values
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy
    Number of subjects analysed
    11 [8]
    Units: ng/mL
    arithmetic mean (standard deviation)
        Cpre: Day 1 (Single dose)
    6372.7 ± 21135.95
        Cpre: Day 5 (Repeated doses)
    286 ± 319.05
        CT: Day 1 (Single dose)
    108045.5 ± 27981.04
        CT: Day 5 (Repeated doses)
    157470 ± 99849.26
    Notes
    [8] - N' (number of participants analyzed) signifies those participants who were evaluable for this OM
    No statistical analyses for this end point

    Secondary: Apparent terminal rate constant

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    End point title
    Apparent terminal rate constant [9]
    End point description
    The apparent terminal rate constant for cilengitide was calculated by non-compartmental analysis using the computer program WinNonlin, Version 6.2. Cilengitide plasma concentrations were determined after dosing on Day 1 (single dose) and Day 5 (repeated doses) of Week 1.
    End point type
    Secondary
    End point timeframe
    Days 1 and 5 of Week 1
    Notes
    [9] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Only "Cilengitide (5-times) + Temozolomide + Radiotherapy" group was analyzed for this outcome measure as per planned analysis
    End point values
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy
    Number of subjects analysed
    11 [10]
    Units: Per hour
    arithmetic mean (standard deviation)
        Day 1 (Single dose)
    0.32 ± 0.11
        Day 5 (Repeated doses)
    0.32 ± 0.11
    Notes
    [10] - Number of participants analyzed signifies those who were evaluable for this outcome measures.
    No statistical analyses for this end point

    Secondary: Mean residence time from time 0 to infinity (MRT [0-infinity])

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    End point title
    Mean residence time from time 0 to infinity (MRT [0-infinity]) [11]
    End point description
    The MRT (0-infinity) for cilengitide was calculated by non-compartmental analysis using the computer program WinNonlin, Version 6.2. Cilengitide plasma concentrations were determined after dosing on Day 1 (single dose) and Day 5 (repeated doses) of Week 1.
    End point type
    Secondary
    End point timeframe
    Days 1 and 5 of Week 1
    Notes
    [11] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Only "Cilengitide (5-times) + Temozolomide + Radiotherapy" group was analyzed for this outcome measure as per planned analysis
    End point values
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy
    Number of subjects analysed
    11 [12]
    Units: hour
    arithmetic mean (standard deviation)
        Day 1 (Single dose)
    2.8 ± 0.71
        Day 5 (Repeated doses)
    2.9 ± 0.97
    Notes
    [12] - N' (number of participants analyzed) signifies those participants who were evaluable for this OM
    No statistical analyses for this end point

    Secondary: Plasma clearance (CL)

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    End point title
    Plasma clearance (CL) [13]
    End point description
    The CL for cilengitide was calculated by non-compartmental analysis using the computer program WinNonlin, Version 6.2. Cilengitide plasma concentrations were determined after dosing on Day 1 (single dose) and Day 5 (repeated doses) of Week 1.
    End point type
    Secondary
    End point timeframe
    Days 1 and 5 of Week 1
    Notes
    [13] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Only "Cilengitide (5-times) + Temozolomide + Radiotherapy" group was analyzed for this outcome measure as per planned analysis
    End point values
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy
    Number of subjects analysed
    11 [14]
    Units: milliliter per minute
    arithmetic mean (standard deviation)
        Day 1 (Single dose)
    125.7 ± 29.93
        Day 5 (Repeated doses)
    109.3 ± 36.61
    Notes
    [14] - N' (number of participants analyzed) signifies those participants who were evaluable for this OM
    No statistical analyses for this end point

    Secondary: Apparent volume of distribution during the terminal phase (Vz) and apparent volume of distribution at steady state (Vss)

