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    Clinical Trial Results:
    Randomised Phase II Pilot Studiy: Induction Chemotherapy with Docetaxel, Cisplatin und Cetuximab versus Docetaxel, Cisplatin und 5 FU followed by Radiotherapy with Cetuximab for locally advanced or not resectable Carcinoma of the Head and Neck

    Summary
    EudraCT number
    2011-005540-99
    Trial protocol
    AT  
    Global end of trial date
    28 Jan 2021

    Results information
    Results version number
    v2(current)
    This version publication date
    06 May 2022
    First version publication date
    29 Jan 2022
    Other versions
    v1
    Version creation reason
    • New data added to full data set
    • Correction of full data set
    Typing error corrected

    Trial information

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    Trial identification
    Sponsor protocol code
    AGMT_HNO 2
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01884259
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    AGMT
    Sponsor organisation address
    Gentzgasse 60/21, Vienna, Austria, 1180
    Public contact
    Daniela Wolkersdorfer, AGMT gemeinnützige GmbH, +43 6626404412, d.wolkersdorfer@agmt.at
    Scientific contact
    Felix Keil, AGMT gemeinnützige GmbH, +43 66264044112, felix.keil@oegk.at
    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
    08 Dec 2021
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    08 Jun 2018
    Global end of trial reached?
    Yes
    Global end of trial date
    28 Jan 2021
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Response Rate (CR, PR) 3 months after end of therapy (RECIST)
    Protection of trial subjects
    Safety assessments were done on a regular basis. All patients having received at least one dose of the study medication have been followed for adverse events for 28 days after discontinuing study treatment or completion of study treatment. In general, concomitant medications and therapies necessary for supportive care and safety of the patient were allowed and recommended.
    Background therapy
    TPF-arm (Arm A): Docetaxel 75mg/m² day 1; Cisplatin 75mg/m² day 1; 5FU 750 mg/m² day 1 -5 TPC-arm (Arm B): Docetaxel 75 mg/m² day 1; Cisplatin 75mg/m² day 1
    Evidence for comparator
    -
    Actual start date of recruitment
    31 May 2013
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Austria: 100
    Worldwide total number of subjects
    100
    EEA total number of subjects
    100
    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)
    75
    From 65 to 84 years
    25
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    From March 2013 to January 2016, 102 patients were recruited in 8 sites in Austria.

    Pre-assignment
    Screening details
    2 patients were ineligible for study participation and had to be replaced to reach the planned number of 100 eligible patients: 1 patient did not meet inclusion criteria, and 1 patient withdrew consent before treatment was initiated.

    Period 1
    Period 1 title
    Induction chemotherapy
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    TPF-arm (Arm A)
    Arm description
    3 21-day cycles of induction chemotherapy consisting of docetaxel 75 mg/m2 given as a 1-h infusion and cisplatin 75 mg/m2 given as a 2-h infusion on day one, followed by 5FU 750 mg/m2 administered as a continuous infusion for five consecutive days.
    Arm type
    Experimental

    Investigational medicinal product name
    Docetaxel
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Docetaxel 75mg/m2 day 1

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Cisplatin 75 mg/m2 day 1

    Investigational medicinal product name
    5FU
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    5FU 750mg/m2 day 1-5

    Arm title
    TPC-arm (Arm B)
    Arm description
    3 21-day cycles of induction chemotherapy consisting of docetaxel 75 mg/m2 given as a 1-h infusion, cisplatin 75 mg/m2, and cetuximab 400 mg/m2 given as a 2-h infusion on day one as a loading dose, followed by cetuximab 250 mg/m2 given as a 1-h infusion weekly (thrice per cycle).
    Arm type
    Experimental

    Investigational medicinal product name
    Cetuximab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Cetuximab 400 mg/m2 given as a 2-h infusion on day one as a loading dose, followed by cetuximab 250 mg/m2 given as a 1-h infusion weekly (thrice per cycle).

