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    Clinical Trial Results:
    AN OPEN LABEL PHASE II STUDY TO EVALUATE THE EFFICACY AND SAFETY OF INDUCTION AND CONSOLIDATION THERAPY WITH NILOTINIB IN COMBINATION WITH CHEMOTHERAPY IN PATIENTS AGED 55 YEARS AND OVER WITH PHILADELPHIA CHROMOSOME POSITIVE (PH+ OR BCR-ABL+) ACUTE LYMPHOBLASTIC LEUKEMIA (ALL).

    Summary
    EudraCT number
    2010-022855-46
    Trial protocol
    DE   IT   ES  
    Global end of trial date
    10 Mar 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    02 Jun 2022
    First version publication date
    02 Jun 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    EWALL-PH-02
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01528085
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    Novartis internal Code: CAMN107ADE03T
    Sponsors
    Sponsor organisation name
    Goethe University
    Sponsor organisation address
    Theodor-Stern-Kai 7, Frankfurt, Germany, 60590
    Public contact
    Universitätsklinikum Studienzentrale, Med. Klinik II, Goethe University, +49 (0)6963016366, gmall@em.uni-frankfurt.de
    Scientific contact
    Universitätsklinikum Studienzentrale, Med. Klinik II, Goethe University, +49 (0)6963016366, gmall@em.uni-frankfurt.de
    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
    10 Mar 2020
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    10 Mar 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the efficacy of a nilotinib-based induction and consolidation therapy.
    Protection of trial subjects
    A Data Safty Monitoring Board (DSMB) has been instituted for this study in order to ensure its ongoing safety. Safety review meeting will be held as required by the sponsor. Decisions on trial termination, amendment or cessation of patient recruitment based on safety findings will be based on recommendations of the DSMB.
    Background therapy
    PREPHASE (not part of the protocol): Dexamethasone; Intrathecal (i.th.) injection no.1(MTX); Optional: Cyclophosphamide INDUCTION (day 1) : Vincristine; Dexamethasone; Intrathecal injection (triple); G-CSF CONS I (week 8), CONS III (week 16) and CONS V (week 24): Methotrexate with folinic acid rescue; Asparaginase; G-CSF; Intrathecal injection (triple) CONS II (week 12), CONS IV (week 20), CONS VI (week 28): Cytarabine; G-CSF MAINTENANCE (month 8 to month 24): 6-MP; methotrexate; Dexamethasone; vincristine; Intrathecal injection (i.th.) Nilotinib 400mg BID d1 throughout induction, consolidation and maintenance until month 24
    Evidence for comparator
    N.A.
    Actual start date of recruitment
    17 Nov 2011
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Efficacy
    Long term follow-up duration
    1 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 46
    Country: Number of subjects enrolled
    Germany: 33
    Worldwide total number of subjects
    79
    EEA total number of subjects
    79
    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)
    29
    From 65 to 84 years
    49
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    09-Feb-2012 FPI (First Patient In); 08-Jun-2015 LPI (Last Patient In), Trial has been activated in Germany, France and Spain. No Patient in Spain had been recruited.

    Pre-assignment
    Screening details
    Screening applies to confirmed new diagnosis of Philadelphia chromosome or BCR-ABL positive acute lymphoblastic leukaemia (ALL) in Patients 55 years or older.BCR-ABL Assessment is standard of care for ALL. First-line-Therapy (Not previously treated except for prephase therapy)

    Period 1
    Period 1 title
    overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    N.A. (open-label single-arm phase II study) Nilotinib+ Chemotherapy

    Arms
    Arm title
    Nilotinib + Chemotherapy (open-label single-arm study)
    Arm description
    Nilotinib + Backbone Chemotherapy as described above
    Arm type
    open-label single-arm study

    Investigational medicinal product name
    Nilotinib
    Investigational medicinal product code
    Other name
    Tasigna
    Pharmaceutical forms
    Coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    400mg BID, in case of toxicitiy dose reduction possible

    Number of subjects in period 1
    Nilotinib + Chemotherapy (open-label single-arm study)
    Started
    79
    Completed
    74
    Not completed
    5
         not evaluabl. and Premat. discontinuation
    5

