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    Clinical Trial Results:
    A Multicenter, Single arm, Open Label Clinical Trial Evaluating Safety and Health-Related Quality of Life of Aflibercept in Combination with Irinotecan/5FU chemotherapy (FOLFIRI) in Patients with Metastatic Colorectal Cancer (mCRC) Previously Treated with an Oxaliplatin-Containing Regimen

    Summary
    EudraCT number
    2012-000048-89
    Trial protocol
    FR  
    Global end of trial date
    09 Jun 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    24 Jun 2016
    First version publication date
    24 Jun 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    AFLIBL06266
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01670721
    WHO universal trial number (UTN)
    U1111-1128-9325
    Other trial identifiers
    Study Name: AFEQT
    Sponsors
    Sponsor organisation name
    Sanofi aventis recherche & développement
    Sponsor organisation address
    82 avenue Raspail, Gentilly Cedex, France, 94255
    Public contact
    Trial Transparency Team, Sanofi aventis recherche & développement, Contact-US@sanofi.com
    Scientific contact
    Trial Transparency Team, Sanofi aventis recherche & développement, Contact-US@sanofi.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
    07 Jan 2016
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    09 Jun 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the safety of aflibercept in subjects with mCRC treated with irinotecan/5FU (FOLFIRI) after failure of an oxaliplatin-based regimen (subjects similar to those evaluated in the VELOUR trial [EFC10262, NCT00561470]) according to side effects prevention and management guidelines.
    Protection of trial subjects
    Subjects were fully informed of all pertinent aspects of the clinical trial as well as the possibility to discontinue at any time in language and terms appropriate for the subject and considering the local culture. During the course of the trial, subjects were provided with individual subject cards indicating the nature of the trial the subject is participating, contact details and any information needed in the event of a medical emergency. Collected personal data and human biological samples were processed in compliance with the Sanofi-Aventis Group Personal Data Protection Charter ensuring that the Group abides by the laws governing personal data protection in force in all countries in which it operates.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    08 Aug 2012
    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
    France: 175
    Worldwide total number of subjects
    175
    EEA total number of subjects
    175
    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)
    80
    From 65 to 84 years
    95
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The study was conducted at 38 sites in France. A total of 182 subjects were screened between 08 August 2012 and 30 June 2014, out of which 175 subjects were enrolled and treated.

    Pre-assignment
    Screening details
    Subjects enrolled in the study to assess the safety of Aflibercept in subjects treated with a combination of Aflibercept with FOLFIRI regimen (Irinotecan, Leucovorin and 5-Fluorouracil [5-FU]). 81 subjects with disease progression (DP) and 41 with adverse events (AEs) were considered as completed.

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

    Arms
    Arm title
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin)
    Arm description
    Aflibercept 4 mg/kg followed by Irinotecan 180 mg/m^2 and Leucovorin 400 mg/m^2 at the same time followed by 5-FU 400 mg/m^2 followed by 5-FU 2400 mg/m^2 on Day 1 of each cycle (1 Cycle = 2 weeks), until DP, unacceptable toxicity, death, Investigator's decision or subject's refusal of further treatment.
    Arm type
    Experimental

    Investigational medicinal product name
    Aflibercept
    Investigational medicinal product code
    AVE0005
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Aflibercept 4 mg/kg intravenous (IV) infusion over 60 minutes.

    Investigational medicinal product name
    Irinotecan
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Irinotecan 180 mg/m^2 IV infusion over 90 minutes.

    Investigational medicinal product name
    Leucovorin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Leucovorin 400 mg/m^2 IV infusion over 120 minutes.

    Investigational medicinal product name
    5-Fluorouracil
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous bolus use
    Dosage and administration details
    5-FU 400 mg/m^2 bolus IV infusion over 2-4 minutes.

    Investigational medicinal product name
    5-Fluorouracil
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    5-FU 2400 mg/m^2 continuous IV infusion over 46 hours.