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    End point title
    Apparent volume of distribution during the terminal phase (Vz) and apparent volume of distribution at steady state (Vss) [15]
    End point description
    The Vz (after single dose) and Vss (after repeated doses) for cilengitide were calculated by non-compartmental analysis using the computer program WinNonlin, Version 6.2. Cilengitide plasma concentrations were determined after dosing on Day 1 (single dose) and Day 5 (repeated doses) of Week 1.
    End point type
    Secondary
    End point timeframe
    Days 1 and 5 of Week 1
    Notes
    [15] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Only "Cilengitide (5-times) + Temozolomide + Radiotherapy" group was analyzed for this outcome measure as per planned analysis
    End point values
    Cilengitide (5-times weekly) + Temozolomide + Radiotherapy
    Number of subjects analysed
    11 [16]
    Units: liter
    arithmetic mean (standard deviation)
        Vz
    24.7 ± 6.29
        Vss
    19.2 ± 8.54
    Notes
    [16] - N' (number of participants analyzed) signifies those participants who were evaluable for this OM
    No statistical analyses for this end point

    Secondary: Number of subjects with adverse events (AEs), serious AEs, treatment-Related AEs, Treatment-Related Serious AEs, AEs leading to death, treatment-related AEs leading to death, AEs of Grade 3 or 4 and treatment-related AEs of Grade 3 or 4

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    End point title
    Number of subjects with adverse events (AEs), serious AEs, treatment-Related AEs, Treatment-Related Serious AEs, AEs leading to death, treatment-related AEs leading to death, AEs of Grade 3 or 4 and treatment-related AEs of Grade 3 or 4
    End point description
    An AE was defined as any new untoward medical occurrences/worsening of pre-existing medical condition without regard to possibility of causal relationship. Treatment-emergent AEs are the events between first dose of study drug and up to 28 days after last dose of study treatment. A serious AE was an AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect. Treatment-related AEs were the AEs which were suspected to be reasonably related to the study treatment (cilengitide, or radiotherapy, or temozolomide) as per investigator assessment. The severity of AEs was assessed according to the National Cancer Institute-Common Toxicity Criteria (NCI-CTCAE) (Version 3.0): Grade 1=mild, Grade 2=moderate, Grade 3=severe, Grade 4=life threatening or disabling. Note: Death (Grade 5) was regarded as an outcome.
    End point type
    Secondary
    End point timeframe
    Time from first dose up to 28 days after last dose of study treatment, reported between day of first participant randomized, that was, Jun 2009 until cut-off date (07 Feb 2013).
    End point values
    Cilengitide (2-times weekly) + Temozolomide + Radiotherapy-SAF Cilengitide (5-times weekly) + Temozolomide + Radiotherapy-SAF Temozolomide + Radiotherapy-SAF
    Number of subjects analysed
    89
    81
    85
    Units: Participants
        AEs
    88
    80
    82
        Serious AEs
    47
    36
    30
        Treatment-related AEs
    70
    64
    56
        Treatment-related serious AEs
    13
    4
    5
        AEs leading to death
    8
    8
    5
        Treatment-related AEs leading to death
    2
    2
    1
        AEs of Grade 3 or 4
    57
    47
    45
        Treatment-related AEs of Grade 3 or 4
    25
    19
    17
    No statistical analyses for this end point

    Secondary: Number of subjects with AEs belonging to Standardized Medical Dictionary for Regulatory Activities (MedDRA) Queries (SMQs) thromboembolic events and haemorrhage With NCI−CTC Toxicity Grade 3 or 4

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    End point title
    Number of subjects with AEs belonging to Standardized Medical Dictionary for Regulatory Activities (MedDRA) Queries (SMQs) thromboembolic events and haemorrhage With NCI−CTC Toxicity Grade 3 or 4
    End point description
    Thromboembolic events (standardized MedDRA query [SMQ]) Grade 3 or 4 AEs encompassed hemiparesis and cerebrovascular accident, pulmonary embolism, and deep vein thrombosis. Thromboembolic events (SMQ) of any grade and of Grade 3 or 4 were generally more frequent in the Cilengitide + Temozolomide/Radiotherapy group than in the Temozolomide/Radiotherapy group but were still in the expected range of this patient population The severity of AEs was assessed according to the National Cancer Institute-Common Toxicity Criteria (NCI-CTCAE) (version 3.0): Grade 1=mild, Grade 2=moderate, Grade 3=severe, Grade 4=life threatening or disabling. Note: Death (Grade 5) was regarded as an outcome.
    End point type
    Secondary
    End point timeframe
    Time from first dose up to 28 days after last dose of study treatment, reported between day of first participant randomized, that was, Jun 2009 until cut-off date (07 Feb 2013)
    End point values
    Cilengitide (2-times weekly) + Temozolomide + Radiotherapy-SAF Cilengitide (5-times weekly) + Temozolomide + Radiotherapy-SAF Temozolomide + Radiotherapy-SAF
    Number of subjects analysed
    89
    81
    85
    Units: Participants
        SMQ: Thromboembolic events
    17
    10
    12
        SMQ:Hemorrhage
    3
    0
    1
    No statistical analyses for this end point