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    overall trial (overall period)
    Reporting group description
    All PAtients enrolled, 74 of them evaluable

    Reporting group values
    overall trial (overall period) Total
    Number of subjects
    79 79
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        median (full range (min-max))
    66 (55 to 85) -
    Gender categorical
    Units: Subjects
        Female
    44 44
        Male
    35 35
    Subject analysis sets

    Subject analysis set title
    Evaluable Patients
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All Evaluable Patients

    Subject analysis sets values
    Evaluable Patients
    Number of subjects
    74
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        median (full range (min-max))
    66 (55 to 85)
    Gender categorical
    Units: Subjects
        Female
    40
        Male
    34

    End points

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    End points reporting groups
    Reporting group title
    Nilotinib + Chemotherapy (open-label single-arm study)
    Reporting group description
    Nilotinib + Backbone Chemotherapy as described above

    Subject analysis set title
    Evaluable Patients
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All Evaluable Patients

    Primary: Event Free Survival

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    End point title
    Event Free Survival [1]
    End point description
    To evaluate the efficacy of a nilotinib-based induction and consolidation therapy.
    End point type
    Primary
    End point timeframe
    12 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: Only descriptive statistics
    End point values
    Evaluable Patients
    Number of subjects analysed
    74
    Units: Percent
    76
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    AEs collected under Nilotinib treatment up to max 2 years.
    Adverse event reporting additional description
    Only Non-Serious-Adverse-Events with max. CTCAE Grade 3 or 4 are collected. Observed SAEs are listed with all reported events (One case can include more than one event.)
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE
    Dictionary version
    4
    Reporting groups
    Reporting group title
    Evaluable Patients
    Reporting group description
    All Patients until EOT (Nilo Treatment max 2 years+ safety Intervall, No post SCT Events included)

