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    Clinical Trial Results:
    A randomised placebo-controlled, double blinded, phase III trial of sorafenib in combination with transarterial chemoembolisation in hepatocellular cancer.

    Summary
    EudraCT number
    2008-005073-36
    Trial protocol
    GB   IE  
    Global end of trial date
    27 Nov 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    20 Jul 2025
    First version publication date
    20 Jul 2025
    Other versions
    Summary report(s)
    Lay summary

    Trial information

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    Trial identification
    Sponsor protocol code
    07130
    Additional study identifiers
    ISRCTN number
    ISRCTN93375053
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    University College London
    Sponsor organisation address
    250 Euston Road, London, United Kingdom, NW1 2PG
    Public contact
    UCLH/UCL Joint Research Office, University College London, uclh.jro-communications@nhs.net
    Scientific contact
    Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, crctu-generalenquiries@trials.bham.ac.uk
    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
    25 Feb 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    27 Nov 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The principal objective of this study is to determine whether the addition of sorafenib to TransArterial ChemoEmbolisation (TACE) performed with doxorubicin eluting beads, prolongs progression free survival in patients with unresectable Hepatocellular Carcinoma compared to TACE alone. TACE is the standard treatment for patients with liver cancer that cannot be removed by surgery. This procedure involves blocking the blood vessel that supplies the tumour with small particles and killing it by starving it of oxygen. These particles can be loaded with the chemotherapy drug doxorubicin which is delivered directly to the tumour and may increase the effectiveness of the procedure. Sorafenib is a relatively new anti-cancer treatment which is approved for use in the treatment of liver cancer. It works by slowing down the growth of cancer cells and it also slows the rate of new vessel formation on which tumour growth depends.
    Protection of trial subjects
    This study was conducted in conformance with Good Clinical Practice standards and applicable regulations regarding ethical committee review, informed consent, and the protection of human subjects participating in biomedical research. Site staff received GCP and trial specific training prior to recruiting patients to the study. A Data Monitoring Committee reviewed patient safety data throughout the trial. Additional measures were taken during the course of the study to monitor subject safety: (1) Medical history prior to randomisation to identify safety-related exclusion criteria, (2) Continuous assessment of adverse events and serious adverse events, (3) ECG, Haematology and biochemistry laboratory tests at regular intervals, (4) full review of body system through physical examination and vital signs assessment
    Background therapy
    A first trans-arterial chemoembolisation (TACE) will be performed between 2 and 5 weeks after randomisation using DC Bead® loaded with Doxorubicin-HCl 150mg. In the absence of complete devascularisation of the tumour(s), as assessed by follow-up contrast enhanced scan, further TACE(s) should be performed unless technical or patient factors preclude retreatment. After six procedures further TACE with DC Bead® should only be performed if the left ventricular ejection fraction is ≥45% on repeat assessment. If the ejection fraction is <45% bland embolisation with unloaded DC Bead® should be performed.
    Evidence for comparator
    -
    Actual start date of recruitment
    19 Nov 2010
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 313
    Worldwide total number of subjects
    313
    EEA total number of subjects
    0
    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)
    127
    From 65 to 84 years
    183
    85 years and over
    3

    Subject disposition

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    Recruitment
    Recruitment details
    23 UK sites and 1 Irish site took part in the study. The trial opened to recruitment on 04-Nov-2010. The first participant was recruited into the trial on 19-Nov-2010. The last subject was recruited on 27-Nov-2015. All patients were recruited in the UK.

    Pre-assignment
    Screening details
    Formal screening logs were requested. A total of 399 patients were considered for the trial, of these 313 were recruited and 86 subjects excluded. Reasons for exclusion: 81 patients did not meet all entry criteria; 5 declined to participate.

    Period 1
    Period 1 title
    Overall period
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator
    Blinding implementation details
    Study medication was labelled with a unique number (Treatment Pack Number) which was assigned to a patient. A 24 hour unblinding service was provided by CRCTU (office hours) and Guys and St Thomas emergency scientific & medical services (outside office hours). Unblinding was performed for medical reasons i.e. when knowledge of the treatment was essential for the correct patient clinical care, including externally verified evidence of disease progression.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Sorafenib
    Arm description
    Patients who commenced Sorafenib treatment
    Arm type
    Experimental

    Investigational medicinal product name
    Sorafenib
    Investigational medicinal product code
    Other name
    Nexavar
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    200 mg po BD, continuous dosing until death, disease progression, unacceptable toxicities or withdrawal of patient consent.