    Secondary: Number of subjects with clinically significant abnormal electrocardiogram (ECG) and lab parameters

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    End point title
    Number of subjects with clinically significant abnormal electrocardiogram (ECG) and lab parameters
    End point description
    Any clinically significant abnormal ECG and lab finding was planned to be reported as AE only so they have been captured in the below mentioned adverse event section
    End point type
    Secondary
    End point timeframe
    Time from first dose up to 28 days after last dose of study treatment, reported between day of first subject randomized, that was, Jun 2009 until cut-off date (07 Feb 2013).
    End point values
    Cilengitide (2-times weekly) + Temozolomide + Radiotherapy-SAF Cilengitide (5-times weekly) + Temozolomide + Radiotherapy-SAF Temozolomide + Radiotherapy-SAF
    Number of subjects analysed
    0 [17]
    0 [18]
    0 [19]
    Units: Participants
        Abnormal ECG
        Abnormal Laboratory values
    Notes
    [17] - As stated in the end point description, this outcome measure was not evaluated.
    [18] - As stated in the end point description, this outcome measure was not evaluated.
    [19] - As stated in the end point description, this outcome measure was not evaluated.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Time from first dose up to 28 days after last dose of study treatment, reported between day of first participant randomized, that is, Jun 2009 until cut-off date (07 Feb 2013)
    Adverse event reporting additional description
    Safety population included all participants who received any dose of study treatment that is Cilengitide, Temozolomide or Radiotherapy. 1 participant who was randomized to cilengitide 5-times weekly, but who actually received Cilengitide 2-times weekly was allocated to the cilengitide 2-times weekly treatment group for the safety population
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    15
    Reporting groups
    Reporting group title
    Cilengitide twice a week + Temozolomide + Radiotherapy
    Reporting group description
    In Group A, 2000 mg cilengitide will be administered twice weekly by i.v. infusion throughout the study. Treatment will start 1 week prior to RTX and TMZ standard treatment (Week -1), i.e. as single agent. During Weeks 1-6, cilengitide will be administered in combination with RTX and TMZ and for a further 6 cycles (Week 7-34) in combination with TMZ maintenance treatment, according to the RTX and TMZ standard treatment. After completion of RTX and TMZ standard treatment, subjects continue receiving 2000 mg cilengitide i.v. 2x/week as maintenance for another 10 months.

    Reporting group title
    Cilengitide 5 times a week + Temozolomide + Radiotherapy
    Reporting group description
    In Group B, treatment with cilengitide as twice weekly i.v. infusion of 2000 mg per infusion will start 1 week prior to RTX and TMZ standard treatment (Week -1), i.e. as single agent. Thereafter, during combination with RTX and TMZ (Weeks 1-6), subjects will receive 2000 mg cilengitide i.v. 5x/week on days of RTX. After this 6-week intense treatment, subjects will receive 2000 mg cilengitide i.v. 2x/week in combination with TMZ maintenance treatment for a further 6 cycles (Week 7-34). After completion of RTX and TMZ standard treatment, subjects continue receiving 2000 mg cilengitide i.v. 2x/week as maintenance for another 10 months.

    Reporting group title
    Temozolomide + Radiotherapy
    Reporting group description
    Subjects in Group C will not receive cilengitide during the study.

