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    Clinical Trial Results:
    RAPTOR: A single arm, multicenter phase II trial of RAD001 as monotherapy in the treatment of advanced papillary renal cell cancer

    Summary
    EudraCT number
    2008-006181-28
    Trial protocol
    FR   BE   GB   DE   ES   IT  
    Global end of trial date
    13 Oct 2014

    Results information
    Results version number
    v1(current)
    This version publication date
    24 Jul 2016
    First version publication date
    24 Jul 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CRAD001LFR08
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    CH-4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
    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
    13 Oct 2014
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    13 Oct 2014
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the efficacy of everolimus as monotherapy in patients with metastatic papillary renal cancer. Efficacy was defined as the percentage of patients progression-free at 6 months.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    27 Jul 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
    Belgium: 6
    Country: Number of subjects enrolled
    France: 30
    Country: Number of subjects enrolled
    Germany: 6
    Country: Number of subjects enrolled
    Italy: 11
    Country: Number of subjects enrolled
    Poland: 16
    Country: Number of subjects enrolled
    Spain: 17
    Country: Number of subjects enrolled
    United Kingdom: 6
    Worldwide total number of subjects
    92
    EEA total number of subjects
    92
    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)
    54
    From 65 to 84 years
    38
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    All patients were screened for inclusion and exclusion criteria and baseline evaluations were performed within two weeks and up to a maximum of 4 weeks for specific exams, before the first dose of study drug.

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

    Arms
    Arm title
    RAD001
    Arm description
    10 mg/day
    Arm type
    Experimental

    Investigational medicinal product name
    Everolimus
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Chewable/dispersible tablet
    Routes of administration
    Oral use
    Dosage and administration details
    5 mg tablets 10 mg/day

    Number of subjects in period 1
    RAD001
    Started
    92
    Completed
    0
    Not completed
    92
         Adverse event, serious fatal
    9
         Consent withdrawn by subject
    3
         Disease progression
    55
         Adverse event, non-fatal
    20
         Lost to follow-up
    3
         Missing
    1
         Protocol deviation
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    RAD001
    Reporting group description
    10 mg/day

    Reporting group values
    RAD001 Total
    Number of subjects
    92 92
    Age Categorical
    Units: participants
        Between 18 and 65 years
    54 54
        >=65 years
    38 38
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    59.2 ( 14.9 ) -
    Gender, Male/Female
    Units: participants
        Male
    72 72
        Female
    20 20

    End points

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    End points reporting groups
    Reporting group title
    RAD001
    Reporting group description
    10 mg/day

    Primary: To evaluate efficacy of RAD001 as monotherapy for the treatment of papillary renal cancer. Efficacy is defined as the percentage of patients progression-free at 6 months.

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    End point title
    To evaluate efficacy of RAD001 as monotherapy for the treatment of papillary renal cancer. Efficacy is defined as the percentage of patients progression-free at 6 months. [1]
    End point description
    PFSR at 6 months based on central review
    End point type
    Primary
    End point timeframe
    6 mos
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only summary stats available as this is a one arm study. EU only provides for comparative statistics.
    End point values
    RAD001
    Number of subjects analysed
    92
    Units: % participants
    number (confidence interval 80%)
        (PPFF Set, N=44)
    34.1 (24.5 to 44.8)
        (PPSet, N=66)
    33.3 (25.6 to 41.8)
        (ITT Set, N=86)
    32.6 (25.9 to 39.9)
    No statistical analyses for this end point

    Secondary: Disease control rate (SD + PR + CR)

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    End point title
    Disease control rate (SD + PR + CR)
    End point description
    DCR was defined as the proportion of patients with a best overall response of CR, PR or SD and ORR as the percentage of patients with CR or PR
    End point type
    Secondary
    End point timeframe
    6 mos
    End point values
    RAD001
    Number of subjects analysed
    92
    Units: % Participants
    number (confidence interval 90%)
        PP set
    65.2 (54.4 to 74.9)
        ITT set
    65.1 (55.8 to 73.6)
    No statistical analyses for this end point