    Arm title
    Placebo
    Arm description
    Patients who commenced Placebo treatment
    Arm type
    Placebo

    Investigational medicinal product name
    Matched placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    200 mg po BD, continuous dosing until death, disease progression, unacceptable toxicities or withdrawal of patient consent.

    Number of subjects in period 1
    Sorafenib Placebo
    Started
    157
    156
    Completed
    113
    134
    Not completed
    44
    22
         Ineligible
    4
    3
         Insufficient Treatment
    40
    19

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Sorafenib
    Reporting group description
    Patients who commenced Sorafenib treatment

    Reporting group title
    Placebo
    Reporting group description
    Patients who commenced Placebo treatment

    Reporting group values
    Sorafenib Placebo Total
    Number of subjects
    157 156 313
    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)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        median (inter-quartile range (Q1-Q3))
    65 (57 to 71) 68 (63 to 74) -
    Gender categorical
    Units: Subjects
        Female
    18 18 36
        Male
    139 138 277
    ECOG Performance Status
    Units: Subjects
        PS 0
    98 97 195
        PS 1
    58 58 116
        Not known
    1 1 2
    Disease focality
    Number of nodules
    Units: Subjects
        = 1
    59 40 99
        = 2
    33 41 74
        = 3
    16 17 33
        > 3
    42 49 91
        Not known
    7 9 16
    Disease Extent
    Units: Subjects
        Unilobar
    94 76 170
        Bilobar
    59 74 133
        Unknown
    4 6 10
    Cirrhosis
    Units: Subjects
        Present
    129 122 251
        Absent
    28 33 61
        Unknown
    0 1 1
    Previous liver resection or ablative therapy
    Units: Subjects
        Yes
    11 20 31
        No
    146 135 281
        Unknown
    0 1 1
    Child-Pugh score
    Units: Subjects
        = 5
    106 114 220
        = 6
    39 34 73
        = 7
    4 2 6
        = 8
    1 1 2
        Not known
    7 5 12
    Hepatoma arterial-embolisation prognostic score
    Units: Subjects
        HAP A
    44 43 87
        HAP B
    52 61 113
        HAP C
    41 34 75
        HAP D
    14 10 24
        Not known
    6 8 14
    Cause of cirrhosis
    Units: Subjects
        Alcohol
    44 40 84
        Hepatitis C
    15 9 24
        Hepatitis C and alcohol
    10 12 22
        Hepatitis B
    7 7 14
        Hepatitis B and C
    3 3 6
        Hepatitis B and C and alcohol
    3 2 5
        Hepatitis B and alcohol
    2 2 4
        Other
    45 47 92
        N/A - No cirrhosis present
    28 34 62
    Hepatocellular carcinoma diagnosis method
    Units: Subjects
        Histology
    35 47 82
        Radiology
    122 106 228
        Not known
    0 3 3
    Baseline blood pressure
    Units: Subjects
        Normal
    80 77 157
        Grade 1 hypertension (mild)
    7 9 16
        Grade 1 isolated systolic hypertension
    48 41 89
        Grade 2 hypertension (moderate)
    2 1 3
        Grade 2 isolated systolic hypertension
    8 14 22
        Unknown
    12 14 26
    serum α-fetoprotein (AFP) concentration
    Units: KU/L
        median (inter-quartile range (Q1-Q3))
    23 (5 to 241) 25 (5 to 280) -
    Serum Creatinine
    Units: micromole(s)/litre
        median (inter-quartile range (Q1-Q3))
    75 (64 to 89) 75 (65 to 92) -
    Serum bilirubin
    Units: micromole(s)/litre
        median (inter-quartile range (Q1-Q3))
    14 (9 to 21) 13 (10 to 20) -
    Dominant tumour diameeter
    Units: centimetre
        median (inter-quartile range (Q1-Q3))
    6 (4 to 8) 5 (4 to 8) -
    Weight
    Units: kilogram(s)
        median (inter-quartile range (Q1-Q3))
    83.1 (70.6 to 95.4) 81.6 (71.2 to 95.0) -
    Height
    Units: metre
        median (inter-quartile range (Q1-Q3))
    1.7 (1.7 to 1.8) 1.7 (1.7 to 1.8) -