    Serious adverse events
    Cilengitide twice a week + Temozolomide + Radiotherapy Cilengitide 5 times a week + Temozolomide + Radiotherapy Temozolomide + Radiotherapy
    Total subjects affected by serious adverse events
         subjects affected / exposed
    47 / 89 (52.81%)
    36 / 81 (44.44%)
    30 / 85 (35.29%)
         number of deaths (all causes)
    65
    61
    67
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    NEOPLASM RECURRENCE
         subjects affected / exposed
    2 / 89 (2.25%)
    2 / 81 (2.47%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    NEOPLASM PROGRESSION
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    BRAIN STEM GLIOMA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    BRAIN NEOPLASM MALIGNANT
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HEAVY CHAIN DISEASE
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    NEOPLASMS BENIGN, MALIGNANT AND UNSPECIFIED #(INCL CYSTS AND POLYPS)
         subjects affected / exposed
    5 / 89 (5.62%)
    3 / 81 (3.70%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    Vascular disorders
    THROMBOSIS
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HYPOTENSION
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HAEMATOMA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    DEEP VEIN THROMBOSIS
         subjects affected / exposed
    4 / 89 (4.49%)
    1 / 81 (1.23%)
    3 / 85 (3.53%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    HYPERTENSION
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    VENOUS THROMBOSIS
         subjects affected / exposed
    1 / 89 (1.12%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    ASTHENIA
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    CHEST DISCOMFORT
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    CONDITION AGGRAVATED
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    DEVICE MALFUNCTION
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    DISEASE PROGRESSION
         subjects affected / exposed
    2 / 89 (2.25%)
    2 / 81 (2.47%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    FATIGUE
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    2 / 85 (2.35%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    GENERAL PHYSICAL HEALTH DETERIORATION
         subjects affected / exposed
    2 / 89 (2.25%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    TERMINAL STATE
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    PYREXIA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    3 / 85 (3.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    NON-CARDIAC CHEST PAIN
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    GENERALISED OEDEMA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    GAIT DISTURBANCE
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    GENERAL DISORDERS AND ADMINISTRATION SITE #CONDITIONS
         subjects affected / exposed
    9 / 89 (10.11%)
    3 / 81 (3.70%)
    8 / 85 (9.41%)
         occurrences causally related to treatment / all
    1 / 9
    0 / 3
    1 / 8
         deaths causally related to treatment / all
    0 / 3
    0 / 1
    0 / 1
    Social circumstances
    SOCIAL STAY HOSPITALISATION
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    DYSPNOEA
         subjects affected / exposed
    2 / 89 (2.25%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HAEMOPTYSIS
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    PULMONARY EMBOLISM
         subjects affected / exposed
    9 / 89 (10.11%)
    2 / 81 (2.47%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    3 / 9
    1 / 2
    0 / 1
         deaths causally related to treatment / all
    1 / 1
    1 / 1
    0 / 1
    PNEUMONIA ASPIRATION
         subjects affected / exposed
    2 / 89 (2.25%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HYPOXIA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    MEDIASTINAL HAEMORRHAGE
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    LUNG DISORDER
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    PLEURAL EFFUSION
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    MENTAL STATUS CHANGES
         subjects affected / exposed
    1 / 89 (1.12%)
    1 / 81 (1.23%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    INSOMNIA
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    PSYCHOTIC DISORDER
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Investigations
    AMYLASE INCREASED
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    WHITE BLOOD CELL COUNT DECREASED
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    PLATELET COUNT DECREASED