    Investigational medicinal product name
    Docetaxel
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Docetaxel 75mg/m2 day 1

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Cisplatin 75 mg/m2 day 1

    Number of subjects in period 1
    TPF-arm (Arm A) TPC-arm (Arm B)
    Started
    49
    51
    Completed
    46
    46
    Not completed
    3
    5
         death
    -
    1
         drop-out
    3
    4
    Period 2
    Period 2 title
    Radiation therapy plus Cetuximab
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    TPF-arm (Arm A)
    Arm description
    RT started maximum 6 weeks after the last administration of docetaxel and cisplatin. A loading dose of cetuximab 400 mg/m2 intravenously over 120 min was administered to the TPF arm one week before the start of concomitant boost RT. Followed by weekly infusions of cetuximab 250 mg/m2 during the whole course of RT (seven infusions in total).
    Arm type
    Experimental

    Investigational medicinal product name
    Cetuximab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    Loading dose 400mg/m2; followed by weekly infusions with 250 mg/m2

    Arm title
    TPC-arm (Arm B)
    Arm description
    RT started maximum 6 weeks after the last administration of docetaxel and cisplatin. A dose of cetuximab 250mg/m2 intravenously over 120 min was administered to the TPC arm one week before the start of concomitant boost RT. Followed by weekly infusions of cetuximab 250 mg/m2 during the whole course of RT (seven infusions in total).
    Arm type
    Experimental

    Investigational medicinal product name
    Cetuximab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Infusion
    Dosage and administration details
    250 mg/m2 one week before and during the whole course of RT (seven infusions in total).

    Number of subjects in period 2 [1]
    TPF-arm (Arm A) TPC-arm (Arm B)
    Started
    44
    45
    Completed
    44
    44
    Not completed
    0
    1
         death
    -
    1
    Notes
    [1] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: TPF-arm (Arm A): 2 patients did not start radiotherapy+C: 1 patient due to PD, 1 patient due to protocol violation (Radiation therapist decided to administer RT without cetuximab); TPC-arm (Arm B): 1 patient did not start radiotherapy+C due to PD

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    TPF-arm (Arm A)
    Reporting group description
    3 21-day cycles of induction chemotherapy consisting of docetaxel 75 mg/m2 given as a 1-h infusion and cisplatin 75 mg/m2 given as a 2-h infusion on day one, followed by 5FU 750 mg/m2 administered as a continuous infusion for five consecutive days.

    Reporting group title
    TPC-arm (Arm B)
    Reporting group description
    3 21-day cycles of induction chemotherapy consisting of docetaxel 75 mg/m2 given as a 1-h infusion, cisplatin 75 mg/m2, and cetuximab 400 mg/m2 given as a 2-h infusion on day one as a loading dose, followed by cetuximab 250 mg/m2 given as a 1-h infusion weekly (thrice per cycle).

    Reporting group values
    TPF-arm (Arm A) TPC-arm (Arm B) Total
    Number of subjects
    49 51 100
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    36 39 75
        From 65-84 years
    13 12 25
        85 years and over
    0 0 0
    Age continuous
    Units: years
        arithmetic mean (full range (min-max))
    58.3 (40 to 72) 58.2 (35 to 78) -
    Gender categorical
    Units: Subjects
        Female
    7 6 13
        Male
    42 45 87

    End points

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    End points reporting groups
    Reporting group title
    TPF-arm (Arm A)
    Reporting group description
    3 21-day cycles of induction chemotherapy consisting of docetaxel 75 mg/m2 given as a 1-h infusion and cisplatin 75 mg/m2 given as a 2-h infusion on day one, followed by 5FU 750 mg/m2 administered as a continuous infusion for five consecutive days.

    Reporting group title
    TPC-arm (Arm B)
    Reporting group description
    3 21-day cycles of induction chemotherapy consisting of docetaxel 75 mg/m2 given as a 1-h infusion, cisplatin 75 mg/m2, and cetuximab 400 mg/m2 given as a 2-h infusion on day one as a loading dose, followed by cetuximab 250 mg/m2 given as a 1-h infusion weekly (thrice per cycle).
    Reporting group title
    TPF-arm (Arm A)
    Reporting group description
    RT started maximum 6 weeks after the last administration of docetaxel and cisplatin. A loading dose of cetuximab 400 mg/m2 intravenously over 120 min was administered to the TPF arm one week before the start of concomitant boost RT. Followed by weekly infusions of cetuximab 250 mg/m2 during the whole course of RT (seven infusions in total).

    Reporting group title
    TPC-arm (Arm B)
    Reporting group description
    RT started maximum 6 weeks after the last administration of docetaxel and cisplatin. A dose of cetuximab 250mg/m2 intravenously over 120 min was administered to the TPC arm one week before the start of concomitant boost RT. Followed by weekly infusions of cetuximab 250 mg/m2 during the whole course of RT (seven infusions in total).