    End points

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    End points reporting groups
    Reporting group title
    Sorafenib
    Reporting group description
    Patients who commenced Sorafenib treatment

    Reporting group title
    Placebo
    Reporting group description
    Patients who commenced Placebo treatment

    Primary: Progression free survival time

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    End point title
    Progression free survival time
    End point description
    Time interval between randomisation and progression according to Response Evaluation Criteria In Solid Tumours version 1.1 (RECIST v1.1) or death due to any cause, analysed by intention-to-treat.
    End point type
    Primary
    End point timeframe
    Interval between the date of randomisation and the date of progression or death from any cause
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: day
        median (confidence interval 95%)
    238.0 (221.0 to 281.0)
    235.0 (195.0 to 322.0)
    Statistical analysis title
    Progression Free Survival
    Statistical analysis description
    PFS (Intention to Treat analysis)
    Comparison groups
    Sorafenib v Placebo
    Number of subjects included in analysis
    313
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.66
    Method
    Regression, Cox
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.94
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.72
         upper limit
    1.23

    Secondary: Overall survival time

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    End point title
    Overall survival time
    End point description
    Time interval between randomisation and death due to any cause, analysed by intention-to-treat.
    End point type
    Secondary
    End point timeframe
    Time interval between randomisation and death due to any cause
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: day
        median (confidence interval 95%)
    631.0 (437.0 to 879.0)
    598.0 (500.0 to 707)
    Statistical analysis title
    Overall Survival
    Statistical analysis description
    OS (Intention to Treat) Analysis
    Comparison groups
    Sorafenib v Placebo
    Number of subjects included in analysis
    313
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.77
    Method
    Regression, Cox
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.95
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.69
         upper limit
    1.32

    Secondary: Number of TACE Procedures

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    End point title
    Number of TACE Procedures
    End point description
    End point type
    Secondary
    End point timeframe
    12 months
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: TACE Procedures
    268
    326
    No statistical analyses for this end point

    Secondary: Time To Progression

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    End point title
    Time To Progression
    End point description
    End point type
    Secondary
    End point timeframe
    Date of randomisation to date of progression
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: day
        median (confidence interval 95%)
    326.0 (240.0 to 410.0)
    320.0 (232.0 to 398)
    Statistical analysis title
    Time To Progression
    Statistical analysis description
    TTP (Intention to Treat analysis)
    Comparison groups
    Sorafenib v Placebo
    Number of subjects included in analysis
    313
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.22
    Method
    Regression, Cox
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.83
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.61
         upper limit
    1.12

    Secondary: Disease Control (RECIST)

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    End point title
    Disease Control (RECIST)
    End point description
    Disease Control = Response as defined by RECIST v1.1 - categorised as either Complete Response, Partial Response or Stable Disease. Assessed locally.
    End point type
    Secondary
    End point timeframe
    12 months
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: patients
    117
    121
    No statistical analyses for this end point

    Secondary: EORTC C30 - Physical functioning (6 months)

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    End point title
    EORTC C30 - Physical functioning (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    78.3 ( 21.2 )
    77.5 ( 22.1 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Role functioning (6 months)

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    End point title
    EORTC C30 - Role functioning (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    78.9 ( 27.7 )
    78.9 ( 28.5 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Emotional functioning (6 months)

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    End point title
    EORTC C30 - Emotional functioning (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    78.5 ( 22.6 )
    76.2 ( 24.0 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Cognitive functioning (6 months)

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    End point title
    EORTC C30 - Cognitive functioning (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    81.8 ( 24.1 )
    83.8 ( 21.8 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Social functioning (6 months)

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    End point title
    EORTC C30 - Social functioning (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    82.0 ( 24.1 )
    82.3 ( 26.4 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Overall QOL

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    End point title
    EORTC C30 - Overall QOL
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    70.4 ( 22.2 )
    70.6 ( 24.2 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Fatigue (6 months)