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    2 / 85 (2.35%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    FIBRIN D DIMER INCREASED
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    LIPASE INCREASED
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HEPATIC ENZYME INCREASED
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    NEUTROPHIL COUNT DECREASED
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    SPINAL COMPRESSION FRACTURE
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    ATRIAL FIBRILLATION
         subjects affected / exposed
    2 / 89 (2.25%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    ACUTE MYOCARDIAL INFARCTION
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    BRADYCARDIA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    BUNDLE BRANCH BLOCK RIGHT
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    PULSELESS ELECTRICAL ACTIVITY
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    CARDIAC FAILURE CONGESTIVE
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    CARDIAC FAILURE
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Nervous system disorders
    CONVULSION
         subjects affected / exposed
    5 / 89 (5.62%)
    7 / 81 (8.64%)
    3 / 85 (3.53%)
         occurrences causally related to treatment / all
    0 / 5
    2 / 7
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    COGNITIVE DISORDER
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    APHASIA
         subjects affected / exposed
    0 / 89 (0.00%)
    2 / 81 (2.47%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    CEREBRAL CYST
         subjects affected / exposed
    0 / 89 (0.00%)
    3 / 81 (3.70%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    BRAIN OEDEMA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    2 / 85 (2.35%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    CEREBRAL VENTRICLE DILATATION
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HEADACHE
         subjects affected / exposed
    1 / 89 (1.12%)
    1 / 81 (1.23%)
    3 / 85 (3.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HAEMORRHAGE INTRACRANIAL
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    DYSARTHRIA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    EPILEPSY
         subjects affected / exposed
    4 / 89 (4.49%)
    2 / 81 (2.47%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    DYSKINESIA
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    GRAND MAL CONVULSION
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    PARTIAL SEIZURES
         subjects affected / exposed
    1 / 89 (1.12%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    NEUROLOGICAL DECOMPENSATION
         subjects affected / exposed
    0 / 89 (0.00%)
    3 / 81 (3.70%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    HEMIANOPIA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HYDROCEPHALUS
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HEMIPARESIS
         subjects affected / exposed
    4 / 89 (4.49%)
    3 / 81 (3.70%)
    5 / 85 (5.88%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 3
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    MOTOR DYSFUNCTION
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    PYRAMIDAL TRACT SYNDROME
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    SOMNOLENCE
         subjects affected / exposed
    2 / 89 (2.25%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    RADICULAR PAIN
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    UNRESPONSIVE TO STIMULI
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    ANAEMIA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    THROMBOCYTOPENIA
         subjects affected / exposed
    2 / 89 (2.25%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    PANCYTOPENIA
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    1 / 1
    NEUTROPENIA
         subjects affected / exposed
    1 / 89 (1.12%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    FEBRILE NEUTROPENIA
         subjects affected / exposed
    1 / 89 (1.12%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Eye disorders
    RETINAL ARTERY EMBOLISM
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    DIARRHOEA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    NAUSEA
         subjects affected / exposed
    1 / 89 (1.12%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    DYSPHAGIA
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    FOOD POISONING
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    LARGE INTESTINE PERFORATION
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    RETROPERITONEAL HAEMORRHAGE
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    VOMITING
         subjects affected / exposed
