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    Clinical Trial Results:
    A Phase IIIb, multicentre, open-label study of nilotinib in adult patients with newly diagnosed Philadelphia chromosome and/or BCR-ABL positive CML in chronic phase

    Summary
    EudraCT number
    2009-017775-19
    Trial protocol
    FR   NL   BE   HU   ES   FI   GB   PT   DE   SE   CZ   DK   SK   GR   AT   LT   IT   LV   SI   EE   BG  
    Global end of trial date
    07 Jul 2014

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

    Trial information

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    Trial identification
    Sponsor protocol code
    CAMN107EIC01
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01061177
    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
    07 Jul 2014
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    07 Jul 2014
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective was to evaluate the rate of molecular response (MR4.0) at 18 months of nilotinib treatment.
    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
    20 May 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
    Austria: 17
    Country: Number of subjects enrolled
    Belgium: 30
    Country: Number of subjects enrolled
    Bulgaria: 21
    Country: Number of subjects enrolled
    Croatia: 4
    Country: Number of subjects enrolled
    Czech Republic: 16
    Country: Number of subjects enrolled
    Denmark: 14
    Country: Number of subjects enrolled
    Estonia: 1
    Country: Number of subjects enrolled
    Finland: 4
    Country: Number of subjects enrolled
    France: 150
    Country: Number of subjects enrolled
    Germany: 258
    Country: Number of subjects enrolled
    Greece: 10
    Country: Number of subjects enrolled
    Hungary: 35
    Country: Number of subjects enrolled
    Italy: 154
    Country: Number of subjects enrolled
    Latvia: 3
    Country: Number of subjects enrolled
    Lithuania: 15
    Country: Number of subjects enrolled
    Netherlands: 28
    Country: Number of subjects enrolled
    Norway: 12
    Country: Number of subjects enrolled
    Poland: 66
    Country: Number of subjects enrolled
    Portugal: 11
    Country: Number of subjects enrolled
    Romania: 61
    Country: Number of subjects enrolled
    Slovakia: 10
    Country: Number of subjects enrolled
    Slovenia: 3
    Country: Number of subjects enrolled
    Spain: 100
    Country: Number of subjects enrolled
    Sweden: 33
    Country: Number of subjects enrolled
    Switzerland: 5
    Country: Number of subjects enrolled
    United Kingdom: 28
    Worldwide total number of subjects
    1089
    EEA total number of subjects
    1084
    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)
    864
    From 65 to 84 years
    221
    85 years and over
    4

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A maximum of 806 patients were planned to be enrolled into the study and were to receive nilotinib 300 mg bid for a duration of up to 24 months. In order to allow the completion of additional national sub-studies 976 patients were planned to be enrolled.

    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
    Nilotinib
    Arm description
    This was a single-arm study; therefore all participants received nilotinib (AMN107) 300 mg bid given as two 150 mg capsules twice daily.
    Arm type
    Experimental

    Investigational medicinal product name
    Nilotinib
    Investigational medicinal product code
    AMN107
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    nilotinib 300 mg bid given as two 150 mg capsules (to be swallowed whole with a glass of water)

    Number of subjects in period 1
    Nilotinib
    Started
    1089
    ITT_MR (b2a2 &/or b3a2 +ve pts only)
    1056
    ITT_CyR (Ph+ patients only)
    983
    Completed
    881
    Not completed
    208
         Adverse event, serious fatal
    4
         Consent withdrawn by subject
    27
         Disease progression
    17
         Abnormal test procedure results
    4
         Adverse event, non-fatal
    117
         New cancer therapy
    9
         Abnormal laboratory values
    6
         Administratie problems
    4
         Lost to follow-up
    9
         Protocol deviation
    11

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Nilotinib
    Reporting group description
    This was a single-arm study; therefore all participants received nilotinib (AMN107) 300 mg bid given as two 150 mg capsules twice daily.

