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    Clinical Trial Results:
    First Line Pazopanib in Poor Risk Patients with Metastatic Renal Cell Carcinoma

    Summary
    EudraCT number
    2011-001138-40
    Trial protocol
    DE  
    Global end of trial date
    31 Jul 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    31 Mar 2018
    First version publication date
    31 Mar 2018
    Other versions
    Summary report(s)
    FLIPPER Synopsis

    Trial information

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    Trial identification
    Sponsor protocol code
    IOM-605
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01521715
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    iOMEDICO AG
    Sponsor organisation address
    Hanferstr. 28, Freiburg, Germany, 79108
    Public contact
    iOMEDICO AG, iOMEDICO AG, 0049 761152420, info@iomedico.com
    Scientific contact
    iOMEDICO AG, iOMEDICO AG, 0049 761152420, info@iomedico.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
    23 Jan 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    31 Jul 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    31 Jul 2017
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    Primary analysis will focus on the rate of poor risk patients as defined by the MSKCC criteria who are free of disease progression at 6 months after start of first line treatment with pazopanib.
    Protection of trial subjects
    Informed consent of patient has been obtained in accordance with § 40 I 3 No. 3 Lit. b), II 1 AMG and § 40 I 3 No. 3 Lit. c). IIa 1&2 AMG by each investigator prior to inclusion of each patient to the study. The nature, objective and importance of the study, the possible benefits and disadvantages or risks, and the study procedures were explained to each patient orally and in writing. The patients were informed that their participation was voluntary, that they were free to withdraw from the study at any time, and that choosing not to participate would not impact on the patient’s care or future treatment. The patients were also informed that, by signing the ICF, they explicitly permitted authorized representatives of the sponsor and the regulatory authorities access to study-related personal data to the extent permitted by the applicable law(s) and/or regulations without violating the confidentiality of the patient, to the extent permitted by the applicable law(s) and/or regulations. The patients were also informed that their consent to access their data might not be revoked. Each patient was given sufficient time to read the ICF and to ask questions to the investigator prior to giving his/her written consent. Before entry to the study and prior to the conduct of any study-related procedure consent was recorded by means of the patient’s dated signature. The patient was given a copy of the information sheet and his/her signed consent form. The consent form was retained by the investigator as part of the study records. The investigator did not undertake any investigation specifically required only for the clinical study until valid consent has been obtained. The terms of the consent and the date when it was obtained were also documented in the electronic case report form (eCRF).
    Background therapy
    Not applicable.
    Evidence for comparator
    Not applicable.
    Actual start date of recruitment
    24 Jan 2012
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Efficacy
    Long term follow-up duration
    7 Months
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 44
    Worldwide total number of subjects
    44
    EEA total number of subjects
    44
    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)
    18
    From 65 to 84 years
    24
    85 years and over
    2

    Subject disposition

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    Recruitment
    Recruitment details
    The investigator enrolled patients based on previously defined inclusion (IC) and exclusion criteriea (EC). Patients who fulfilled all of the IC and non of the EC were eligible to FLIPPER trial. The recruitment of eligible patients was competitive among the centers participating in the trial.

    Pre-assignment
    Screening details
    In total n=60 patients were screened and according to the inclusion and exclusion criteria n=44 patients were enrolled into the study . One patient enrolled did not receive study treatment. Screening period was performed from day -30 to start of treatment. Tumor assessemnt was to be performed no later than 14 days prior to start of study treatment.