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    End point title
    EORTC C30 - Fatigue (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    32.2 ( 26.6 )
    29.9 ( 26.7 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Nausea and Vomiting (6 months)

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    End point title
    EORTC C30 - Nausea and Vomiting (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    7.6 ( 17.8 )
    5.8 ( 14.3 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Pain (6 months)

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    End point title
    EORTC C30 - Pain (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    22.0 ( 28.0 )
    21.5 ( 27.2 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Dyspnoea (6 months)

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    End point title
    EORTC C30 - Dyspnoea (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    20.8 ( 27.7 )
    17.5 ( 26.3 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Insomnia (6 months)

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    End point title
    EORTC C30 - Insomnia (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    34.6 ( 32.0 )
    28.8 ( 34.0 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Appetite Loss (6 months)

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    End point title
    EORTC C30 - Appetite Loss (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    20.4 ( 28.2 )
    18.1 ( 28.2 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Constipation (6 months)

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    End point title
    EORTC C30 - Constipation (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    12.0 ( 22.6 )
    18.1 ( 28.2 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Diarrhoea (6 months)

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    End point title
    EORTC C30 - Diarrhoea (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    12.1 ( 24.1 )
    8.2 ( 19.2 )
    No statistical analyses for this end point

    Secondary: EORTC C30 - Financial Difficulties (6 months)

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    End point title
    EORTC C30 - Financial Difficulties (6 months)
    End point description
    End point type
    Secondary
    End point timeframe
    6 months after randomisation
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: score (1-100)
        arithmetic mean (standard deviation)
    23.2 ( 34.4 )
    15.2 ( 28.9 )
    No statistical analyses for this end point

    Secondary: Disease Control (mRECIST)

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    End point title
    Disease Control (mRECIST)
    End point description
    Disease Control = Response as defined by modified RECIST v1.1 - categorised as either Complete Response, Partial Response or Stable Disease. Assessed locally.
    End point type
    Secondary
    End point timeframe
    12 months
    End point values
    Sorafenib Placebo
    Number of subjects analysed
    157
    156
    Units: patients
    117
    120
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Details of all AEs were recorded and reported from the start of study treatment up to 30 days after last administration of study treatment or until end of study.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE
    Dictionary version
    4.0
    Reporting groups
    Reporting group title
    Sorafenib
    Reporting group description
    Patients who commenced Sorafenib treatment

    Reporting group title
    Placebo
    Reporting group description
    Patients who commenced Placebo treatment