    Secondary: Objective response rate

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    End point title
    Objective response rate
    End point description
    ORR is defined as the proportion of patients with tumor size reduction of a predefined amount and for a minimum time period. Response duration usually is measured from the time of initial response until documented tumor progression
    End point type
    Secondary
    End point timeframe
    End of trial
    End point values
    RAD001
    Number of subjects analysed
    92
    Units: % participants
    number (confidence interval 90%)
        PP Set
    1.5 (0.1 to 7)
        ITT Set
    1.2 (0.1 to 5.4)
    No statistical analyses for this end point

    Secondary: Duration of response

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    End point title
    Duration of response
    End point description
    The DOR analysis applied only to patients whose overall response was CR or PR and was defined as the time from onset of response (CR/PR) to progression or death from any cause.
    End point type
    Secondary
    End point timeframe
    End of trial
    End point values
    RAD001
    Number of subjects analysed
    92
    Units: days
    median (confidence interval 95%)
        local review PP set
    169 (64 to 169)
        local review ITT set
    226 (64 to 928)
    No statistical analyses for this end point

    Secondary: Median progression free survival

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    End point title
    Median progression free survival
    End point description
    PFS was defined as the time from first study drug administration to objective tumor progression or death from any cause.
    End point type
    Secondary
    End point timeframe
    End of trial
    End point values
    RAD001
    Number of subjects analysed
    92
    Units: days
    median (confidence interval 95%)
        PP set
    118 (65 to 174)
        ITT set
    113 (77 to 167)
    No statistical analyses for this end point

    Secondary: Incidence of adverse events, serious adverse events, and death.

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    End point title
    Incidence of adverse events, serious adverse events, and death.
    End point description
    End point type
    Secondary
    End point timeframe
    End of trial
    End point values
    RAD001
    Number of subjects analysed
    92
    Units: % participants
    number (not applicable)
        Patients with any AE
    100
        AE with suspected relation to study drug
    97.83
        AE leading to dose adjustment or interruption
    53.26
        AE leading to permanent discontinuation
    27.17
        AE requiring concomitant medication
    90.22
        Patients with serious adverse event (SAE)
    46.74
        SAE suspected relation to study drug
    23.91
        SAE leading to permanent discontinuation
    10.87
        Patients died
    10.87
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse Events are collected from First Patient First Visit (FPFV) until Last Patient Last Visit (LPLV). All Adverse events are reported in this record from First Patient First Treatment until Last Patient Last Visit.
    Adverse event reporting additional description
    Consistent with EudraCT disclosure specifications, Novartis has reported under the Serious adverse events field “number of deaths resulting from adverse events” all those deaths, resulting from serious adverse events that are deemed to be causally related to treatment by the investigator
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    All patients
    Reporting group description
    All patients

