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    Clinical Trial Results:
    Trial in Extensive-Disease Small Cell Lung Cancer (ED-SCLC) Subjects Comparing Ipilimumab Plus Etoposide and Platinum Therapy to Etoposide and Platinum Therapy Alone

    Summary
    EudraCT number
    2011-000850-48
    Trial protocol
    BE   FI   IT   SE   DE   CZ   AT   GB   PT   HU   ES   NL   IE   FR  
    Global end of trial date
    17 May 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    02 Jun 2018
    First version publication date
    02 Jun 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CA184-156
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01450761
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Bristol-Myers Squibb
    Sponsor organisation address
    Chaussée de la Hulpe 185, Brussels, Belgium, 1170
    Public contact
    EU Study Start-Up Unit, Bristol-Myers Squibb International Corporation, clinical.trials@bms.com
    Scientific contact
    BMS Study Director, Bristol-Myers Squibb, Clinical.Trials@bms.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    17 May 2017
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    17 May 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The purpose of the study is to determine whether the addition of Ipilimumab to Etoposide and Platinum therapy will extend the lives of patients with Extensive-Stage Disease Small Cell Lung Cancer (ED-SCLC) more than Etoposide and Platinum therapy alone.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and in compliance with all International Conference on Harmonization Good Clinical Practice Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were followed.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    31 Jan 2012
    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
    Argentina: 9
    Country: Number of subjects enrolled
    Austria: 40
    Country: Number of subjects enrolled
    Belgium: 26
    Country: Number of subjects enrolled
    Brazil: 5
    Country: Number of subjects enrolled
    Canada: 3
    Country: Number of subjects enrolled
    Chile: 4
    Country: Number of subjects enrolled
    China: 113
    Country: Number of subjects enrolled
    Colombia: 1
    Country: Number of subjects enrolled
    Czech Republic: 41
    Country: Number of subjects enrolled
    Germany: 120
    Country: Number of subjects enrolled
    Spain: 54
    Country: Number of subjects enrolled
    France: 16
    Country: Number of subjects enrolled
    United Kingdom: 24
    Country: Number of subjects enrolled
    Hong Kong: 5
    Country: Number of subjects enrolled
    Hungary: 104
    Country: Number of subjects enrolled
    Ireland: 7
    Country: Number of subjects enrolled
    Israel: 24
    Country: Number of subjects enrolled
    Italy: 11
    Country: Number of subjects enrolled
    Japan: 96
    Country: Number of subjects enrolled
    Korea, Republic of: 72
    Country: Number of subjects enrolled
    Mexico: 5
    Country: Number of subjects enrolled
    Netherlands: 17
    Country: Number of subjects enrolled
    Peru: 1
    Country: Number of subjects enrolled
    Poland: 109
    Country: Number of subjects enrolled
    Portugal: 10
    Country: Number of subjects enrolled
    Russian Federation: 188
    Country: Number of subjects enrolled
    Sweden: 7
    Country: Number of subjects enrolled
    Thailand: 8
    Country: Number of subjects enrolled
    Taiwan: 7
    Country: Number of subjects enrolled
    United States: 274
    Country: Number of subjects enrolled
    South Africa: 5
    Country: Number of subjects enrolled
    Switzerland: 8
    Worldwide total number of subjects
    1414
    EEA total number of subjects
    586
    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)
    841
    From 65 to 84 years
    572
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Of the 1414 enrolled participants, 566 participants each were randomized to Ipilimumab and placebo arms. The remaining 282 participants were not randomized, the most frequently reported reason being that the participants no longer met study criteria.

    Period 1
    Period 1 title
    Randomization
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Ipilimumab and platinum/etoposide
    Arm description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with ipilimumab (10 mg/kg IV) every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, ipilimumab (10 mg/kg IV) was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of ipilimumab.
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Arm title
    Placebo and platinum/etoposide
    Arm description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with placebo every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, placebo was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of placebo.
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 1
    Ipilimumab and platinum/etoposide Placebo and platinum/etoposide
    Started
    566
    566
    Completed
    562
    561
    Not completed
    4
    5
         Consent withdrawn by subject
    2
    -
         Disease progression
    -
    2
         Adverse event unrelated to study drug
    1
    -
         Unspecified
    -
    1
         Subject no longer meets study criteria
    1
    2
    Period 2
    Period 2 title
    Lead-in Chemotherapy
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Ipilimumab and platinum/etoposide
    Arm description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with ipilimumab (10 mg/kg IV) every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, ipilimumab (10 mg/kg IV) was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of ipilimumab.
    Arm type
    Experimental