    Serious adverse events
    Sorafenib Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    65 / 157 (41.40%)
    50 / 156 (32.05%)
         number of deaths (all causes)
    76
    88
         number of deaths resulting from adverse events
    14
    14
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Squamous cell carcinoma
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Treatment related secondary malignancy
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung adenocarcinoma
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Primary lung lesion
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Haematoma
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypertension
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Peripheral ischaemia
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thromboembolic event
         subjects affected / exposed
    2 / 157 (1.27%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Surgical and medical procedures
    Surgical treatment for indurated area of buttock
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Death NOS
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Sudden death NOS
         subjects affected / exposed
    0 / 157 (0.00%)
    2 / 156 (1.28%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Fatigue
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Fever
         subjects affected / exposed
    6 / 157 (3.82%)
    5 / 156 (3.21%)
         occurrences causally related to treatment / all
    1 / 6
    0 / 5
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Gait disturbance
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain
         subjects affected / exposed
    2 / 157 (1.27%)
    3 / 156 (1.92%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Localised oedema
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Night sweats
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Social circumstances
    Social circumstances
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Aspiration
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest infection
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    0 / 157 (0.00%)
    3 / 156 (1.92%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epistaxis
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusion
         subjects affected / exposed
    2 / 157 (1.27%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Blood bilirubin increased
         subjects affected / exposed
    2 / 157 (1.27%)
    3 / 156 (1.92%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Accidental embolisation of gallbladder
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Postoperative haemorrhage
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fracture
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Post embolisation syndrome
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Atrial flutter
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest pain - cardiac
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sinus bradycardia
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Encephalopathy
         subjects affected / exposed
    5 / 157 (3.18%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    3 / 5
    0 / 1
         deaths causally related to treatment / all
    1 / 2
    0 / 0
    Lethargy
         subjects affected / exposed
    2 / 157 (1.27%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stroke
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dysphasia
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intracranial haemorrhage
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    3 / 157 (1.91%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Platelet count decreased
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Eyelid function disorder
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    9 / 157 (5.73%)
    3 / 156 (1.92%)
         occurrences causally related to treatment / all
    4 / 9
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 157 (0.64%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diverticular perforation
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Oesophageal haemorrhage
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal varices haemorrhage
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal varices
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric haemorrhage
         subjects affected / exposed
    1 / 157 (0.64%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Melaena
         subjects affected / exposed
    2 / 157 (1.27%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mucositis oral
         subjects affected / exposed
    2 / 157 (1.27%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    2 / 157 (1.27%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Vomiting
         subjects affected / exposed
    3 / 157 (1.91%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Ascites
         subjects affected / exposed
    1 / 157 (0.64%)
    4 / 156 (2.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Duodenal ulcer
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematemesis
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Nausea
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatitis
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Blocked biliary stent
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic failure
         subjects affected / exposed
    3 / 157 (1.91%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Hepatic pain
         subjects affected / exposed
    1 / 157 (0.64%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Jaundice
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Liver abscess
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bile duct stenosis
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Cholecystitis
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic sepsis
         subjects affected / exposed
    1 / 157 (0.64%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 157 (0.64%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Urinary retention
         subjects affected / exposed
    1 / 157 (0.64%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Urinary frequency
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Arthritis
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Flank pain
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Anorectal infection
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic infection
         subjects affected / exposed
    1 / 157 (0.64%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    4 / 157 (2.55%)
    2 / 156 (1.28%)
         occurrences causally related to treatment / all
    3 / 5
    1 / 2
         deaths causally related to treatment / all
    1 / 2
    0 / 0
    Urinary sepsis
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchial infection
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin infection
         subjects affected / exposed
    0 / 157 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Liver Infection
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    0 / 157 (0.00%)
    2 / 156 (1.28%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Hyponatraemia
         subjects affected / exposed
    1 / 157 (0.64%)
    2 / 156 (1.28%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    1 / 157 (0.64%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Sorafenib Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    139 / 157 (88.54%)