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

    Arms
    Arm title
    Pazopanib Treatment
    Arm description
    As recommended in the SmPC, 800 mg (2x400 mg) pazopanib per day were to be taken orally without food at least one hour before or two hours after a meal at approximately the same time of day. Administration should have been continued until progression or occurrence of intolerable toxicity.
    Arm type
    Experimental

    Investigational medicinal product name
    Pazopanib
    Investigational medicinal product code
    Other name
    Votrient
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Administration of pazopanib: 2 tablets with a dose of 400 mg once daily (total daily dose 800 mg)

    Number of subjects in period 1
    Pazopanib Treatment
    Started
    44
    Completed
    27
    Not completed
    17
         AE related to study drug
    1
         Consent withdrawn by subject
    2
         Other reason - End of Study
    1
         Non-compliance
    1
         More that 21 days withoutstudy medication
    3
         Patient wish (not toxicity)
    6
         AE not related to study drug
    2
         Enrolled but never treated
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    -

    Reporting group values
    Overall trial Total
    Number of subjects
    44 44
    Age categorical
    Age at start of treatment
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    19 19
        From 65-84 years
    23 23
        85 years and over
    2 2
    Age continuous
    Units: years
        median (full range (min-max))
    66 (40 to 87) -
    Gender categorical
    Units: Subjects
        Female
    9 9
        Male
    35 35
    Ethic origin
    Units: Subjects
        Caucasian
    44 44
    Karnofsky Performance Status
    Please note: Reporting group 1 (overall trial) values correspond to Reporting group 2 (SAF) since baseline characteristics were analysed for SAF and mITT population only; therefore, one patient in Reporting group 1 was considered as missing.
    Units: Subjects
        >70
    7 7
        <=70
    35 35
        missing
    2 2
    MSKCC at inclusion
    Please note: Reporting group 1 (overall trial) values correspond to Reporting group 2 (SAF) since baseline characteristics were analysed for SAF and mITT population only; therefore, one patient in Reporting group 1 was considered as missing.
    Units: Subjects
        intermediate
    11 11
        poor
    29 29
        missing
    4 4
    UICC stage at inclusion
    Please note: Reporting group 1 (overall trial) values correspond to Reporting group 2 (SAF) since baseline characteristics were analysed for SAF and mITT population only; therefore, one patient in Reporting group 1 was considered as missing.
    Units: Subjects
        Stage IV
    43 43
        missing
    1 1
    Time from primary diagnosis to start of treatment
    Units: Subjects
        >=1 year
    5 5
        < 1 year
    36 36
        missing
    3 3
    Prior nephrectomy
    Units: Subjects
        Nephrectomie
    31 31
        No nephrectomie
    9 9
        Partial nephrectomie
    3 3
        missing
    1 1
    Histology of the primary tumor
    Units: Subjects
        Predominatly cler cell
    43 43
        missing
    1 1
    Location of tumor at diagnosis
    Location of tumor at initial diagnosis (left/right kidney)
    Units: Subjects
        Left kidney
    26 26
        Right Kidney
    17 17
        missing
    1 1
    Number of documented disease sites
    Most frequently documented lesions (>10% of patients affected in SAF) were [n (%)]: lung 28 (65.1%); lymph nodes 24 (55.8%); kidney 14 (32.6%); bone 11 (25.6%); liver 8 (18.6%); pleura 5 (11.6%).
    Units: Subjects
        <2
    9 9
        >=2
    32 32
        missing
    3 3
    Weight
    Please note: Reporting group 1 (overall trial) values correspond to Reporting group 2 (SAF) since baseline characteristics were analysed for SAF and mITT population only.
    Units: kg
        median (full range (min-max))
    74.5 (53.0 to 167.2) -
    Body Mass Index (BMI)
    Please note: Reporting group 1 (overall trial) values correspond to Reporting group 2 (SAF) since baseline characteristics were analysed for SAF and mITT population only.
    Units: kg/m2
        median (full range (min-max))
    24.3 (16.7 to 45.4) -
    Subject analysis sets

    Subject analysis set title
    Safety Analysis Set (SAF)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The SAF set includes all patients who received at least one dose of pazopanib. This population is relevant for all safety parameters.