    Investigational medicinal product name
    Ipilimumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    ipilimumab (10 mg/kg IV) every 3 weeks

    Arm title
    Placebo and platinum/etoposide
    Arm description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with placebo every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, placebo was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of placebo.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Placebo administered by IV every 3 weeks

    Number of subjects in period 2
    Ipilimumab and platinum/etoposide Placebo and platinum/etoposide
    Started
    562
    561
    Completed
    478
    476
    Not completed
    84
    85
         Adverse event, serious fatal
    3
    3
         Consent withdrawn by subject
    14
    12
         Disease progression
    33
    32
         Study drug toxicity
    6
    10
         Adverse event unrelated to study drug
    21
    19
         No longer meets study criteria
    3
    7
         Unspecified
    2
    2
         Lost to follow-up
    2
    -
    Period 3
    Period 3 title
    Treatment with blinded study therapy
    Is this the baseline period?
    Yes [1]
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Ipilimumab and platinum/etoposide
    Arm description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with ipilimumab (10 mg/kg IV) every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, ipilimumab (10 mg/kg IV) was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of ipilimumab.
    Arm type
    Experimental

    Investigational medicinal product name
    Ipilimumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    ipilimumab (10 mg/kg IV) every 12 weeks

    Arm title
    Placebo and platinum/etoposide
    Arm description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with placebo every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, placebo was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of placebo.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Placebo administered by IV every 12 weeks

    Notes
    [1] - Period 1 is not the baseline period. It is expected that period 1 will be the baseline period.
    Justification: Baseline statistics were calculated for subjects that received at least one dose of blinded study therapy.
    Number of subjects in period 3 [2]
    Ipilimumab and platinum/etoposide Placebo and platinum/etoposide
    Started
    478
    476
    Completed
    0
    0
    Not completed
    478
    476
         Subject request to discontinue treatment
    15
    8
         Disease progression
    318
    415
         Other/Unspecified
    5
    4
         Maximum clinical benefit
    1
    2
         No longer meets study criteria
    1
    2
         Consent withdrawn by subject
    12
    5
         Study drug toxicity
    87
    9
         Death
    5
    6
         Not reported
    2
    2
         Adverse event unrelated to study drug
    27
    19
         Lost to follow-up
    2
    1
         Poor/non-compliance
    1
    -
         Administrative reason by sponsor
    2
    3
    Notes
    [2] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: Of the 1414 enrolled subjects, 566 participants each were randomized to Ipilimumab and placebo arms. The remaining 282 subjects were not randomized, the most frequently reported reason being that the subjects no longer met study criteria.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Ipilimumab and platinum/etoposide
    Reporting group description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with ipilimumab (10 mg/kg IV) every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, ipilimumab (10 mg/kg IV) was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of ipilimumab.

    Reporting group title
    Placebo and platinum/etoposide
    Reporting group description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with placebo every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, placebo was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of placebo.

    Reporting group values
    Ipilimumab and platinum/etoposide Placebo and platinum/etoposide Total
    Number of subjects
    478 476 954
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    299 277 576
        From 65-84 years
    178 199 377
        85 years and over
    1 0 1
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    61.3 ( 8.90 ) 62.6 ( 8.61 ) -
    Sex: Female, Male
    Units: Subjects
        Female
    161 150 311
        Male
    317 326 643

    End points

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    End points reporting groups
    Reporting group title
    Ipilimumab and platinum/etoposide
    Reporting group description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with ipilimumab (10 mg/kg IV) every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, ipilimumab (10 mg/kg IV) was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of ipilimumab.

    Reporting group title
    Placebo and platinum/etoposide
    Reporting group description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with placebo every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, placebo was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of placebo.
    Reporting group title
    Ipilimumab and platinum/etoposide
    Reporting group description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with ipilimumab (10 mg/kg IV) every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, ipilimumab (10 mg/kg IV) was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of ipilimumab.

    Reporting group title
    Placebo and platinum/etoposide
    Reporting group description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with placebo every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, placebo was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of placebo.
    Reporting group title
    Ipilimumab and platinum/etoposide
    Reporting group description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with ipilimumab (10 mg/kg IV) every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, ipilimumab (10 mg/kg IV) was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of ipilimumab.