    Reporting group values
    Nilotinib Total
    Number of subjects
    1089 1089
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    864 864
        From 65-84 years
    221 221
        85 years and over
    4 4
    Age Continuous |
    Units: Years
        arithmetic mean (standard deviation)
    51.6 ( 14.87 ) -
    Gender, Male/Female
    Units: Participants
        Female
    447 447
        Male
    642 642
    Race/Ethnicity, Customized
    Units: Subjects
        Caucacian
    1045 1045
        Black
    6 6
        Oriental
    5 5
        Native American
    2 2
        Other
    31 31
    Study Specific Characteristic
    ECOG = Eastern Cooperative Oncology Group
    Units: Subjects
        No restrictions (0)
    867 867
        Only light work (1)
    199 199
        Only self care (2)
    21 21
        Limited self care (3)
    0 0
        Completely disabled (4)
    0 0
        Missing
    2 2
    Study Specific Characteristic |
    Units: Kg
        arithmetic mean (standard deviation)
    77.47 ( 15.73 ) -

    End points

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    End points reporting groups
    Reporting group title
    Nilotinib
    Reporting group description
    This was a single-arm study; therefore all participants received nilotinib (AMN107) 300 mg bid given as two 150 mg capsules twice daily.

    Primary: Percentage of participants with molecular response (MR4^0) at 18 months

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    End point title
    Percentage of participants with molecular response (MR4^0) at 18 months [1]
    End point description
    MR4^0 was defined as either (i) detectable disease ≤ 0.01% BCR-ABL ratio (international scale (IS)) with mean ABL transcripts ≥ 10 000 or (ii) undetectable disease in complementary deoxyribonucleic acid (cDNA) with ≥ 10 000 ABL transcripts. No statistical analysis was planned for this primary outcome.
    End point type
    Primary
    End point timeframe
    at 18 months
    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: No statistical analysis was planned for this endpoint.
    End point values
    Nilotinib
    Number of subjects analysed
    1056
    Units: Percentage of Participants
        number (not applicable)
    38.3
    No statistical analyses for this end point

    Secondary: Percentage of participants free from progression to accelerated phase/blast crisis (AP/BC) at 12 and 24 months

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    End point title
    Percentage of participants free from progression to accelerated phase/blast crisis (AP/BC) at 12 and 24 months
    End point description
    The following events were considered disease progression to AP/BC: Death due to disease under study; AP, as defined by any of the following: ≥ 15% blasts in the peripheral blood or bone marrow, but < 30% blasts in both the peripheral blood and bone marrow, ≥ 30% blasts plus promyelocytes in peripheral blood or bone marrow,  ≥ 20% basophils in the peripheral blood, Thrombocytopenia (< 100 × 109/L) that was unrelated to therapy, Evidence of clonal evolution, as determined by medical review with consensus of the SSMC/DMC. BC was defined as: ≥ 30% blasts in peripheral blood or bone marrow, Appearance of extramedullary involvement other than hepatosplenomegaly proven by biopsy
    End point type
    Secondary
    End point timeframe
    at 12 and 24 months
    End point values
    Nilotinib
    Number of subjects analysed
    1089
    Units: Percentage of participants
    number (not applicable)
        Pts free from progression to AP/BC at 12 months
    99.4
        Pts free from progression to AP/BC at 24 months
    99.4
    No statistical analyses for this end point

    Secondary: Rate of event free survival at 12 and 24 months

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    End point title
    Rate of event free survival at 12 and 24 months
    End point description
    EFS was defined as the time from the date of Day 1 (first treatment) + 1 day to the first occurrence of any of the following: Loss of complete hematologic response (CHR), Loss of CCyR, Death from any cause, Progression to the AP or BC of CML, Not achieving CHR up to 3 months (ie, 91 + 15 days), Not achieving CCyR up to 18 months (ie, 548 + 15 days), whichever is earlier.
    End point type
    Secondary
    End point timeframe
    at 12 and 24 months
    End point values
    Nilotinib
    Number of subjects analysed
    1089
    Units: Percentage of participants
    number (not applicable)
        Percentage of participants with EFS at 12 months
    71.7
        Percentage of participants with EFS at 24 months
    69.1
    No statistical analyses for this end point

    Secondary: Percentage of participants with major molecular response (MMR) at, as well as by, 12 and 24 months

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    End point title
    Percentage of participants with major molecular response (MMR) at, as well as by, 12 and 24 months
    End point description
    MMR was defined as BCR-ABL ratio (IS) ≤ 0.1% in a peripheral blood sample. BCR-ABL1 is an abnormal gene found in chronic myeloid leukemia (CML) and acute lymphoblastic leukemia (ALL). The chromosomal defect in the Philadelphia chromosome is a translocation, in which parts of two chromosomes, 9 and 22, swap places. The result is that a fusion gene is created by juxtapositioning the Abl1 gene on chromosome 9 to a part of the BCR ("breakpoint cluster region") gene on chromosome 22. Depending upon the breakpoints on the BCR gene, there are several forms of fusion proteins.
    End point type
    Secondary
    End point timeframe
    12 months, 24 months
    End point values
    Nilotinib
    Number of subjects analysed
    1056
    Units: Percentage of participants
    number (not applicable)
        at 12 months
    56.2
        at 24 months
    61.1
        by 12 months
    68.8
        by 24 months
    80.3
    No statistical analyses for this end point