    Subject analysis set title
    mITT
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT population includes all patients who received at least one dose of pazopanib and which fulfill one of the following points: • have PD prior to 26 weeks +7 days after therapy start • died because of tumor progression prior to 26 weeks +7 days after therapy start • are assessable with regard to their disease status at 26 weeks ±7 days after therapy start (3rd tumor evaluation) • experience SD, partial remission or complete remission after 26 weeks +7 days after therapy start The mITT set is relevant for the analyses of the primary and secondary efficacy parameters.

    Subject analysis sets values
    Safety Analysis Set (SAF) mITT
    Number of subjects
    43
    34
    Age categorical
    Age at start of treatment
    Units: Subjects
        In utero
    0
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
    0
        Newborns (0-27 days)
    0
    0
        Infants and toddlers (28 days-23 months)
    0
    0
        Children (2-11 years)
    0
    0
        Adolescents (12-17 years)
    0
    0
        Adults (18-64 years)
    18
    14
        From 65-84 years
    23
    20
        85 years and over
    2
    0
    Age continuous
    Units: years
        median (full range (min-max))
    66 (40 to 87)
    66 (40 to 83)
    Gender categorical
    Units: Subjects
        Female
    9
    8
        Male
    34
    26
    Ethic origin
    Units: Subjects
        Caucasian
    43
    34
    Karnofsky Performance Status
    Please note: Reporting group 1 (overall trial) values correspond to Reporting group 2 (SAF) since baseline characteristics were analysed for SAF and mITT population only; therefore, one patient in Reporting group 1 was considered as missing.
    Units: Subjects
        >70
    7
    5
        <=70
    35
    28
        missing
    1
    1
    MSKCC at inclusion
    Please note: Reporting group 1 (overall trial) values correspond to Reporting group 2 (SAF) since baseline characteristics were analysed for SAF and mITT population only; therefore, one patient in Reporting group 1 was considered as missing.
    Units: Subjects
        intermediate
    11
    9
        poor
    29
    22
        missing
    3
    3
    UICC stage at inclusion
    Please note: Reporting group 1 (overall trial) values correspond to Reporting group 2 (SAF) since baseline characteristics were analysed for SAF and mITT population only; therefore, one patient in Reporting group 1 was considered as missing.
    Units: Subjects
        Stage IV
    43
    34
        missing
    0
    0
    Time from primary diagnosis to start of treatment
    Units: Subjects
        >=1 year
    5
    4
        < 1 year
    36
    28
        missing
    2
    2
    Prior nephrectomy
    Units: Subjects
        Nephrectomie
    31
    26
        No nephrectomie
    9
    7
        Partial nephrectomie
    3
    1
        missing
    0
    0
    Histology of the primary tumor
    Units: Subjects
        Predominatly cler cell
    43
    34
        missing
    0
    0
    Location of tumor at diagnosis
    Location of tumor at initial diagnosis (left/right kidney)
    Units: Subjects
        Left kidney
    26
    23
        Right Kidney
    17
    11
        missing
    0
    0
    Number of documented disease sites
    Most frequently documented lesions (>10% of patients affected in SAF) were [n (%)]: lung 28 (65.1%); lymph nodes 24 (55.8%); kidney 14 (32.6%); bone 11 (25.6%); liver 8 (18.6%); pleura 5 (11.6%).
    Units: Subjects
        <2
    9
    7
        >=2
    32
    27
        missing
    2
    0
    Weight
    Please note: Reporting group 1 (overall trial) values correspond to Reporting group 2 (SAF) since baseline characteristics were analysed for SAF and mITT population only.
    Units: kg
        median (full range (min-max))
    74.5 (53.0 to 167.2)
    74.0 (53. to 130)
    Body Mass Index (BMI)
    Please note: Reporting group 1 (overall trial) values correspond to Reporting group 2 (SAF) since baseline characteristics were analysed for SAF and mITT population only.
    Units: kg/m2
        median (full range (min-max))
    24.3 (16.7 to 45.4)
    24 (16.7 to 40.6)

    End points

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    End points reporting groups
    Reporting group title
    Pazopanib Treatment
    Reporting group description
    As recommended in the SmPC, 800 mg (2x400 mg) pazopanib per day were to be taken orally without food at least one hour before or two hours after a meal at approximately the same time of day. Administration should have been continued until progression or occurrence of intolerable toxicity.