    Reporting group title
    Placebo and platinum/etoposide
    Reporting group description
    During the lead-in chemotherapy (induction) phase, participants received platinum/etoposide (investigator's choice of platinum) every 3 weeks for 4 cycles, with placebo every 3 weeks for cycles 3-6. During the treatment with blinded study therapy phase, placebo was administered every 12 weeks, beginning 9-12 weeks after the last induction dose, for a maximum treatment period of 3 years from the first dose of placebo.

    Primary: Overall Survival (OS) in participants who received at least one dose of blinded study therapy

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    End point title
    Overall Survival (OS) in participants who received at least one dose of blinded study therapy
    End point description
    Overall Survival was defined as the time from the date of randomization until the date of death from any cause. For participants without documentation of death, OS was censored on the last date the participant was known to be alive.
    End point type
    Primary
    End point timeframe
    Randomization until date of death, up to March 2015, approximately 38 months
    End point values
    Ipilimumab and platinum/etoposide Placebo and platinum/etoposide
    Number of subjects analysed
    478
    476
    Units: months
        median (confidence interval 95%)
    10.97 (10.45 to 11.33)
    10.94 (10.02 to 11.50)
    Statistical analysis title
    Comparison of Overall Survival
    Statistical analysis description
    Comparison of Overall Survival Between Treatment Groups in Randomized Subjects who Received At Least One Dose of Blinded Study Therapy
    Comparison groups
    Ipilimumab and platinum/etoposide v Placebo and platinum/etoposide
    Number of subjects included in analysis
    954
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.3775
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.936
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.807
         upper limit
    1.085

    Secondary: Overall Survival in all Randomized Participants

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    End point title
    Overall Survival in all Randomized Participants
    End point description
    Overall Survival was defined as the time from the date of randomization until the date of death from any cause. For participants without documentation of death, OS was censored on the last date the participant was known to be alive.
    End point type
    Secondary
    End point timeframe
    From randomization until date of death, up to March 2015, approximately 38 months
    End point values
    Ipilimumab and platinum/etoposide Placebo and platinum/etoposide
    Number of subjects analysed
    566
    566
    Units: months
        median (confidence interval 95%)
    10.22 (9.59 to 10.81)
    9.95 (9.33 to 10.94)
    Statistical analysis title
    Comparison of Overall Survival
    Statistical analysis description
    Comparison of Overall Survival Between Treatment Groups in All Randomized Subjects
    Comparison groups
    Ipilimumab and platinum/etoposide v Placebo and platinum/etoposide
    Number of subjects included in analysis
    1132
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.5678
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.961
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.838
         upper limit
    1.102

    Secondary: Progression Free Survival (PFS) time in participants who have received at least one dose of blinded study therapy

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    End point title
    Progression Free Survival (PFS) time in participants who have received at least one dose of blinded study therapy
    End point description
    Progression-Free Survival was defined as the time from the date of randomization to the date of progression per modified World Health Organization (mWHO) criteria or death, whichever occured first. A participant who died without reported progression per mWHO criteria was considered progressed on the date of death. For those participants who remained alive and did not progress, PFS was censored on the date of last evaluable tumor assessment. For those participants who remained alive and had no recorded post-baseline tumor assessment, PFS was censored on the day of randomization.
    End point type
    Secondary
    End point timeframe
    From randomization until disease progression, up to March 2015, approximately 38 months
    End point values
    Ipilimumab and platinum/etoposide Placebo and platinum/etoposide
    Number of subjects analysed
    478
    476
    Units: months
        median (confidence interval 95%)
    4.63 (4.50 to 4.99)
    4.44 (4.37 to 4.63)
    Statistical analysis title
    Comparison of Progression-Free Survival
    Statistical analysis description
    Comparison of Progression-Free Survival Between Treatment Groups in Randomized Subjects who Received At Least one Dose of Blinded Study Therapy
    Comparison groups
    Ipilimumab and platinum/etoposide v Placebo and platinum/etoposide
    Number of subjects included in analysis
    954
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0161
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.851
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.747
         upper limit
    0.971

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first dose to last dose plus 90 days, through study completion (May 2017)
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.0
    Reporting groups
    Reporting group title
    10 MG/KG IPILIMUMAB + PLATINUM/ETOPOSIDE
    Reporting group description
    Subjects received platinum/etoposide (investigator’s choice of platinum) every 3 weeks for 4 cycles with Ipilimumab 10 milligram per kilogram (mg/kg) was administered intravenously (IV) every 3 weeks from cycles 3 - 6 of the induction phase . During the Maintenance phase ipilimiumab (10 mg/kg IV) was administered every 12 weeks, beginning 9-12 weeks after the last Induction dose, for a maximum treatment period of 3 years from the first dose of ipilimumab.