    2 / 89 (2.25%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    TOXIC SKIN ERUPTION
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    URINARY INCONTINENCE
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    RENAL FAILURE ACUTE
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    NEPHROTIC SYNDROME
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    OLIGURIA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    MUSCULAR WEAKNESS
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    BACTERIAL SEPSIS
         subjects affected / exposed
    0 / 89 (0.00%)
    0 / 81 (0.00%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    MENINGITIS
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    HERPES ZOSTER
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    GASTROENTERITIS
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    BRONCHITIS
         subjects affected / exposed
    1 / 89 (1.12%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    STAPHYLOCOCCAL INFECTION
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    STAPHYLOCOCCAL BACTERAEMIA
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    PNEUMONIA
         subjects affected / exposed
    2 / 89 (2.25%)
    0 / 81 (0.00%)
    2 / 85 (2.35%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    PNEUMOCYSTIS JIROVECI PNEUMONIA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    NASOPHARYNGITIS
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    HYPOVOLAEMIA
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HYPONATRAEMIA
         subjects affected / exposed
    0 / 89 (0.00%)
    1 / 81 (1.23%)
    1 / 85 (1.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HYPERGLYCAEMIA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    DECREASED APPETITE
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    FAILURE TO THRIVE
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    DEHYDRATION
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    HYPERCALCAEMIA
         subjects affected / exposed
    1 / 89 (1.12%)
    0 / 81 (0.00%)
    0 / 85 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Cilengitide twice a week + Temozolomide + Radiotherapy Cilengitide 5 times a week + Temozolomide + Radiotherapy Temozolomide + Radiotherapy
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    83 / 89 (93.26%)
    79 / 81 (97.53%)
    76 / 85 (89.41%)
    Vascular disorders
    HYPERTENSION
         subjects affected / exposed
    5 / 89 (5.62%)
    6 / 81 (7.41%)
    3 / 85 (3.53%)
         occurrences all number
    5
    6
    3
    General disorders and administration site conditions
    FATIGUE
         subjects affected / exposed
    27 / 89 (30.34%)
    21 / 81 (25.93%)
    19 / 85 (22.35%)
         occurrences all number
    27
    21
    19
    OEDEMA PERIPHERAL
         subjects affected / exposed
    9 / 89 (10.11%)
    5 / 81 (6.17%)
    8 / 85 (9.41%)
         occurrences all number
    9
    5
    8
    PYREXIA
         subjects affected / exposed
    16 / 89 (17.98%)
    14 / 81 (17.28%)
    8 / 85 (9.41%)
         occurrences all number
    16
    14
    8
    ASTHENIA
         subjects affected / exposed
    22 / 89 (24.72%)
    25 / 81 (30.86%)
    11 / 85 (12.94%)
         occurrences all number
    22
    25
    11
    GAIT DISTURBANCE
         subjects affected / exposed
    3 / 89 (3.37%)
    7 / 81 (8.64%)
    10 / 85 (11.76%)
         occurrences all number
    3
    7
    10
    Respiratory, thoracic and mediastinal disorders
    DYSPNOEA
         subjects affected / exposed
    5 / 89 (5.62%)
    4 / 81 (4.94%)
    3 / 85 (3.53%)
         occurrences all number
    5
    4
    3
    COUGH
         subjects affected / exposed
    9 / 89 (10.11%)
    7 / 81 (8.64%)
    3 / 85 (3.53%)
         occurrences all number
    9
    7
    3
    Psychiatric disorders
    ANXIETY
         subjects affected / exposed
    6 / 89 (6.74%)
    7 / 81 (8.64%)
    6 / 85 (7.06%)
         occurrences all number
    6
    7
    6
    INSOMNIA
         subjects affected / exposed
    12 / 89 (13.48%)
    15 / 81 (18.52%)
    12 / 85 (14.12%)
         occurrences all number
    12
    15
    12
    DEPRESSION
         subjects affected / exposed
    12 / 89 (13.48%)
    9 / 81 (11.11%)
    2 / 85 (2.35%)
         occurrences all number
    12
    9
    2
    Investigations
    PLATELET COUNT DECREASED
         subjects affected / exposed
    3 / 89 (3.37%)
    0 / 81 (0.00%)
    5 / 85 (5.88%)
         occurrences all number
    3
    0
    5
    NEUTROPHIL COUNT DECREASED
         subjects affected / exposed
    0 / 89 (0.00%)
    5 / 81 (6.17%)
    3 / 85 (3.53%)
         occurrences all number