    Primary: Response three months after RT + C

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    End point title
    Response three months after RT + C [1]
    End point description
    The primary end-point of the study was overall response rate (ORR: complete remission [CR] + partial remission [PR]) three months after RT + C was finished, assessed on the basis of CT or MRI performance as per the RECIST 1.1 criteria.
    End point type
    Primary
    End point timeframe
    Three months after radiotherapy plus cetuximab
    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: ORR in TPF-arm (Arm A) was 63.6%; ORR in TPC-arm (Arm B) was 74.5%
    End point values
    TPF-arm (Arm A) TPC-arm (Arm B)
    Number of subjects analysed
    49
    51
    Units: subjects
        Complete Remission (CR)
    16
    25
        Partial Remission (PR)
    15
    13
        Stable Disease (SD)
    3
    2
        Overall Response Rate (ORR)
    31
    38
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    SAEs of all patients who have received medication as part of the study must have been reported until 28 days after the last study therapy, and (S)AEs must have been followed up at least 28 days after the last study therapy.
    Adverse event reporting additional description
    In addition radiation toxicity was recorded once at the end of radiation, 30 days, 3 months after the end of cetuximab and radiotherapy, and at 12, 24, and 60 months after the start of the study, respectively.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21.0
    Reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    Relation to IMP cetuximab is given.