    Secondary: Percentage of participants with complete cytogenetic response (CCyR) at, as well as by, 12 and 24 months

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    End point title
    Percentage of participants with complete cytogenetic response (CCyR) at, as well as by, 12 and 24 months
    End point description
    CCyR parameters were defined as 0% Philadelphia positive (Ph+) metaphases. Loss of CCyR was defined as a patient exceeding the CCyR criteria (ie, > 0% Ph+ metaphases) at a subsequent visit after the patient had achieved CCyR.
    End point type
    Secondary
    End point timeframe
    at 12 and 24 months
    End point values
    Nilotinib
    Number of subjects analysed
    983
    Units: Percentage of participants
    number (not applicable)
        at 12 months
    72.4
        at 24 months
    65.6
        By Month 12
    82.5
        By Month 24
    89
    No statistical analyses for this end point

    Secondary: Percentage of participants with major cytogenetic response (MCyR) at, as well as by, 12 and 24 months

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    End point title
    Percentage of participants with major cytogenetic response (MCyR) at, as well as by, 12 and 24 months
    End point description
    MCyR parameters were defined as 0 to 35% Philadelphia positive (Ph+) metaphases.
    End point type
    Secondary
    End point timeframe
    at 12 and 24 months
    End point values
    Nilotinib
    Number of subjects analysed
    983
    Units: Percentage of participants
    number (not applicable)
        at 12 months
    73.8
        at 24 months
    66.2
        by 12 months
    86.7
        by 24 months
    91.4
    No statistical analyses for this end point

    Secondary: Percentage of participants free from progression to AP/BC with MR4^0 at 12 months

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    End point title
    Percentage of participants free from progression to AP/BC with MR4^0 at 12 months
    End point description
    The following events were considered disease progression to AP/BC: Death due to disease under study; AP, as defined by any of the following: ≥ 15% blasts in the peripheral blood or bone marrow, but < 30% blasts in both the peripheral blood and bone marrow, ≥ 30% blasts plus promyelocytes in peripheral blood or bone marrow,  ≥ 20% basophils in the peripheral blood, Thrombocytopenia (< 100 × 109/L) that was unrelated to therapy, Evidence of clonal evolution, as determined by medical review with consensus of the SSMC/DMC. BC was defined as: ≥ 30% blasts in peripheral blood or bone marrow, Appearance of extramedullary involvement other than hepatosplenomegaly proven by biopsy
    End point type
    Secondary
    End point timeframe
    at 12 months
    End point values
    Nilotinib
    Number of subjects analysed
    1089
    Units: Percentage of participants
        number (not applicable)
    100
    No statistical analyses for this end point

    Secondary: Percentage of participants with event free survival in participants achieving MR4^0 at 12 months

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    End point title
    Percentage of participants with event free survival in participants achieving MR4^0 at 12 months
    End point description
    EFS was defined as the time from the date of Day 1 (first treatment) + 1 day to the first occurrence of any of the following: Loss of complete hematologic response (CHR), Loss of CCyR, Death from any cause, Progression to the AP or BC of CML, Not achieving CHR up to 3 months (ie, 91 + 15 days), Not achieving CCyR up to 18 months (ie, 548 + 15 days), whichever is earlier.
    End point type
    Secondary
    End point timeframe
    at 12 months
    End point values
    Nilotinib
    Number of subjects analysed
    1089
    Units: Percentage of participants
        number (not applicable)
    87
    No statistical analyses for this end point

    Secondary: Percentage of participants with Progression Free Survival (PFS) at 12 and 24 months

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    End point title
    Percentage of participants with Progression Free Survival (PFS) at 12 and 24 months
    End point description
    PFS was defined by the study protocol as the time from the date of start of study drug to the date of earliest progression to AP/BC, or the date of death from any cause.
    End point type
    Secondary
    End point timeframe
    12 months, 24 months
    End point values
    Nilotinib
    Number of subjects analysed
    1089
    Units: Percentage of participants
    number (not applicable)
        at 12 months
    99.2
        at 24 months
    99
    No statistical analyses for this end point

    Secondary: Rate of molecular response (MR4^0) at, as well as by, 12 and 24 months