    Subject analysis set title
    Safety Analysis Set (SAF)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The SAF set includes all patients who received at least one dose of pazopanib. This population is relevant for all safety parameters.

    Subject analysis set title
    mITT
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT population includes all patients who received at least one dose of pazopanib and which fulfill one of the following points: • have PD prior to 26 weeks +7 days after therapy start • died because of tumor progression prior to 26 weeks +7 days after therapy start • are assessable with regard to their disease status at 26 weeks ±7 days after therapy start (3rd tumor evaluation) • experience SD, partial remission or complete remission after 26 weeks +7 days after therapy start The mITT set is relevant for the analyses of the primary and secondary efficacy parameters.

    Primary: 6-month PFS rate

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    End point title
    6-month PFS rate [1]
    End point description
    Proportion of patients free of progression at 6 months (26 weeks ±7 days) after start of first-line therapy with pazopanib. The analysis includes all patients that received at least one dose of pazopanib and which are assessable with regard to their disease status at 26 weeks ±7 days (or before in case of progressive disease (PD) prior to 26 weeks ±7 days after therapy start). ***************************************************************** Final result: 6-months PFS rate [n (%, [95%-CI])]: 12 (35.29%, [19.7 - 53.5]) *****************************************************************
    End point type
    Primary
    End point timeframe
    Time from first application of pazopanib to progression or death of any cause.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Planned patient number (n=80) could not be reached in a timely manner and patient number of the mITT population (n=34) was substantially lower than expected. Therefore, the statistical analysis for the primary endpoint is merely descriptive.
    End point values
    mITT
    Number of subjects analysed
    34
    Units: Number
    12
    No statistical analyses for this end point

    Secondary: Median Progression Free Survival (PFS) - Kaplan-Meier

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    End point title
    Median Progression Free Survival (PFS) - Kaplan-Meier
    End point description
    PFS is defined as time from first application of pazopanib to progression (PD according to RECIST 1.1) or death of any cause before start of new antineoplastic treatment. Patients without PD or death were censored at their last date of tumor evaluation.
    End point type
    Secondary
    End point timeframe
    Time from first application of pazopanib to progression or death of any cause.
    End point values
    mITT
    Number of subjects analysed
    34
    Units: months
        median (confidence interval 95%)
    4.5 (3.6 to 7.8)
    Attachments
    PFS (mITT)
    No statistical analyses for this end point

    Secondary: Overall survival (OS)

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    End point title
    Overall survival (OS)
    End point description
    OS defined as time from first application of pazopanib to death of any cause. Patients alive at the end of the study were censored with the date of the last contact to the patient
    End point type
    Secondary
    End point timeframe
    OS is defined as time from first application of pazopanib to death of any cause.
    End point values
    mITT
    Number of subjects analysed
    34
    Units: months
        median (confidence interval 95%)
    9.3 (6.6 to 22.2)
    Attachments
    OS Kaplan-Meier Plot (mITT)
    No statistical analyses for this end point

    Secondary: Objective Response Rate (ORR)

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    End point title
    Objective Response Rate (ORR)
    End point description
    ORR was defined as rate of patients with complete response (CR) or partial response (PR).
    End point type
    Secondary
    End point timeframe
    Treatment period of pazopanib treatment [Time from first occurrence of a response (at least PR) to a documented PD or death due to PD (whichever came first)].
    End point values
    mITT
    Number of subjects analysed
    34
    Units: number
    11
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR)