    Reporting group title
    PLACEBO + PLATINUM/ETOPOSIDE
    Reporting group description
    Subjects received platinum/etoposide (investigator’s choice of platinum) every 3 weeks for 4 cycles with placebo every 3 weeks from cycle 3-6 during the Induction phase. During the Maintenance phase placebo was administered every 12 weeks, beginning 9-12 weeks after the last Induction dose, for a maximum treatment period of 3 years from the first dose of placebo.

    Serious adverse events
    10 MG/KG IPILIMUMAB + PLATINUM/ETOPOSIDE PLACEBO + PLATINUM/ETOPOSIDE
    Total subjects affected by serious adverse events
         subjects affected / exposed
    316 / 562 (56.23%)
    278 / 561 (49.55%)
         number of deaths (all causes)
    91
    118
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Bone neoplasm
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colon cancer
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung cancer metastatic
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Lung neoplasm malignant
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Malignant neoplasm progression
         subjects affected / exposed
    36 / 562 (6.41%)
    43 / 561 (7.66%)
         occurrences causally related to treatment / all
    0 / 39
    0 / 45
         deaths causally related to treatment / all
    0 / 30
    0 / 38
    Metastases to central nervous system
         subjects affected / exposed
    3 / 562 (0.53%)
    8 / 561 (1.43%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 8
         deaths causally related to treatment / all
    0 / 1
    0 / 2
    Metastases to meninges
         subjects affected / exposed
    3 / 562 (0.53%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 1
         deaths causally related to treatment / all
    0 / 3
    0 / 0
    Metastatic neoplasm
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Metastatic pain
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neoplasm progression
         subjects affected / exposed
    0 / 562 (0.00%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Small cell lung cancer
         subjects affected / exposed
    9 / 562 (1.60%)
    13 / 561 (2.32%)
         occurrences causally related to treatment / all
    0 / 9
    0 / 13
         deaths causally related to treatment / all
    0 / 8
    0 / 12
    Tumour embolism
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour haemorrhage
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Tumour pain
         subjects affected / exposed
    0 / 562 (0.00%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Circulatory collapse
         subjects affected / exposed
    1 / 562 (0.18%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 2
    Deep vein thrombosis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Embolism
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peripheral arterial occlusive disease
         subjects affected / exposed
    0 / 562 (0.00%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peripheral ischaemia
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Superior vena cava syndrome
         subjects affected / exposed
    0 / 562 (0.00%)
    7 / 561 (1.25%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombophlebitis
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombosis
         subjects affected / exposed
    2 / 562 (0.36%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular occlusion
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    4 / 562 (0.71%)
    5 / 561 (0.89%)
         occurrences causally related to treatment / all
    0 / 4
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    5 / 562 (0.89%)
    5 / 561 (0.89%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Condition aggravated
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Death
         subjects affected / exposed
    4 / 562 (0.71%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 3
         deaths causally related to treatment / all
    0 / 3
    0 / 3
    Disease progression
         subjects affected / exposed
    6 / 562 (1.07%)
    9 / 561 (1.60%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 9
         deaths causally related to treatment / all
    0 / 3
    0 / 9
    Euthanasia
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Fatigue
         subjects affected / exposed
    4 / 562 (0.71%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    1 / 5
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    13 / 562 (2.31%)
    5 / 561 (0.89%)
         occurrences causally related to treatment / all
    3 / 16
    1 / 5
         deaths causally related to treatment / all
    0 / 3
    1 / 2
    Influenza like illness
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malaise
         subjects affected / exposed
    1 / 562 (0.18%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Multi-Organ failure
         subjects affected / exposed
    0 / 562 (0.00%)
    6 / 561 (1.07%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    1 / 5
    Non-Cardiac chest pain
         subjects affected / exposed
    2 / 562 (0.36%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain
         subjects affected / exposed
    1 / 562 (0.18%)
    4 / 561 (0.71%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    7 / 562 (1.25%)
    5 / 561 (0.89%)
         occurrences causally related to treatment / all
    1 / 7
    2 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sudden cardiac death
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Sudden death
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Immune system disorders
    Drug hypersensitivity
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Food allergy
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypersensitivity
         subjects affected / exposed
    2 / 562 (0.36%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Prostatitis
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Acute respiratory failure
         subjects affected / exposed
    1 / 562 (0.18%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Apnoea
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchospasm
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    4 / 562 (0.71%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    1 / 4
    1 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cough
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    13 / 562 (2.31%)
    16 / 561 (2.85%)
         occurrences causally related to treatment / all
    1 / 13
    2 / 16
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Epistaxis
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    4 / 562 (0.71%)
    5 / 561 (0.89%)
         occurrences causally related to treatment / all
    1 / 5
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hiccups
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoxia
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Interstitial lung disease
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Obstructive airways disorder
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    6 / 562 (1.07%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 6
    2 / 5
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Pneumonitis
         subjects affected / exposed
    2 / 562 (0.36%)
    4 / 561 (0.71%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary artery thrombosis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    9 / 562 (1.60%)
    4 / 561 (0.71%)
         occurrences causally related to treatment / all
    2 / 9
    0 / 4
         deaths causally related to treatment / all
    0 / 1
    0 / 3
    Pulmonary haemorrhage
         subjects affected / exposed