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    End point title
    Rate of molecular response (MR4^0) at, as well as by, 12 and 24 months
    End point description
    MR4^0 was defined as either (i) detectable disease ≤ 0.01% BCR-ABL ratio (international scale (IS)) with mean ABL transcripts ≥ 10 000 or (ii) undetectable disease in complementary deoxyribonucleic acid (cDNA) with ≥ 10 000 ABL transcripts.
    End point type
    Secondary
    End point timeframe
    12 and 24 months
    End point values
    Nilotinib
    Number of subjects analysed
    1056
    Units: Percentage of particiapants
    number (not applicable)
        at 12 months
    30.7
        at 24 months
    40.2
        by month 12
    36.9
        by month 24
    55
    No statistical analyses for this end point

    Secondary: Rate of molecular response (MR4^5) at, as well as by, 12 and 24 months

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    End point title
    Rate of molecular response (MR4^5) at, as well as by, 12 and 24 months
    End point description
    MR4^5 was defined as either (i) detectable disease ≤ 0.0032% BCR-ABL ratio (IS) with mean ABL transcripts ≥ 32 000 or (ii) undetectable disease in cDNA with ≥ 32 000 ABL transcripts).
    End point type
    Secondary
    End point timeframe
    12 and 24 months
    End point values
    Nilotinib
    Number of subjects analysed
    1056
    Units: Percentage of particiapants
    number (not applicable)
        at 12 months
    15.2
        at 24 months
    21.9
        by 12 months
    20.6
        by 24 months
    38.4
    No statistical analyses for this end point

    Secondary: Rate of complete hematologic response (CHR) at, as well as by, 12 and 24 months

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    End point title
    Rate of complete hematologic response (CHR) at, as well as by, 12 and 24 months
    End point description
    CHR was defined as all of the following present for ≥ 4 weeks in the peripheral blood: WBC count < 10 x 109/L, Platelet count < 450 x 109/L, No circulating peripheral blood blasts, promyelocytes, myelocytes, or metamyelocytes in the peripheral blood, The presence of < 5% basophils, No evidence of disease-related symptoms and extramedullary disease, including spleen and liver. Loss of CHR was defined as the appearance of any of the following after having achieved a CHR confirmed by a second determination ≥ 4 weeks later (unless associated with progression to AP/BC or death, which was considered to be a confirmed loss of CHR event on its own): WBC count that increased to > 20.0 x 109/L, Platelet count that increased to ≥ 600 x 109/L, Any palpable spleen, defined as size of spleen below costal margin > 5 cm,  Appearance of > 5% myelocytes plus metamyelocytes, or any promyelocytes or blasts in the peripheral blood.
    End point type
    Secondary
    End point timeframe
    12 months, 24 months
    End point values
    Nilotinib
    Number of subjects analysed
    1089
    Units: Percentage of prticipants
    number (not applicable)
        by Month 24
    89.1
        at 12 months
    82.7
        at 24 months
    75.5
        by Month12
    86.2
    No statistical analyses for this end point

    Secondary: Percentage of participants with Event Free Survival (EFS) at 12 and 24 months

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    End point title
    Percentage of participants with Event Free Survival (EFS) at 12 and 24 months
    End point description
    EFS was defined as the time from the date of Day 1 (first treatment) + 1 day to the first occurrence of any of the following: Loss of CHR, Loss of CCyR, Death from any cause, Progression to the AP or BC of CML, Not achieving CHR up to 3 months (ie, 91 + 15 days), Not achieving CCyR up to 18 months (ie, 548 + 15 days), whichever is earlier.
    End point type
    Secondary
    End point timeframe
    12 months, 24 months
    End point values
    Nilotinib
    Number of subjects analysed
    1089
    Units: Percentage of participants
    number (not applicable)
        at 12 months
    71.7
        at 24 months
    69.1
    No statistical analyses for this end point

    Secondary: Percentage of participants with Overall Survival at 12 and 24 months

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    End point title
    Percentage of participants with Overall Survival at 12 and 24 months
    End point description
    OS was defined as the time between the date of Day 1 (first treatment) and the date of death from any cause. Deaths which occurred after the 24-month time window and which were occasionally reported by some Investigators were excluded from the analysis. This is in agreement with the protocol stating that patients were to be followed for survival and progression to AP/BC up to 24 months after the participants treatment start.
    End point type
    Secondary
    End point timeframe
    12 months, 24 months
    End point values
    Nilotinib
    Number of subjects analysed
    1089
    Units: Percentage of participants
    number (not applicable)
        at 12 months
    99.6
        at 24 months
    98.9
    No statistical analyses for this end point