    0
    5
    3
    Injury, poisoning and procedural complications
    RADIATION SKIN INJURY
         subjects affected / exposed
    11 / 89 (12.36%)
    3 / 81 (3.70%)
    3 / 85 (3.53%)
         occurrences all number
    11
    3
    3
    FALL
         subjects affected / exposed
    2 / 89 (2.25%)
    5 / 81 (6.17%)
    2 / 85 (2.35%)
         occurrences all number
    2
    5
    2
    Nervous system disorders
    APHASIA
         subjects affected / exposed
    7 / 89 (7.87%)
    4 / 81 (4.94%)
    6 / 85 (7.06%)
         occurrences all number
    7
    4
    6
    CONVULSION
         subjects affected / exposed
    9 / 89 (10.11%)
    10 / 81 (12.35%)
    10 / 85 (11.76%)
         occurrences all number
    9
    10
    10
    DIZZINESS
         subjects affected / exposed
    6 / 89 (6.74%)
    5 / 81 (6.17%)
    5 / 85 (5.88%)
         occurrences all number
    6
    5
    5
    DYSGEUSIA
         subjects affected / exposed
    6 / 89 (6.74%)
    4 / 81 (4.94%)
    2 / 85 (2.35%)
         occurrences all number
    6
    4
    2
    HEADACHE
         subjects affected / exposed
    38 / 89 (42.70%)
    33 / 81 (40.74%)
    27 / 85 (31.76%)
         occurrences all number
    38
    33
    27
    HEMIPARESIS
         subjects affected / exposed
    7 / 89 (7.87%)
    5 / 81 (6.17%)
    6 / 85 (7.06%)
         occurrences all number
    7
    5
    6
    MEMORY IMPAIRMENT
         subjects affected / exposed
    7 / 89 (7.87%)
    8 / 81 (9.88%)
    7 / 85 (8.24%)
         occurrences all number
    7
    8
    7
    PARAESTHESIA
         subjects affected / exposed
    2 / 89 (2.25%)
    6 / 81 (7.41%)
    0 / 85 (0.00%)
         occurrences all number
    2
    6
    0
    TREMOR
         subjects affected / exposed
    6 / 89 (6.74%)
    5 / 81 (6.17%)
    3 / 85 (3.53%)
         occurrences all number
    6
    5
    3
    Blood and lymphatic system disorders
    THROMBOCYTOPENIA
         subjects affected / exposed
    11 / 89 (12.36%)
    15 / 81 (18.52%)
    17 / 85 (20.00%)
         occurrences all number
    11
    15
    17
    ANAEMIA
         subjects affected / exposed
    5 / 89 (5.62%)
    9 / 81 (11.11%)
    1 / 85 (1.18%)
         occurrences all number
    5
    9
    1
    NEUTROPENIA
         subjects affected / exposed
    12 / 89 (13.48%)
    9 / 81 (11.11%)
    8 / 85 (9.41%)
         occurrences all number
    12
    9
    8
    LYMPHOPENIA
         subjects affected / exposed
    9 / 89 (10.11%)
    7 / 81 (8.64%)
    7 / 85 (8.24%)
         occurrences all number
    9
    7
    7
    LEUKOPENIA
         subjects affected / exposed
    5 / 89 (5.62%)
    6 / 81 (7.41%)
    7 / 85 (8.24%)
         occurrences all number
    5
    6
    7
    Eye disorders
    VISION BLURRED
         subjects affected / exposed
    6 / 89 (6.74%)
    2 / 81 (2.47%)
    1 / 85 (1.18%)
         occurrences all number
    6
    2
    1
    Gastrointestinal disorders
    NAUSEA
         subjects affected / exposed
    33 / 89 (37.08%)
    30 / 81 (37.04%)
    30 / 85 (35.29%)
         occurrences all number
    33
    30
    30
    CONSTIPATION
         subjects affected / exposed
    26 / 89 (29.21%)
    27 / 81 (33.33%)
    27 / 85 (31.76%)
         occurrences all number
    26
    27
    27
    DIARRHOEA
         subjects affected / exposed
    8 / 89 (8.99%)
    6 / 81 (7.41%)
    2 / 85 (2.35%)
         occurrences all number
    8
    6
    2
    ABDOMINAL PAIN UPPER
         subjects affected / exposed
    5 / 89 (5.62%)
    5 / 81 (6.17%)
    1 / 85 (1.18%)
         occurrences all number
    5
    5
    1
    VOMITING
         subjects affected / exposed
    18 / 89 (20.22%)
    18 / 81 (22.22%)
    21 / 85 (24.71%)
         occurrences all number
    18
    18
    21
    STOMATITIS
         subjects affected / exposed
    5 / 89 (5.62%)
    1 / 81 (1.23%)
    2 / 85 (2.35%)
         occurrences all number
    5
    1
    2
    Skin and subcutaneous tissue disorders
    URTICARIA
         subjects affected / exposed
    2 / 89 (2.25%)
    7 / 81 (8.64%)
    2 / 85 (2.35%)
         occurrences all number
    2
    7
    2
    RASH
         subjects affected / exposed
    11 / 89 (12.36%)
    8 / 81 (9.88%)
    3 / 85 (3.53%)
         occurrences all number
    11
    8
    3
    ERYTHEMA
         subjects affected / exposed
    4 / 89 (4.49%)
    5 / 81 (6.17%)
    3 / 85 (3.53%)
         occurrences all number
    4
    5
    3
    ALOPECIA
         subjects affected / exposed
    14 / 89 (15.73%)
    18 / 81 (22.22%)
    11 / 85 (12.94%)
         occurrences all number
    14
    18
    11
    PRURITUS
         subjects affected / exposed
    9 / 89 (10.11%)
    11 / 81 (13.58%)