    147 / 156 (94.23%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    19 / 157 (12.10%)
    8 / 156 (5.13%)
         occurrences all number
    36
    8
    General disorders and administration site conditions
    Dyspepsia
         subjects affected / exposed
    9 / 157 (5.73%)
    5 / 156 (3.21%)
         occurrences all number
    19
    11
    Fatigue
         subjects affected / exposed
    127 / 157 (80.89%)
    125 / 156 (80.13%)
         occurrences all number
    556
    510
    Fever
         subjects affected / exposed
    14 / 157 (8.92%)
    19 / 156 (12.18%)
         occurrences all number
    15
    22
    Flu like symptoms
         subjects affected / exposed
    9 / 157 (5.73%)
    9 / 156 (5.77%)
         occurrences all number
    11
    9
    Pain
         subjects affected / exposed
    24 / 157 (15.29%)
    22 / 156 (14.10%)
         occurrences all number
    34
    34
    Oedema limbs
         subjects affected / exposed
    3 / 157 (1.91%)
    18 / 156 (11.54%)
         occurrences all number
    3
    32
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    10 / 157 (6.37%)
    17 / 156 (10.90%)
         occurrences all number
    11
    22
    Dyspnea
         subjects affected / exposed
    11 / 157 (7.01%)
    18 / 156 (11.54%)
         occurrences all number
    13
    37
    Hoarseness
         subjects affected / exposed
    17 / 157 (10.83%)
    8 / 156 (5.13%)
         occurrences all number
    56
    9
    Psychiatric disorders
    Depression
         subjects affected / exposed
    10 / 157 (6.37%)
    5 / 156 (3.21%)
         occurrences all number
    14
    11
    Insomnia
         subjects affected / exposed
    15 / 157 (9.55%)
    8 / 156 (5.13%)
         occurrences all number
    27
    13
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    9 / 157 (5.73%)
    9 / 156 (5.77%)
         occurrences all number
    10
    11
    Alkaline Phosphatase Increased
         subjects affected / exposed
    13 / 157 (8.28%)
    9 / 156 (5.77%)
         occurrences all number
    17
    15
    Blood bilirubin increased
         subjects affected / exposed
    16 / 157 (10.19%)
    12 / 156 (7.69%)
         occurrences all number
    20
    12
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    13 / 157 (8.28%)
    11 / 156 (7.05%)
         occurrences all number
    33
    15
    Platelet count decreased
         subjects affected / exposed
    14 / 157 (8.92%)
    9 / 156 (5.77%)
         occurrences all number
    35
    14
    Weight Loss
         subjects affected / exposed
    21 / 157 (13.38%)
    13 / 156 (8.33%)
         occurrences all number
    27
    15
    Injury, poisoning and procedural complications
    Haemorrhage
         subjects affected / exposed
    34 / 157 (21.66%)
    17 / 156 (10.90%)
         occurrences all number
    65
    26
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    8 / 157 (5.10%)
    4 / 156 (2.56%)
         occurrences all number
    12
    7
    Headache
         subjects affected / exposed
    10 / 157 (6.37%)
    14 / 156 (8.97%)
         occurrences all number
    15
    29
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    19 / 157 (12.10%)
    11 / 156 (7.05%)
         occurrences all number
    34
    18
    Gastrointestinal disorders
    Ascites
         subjects affected / exposed
    14 / 157 (8.92%)
    10 / 156 (6.41%)
         occurrences all number
    21
    15
    Abdominal pain
         subjects affected / exposed
    94 / 157 (59.87%)
    93 / 156 (59.62%)
         occurrences all number
    243
    225
    Diarrhoea
         subjects affected / exposed
    88 / 157 (56.05%)
    52 / 156 (33.33%)
         occurrences all number
    319
    95
    Mouth pain
         subjects affected / exposed
    41 / 157 (26.11%)
    22 / 156 (14.10%)
         occurrences all number
    94
    39
    Dry mouth
         subjects affected / exposed
    8 / 157 (5.10%)
    4 / 156 (2.56%)
         occurrences all number
    10
    5
    Constipation
         subjects affected / exposed
    24 / 157 (15.29%)
    47 / 156 (30.13%)
         occurrences all number
    35
    85
    Mucositis
         subjects affected / exposed
    11 / 157 (7.01%)
    4 / 156 (2.56%)
         occurrences all number
    15
    4
    Nausea
         subjects affected / exposed
    73 / 157 (46.50%)
    68 / 156 (43.59%)
         occurrences all number
    133
    138
    Oral Dysesthesia
         subjects affected / exposed
    10 / 157 (6.37%)
    5 / 156 (3.21%)
         occurrences all number
    20
    8
    Vomiting
         subjects affected / exposed
    24 / 157 (15.29%)
    17 / 156 (10.90%)
         occurrences all number
    34
    24
    Hepatobiliary disorders
    Hepatic failure
         subjects affected / exposed
    10 / 157 (6.37%)
    7 / 156 (4.49%)
         occurrences all number
    10
    7
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    22 / 157 (14.01%)
    14 / 156 (8.97%)
         occurrences all number
    61
    17
    Dry skin
         subjects affected / exposed
    23 / 157 (14.65%)
    19 / 156 (12.18%)
         occurrences all number
    37
    32
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    66 / 157 (42.04%)
    16 / 156 (10.26%)
         occurrences all number
    266
    30
    Pruritus
         subjects affected / exposed
    14 / 157 (8.92%)
    25 / 156 (16.03%)
         occurrences all number
    17
    45
    Rash
         subjects affected / exposed
    64 / 157 (40.76%)
    35 / 156 (22.44%)
         occurrences all number
    137
    75
    Skin ulcer
         subjects affected / exposed
    10 / 157 (6.37%)
    2 / 156 (1.28%)
         occurrences all number
    14
    4
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    13 / 157 (8.28%)
    16 / 156 (10.26%)
         occurrences all number
    19
    29
    Back pain
         subjects affected / exposed
    11 / 157 (7.01%)
    17 / 156 (10.90%)
         occurrences all number
    25
    31
    Chest wall pain
         subjects affected / exposed
    8 / 157 (5.10%)
    7 / 156 (4.49%)
         occurrences all number
    11
    8
    Muscle Cramps
         subjects affected / exposed
    9 / 157 (5.73%)
    2 / 156 (1.28%)
         occurrences all number
    20
    2
    Myalgia
         subjects affected / exposed
    7 / 157 (4.46%)
    17 / 156 (10.90%)
         occurrences all number
    11
    32
    Infections and infestations
    Lung infection
         subjects affected / exposed
    12 / 157 (7.64%)
    10 / 156 (6.41%)
         occurrences all number
    17
    15
    Bronchial Infection
         subjects affected / exposed
    6 / 157 (3.82%)
    9 / 156 (5.77%)
         occurrences all number
    7
    20
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    54 / 157 (34.39%)
    53 / 156 (33.97%)
         occurrences all number
    94
    88
    Hypoalbuminemia
         subjects affected / exposed
    10 / 157 (6.37%)
    7 / 156 (4.49%)
         occurrences all number
    15
    8
    Hypocalcemia
         subjects affected / exposed
    11 / 157 (7.01%)
    1 / 156 (0.64%)
         occurrences all number
    12
    1
    Hypophosphatemia
         subjects affected / exposed
    12 / 157 (7.64%)
    5 / 156 (3.21%)
         occurrences all number
    16
    6