    Number of subjects in period 1
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin)
    Started
    175
    Completed
    122
    Not completed
    53
         Subject's decision
    15
         Other than specified
    38

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin)
    Reporting group description
    Aflibercept 4 mg/kg followed by Irinotecan 180 mg/m^2 and Leucovorin 400 mg/m^2 at the same time followed by 5-FU 400 mg/m^2 followed by 5-FU 2400 mg/m^2 on Day 1 of each cycle (1 Cycle = 2 weeks), until DP, unacceptable toxicity, death, Investigator's decision or subject's refusal of further treatment.

    Reporting group values
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin) Total
    Number of subjects
    175 175
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    64.5 ± 11 -
    Gender categorical
    Units: Subjects
        Female
    77 77
        Male
    98 98

    End points

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    End points reporting groups
    Reporting group title
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin)
    Reporting group description
    Aflibercept 4 mg/kg followed by Irinotecan 180 mg/m^2 and Leucovorin 400 mg/m^2 at the same time followed by 5-FU 400 mg/m^2 followed by 5-FU 2400 mg/m^2 on Day 1 of each cycle (1 Cycle = 2 weeks), until DP, unacceptable toxicity, death, Investigator's decision or subject's refusal of further treatment.

    Primary: Percentage of Subjects With Adverse Events (AEs)

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    End point title
    Percentage of Subjects With Adverse Events (AEs) [1]
    End point description
    Any untoward medical occurrence in a subject who received investigational medicinal product (IMP) was considered an AE without regard to possibility of causal relationship with this treatment. Treatment-emergent adverse events (TEAEs) were defined as AEs that developed or worsened or became serious during on-treatment period. On-treatment period was defined as the time from the first dose of treatment to 30 days after the last dose of treatment (either Aflibercept or FOLFIRI). A serious adverse event (SAE) was defined as any untoward medical occurrence that resulted in any of the following outcomes: death, life-threatening, required initial or prolonged in-patient hospitalization, persistent or significant disability/incapacity, congenital anomaly/birth defect, or considered as medically important event. Any TEAE included subject with both serious and non-serious AEs.
    End point type
    Primary
    End point timeframe
    Baseline upto 30 days after the last treatment administration (either Aflibercept or FOLFIRI whichever comes last) (maximum exposure: 723 days)
    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: As the endpoint is descriptive in nature, no statistical analysis is provided.
    End point values
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin)
    Number of subjects analysed
    175
    Units: Percentage of subjects
    number (not applicable)
        Any TEAE
    100
        Any serious TEAE
    40.6
        Any serious related TEAE
    21.1
        Any TEAE leading to death
    9.1
        Any TEAE (permanent treatment discontinuation)
    23.4
        Any TEAE (premature treatment discontinuation)
    16
    No statistical analyses for this end point

    Secondary: Change from Baseline in Health Related Quality of Life (HRQL) European Organization for Research And Treatment For Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)