    Serious adverse events
    Overall trial
    Total subjects affected by serious adverse events
         subjects affected / exposed
    77 / 100 (77.00%)
         number of deaths (all causes)
    41
         number of deaths resulting from adverse events
    4
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Adenoma benign
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Hypertension
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombosis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Mucosal inflammation
         subjects affected / exposed
    18 / 100 (18.00%)
         occurrences causally related to treatment / all
    0 / 27
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    11 / 100 (11.00%)
         occurrences causally related to treatment / all
    2 / 17
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Impaired healing
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Extravasation
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pain
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Facial pain
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Asthenia
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fatigue
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Anaphylactic reaction
         subjects affected / exposed
    2 / 100 (2.00%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumothorax
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary fibrosis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Delirium
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    C-reactive protein increased
         subjects affected / exposed
    9 / 100 (9.00%)
         occurrences causally related to treatment / all
    0 / 9
         deaths causally related to treatment / all
    0 / 0
    Blood creatine increased
         subjects affected / exposed
    5 / 100 (5.00%)
         occurrences causally related to treatment / all
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    Weight decreased
         subjects affected / exposed
    2 / 100 (2.00%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    White blood cell count decreased
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Inflammatory marker increased
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Creatinine renal clearance decreased
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Radiation skin injury
         subjects affected / exposed
    6 / 100 (6.00%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Infusion related reaction
         subjects affected / exposed
    2 / 100 (2.00%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Laceration
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Arteriospasm coronary
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Acute myocardial infarction
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Acute right ventricular failure
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Orthostatic intolerance
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Peroneal nerve palsy
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dizziness
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Aphasia
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neuropathy peripheral
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Leukopenia
         subjects affected / exposed
    7 / 100 (7.00%)
         occurrences causally related to treatment / all
    0 / 9
         deaths causally related to treatment / all
    0 / 0
    Neutropenia
         subjects affected / exposed
    5 / 100 (5.00%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    3 / 100 (3.00%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Anaemia
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    13 / 100 (13.00%)
         occurrences causally related to treatment / all
    3 / 18
         deaths causally related to treatment / all
    0 / 0
    Dysphagia
         subjects affected / exposed
    13 / 100 (13.00%)
         occurrences causally related to treatment / all
    0 / 13
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    3 / 100 (3.00%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Stomatitis
         subjects affected / exposed
    3 / 100 (3.00%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cheilitis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rectal haemorrhage
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastritis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Hepatic necrosis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bile duct stone
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Biliary colic
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Dermatitis
         subjects affected / exposed
    9 / 100 (9.00%)
         occurrences causally related to treatment / all
    1 / 11
         deaths causally related to treatment / all
    0 / 0
    Rash
         subjects affected / exposed
    2 / 100 (2.00%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Acne
         subjects affected / exposed
    2 / 100 (2.00%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Seborrhoeic dermatitis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin lesion
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Dermatitis acneiform
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal failure
         subjects affected / exposed
    4 / 100 (4.00%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Acute kidney injury
         subjects affected / exposed
    3 / 100 (3.00%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Renal impairment
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Pain in extremity
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Back pain
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    8 / 100 (8.00%)
         occurrences causally related to treatment / all
    1 / 11
         deaths causally related to treatment / all
    0 / 3
    Infection
         subjects affected / exposed
    6 / 100 (6.00%)
         occurrences causally related to treatment / all
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    Device related infection
         subjects affected / exposed
    3 / 100 (3.00%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Staphylococcal infection
         subjects affected / exposed
    3 / 100 (3.00%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal infection
         subjects affected / exposed
    2 / 100 (2.00%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Wound infection
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pseudomonal sepsis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oral candidiasis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Brain abscess
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cystitis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Clostridial infection
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tracheitis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tracheostomy infection
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Influenza
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abscess
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Mastoiditis
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Hypokalaemia
         subjects affected / exposed
    2 / 100 (2.00%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Hypophagia
         subjects affected / exposed
    1 / 100 (1.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Electrolyte imbalance
         subjects affected / exposed
    1 / 100 (1.00%)
         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
    Overall trial
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    99 / 100 (99.00%)
    Investigations
    Weight decreased
         subjects affected / exposed
    74 / 100 (74.00%)
         occurrences all number
    115
    C-reactive protein increased
         subjects affected / exposed
    10 / 100 (10.00%)
         occurrences all number
    14
    Blood creatine increased
         subjects affected / exposed
    6 / 100 (6.00%)
         occurrences all number
    7
    Injury, poisoning and procedural complications
    Radiation skin injury
         subjects affected / exposed
    24 / 100 (24.00%)
         occurrences all number
    24
    Vascular disorders
    Lymphoedema
         subjects affected / exposed
    7 / 100 (7.00%)
         occurrences all number
    7
    Nervous system disorders
    Dysgeusia
         subjects affected / exposed
    20 / 100 (20.00%)
         occurrences all number
    23
    Neuropathy peripheral
         subjects affected / exposed
    6 / 100 (6.00%)
         occurrences all number
    7
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    50 / 100 (50.00%)
         occurrences all number
    122
    Leukopenia
         subjects affected / exposed
    33 / 100 (33.00%)
         occurrences all number
    61
    Thrombocytopenia
         subjects affected / exposed
    29 / 100 (29.00%)
         occurrences all number
    50
    Neutropenia
         subjects affected / exposed
    24 / 100 (24.00%)
         occurrences all number
    33
    General disorders and administration site conditions
    Mucosal inflammation
         subjects affected / exposed
    71 / 100 (71.00%)
         occurrences all number
    123
    Fatigue
         subjects affected / exposed
    35 / 100 (35.00%)
         occurrences all number
    42
    Pain
         subjects affected / exposed
    19 / 100 (19.00%)
         occurrences all number
    20
    Application site oedema
         subjects affected / exposed
    10 / 100 (10.00%)
         occurrences all number
    11
    Pyrexia
         subjects affected / exposed
    7 / 100 (7.00%)
         occurrences all number
    7
    Gastrointestinal disorders
    Dry mouth
         subjects affected / exposed
    53 / 100 (53.00%)
         occurrences all number
    65
    Dysphagia
         subjects affected / exposed
    49 / 100 (49.00%)
         occurrences all number
    52
    Diarrhoea
         subjects affected / exposed
    24 / 100 (24.00%)
         occurrences all number
    26
    Nausea
         subjects affected / exposed
    24 / 100 (24.00%)
         occurrences all number
    32
    Stomatitis
         subjects affected / exposed
    14 / 100 (14.00%)
         occurrences all number
    17
    Skin and subcutaneous tissue disorders
    Dermatitis acneiform
         subjects affected / exposed
    35 / 100 (35.00%)
         occurrences all number
    54
    Dermatitis
         subjects affected / exposed
    31 / 100 (31.00%)
         occurrences all number
    39
    Rash
         subjects affected / exposed
    15 / 100 (15.00%)
         occurrences all number
    18
    Acne
         subjects affected / exposed
    14 / 100 (14.00%)
         occurrences all number
    18
    Infections and infestations
    Candida infection
         subjects affected / exposed
    11 / 100 (11.00%)
         occurrences all number
    11
    Urinary tract infection
         subjects affected / exposed
    6 / 100 (6.00%)
         occurrences all number
    6
    Metabolism and nutrition disorders
    Hypokalaemia
         subjects affected / exposed
    33 / 100 (33.00%)
         occurrences all number
    47
    Hypomagnesaemia
         subjects affected / exposed
    14 / 100 (14.00%)
         occurrences all number
    21
    Hypocalcaemia
         subjects affected / exposed
    7 / 100 (7.00%)
         occurrences all number
    10

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    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

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/34022697
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