    Serious adverse events
    All patients
    Total subjects affected by serious adverse events
         subjects affected / exposed
    43 / 92 (46.74%)
         number of deaths (all causes)
    11
         number of deaths resulting from adverse events
    1
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasm progression
         subjects affected / exposed
    4 / 92 (4.35%)
         occurrences causally related to treatment / all
    2 / 4
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Varicose vein
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypertension
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    2 / 92 (2.17%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Venous thrombosis
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    4 / 92 (4.35%)
         occurrences causally related to treatment / all
    3 / 5
         deaths causally related to treatment / all
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Condition aggravated
         subjects affected / exposed
    2 / 92 (2.17%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Multi-organ failure
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Mucosal inflammation
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    2 / 92 (2.17%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    4 / 92 (4.35%)
         occurrences causally related to treatment / all
    2 / 4
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Vaginal haemorrhage
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea exertional
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    3 / 92 (3.26%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Lung disorder
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Interstitial lung disease
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nasal septum deviation
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oropharyngeal pain
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    4 / 92 (4.35%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Pulmonary arterial hypertension
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Depression
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hallucination
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Lumbar vertebral fracture
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Atrial flutter
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cor pulmonale
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tricuspid valve incompetence
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Aphasia
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hemiparesis
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal cord compression
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tremor
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    4 / 92 (4.35%)
         occurrences causally related to treatment / all
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Ascites
         subjects affected / exposed
    2 / 92 (2.17%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    2 / 92 (2.17%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Ileus
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Large intestine polyp
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oesophagitis
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Subileus
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholestasis
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash erythematous
         subjects affected / exposed
    2 / 92 (2.17%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal failure
         subjects affected / exposed
    3 / 92 (3.26%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Renal failure acute
         subjects affected / exposed
    4 / 92 (4.35%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bone pain
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fistula
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Anal infection
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bacteraemia
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal infection
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    2 / 92 (2.17%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Postoperative abscess
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia bacterial
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Respiratory tract infection
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    2 / 92 (2.17%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Fluid overload
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    1 / 92 (1.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    All patients
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    90 / 92 (97.83%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    6 / 92 (6.52%)
         occurrences all number
    6
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    39 / 92 (42.39%)
         occurrences all number
    52
    Chest pain
         subjects affected / exposed
    7 / 92 (7.61%)
         occurrences all number
    8
    Fatigue
         subjects affected / exposed
    30 / 92 (32.61%)
         occurrences all number
    37
    Mucosal inflammation
         subjects affected / exposed
    36 / 92 (39.13%)
         occurrences all number
    56
    Oedema peripheral
         subjects affected / exposed
    29 / 92 (31.52%)
         occurrences all number
    37
    Pyrexia
         subjects affected / exposed
    25 / 92 (27.17%)
         occurrences all number
    33
    Pain
         subjects affected / exposed
    7 / 92 (7.61%)
         occurrences all number
    12
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    36 / 92 (39.13%)
         occurrences all number
    47
    Dyspnoea
         subjects affected / exposed
    29 / 92 (31.52%)
         occurrences all number
    35
    Epistaxis
         subjects affected / exposed
    26 / 92 (28.26%)
         occurrences all number
    41
    Pneumonitis
         subjects affected / exposed
    7 / 92 (7.61%)
         occurrences all number
    7
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    9 / 92 (9.78%)
         occurrences all number
    10
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    8 / 92 (8.70%)
         occurrences all number
    9
    Aspartate aminotransferase increased
         subjects affected / exposed
    6 / 92 (6.52%)
         occurrences all number
    9
    Alanine aminotransferase increased
         subjects affected / exposed
    7 / 92 (7.61%)
         occurrences all number
    10
    Platelet count decreased
         subjects affected / exposed
    6 / 92 (6.52%)
         occurrences all number
    14
    Weight decreased
         subjects affected / exposed
    12 / 92 (13.04%)
         occurrences all number
    13
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    6 / 92 (6.52%)
         occurrences all number
    6
    Nervous system disorders
    Dysgeusia
         subjects affected / exposed
    23 / 92 (25.00%)
         occurrences all number
    27
    Headache
         subjects affected / exposed
    16 / 92 (17.39%)
         occurrences all number
    22
    Blood and lymphatic system disorders
    Thrombocytopenia
         subjects affected / exposed
    10 / 92 (10.87%)
         occurrences all number
    12
    Anaemia
         subjects affected / exposed
    25 / 92 (27.17%)
         occurrences all number
    29
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    23 / 92 (25.00%)
         occurrences all number
    32
    Aphthous stomatitis
         subjects affected / exposed
    11 / 92 (11.96%)
         occurrences all number
    16
    Ascites
         subjects affected / exposed
    5 / 92 (5.43%)
         occurrences all number
    5
    Constipation
         subjects affected / exposed
    15 / 92 (16.30%)
         occurrences all number
    18
    Diarrhoea
         subjects affected / exposed
    36 / 92 (39.13%)
         occurrences all number
    52
    Nausea
         subjects affected / exposed
    27 / 92 (29.35%)
         occurrences all number
    36
    Dry mouth
         subjects affected / exposed
    8 / 92 (8.70%)
         occurrences all number
    8
    Stomatitis
         subjects affected / exposed
    23 / 92 (25.00%)
         occurrences all number
    32
    Vomiting
         subjects affected / exposed
    16 / 92 (17.39%)
         occurrences all number
    21
    Skin and subcutaneous tissue disorders
    Acne
         subjects affected / exposed
    5 / 92 (5.43%)
         occurrences all number
    5
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    5 / 92 (5.43%)
         occurrences all number
    5
    Nail disorder
         subjects affected / exposed
    13 / 92 (14.13%)
         occurrences all number
    14
    Dry skin
         subjects affected / exposed
    12 / 92 (13.04%)
         occurrences all number
    12
    Pruritus
         subjects affected / exposed
    20 / 92 (21.74%)
         occurrences all number
    25
    Rash
         subjects affected / exposed
    53 / 92 (57.61%)
         occurrences all number
    77
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    11 / 92 (11.96%)
         occurrences all number
    12
    Back pain
         subjects affected / exposed
    16 / 92 (17.39%)
         occurrences all number
    21
    Musculoskeletal pain
         subjects affected / exposed
    5 / 92 (5.43%)
         occurrences all number
    7
    Pain in extremity
         subjects affected / exposed
    10 / 92 (10.87%)
         occurrences all number
    11
    Myalgia
         subjects affected / exposed
    5 / 92 (5.43%)
         occurrences all number
    7
    Infections and infestations
    Rhinitis
         subjects affected / exposed
    9 / 92 (9.78%)
         occurrences all number
    9
    Bronchitis
         subjects affected / exposed
    5 / 92 (5.43%)
         occurrences all number
    5
    Urinary tract infection
         subjects affected / exposed
    6 / 92 (6.52%)
         occurrences all number
    8
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    36 / 92 (39.13%)
         occurrences all number
    48
    Hyperglycaemia
         subjects affected / exposed
    12 / 92 (13.04%)
         occurrences all number
    12
    Hypercholesterolaemia
         subjects affected / exposed
    15 / 92 (16.30%)
         occurrences all number
    20
    Hypertriglyceridaemia
         subjects affected / exposed
    10 / 92 (10.87%)
         occurrences all number
    15
    Hypocalcaemia
         subjects affected / exposed
    5 / 92 (5.43%)
         occurrences all number
    5
    Hypophosphataemia
         subjects affected / exposed
    8 / 92 (8.70%)
         occurrences all number
    10