    1 / 562 (0.18%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Respiratory distress
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    9 / 562 (1.60%)
    14 / 561 (2.50%)
         occurrences causally related to treatment / all
    1 / 9
    0 / 15
         deaths causally related to treatment / all
    0 / 4
    0 / 12
    Psychiatric disorders
    Acute psychosis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anxiety
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Confusional state
         subjects affected / exposed
    1 / 562 (0.18%)
    4 / 561 (0.71%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Depression
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mental disorder
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mental status changes
         subjects affected / exposed
    2 / 562 (0.36%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    3 / 562 (0.53%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood sodium decreased
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Full blood count decreased
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical condition abnormal
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoglobin decreased
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lipase increased
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Weight decreased
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Contrast media reaction
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Femoral neck fracture
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fracture
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hip fracture
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Overdose
         subjects affected / exposed
    2 / 562 (0.36%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rib fracture
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subdural haematoma
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Toxicity to various agents
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular graft occlusion
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Acute coronary syndrome
         subjects affected / exposed
    2 / 562 (0.36%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Angina pectoris
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Arrhythmia supraventricular
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    4 / 562 (0.71%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cardiac failure
         subjects affected / exposed
    3 / 562 (0.53%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 3
    0 / 2
    Cardiac failure acute
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Cardiac failure congestive
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac tamponade
         subjects affected / exposed
    0 / 562 (0.00%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardio-Respiratory distress
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cardiogenic shock
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Cardiopulmonary failure
         subjects affected / exposed
    1 / 562 (0.18%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    0 / 3
    Cardiovascular insufficiency
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Myocardial infarction
         subjects affected / exposed
    3 / 562 (0.53%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 3
    0 / 0
    Myocardial ischaemia
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pericardial effusion
         subjects affected / exposed
    2 / 562 (0.36%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Right ventricular failure
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Ataxia
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Brain oedema
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cauda equina syndrome
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Central nervous system haemorrhage
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebral haemorrhage
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Cerebral infarction
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cerebral ischaemia
         subjects affected / exposed
    3 / 562 (0.53%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    1 / 562 (0.18%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Cognitive disorder
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Depressed level of consciousness
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dizziness
         subjects affected / exposed
    2 / 562 (0.36%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dysarthria
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Embolic stroke
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epilepsy
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Guillain-Barre syndrome
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    4 / 562 (0.71%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic encephalopathy
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Iiird nerve disorder
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ischaemic neuropathy
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Memory impairment
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Monoplegia
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myasthenic syndrome
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neuralgia
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Paraparesis
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Paraplegia
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Partial seizures
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Presyncope
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyramidal tract syndrome
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    5 / 562 (0.89%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal cord compression
         subjects affected / exposed
    2 / 562 (0.36%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal cord disorder
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    4 / 562 (0.71%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Toxic encephalopathy
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vertebral artery occlusion
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Viith nerve paralysis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    13 / 562 (2.31%)
    23 / 561 (4.10%)
         occurrences causally related to treatment / all
    15 / 15
    24 / 27
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bone marrow failure
         subjects affected / exposed
    3 / 562 (0.53%)
    5 / 561 (0.89%)
         occurrences causally related to treatment / all
    3 / 3
    3 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 3
    Eosinophilia
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile bone marrow aplasia
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    25 / 562 (4.45%)
    15 / 561 (2.67%)
         occurrences causally related to treatment / all
    20 / 30
    12 / 16
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Granulocytopenia
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematotoxicity
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Leukopenia
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    15 / 562 (2.67%)
    20 / 561 (3.57%)
         occurrences causally related to treatment / all
    16 / 18
    19 / 21
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Pancytopenia
         subjects affected / exposed
    6 / 562 (1.07%)
    7 / 561 (1.25%)
         occurrences causally related to treatment / all
    7 / 7
    5 / 8
         deaths causally related to treatment / all
    1 / 1
    1 / 1
    Thrombocytopenia
         subjects affected / exposed