    5 / 85 (5.88%)
         occurrences all number
    9
    11
    5
    Renal and urinary disorders
    URINARY INCONTINENCE
         subjects affected / exposed
    3 / 89 (3.37%)
    5 / 81 (6.17%)
    3 / 85 (3.53%)
         occurrences all number
    3
    5
    3
    Musculoskeletal and connective tissue disorders
    ARTHRALGIA
         subjects affected / exposed
    4 / 89 (4.49%)
    5 / 81 (6.17%)
    2 / 85 (2.35%)
         occurrences all number
    4
    5
    2
    BACK PAIN
         subjects affected / exposed
    7 / 89 (7.87%)
    3 / 81 (3.70%)
    0 / 85 (0.00%)
         occurrences all number
    7
    3
    0
    MUSCLE SPASMS
         subjects affected / exposed
    2 / 89 (2.25%)
    5 / 81 (6.17%)
    1 / 85 (1.18%)
         occurrences all number
    2
    5
    1
    MUSCULAR WEAKNESS
         subjects affected / exposed
    9 / 89 (10.11%)
    19 / 81 (23.46%)
    4 / 85 (4.71%)
         occurrences all number
    9
    19
    4
    MUSCULOSKELETAL PAIN
         subjects affected / exposed
    7 / 89 (7.87%)
    3 / 81 (3.70%)
    2 / 85 (2.35%)
         occurrences all number
    7
    3
    2
    NECK PAIN
         subjects affected / exposed
    6 / 89 (6.74%)
    2 / 81 (2.47%)
    1 / 85 (1.18%)
         occurrences all number
    6
    2
    1
    PAIN IN EXTREMITY
         subjects affected / exposed
    9 / 89 (10.11%)
    3 / 81 (3.70%)
    6 / 85 (7.06%)
         occurrences all number
    9
    3
    6
    Infections and infestations
    NASOPHARYNGITIS
         subjects affected / exposed
    9 / 89 (10.11%)
    5 / 81 (6.17%)
    1 / 85 (1.18%)
         occurrences all number
    9
    5
    1
    ORAL CANDIDIASIS
         subjects affected / exposed
    6 / 89 (6.74%)
    6 / 81 (7.41%)
    3 / 85 (3.53%)
         occurrences all number
    6
    6
    3
    UPPER RESPIRATORY TRACT INFECTION
         subjects affected / exposed
    6 / 89 (6.74%)
    10 / 81 (12.35%)
    5 / 85 (5.88%)
         occurrences all number
    6
    10
    5
    URINARY TRACT INFECTION
         subjects affected / exposed
    6 / 89 (6.74%)
    10 / 81 (12.35%)
    6 / 85 (7.06%)
         occurrences all number
    6
    10
    6
    Metabolism and nutrition disorders
    DECREASED APPETITE
         subjects affected / exposed
    20 / 89 (22.47%)
    18 / 81 (22.22%)
    18 / 85 (21.18%)
         occurrences all number
    20
    18
    18
    HYPERGLYCAEMIA
         subjects affected / exposed
    6 / 89 (6.74%)
    5 / 81 (6.17%)
    1 / 85 (1.18%)
         occurrences all number
    6
    5
    1
    HYPONATRAEMIA
         subjects affected / exposed
    3 / 89 (3.37%)
    4 / 81 (4.94%)
    5 / 85 (5.88%)
         occurrences all number
    3
    4
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    19 Mar 2010
    This amendment dated 19 Mar 2010 was substantial and applied to all sites. The main purpose of this amendment was to: • Allow inclusion of subjects with transient increase of transaminases due to narcotic use as a result of general anesthesia for surgery if transaminases were within normal limits prior to surgery and considering that this elevation of transaminases did not reflect a chronic underlying liver disease. • Allow inclusion of subjects with prior low dose RTX for tinea capitis of the head because clinical experience over the last 30 years in treatment of patients with GBM who were irradiated because of tinea capitis did not raise any concerns regarding special early or late side effects of low dose RTX, and therefore to give these patients the opportunity to be treated within this study. • Exclude subjects, only if major surgery was planned and to allow planned minor surgical procedures such as implantation of a port-a-cath or dental extraction as the safety profile of cilengitide so far included no concerns regarding bleeding and wound healing complications for these kinds of minor interventions. • Allow cilengitide re-escalation after first occurrence of Grade 4 toxicity on a case-by-case basis as this is most frequently Grade 4 thrombocytopenia when cilengitide is combined with TMZ and from the known safety profile of both drugs, thrombocytopenia is most likely related to TMZ. • Allow the restart of TMZ treatment for the maintenance phase after discontinuation for Grade 4 hematologic or Grade 3/4 non-hematologic toxicity during the continuous concomitant treatment phase, which is in line with the current Summary of Product Characteristics for TMZ and because TMZ can be well tolerated during maintenance treatment when it is only administered over 5 days every 4 weeks .

    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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