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    07 Apr 2010
    Addition of guidelines regarding the management of hepatitis B and hepatitis C infections. Reactivation of hepatitis B virus (HBV) has been observed in patients with cancer receiving chemotherapy (Yeo et al 2004). Sporadic cases of hepatitis B reactivation has also been seen in this setting with everolimus. Use of antivirals treatments during anti-cancer therapy has been shown to reduce the risk of hepatitis B virus reactivation and associated morbidity and mortality (Loomba et al 2008). Guidance on the management of patients at risk of hepatitis C viral reactivation was also provided. Clarification of inclusion criteria n° 9, 10 adding or modifying notes Clarification of exclusion criterion n° 10 adding or modifying notes Addition of exclusion criterion n° 15 Management of hyperglycemia and duration of use of adequate contraception after end of trial therapy to provide a language that was consistent with the most recent Everolimus Core Data Sheet Version 1.3. Updated everolimus safety information based on the updated investigator brochure version 8 (mainly Appendix 16.1.1 - Section 5.1.1.1) Guidance on the usage of CYP3A4 and/or PgP inducers and inhibitors was modified to be consistent with Internal Clinical Pharmacology Drug-drug interaction (DDI) memo, which was updated Dec. 2, 2009. The memo summarized DDI data from three sources including the FDA’s “Guidance for Industry, Drug Interaction Studies, the University of Washington’s Drug Interaction Database, and Indiana University School of Medicine's Drug Interaction Table." Language regarding the administration of everolimus was modified to administer everolimus after meals in clinical trials. This approach had been approved as the global strategy within the Afinitor (everolimus) Program Team to achieve consistency between the various clinical trials.

    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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