    4 / 562 (0.71%)
    8 / 561 (1.43%)
         occurrences causally related to treatment / all
    3 / 4
    7 / 9
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    2 / 562 (0.36%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Glaucoma
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    4 / 562 (0.71%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    2 / 4
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    0 / 562 (0.00%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Autoimmune colitis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    24 / 562 (4.27%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    24 / 26
    1 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Colitis ulcerative
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Constipation
         subjects affected / exposed
    0 / 562 (0.00%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    42 / 562 (7.47%)
    13 / 561 (2.32%)
         occurrences causally related to treatment / all
    45 / 48
    4 / 13
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diverticular perforation
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Duodenal perforation
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dysphagia
         subjects affected / exposed
    0 / 562 (0.00%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enteritis
         subjects affected / exposed
    2 / 562 (0.36%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterocolitis
         subjects affected / exposed
    2 / 562 (0.36%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Faecaloma
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric ulcer perforation
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastritis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal hypomotility
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematemesis
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ileus
         subjects affected / exposed
    2 / 562 (0.36%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal perforation
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    12 / 562 (2.14%)
    5 / 561 (0.89%)
         occurrences causally related to treatment / all
    7 / 13
    3 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Odynophagia
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophagitis
         subjects affected / exposed
    0 / 562 (0.00%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatitis
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Proctalgia
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stomatitis
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subileus
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    10 / 562 (1.78%)
    9 / 561 (1.60%)
         occurrences causally related to treatment / all
    5 / 12
    5 / 11
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholangitis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholangitis sclerosing
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystitis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Drug-Induced liver injury
         subjects affected / exposed
    4 / 562 (0.71%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    6 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic failure
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic function abnormal
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatitis acute
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatocellular injury
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatotoxicity
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Hyperbilirubinaemia
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rash
         subjects affected / exposed
    3 / 562 (0.53%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rash macular
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    4 / 562 (0.71%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    2 / 4
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematuria
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Proteinuria
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tubulointerstitial nephritis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endocrine disorders
    Adrenal insufficiency
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Autoimmune thyroiditis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperthyroidism
         subjects affected / exposed
    2 / 562 (0.36%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypophysitis
         subjects affected / exposed
    4 / 562 (0.71%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    5 / 5
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypopituitarism
         subjects affected / exposed
    2 / 562 (0.36%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypothyroidism
         subjects affected / exposed
    3 / 562 (0.53%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Inappropriate antidiuretic hormone secretion
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myxoedema
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    2 / 562 (0.36%)
    5 / 561 (0.89%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bone pain
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Flank pain
         subjects affected / exposed
    0 / 562 (0.00%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Groin pain
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Joint range of motion decreased
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Muscular weakness
         subjects affected / exposed
    3 / 562 (0.53%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal pain
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myositis
         subjects affected / exposed
    2 / 562 (0.36%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rheumatoid arthritis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal pain
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Adrenalitis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Appendicitis
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atypical pneumonia
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchopneumonia
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    0 / 562 (0.00%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Encephalitis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epididymitis
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis viral
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    H1n1 influenza
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    3 / 562 (0.53%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    1 / 3
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infectious pleural effusion
         subjects affected / exposed
    1 / 562 (0.18%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Influenza
         subjects affected / exposed
    2 / 562 (0.36%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lobar pneumonia
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    3 / 562 (0.53%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 562 (0.18%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Neutropenic sepsis
         subjects affected / exposed
    0 / 562 (0.00%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oral candidiasis
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    33 / 562 (5.87%)
    16 / 561 (2.85%)
         occurrences causally related to treatment / all
    7 / 34
    5 / 16
         deaths causally related to treatment / all
    1 / 8
    0 / 5
    Pneumonia bacterial
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary sepsis
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyomyositis
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rectal abscess
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    3 / 562 (0.53%)
    6 / 561 (1.07%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory tract infection bacterial
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    7 / 562 (1.25%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    3 / 8
    3 / 3
         deaths causally related to treatment / all
    2 / 4
    2 / 2
    Septic shock
         subjects affected / exposed
    3 / 562 (0.53%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 3
    2 / 3
         deaths causally related to treatment / all
    0 / 1
    1 / 2
    Staphylococcal infection
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subcutaneous abscess
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tooth abscess
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    2 / 562 (0.36%)
    5 / 561 (0.89%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral infection
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    3 / 562 (0.53%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    4 / 562 (0.71%)
    5 / 561 (0.89%)
         occurrences causally related to treatment / all
    3 / 4
    4 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diabetes mellitus
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diabetic ketoacidosis
         subjects affected / exposed
    0 / 562 (0.00%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Electrolyte imbalance
         subjects affected / exposed
    2 / 562 (0.36%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    3 / 562 (0.53%)
    3 / 561 (0.53%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    1 / 562 (0.18%)
    1 / 561 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    2 / 562 (0.36%)
    2 / 561 (0.36%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    12 / 562 (2.14%)
    13 / 561 (2.32%)
         occurrences causally related to treatment / all
    3 / 16
    3 / 17
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vitamin d deficiency
         subjects affected / exposed
    1 / 562 (0.18%)
    0 / 561 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    10 MG/KG IPILIMUMAB + PLATINUM/ETOPOSIDE PLACEBO + PLATINUM/ETOPOSIDE
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    519 / 562 (92.35%)
    520 / 561 (92.69%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    47 / 562 (8.36%)
    26 / 561 (4.63%)
         occurrences all number
    65
    31
    Aspartate aminotransferase increased
         subjects affected / exposed
    44 / 562 (7.83%)
    23 / 561 (4.10%)
         occurrences all number
    59
    30
    Haemoglobin decreased
         subjects affected / exposed
    38 / 562 (6.76%)
    32 / 561 (5.70%)
         occurrences all number
    58
    48
    Neutrophil count decreased
         subjects affected / exposed
    87 / 562 (15.48%)
    67 / 561 (11.94%)
         occurrences all number
    198
    183
    Platelet count decreased
         subjects affected / exposed
    39 / 562 (6.94%)
    48 / 561 (8.56%)
         occurrences all number
    78
    96
    Weight decreased
         subjects affected / exposed
    46 / 562 (8.19%)
    41 / 561 (7.31%)
         occurrences all number
    51
    43
    White blood cell count decreased
         subjects affected / exposed
    51 / 562 (9.07%)
    51 / 561 (9.09%)
         occurrences all number
    126
    148
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    52 / 562 (9.25%)
    59 / 561 (10.52%)
         occurrences all number
    63
    68
    Headache
         subjects affected / exposed
    67 / 562 (11.92%)
    56 / 561 (9.98%)
         occurrences all number
    87
    60
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    171 / 562 (30.43%)
    189 / 561 (33.69%)
         occurrences all number
    254
    274
    Leukopenia
         subjects affected / exposed
    73 / 562 (12.99%)
    87 / 561 (15.51%)
         occurrences all number
    132
    179
    Neutropenia
         subjects affected / exposed
    234 / 562 (41.64%)
    261 / 561 (46.52%)
         occurrences all number
    448
    510
    Thrombocytopenia
         subjects affected / exposed
    64 / 562 (11.39%)
    84 / 561 (14.97%)
         occurrences all number
    109
    134
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    55 / 562 (9.79%)
    61 / 561 (10.87%)
         occurrences all number
    72
    74
    Chest pain
         subjects affected / exposed
    38 / 562 (6.76%)
    45 / 561 (8.02%)
         occurrences all number
    38
    55
    Fatigue
         subjects affected / exposed
    180 / 562 (32.03%)
    170 / 561 (30.30%)
         occurrences all number
    214
    221
    Oedema peripheral
         subjects affected / exposed
    38 / 562 (6.76%)
    27 / 561 (4.81%)
         occurrences all number
    43
    33
    Pyrexia
         subjects affected / exposed
    79 / 562 (14.06%)
    60 / 561 (10.70%)
         occurrences all number
    107
    73
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    34 / 562 (6.05%)
    33 / 561 (5.88%)
         occurrences all number
    41
    36
    Abdominal pain upper
         subjects affected / exposed
    30 / 562 (5.34%)
    24 / 561 (4.28%)
         occurrences all number
    32
    24
    Diarrhoea
         subjects affected / exposed
    159 / 562 (28.29%)
    116 / 561 (20.68%)
         occurrences all number
    226
    150
    Constipation
         subjects affected / exposed
    121 / 562 (21.53%)
    99 / 561 (17.65%)
         occurrences all number
    163
    135
    Nausea
         subjects affected / exposed
    232 / 562 (41.28%)
    209 / 561 (37.25%)
         occurrences all number
    440
    357
    Vomiting
         subjects affected / exposed
    115 / 562 (20.46%)
    97 / 561 (17.29%)
         occurrences all number
    182
    153
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    94 / 562 (16.73%)
    81 / 561 (14.44%)
         occurrences all number
    109
    100
    Hiccups
         subjects affected / exposed
    26 / 562 (4.63%)
    32 / 561 (5.70%)
         occurrences all number
    44
    57
    Dyspnoea
         subjects affected / exposed
    75 / 562 (13.35%)
    83 / 561 (14.80%)
         occurrences all number
    90
    98
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    199 / 562 (35.41%)
    208 / 561 (37.08%)
         occurrences all number
    205
    215
    Pruritus
         subjects affected / exposed
    82 / 562 (14.59%)
    15 / 561 (2.67%)
         occurrences all number
    93
    17
    Rash
         subjects affected / exposed
    121 / 562 (21.53%)
    28 / 561 (4.99%)
         occurrences all number
    161
    38
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    53 / 562 (9.43%)
    62 / 561 (11.05%)
         occurrences all number
    64
    70
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    37 / 562 (6.58%)
    26 / 561 (4.63%)
         occurrences all number
    40
    27
    Back pain
         subjects affected / exposed
    43 / 562 (7.65%)
    47 / 561 (8.38%)
         occurrences all number
    49
    54
    Pain in extremity
         subjects affected / exposed
    24 / 562 (4.27%)
    36 / 561 (6.42%)
         occurrences all number
    24
    38
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    169 / 562 (30.07%)
    138 / 561 (24.60%)
         occurrences all number
    268
    199
    Hypokalaemia
         subjects affected / exposed
    47 / 562 (8.36%)
    31 / 561 (5.53%)
         occurrences all number
    53
    49
    Hyponatraemia
         subjects affected / exposed
    53 / 562 (9.43%)
    50 / 561 (8.91%)
         occurrences all number
    81
    82