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    End point title
    Change from Baseline in Health Related Quality of Life (HRQL) European Organization for Research And Treatment For Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30)
    End point description
    EORTC QLQ-C30 (version 3.0) was self-administered questionnaire containing 30 questions. First 28 questions were evaluated on 4-category scale (1=not at all, 2=a little, 3=quite a bit, 4=very much) for 5 functional scales (physical, emotional, cognitive, role & social), 3 symptoms scales (fatigue, nausea/vomiting & pain) and other single items. Last 2 questions were evaluated on overall health and quality of life (QOL) on 7-point category scale (1=very poor & 7=excellent). Baseline corresponded to last evaluable assessment before treatment administration; deterioration: change from baseline≤ -10 and improvement: change from baseline≥ 10.QLQ-C30 analysis population: subjects who signed informed consent form; had an evaluable QLQ-C30 questionnaire at baseline and at least one evaluable assessment post baseline and received at least part of a dose of study treatment. Here, n=number of subjects with available data at specified time-points & 99999=data not available for standard deviation.
    End point type
    Secondary
    End point timeframe
    Pre-dose at Baseline, Day 1 of every odd cycle; and at end of treatment (30 days after last study treatment) (maximum exposure: 99 weeks)
    End point values
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin)
    Number of subjects analysed
    152
    Units: Units on a scale
    arithmetic mean (standard deviation)
        Baseline (n=148)
    69.54 ± 18.97
        At Cycle 3 (n=130)
    -7.56 ± 19.78
        At Cycle 5 (n=99)
    -10.86 ± 19.76
        At Cycle 7 (n=72)
    -8.22 ± 20
        At Cycle 9 (n=51)
    -9.31 ± 19.34
        At Cycle 11 (n=45)
    -14.81 ± 21.24
        At Cycle 13 (n=25)
    -12.67 ± 24.31
        At Cycle 15 (n=24)
    -12.5 ± 18.22
        At Cycle 17 (n=14)
    -14.29 ± 15.82
        At Cycle 19 (n=12)
    -15.28 ± 11.7
        At Cycle 21 (n=10)
    -15.83 ± 19.82
        At Cycle 23 (n=6)
    -9.72 ± 20.01
        At Cycle 25 (n=4)
    -8.33 ± 6.8
        At Cycle 27 (n=4)
    -12.5 ± 15.96
        At Cycle 29 (n=2)
    -8.33 ± 11.79
        At Cycle 31 (n=2)
    -16.67 ± 0
        At Cycle 33 (n=1)
    0 ± 99999
        At Cycle 35 (n=1)
    0 ± 99999
        At Cycle 37 (n=2)
    -8.33 ± 11.79
        At Cycle 39 (n=2)
    -8.33 ± 11.79
        At Cycle 41 (n=2)
    -8.33 ± 11.79
        At Cycle 43 (n=2)
    -12.5 ± 5.89
        At Cycle 45 (n=2)
    -4.17 ± 17.68
        At Cycle 47 (n=1)
    0 ± 99999
        At end of study treatment (n=73)
    -11.19 ± 24.38
    No statistical analyses for this end point

    Secondary: Change From Baseline in HRQL European-Quality of Life-5 Dimension Instrument-3 Levels (EQ-5D-3L) Index Score

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    End point title
    Change From Baseline in HRQL European-Quality of Life-5 Dimension Instrument-3 Levels (EQ-5D-3L) Index Score
    End point description
    EQ-5D was a standardized HRQL questionnaire consisting of EQ-5D descriptive system and Visual Analogue Scale (VAS). EQ-5D descriptive system comprised of 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression measured on 3 levels (no problem, some problems & severe problems) within a particular EQ-5D dimension. 5 dimensional 3-level system was converted into single index utility score. Possible values for single index utility score ranged from -0.594 (severe problems in all dimensions) to 1.0 (no problem in all dimensions) on scale where 1 represented best possible health state. EQ-5D analysis population: subjects who signed informed consent form, had an evaluable EQ-5D questionnaire at baseline and at least one evaluable assessment post baseline and received at least part of one dose of study treatment. Here, n = number of subjects with available data at specified time-points & 99999=data not available for standard deviation.
    End point type
    Secondary
    End point timeframe
    Pre-dose at Baseline, Day 1 of every odd cycle; and at end of treatment (30 days after last study treatment) (maximum exposure: 99 weeks)
    End point values
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin)
    Number of subjects analysed
    148
    Units: Units on a scale
    arithmetic mean (standard deviation)
        Baseline (n=148)
    0.78 ± 0.21
        At Cycle 3 (n=127)
    -0.04 ± 0.23
        At Cycle 5 (n=96)
    -0.08 ± 0.25
        At Cycle 7 (n=72)
    -0.05 ± 0.2
        At Cycle 9 (n=49)
    -0.09 ± 0.23
        At Cycle 11 (n=43)
    -0.06 ± 0.2
        At Cycle 13 (n=24)
    -0.09 ± 0.14
        At Cycle 15 (n=25)
    -0.1 ± 0.16
        At Cycle 17 (n=14)
    -0.03 ± 0.1
        At Cycle 19 (n=12)
    -0.1 ± 0.12
        At Cycle 21 (n=10)
    -0.03 ± 0.18
        At Cycle 23 (n=6)
    -0.08 ± 0.15
        At Cycle 25 (n=3)
    0.04 ± 0.22
        At Cycle 27 (n=3)
    -0.09 ± 0.2
        At Cycle 29 (n=2)
    -0.18 ± 0.04
        At Cycle 31 (n=1)
    0 ± 99999
        At Cycle 37 (n=1)
    -0.15 ± 99999
        At Cycle 39 (n=1)
    0 ± 99999
        At Cycle 41 (n=1)
    0 ± 99999
        At Cycle 43 (n=1)
    0 ± 99999
        At Cycle 45 (n=1)
    0 ± 99999
        At end of study treatment (n=71)
    -0.2 ± 0.31
    No statistical analyses for this end point