    Serious adverse events
    Evaluable Patients
    Total subjects affected by serious adverse events
         subjects affected / exposed
    51 / 74 (68.92%)
         number of deaths (all causes)
    3
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    central nervous system leukaemia
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intestinal adenocarcinoma
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Prostate cancer recurrent
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Squamous cell carcinoma
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Tyroid cancer metastatic
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Hypotension
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Stent placement
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Drug effect prolonged
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Injection site thrombosis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Malaise
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Mucosal inflammation
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Prostatitis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
    Additional description: Observed SAEs are listed with all reported events and one case can include more than one event. Therfore single cases of fatality may be documented in more than one event.
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Dyspnoea
    Additional description: Observed SAEs are listed with all reported events and one case can include more than one event. Therfore single cases of fatality may be documented in more than one event.
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    1 / 1
    Epistaxis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung disorder
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary oedema
    Additional description: Observed SAEs are listed with all reported events and one case can include more than one event. Therfore single cases of fatality may be documented in more than one event.
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Respiratory failure
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Bipolar I disorder
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    C-reactive protein increased
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chemotherapeutic drug level increased
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Liver function test increased
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Atrial flutter
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Ischaemic cardiomyopathy
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Brain Oedema
    Additional description: Observed SAEs are listed with all reported events and one case can include more than one event. Therfore single cases of fatality may be documented in more than one event.
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Cerebral haemorrhage
    Additional description: Observed SAEs are listed with all reported events and one case can include more than one event. Therfore single cases of fatality may be documented in more than one event.
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Headache
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Intracranial haematoma
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Ischaemic cerebral infarction
    Additional description: Observed SAEs are listed with all reported events and one case can include more than one event. Therfore single cases of fatality may be documented in more than one event.
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Paresis cranial nerve
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anemia
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Bone Marrow failure
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Cytopenia
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile bone marrow aplasia
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    10 / 74 (13.51%)
         occurrences causally related to treatment / all
    0 / 13
         deaths causally related to treatment / all
    0 / 0
    Neutropenia
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pancytopenia
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    6 / 74 (8.11%)
         occurrences causally related to treatment / all
    3 / 6
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Eyelid ptosis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal Pain
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Colitis ischaemic
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Duodenal obstruction
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Faecaloma
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ileus paralytic
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Stomatitis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholestasis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatocellular injury
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Angioedema
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haematuria
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal failure
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Bone Pain
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fasciitis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal pain
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pain in extremity
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Abscess limb
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Bacterial infection
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Bacterial sepsis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cystitis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Device related infection
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Enterobacter sepsis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Escherichia bacteraemia
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Escherichia sepsis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis norovirus
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infection
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Mucormycosis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumocystis jirovecii infection
    Additional description: Observed SAEs are listed with all reported events and one case can include more than one event. Therfore single cases of fatality may be documented in more than one event.
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Pneumocystis jirovecii pneumonia
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Pneumonia fungal
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Prostate infection
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pseudomonas infection
    Additional description: Observed SAEs are listed with all reported events and one case can include more than one event. Therfore single cases of fatality may be documented in more than one event.
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Pyelonephritis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Septic shock
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences causally related to treatment / all
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    Staphylococcal infection
    Additional description: Observed SAEs are listed with all reported events and one case can include more than one event. Therfore single cases of fatality may be documented in more than one event.
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Tonsillitis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Hyperglycaemia
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 4%
    Non-serious adverse events
    Evaluable Patients
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    71 / 74 (95.95%)
    Vascular disorders
    Thrombosis/embolism (vascular access-related)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Blood and lymphatic system disorders
    Hemoglobin
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    14 / 74 (18.92%)
         occurrences all number
    24
    Leukocytes (total WBC)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    13 / 74 (17.57%)
         occurrences all number
    20
    Neutrophils/granulocytes (ANC/AGC)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    23 / 74 (31.08%)
         occurrences all number
    60
    Platelets
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    38 / 74 (51.35%)
         occurrences all number
    71
    Blood/Bone Marrow - Other (Specify, __)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    14
    General disorders and administration site conditions
    Weight loss
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences all number
    3
    Pain
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    6
    Gastrointestinal disorders
    Anorexia
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences all number
    3
    Diarrhea
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences all number
    4
    Mucositis/stomatitis (clinical exam)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Nausea
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    6
    Hepatobiliary disorders
    Hepatobiliary/Pancreas - Other (Specify, __)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences all number
    3
    Respiratory, thoracic and mediastinal disorders
    Pneumonitis/pulmonary infiltrates
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Renal and urinary disorders
    Cystitis
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences all number
    3
    Renal failure
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    9 / 74 (12.16%)
         occurrences all number
    10
    Renal/Genitourinary - Other (Specify, __)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Infections and infestations
    Febrile neutropenia (fever of unknown origin without clinically or microb. infection)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    19 / 74 (25.68%)
         occurrences all number
    32
    Infection (documented clinically or microbiologically) with Grade 3 or 4 neutrophils (ANC <1.0 x 10e
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    20 / 74 (27.03%)
         occurrences all number
    24
    Infection - Other (Specify, __)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Infection with normal ANC or Grade 1 or 2 neutrophils
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    10 / 74 (13.51%)
         occurrences all number
    14
    Infection with unknown ANC
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences all number
    4
    Metabolism and nutrition disorders
    ALT, SGPT (serum glutamic pyruvic transaminase)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    11 / 74 (14.86%)
         occurrences all number
    13
    AST, SGOT(serum glutamic oxaloacetic transaminase)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Bilirubin (hyperbilirubinemia)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    9 / 74 (12.16%)
         occurrences all number
    13
    GGT (gamma-Glutamyl transpeptidase)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    14 / 74 (18.92%)
         occurrences all number
    19
    Glucose, serum-high (hyperglycemia)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences all number
    3
    Metabolic/Laboratory - Other (Specify, __)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Uric acid, serum-high (hyperuricemia)
    Additional description: Occurrence of CTCAE Grad 3 and 4
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences all number
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    06 Jan 2014
    Protocol V3 (prolongation of recruitment phase)
    15 Sep 2014
    Protocol V4 (Number of patients/Sample Size increased: 75 evaluable Patients)
    19 Mar 2015
    Protocol V5 (Change in the Position of the “Clinical Trial Leader” / “Leiter der Klinischen Prüfung” according to German AMG)

    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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