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    09 Feb 2012
    The original CA184156 protocol included an option for subjects who progressed > 6 months after completion of first-line chemotherapy to be re-induced with carboplatin/etoposide plus the same blinded study drug received in Induction, if the investigator felt the subjects were candidates for doublet chemotherapy, and if the subjects had not experienced any adverse events which required discontinuation of blinded study drug. This design was based on: • the current recommendation by NCCN, other international guidelines, and investigator feedback that re-induction with the original regimen may be appropriate in these cases; • preliminary data from melanoma suggesting activity and tolerability of ipilimumab in a re-induction setting; • the hypothesis that re-induction with chemotherapy might prime additional immune responses to the relapsed tumor, which could be augmented by ipilimumab. However, the EU member states involved in the review of the Clinical Trial Application (CTA) submitted through the Voluntary Harmonization Procedure (VHP), expressed concern regarding the blinded re-induction phase included in the protocol. Since there is no European consensus on a particular second line regimen, they further recommended that treatment of subjects after progression should be left open to the investigator/patient. To address this feedback, the protocol was modified to remove the Re-induction phase with ipilimumab. Thus, after discontinuation of ipilimumab in the Induction or Maintenance phases, subjects will now transition directly to Toxicity/Progression Follow Up. Second-line therapy (including potential re-induction with chemotherapy) is at discretion of the treating physician and will not include ipilimumab.
    05 Nov 2012
    The purpose of this amendment is: • To add/clarify information on the definition of Women of Childbearing Potential (WOCBP), as well as requirements for pregnancy testing and contraception • To add rationale and guidance for the collection of immune-mediated Adverse Reaction (imAR) data • Other minor changes to correct and/or clarify protocol requirements.
    17 Jul 2014
    The purpose of this amendment is to update the study Primary Endpoint, modify Secondary Endpoints, implement a dosing limit of ipilimumab in the study to 3 years, update the Global Medical Monitor, and incorporate other minor changes for consistency and clarity.

    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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