    Secondary: Rate of molecular response (MR4^0) by 18 months

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    End point title
    Rate of molecular response (MR4^0) by 18 months
    End point description
    MR4^0 was defined as either (i) detectable disease ≤ 0.01% BCR-ABL ratio (international scale (IS)) with mean ABL transcripts ≥ 10 000 or (ii) undetectable disease in complementary deoxyribonucleic acid (cDNA) with ≥ 10 000 ABL transcripts. BCR = Breakpoint Cluster Region gene/BCR gene product BCR-ABL is fusion gene formed from the ABL gene from chromosome 9 fusing with the BCR gene on chromosome 22, the gene product is BCR-ABL tyrosine kinase
    End point type
    Secondary
    End point timeframe
    18 months
    End point values
    Nilotinib
    Number of subjects analysed
    1056
    Units: Percentage of particiapants
        number (not applicable)
    48.5
    No statistical analyses for this end point

    Secondary: Rate of molecular response (MR4^5) by 18 months

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    End point title
    Rate of molecular response (MR4^5) by 18 months
    End point description
    MR4^5 was defined as either (i) detectable disease ≤ 0.0032% BCR-ABL ratio (IS) with mean ABL transcripts ≥ 32 000 or (ii) undetectable disease in cDNA with ≥ 32 000 ABL transcripts). BCR = Breakpoint Cluster Region gene/BCR gene product BCR-ABL is fusion gene formed from the ABL gene from chromosome 9 fusing with the BCR gene on chromosome 22, the gene product is BCR-ABL tyrosine kinase
    End point type
    Secondary
    End point timeframe
    18 months
    End point values
    Nilotinib
    Number of subjects analysed
    1056
    Units: Percentage of particiapants
        number (not applicable)
    31.6
    No statistical analyses for this end point

    Secondary: Percentage of particiapnts with progression free survival in participants achieving MR4^0 at 12 months