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    17 Mar 2010
    Update to unblinding procedures Clarification of randomisation procedures Clarification of drug delivery arrangements Update to the schedule of assessments Update to the case report form completion schedule Clarification of exclusion criteria
    11 Jun 2010
    Update to the Trial Management Group Clarification of additional embolisation procedures permitted Update to contraception requirements Update to DC Bead loading instructions
    11 Mar 2011
    Removal of lipase from the eligibility criteria. Addition of Ireland as a participating country (subject to local regulatory and ethical approvals). The units for AFP have changed from ng/ml to kU/L. Therefore, stratification is now (<331, ≥ 331kU/L). Dual Phase CTs are now permitted If a trial participant or partner of a trial participant becomes pregnant, a pregnancy notification form needs to be completed instead of an SAE Form. The first 60 patients are no longer required to complete the debriefing questionnaire to validate the EORTC QLQ-HCC18 questionnaire as validation of this module has now been completed. The insurance section has been modified to comply with UCL’s insurance SOP and updated policy. The primary difference is that patients may be able to claim compensation without the need to prove negligence. Removal of typographical errors.
    02 Oct 2012
    Changes to the Trial Management Group Exclusion criteria updated to cover patients with prolonged QT/QTC of greater than 450ms Increased ECG monitoring – ECG will now be monitored at each follow up visit, as well as at 72 hours pre-TACE and 7 days post-TACE time points Dose Modifications updated to include discontinuation of sorafenib for patients with QT over 500ms, or 60ms above their baseline reading Appendix 11: Expected Adverse Events updated to reflect additional expected events in line with the current version of the Sorafenib SmPC Appendix 12: Flowchart of Assessments has been revised to include the additional ECGs as earlier indicated
    28 Jan 2013
    Revised procedure for unblinding patients who have been confirmed locally as having progressive disease
    12 Feb 2014
    Update to the trial recruitment end date and recruiting centres. Change to end of trial definition and final analysis timelines following futility analysis and trial’s closure to recruitment. Sites allowed to use standard practice of TACE and CT/MRI scans following the trial’s closure to recruitment. End of translational sub-study sample collection. Changes to the process following progression after the trial’s closure to recruitment. Patients will no longer be formally unblinded following progression as all patients have been unblinded following the trial’s closure to recruitment. Details of maintaining the blind and codebreaking removed as no longer necessary. Change to scan schedule to local standard of care and removal of provision of scans to IXICO following the trial’s closure to recruitment. Change to radiological assessments to local standard of care from week 16 onwards Change to the follow up period following the trial’s closure to recruitment. Change to the sorafenib supply and reallocations process. Packs will no longer be allocated and sites will be provided with a supply of unblinded sorafenib. Clarification of the definition of progression in the trial. Changes to DC Bead loading times following advice from manufacturer Biocompatibles. Changes to expected adverse events following review of Sorafenib SpC.

    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/28648803
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