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    End point title
    Duration of Response (DOR)
    End point description
    DOR was calculated as the time from first occurrence of a response (at least PR) to a documented PD. If a patient did not experience PD prior to onset of a subsequent therapy the time was censored at last date of tumor evaluation or start of new antineoplastic treatment, whatever came first. The analysis was only conducted for patients with response (at least PR).
    End point type
    Secondary
    End point timeframe
    Time from first occurrence of a response (at least PR) to a documented PD or death due to PD (whichever came first).
    End point values
    mITT
    Number of subjects analysed
    11 [2]
    Units: months
        median (confidence interval 95%)
    9.7 (1.8 to 12.4)
    Notes
    [2] - The analysis was conducted only for patients with response (at least partial response)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    TEAE were recorded from day of first dose of study medication to 30 days after last dose of study medication.
    Adverse event reporting additional description
    The analysis of safety data will be based on SAF population.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    20.0
    Reporting groups
    Reporting group title
    Pazopanib Treatment
    Reporting group description
    The analysis of safety data is based on SAF population. AE were recorded from day of first dose of study medication to 30 days after last dose of study medication (TEAE).

    Serious adverse events
    Pazopanib Treatment
    Total subjects affected by serious adverse events
         subjects affected / exposed
    19 / 43 (44.19%)
         number of deaths (all causes)
    27
         number of deaths resulting from adverse events
    7
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Basal cell carcinoma
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Malignant neoplasm of pleura
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Malignant neoplasm progression
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Metastases to bone
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metastases to central nervous system
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neoplasm progression
         subjects affected / exposed
    2 / 43 (4.65%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Cardiac disorders
    Bradycardia
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Cardiac arrest
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Blood and lymphatic system disorders
    Anemia
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Atelectasis
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemoptysis
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemothorax
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pleural effusion
         subjects affected / exposed
    3 / 43 (6.98%)
         occurrences causally related to treatment / all
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Haematuria
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Bone pain
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Osteolysis
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Viral upper respiratory tract infection
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    1 / 43 (2.33%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Pazopanib Treatment
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    36 / 43 (83.72%)
    Investigations
    Blood thyroid stimulating hormone increased
         subjects affected / exposed
    6 / 43 (13.95%)
         occurrences all number
    7
    Weight decreased
         subjects affected / exposed
    3 / 43 (6.98%)
         occurrences all number
    5
    Vascular disorders
    Hypertension
         subjects affected / exposed
    5 / 43 (11.63%)
         occurrences all number
    9
    Nervous system disorders
    Dysgeusia
         subjects affected / exposed
    3 / 43 (6.98%)
         occurrences all number
    3
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    7 / 43 (16.28%)
         occurrences all number
    7
    Mucosal inflammation
         subjects affected / exposed
    3 / 43 (6.98%)
         occurrences all number
    3
    Pain
         subjects affected / exposed
    4 / 43 (9.30%)
         occurrences all number
    4
    Gastrointestinal disorders
    Abdominal pain upper
         subjects affected / exposed
    4 / 43 (9.30%)
         occurrences all number
    4
    Diarrhoea
         subjects affected / exposed
    12 / 43 (27.91%)
         occurrences all number
    12
    Nausea
         subjects affected / exposed
    7 / 43 (16.28%)
         occurrences all number
    7
    Vomiting
         subjects affected / exposed
    5 / 43 (11.63%)
         occurrences all number
    5
    Skin and subcutaneous tissue disorders
    Erythema
         subjects affected / exposed
    3 / 43 (6.98%)
         occurrences all number
    3
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    7 / 43 (16.28%)
         occurrences all number
    7
    Infections and infestations
    Folliculitis
         subjects affected / exposed
    3 / 43 (6.98%)
         occurrences all number
    3
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    6 / 43 (13.95%)
         occurrences all number
    6

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    26 Feb 2014
    Amendment to study protocol (v2.0 dated 19-Nov-2013) and patient informed consent form.
    09 May 2017
    Amendment to study protocol (v4.0 dated 13-Apr-2017) and patient informed consent form (implementation of prematurely study end due to poor recruitment)

    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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