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    End point title
    Percentage of particiapnts with progression free survival in participants achieving MR4^0 at 12 months
    End point description
    PFS was defined by the study protocol as the time from the date of start of study drug to the date of earliest progression to AP/BC, or the date of death from any cause.
    End point type
    Secondary
    End point timeframe
    12 months
    End point values
    Nilotinib
    Number of subjects analysed
    1089
    Units: Percentage of participants
        number (not applicable)
    100
    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 reported in this record are from date of 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
    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
    207 / 1089 (19.01%)
         number of deaths (all causes)
    4
         number of deaths resulting from adverse events
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Bladder neoplasm
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blast cell crisis
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Breast cancer
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cervix carcinoma
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholangiocarcinoma
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colorectal cancer
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colon adenoma
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Duodenal neoplasm
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Endometrial cancer
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Squamous cell carcinoma
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin cancer
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Retroperitoneal cancer
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Prostate cancer
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Non-Hodgkin's lymphoma
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Uterine leiomyoma
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary bladder adenoma
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Aneurysm ruptured
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Arterial occlusive disease
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Arterial haemorrhage
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Arterial disorder
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Aortic stenosis
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    Haemorrhage
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypertension
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Peripheral artery stenosis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Peripheral arterial occlusive disease
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Leriche syndrome
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypertensive crisis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Peripheral ischaemia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Raynaud's phenomenon
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Hysterectomy
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin neoplasm excision
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Device dislocation
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Drug resistance
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Fatigue
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Localised oedema
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Non-cardiac chest pain
         subjects affected / exposed
    4 / 1089 (0.37%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    6 / 1089 (0.55%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Soft tissue inflammation
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Drug hypersensitivity
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Benign prostatic hyperplasia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Genital pain
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Genital swelling
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metrorrhagia
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Menorrhagia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    5 / 1089 (0.46%)
         occurrences causally related to treatment / all
    3 / 8
         deaths causally related to treatment / all
    0 / 0
    Epistaxis
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Hyperventilation
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Sleep apnoea syndrome
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Bipolar disorder
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Confusional state
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Depression
         subjects affected / exposed
    4 / 1089 (0.37%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Depression suicidal
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Suicide attempt
         subjects affected / exposed
    3 / 1089 (0.28%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Amylase increased
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Blood creatine phosphokinase increased
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Blood pressure increased
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    C-reactive protein increased
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Electrocardiogram QT prolonged
         subjects affected / exposed
    3 / 1089 (0.28%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Lipase increased
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    3 / 1089 (0.28%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Transaminases increased
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Cervical vertebral fracture
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Clavicle fracture
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Coronary artery restenosis
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Exposure via father
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Overdose
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sternal injury
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rib fracture
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Road traffic accident
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Post procedural inflammation
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tendon rupture
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Congenital, familial and genetic disorders
    Atrial septal defect
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Acute coronary syndrome
         subjects affected / exposed
    3 / 1089 (0.28%)
         occurrences causally related to treatment / all
    2 / 4
         deaths causally related to treatment / all
    0 / 0
    Acute myocardial infarction
         subjects affected / exposed
    4 / 1089 (0.37%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Angina pectoris
         subjects affected / exposed
    6 / 1089 (0.55%)
         occurrences causally related to treatment / all
    2 / 6
         deaths causally related to treatment / all
    0 / 0
    Angina unstable
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Atrial flutter
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Arteriosclerosis coronary artery
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Aortic valve stenosis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    13 / 1089 (1.19%)
         occurrences causally related to treatment / all
    6 / 13
         deaths causally related to treatment / all
    0 / 0
    Mitral valve disease
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Coronary artery thrombosis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Coronary artery stenosis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    7 / 1089 (0.64%)
         occurrences causally related to treatment / all
    4 / 9
         deaths causally related to treatment / all
    0 / 0
    Mitral valve incompetence
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    3 / 1089 (0.28%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Pericardial effusion
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myocardial ischaemia
         subjects affected / exposed
    3 / 1089 (0.28%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    4 / 1089 (0.37%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Pericarditis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Sick sinus syndrome
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Prinzmetal angina
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Carotid artery stenosis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Carotid artery occlusion
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Aphasia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Carpal tunnel syndrome
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Facial paresis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cranial nerve disorder
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Cerebral ischaemia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cerebral haemorrhage
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Headache
         subjects affected / exposed
    5 / 1089 (0.46%)
         occurrences causally related to treatment / all
    3 / 5
         deaths causally related to treatment / all
    0 / 0
    Hyperaesthesia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Intracranial aneurysm
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Lethargy
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Memory impairment
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Motor neurone disease
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neuropathy peripheral
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Subarachnoid haemorrhage
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sciatica
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Occipital neuralgia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    VIIth nerve paralysis
         subjects affected / exposed
    1 / 1089 (0.09%)
         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
    5 / 1089 (0.46%)
         occurrences causally related to treatment / all
    3 / 5
         deaths causally related to treatment / all
    0 / 0
    Haemorrhagic anaemia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Leukopenia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Neutropenia
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Haemolytic anaemia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancytopenia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Splenic infarction
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    3 / 1089 (0.28%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 1
    Ear and labyrinth disorders
    Deafness
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Vertigo
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Conjunctival disorder
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Eye haemorrhage
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Diabetic retinopathy
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal hernia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain lower
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    4 / 1089 (0.37%)
         occurrences causally related to treatment / all
    2 / 6
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Duodenal ulcer haemorrhage
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Constipation
         subjects affected / exposed
    3 / 1089 (0.28%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Dysphagia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric ulcer perforation
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastritis
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrooesophageal sphincter insufficiency
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemorrhoids
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Haemorrhoids thrombosed
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ileus
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancreatic disorder
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancreatitis
         subjects affected / exposed
    6 / 1089 (0.55%)
         occurrences causally related to treatment / all
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Umbilical hernia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Small intestinal haemorrhage
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    5 / 1089 (0.46%)
         occurrences causally related to treatment / all
    2 / 5
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholangitis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholecystitis
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Gallbladder enlargement
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatic fibrosis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatic steatosis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatotoxicity
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Jaundice
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Diabetic foot
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Dry gangrene
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Photosensitivity reaction
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin haemorrhage
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haematuria
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Incontinence
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Renal colic
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal cyst
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal failure acute
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Urinary retention
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal impairment
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Endocrine disorders
    Goitre
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperthyroidism
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Inappropriate antidiuretic hormone secretion
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Thyroiditis subacute
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    5 / 1089 (0.46%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Arthropathy
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Arthralgia
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Bone pain
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Muscular weakness
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Intervertebral disc protrusion
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal pain
         subjects affected / exposed
    3 / 1089 (0.28%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Neck pain
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pain in extremity
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Rotator cuff syndrome
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Appendicitis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal abscess
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bronchopneumonia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infection
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gangrene
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Epididymitis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diverticulitis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Corneal abscess
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Perirectal abscess
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Phlebitis infective
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    4 / 1089 (0.37%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 1
    Rectal abscess
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection bacterial
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Viral pericarditis
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Diabetes mellitus
         subjects affected / exposed
    3 / 1089 (0.28%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Decreased appetite
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    2 / 1089 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Hypercholesterolaemia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Failure to thrive
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypophosphataemia
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Diabetes mellitus inadequate control
         subjects affected / exposed
    1 / 1089 (0.09%)
         occurrences causally related to treatment / all
    1 / 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
    841 / 1089 (77.23%)
    Investigations
    Blood bilirubin increased
         subjects affected / exposed
    80 / 1089 (7.35%)
         occurrences all number
    157
    Alanine aminotransferase increased
         subjects affected / exposed
    86 / 1089 (7.90%)
         occurrences all number
    117
    Lipase increased
         subjects affected / exposed
    76 / 1089 (6.98%)
         occurrences all number
    95
    Vascular disorders
    Hypertension
         subjects affected / exposed
    64 / 1089 (5.88%)
         occurrences all number
    69
    Nervous system disorders
    Headache
         subjects affected / exposed
    163 / 1089 (14.97%)
         occurrences all number
    206
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    65 / 1089 (5.97%)
         occurrences all number
    71
    Thrombocytopenia
         subjects affected / exposed
    111 / 1089 (10.19%)
         occurrences all number
    162
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    97 / 1089 (8.91%)
         occurrences all number
    113
    Fatigue
         subjects affected / exposed
    150 / 1089 (13.77%)
         occurrences all number
    183
    Gastrointestinal disorders
    Abdominal pain upper
         subjects affected / exposed
    88 / 1089 (8.08%)
         occurrences all number
    104
    Abdominal pain
         subjects affected / exposed
    79 / 1089 (7.25%)
         occurrences all number
    91
    Vomiting
         subjects affected / exposed
    62 / 1089 (5.69%)
         occurrences all number
    72
    Nausea
         subjects affected / exposed
    122 / 1089 (11.20%)
         occurrences all number
    147
    Constipation
         subjects affected / exposed
    65 / 1089 (5.97%)
         occurrences all number
    72
    Diarrhoea
         subjects affected / exposed
    93 / 1089 (8.54%)
         occurrences all number
    115
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    56 / 1089 (5.14%)
         occurrences all number
    65
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    115 / 1089 (10.56%)
         occurrences all number
    127
    Pruritus
         subjects affected / exposed
    180 / 1089 (16.53%)
         occurrences all number
    227
    Dry skin
         subjects affected / exposed
    93 / 1089 (8.54%)
         occurrences all number
    100
    Rash
         subjects affected / exposed
    233 / 1089 (21.40%)
         occurrences all number
    302
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    55 / 1089 (5.05%)
         occurrences all number
    61
    Musculoskeletal and connective tissue disorders
    Muscle spasms
         subjects affected / exposed
    93 / 1089 (8.54%)
         occurrences all number
    110
    Back pain
         subjects affected / exposed
    78 / 1089 (7.16%)
         occurrences all number
    93
    Arthralgia
         subjects affected / exposed
    96 / 1089 (8.82%)
         occurrences all number
    116
    Myalgia
         subjects affected / exposed
    99 / 1089 (9.09%)
         occurrences all number
    108
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    113 / 1089 (10.38%)
         occurrences all number
    147
    Metabolism and nutrition disorders
    Hypophosphataemia
         subjects affected / exposed
    77 / 1089 (7.07%)
         occurrences all number
    152

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    19 Mar 2010
    This amendment was a local, country-specific amendment for Germany and Spain. For Germany, the modifications were made in order to allow the switch from study drug to prescription drug in Germany after registration and reimbursement of nilotinib in the study indication. For Spain, a local sub-study to the main protocol was introduced and was described in Post Text Supplement (PTS) 1 which included the rationale and methodology for conducting the sub-study, which aimedto find biological, biochemical and molecular genetics biomarkers, both at the time of diagnosis and during treatment, to allow predicting response to nilotinib in patients with newly diagnosed CML.
    11 May 2010
    The rationale of Amendment 2 was to specify alternative wording to an existing inclusion
    29 Jun 2010
    Amendment 3 clarified a number of definitions, analyses and tests relating to the conduct of the study, specifically addressing the assessments and visits to be performed during the study, and the assessment of the study endpoints.
    02 Aug 2010
    Incorporated the changes requested by the German IRB committee into the protocol, Referenced the addition of 10 sub-studies to the core protocol as PTS, which Included biological, biochemical, and molecular genetics biomarkers, Added study the stem cell compartment and analyze the correlation between telomere lengths and response to treatment, Included analysis of nilotinib blood plasma levels during treatment, Added study adherence to treatment and quality of life.
    07 Oct 2010
    This local amendment made changes to PTS 4 (a multinational sub-study on the determination of plasma nilotinib levels and single cell quantification of phosphoprotein response during nilotinib treatment in early chronic phase CML). These changes involved: Amendments to the PTS 4 visit schedule table and subsequent alignment of text throughout the document, Amendment of PTS 4 laboratory methodology text.
    09 Feb 2011
    The rationale of this substantial global amendment was to Amend the statistical sections to allow for extension of recruitment in order to completethe sub-studies after the completion of the core trial and Clarify the populations for analysis, providing the rationale for the interim analyses and providing further clarity to the analysis of “by” and “at” time points.
    25 Mar 2011
    These changes involved: Amendments to the methodology section in PTS 1, Amendments to the sample collection methodology in PTS 6, Removal of reference to a participating country (Belgium) and amendment of text relatingto the validation of samples in PTS 7, Amendments to visit schedule and assessments in PTS 9.
    25 Jul 2011
    This substantial local amendment was to allow for prolongation of recruitment in Germany in
    23 Sep 2011
    To include the new EUTOS prognostic score in the analysis of prognosis at diagnosis
    23 Jan 2012
    This local amendment changes involved: Amendments to multiple sections of PTS 10 to revise the text in line with the new working definition of complete molecular response, as introduced in Amendment 9, Amendments to the data collection and data review sections of PTS 11.
    23 Apr 2012
    Amendment 11 provided continued access to nilotinib to patients in study CAMN107EIC01 who a) benefitted from treatment with nilotinib and b) who resided in a country in which nilotinib was not yet reimbursed. Study CAMN107EIC01 was designed to treat patients for a duration of 24 months with nilotinib within the context of the study: following completion of 18 months of study treatment (the primary efficacy analysis time point) all patients were scheduled to receive treatment and be followed up for further 6 months. With this amendment Novartis ensured that patients in countries in which Tasigna 150 mg capsules were not yet reimbursed for the treatment of newly diagnosed patients with Ph+ CML CP had continued access to Tasigna if - according to the Investigator’s judgment - they benefitted from it. The amendment applied to the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Portugal and Romania. The study duration for patients in these countries was extended beyond 24 months until February 2014, at which time LPLV for study CAMN107EIC01 was scheduled.The patients were to receive commercial drug as soon as the 150 mg capsules were reimbursed in the respective country.
    10 Jan 2013
    Amendment 12 provided continued access to nilotinib for patients in study CAMN107EIC01 who a) benefitted from treatment with nilotinib and b) resided in Slovakia or Croatia where nilotinib was not yet reimbursed. Patients were to receive commercial drug as soon as the 150 mg capsules were reimbursed in Slovakia or Croatia. To ensure that legal requirements for prescriptions were met it was added that the prescriptionof nilotinib exclusively followed the assessment of the patient’s individual medical need. Finally, the schedule of assessment for patients who resided in Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Portugal, Slovakia, Croatia and Romania was added.
    16 Dec 2013
    To update the efficacy and safety data of nilotinib according to the Investigator’s Brochure Edition 9 (June 2013), focusing on the 48 month update of the CAMN107A2303 study in newly diagnosed CML-CP patients and 24 month update of the phase I/II open-label study CAMN107A2101 in CML patients. To prolong the study to guarantee continued access to nilotinib for patients who reside in countries where nilotinib was not reimbursed by end of February 2014 and who were deriving benefit from study treatment according to medical judgment. The overall LPLV was to occur on 30-Jun-2014. In case nilotinib was not yet locally reimbursed by 30-Jun-2014, an alternative program to provide patients with nilotinib was activated in each country according to local regulation.To update the definition of EFS based on the CML management recommendations byEuropean LeukemiaNet (Baccarani et al 2009) and SSMC.To clarify the definition of progression to AP/BC and PFS. Furthermore, changes were made on the statistical sections to better clarify the analysis methods. In addition minor inconsistencies and typos in the protocol were corrected.

    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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