    Secondary: Change From Baseline in HRQL EQ-5D-3L VAS Score

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    End point title
    Change From Baseline in HRQL EQ-5D-3L VAS Score
    End point description
    EQ-5D VAS was used to record subject’s rating for his/her current health-related quality of life state and captured on a vertical VAS (0-100), where 0 = worst imaginable health state and 100 = best imaginable health state. Baseline corresponded to last evaluable assessment before treatment administration. EQ-5D analysis population: subjects who signed informed consent form, had an evaluable EQ-5D questionnaire at baseline and at least one evaluable assessment post baseline and received at least part of one dose of study treatment. Here, n = number of subjects with available data at specified time-points & 99999=data not available for standard deviation.
    End point type
    Secondary
    End point timeframe
    Pre-dose at Baseline, Day 1 of every odd cycle; and at end of treatment (30 days after last study treatment) (maximum exposure: 99 weeks)
    End point values
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin)
    Number of subjects analysed
    148
    Units: Units on a scale
    arithmetic mean (standard deviation)
        Baseline (n=125)
    69.48 ± 19.1
        At cycle 3 (n=94)
    -6.23 ± 17.82
        At cycle 5 (n=76)
    -7.62 ± 17.23
        At cycle 7 (n=57)
    -7.79 ± 14.14
        At cycle 9 (n=38)
    -7.55 ± 16.12
        At cycle 11 (n=36)
    -8.67 ± 16.09
        At cycle 13 (n=22)
    -8.95 ± 17.56
        At cycle 15 (n=22)
    -12.41 ± 19.57
        At cycle 17 (n=13)
    -10.31 ± 17.44
        At cycle 19 (n=10)
    -15.7 ± 18.19
        At cycle 21 (n=8)
    -15.13 ± 19.87
        At cycle 23 (n=5)
    -8.8 ± 10.71
        At cycle 25 (n=2)
    -13 ± 4.24
        At cycle 27 (n=3)
    -15.67 ± 9.81
        At cycle 29 (n=2)
    -17.5 ± 3.54
        At cycle 31 (n=1)
    -15 ± 99999
        At cycle 37 (n=1)
    -15 ± 99999
        At cycle 39 (n=1)
    -15 ± 99999
        At cycle 41 (n=1)
    -15 ± 99999
        At cycle 43 (n=1)
    -15 ± 99999
        At cycle 45 (n=1)
    -15 ± 99999
        At end of study treatment (n=55)
    -13.05 ± 20.82
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All Adverse Events (AE) were collected from signature of the informed consent form up to the final visit (Day 723) regardless of seriousness or relationship to investigational product.
    Adverse event reporting additional description
    Reported AEs and deaths are treatment-emergent that is AEs that developed/worsened and deaths that occurred during 'on-treatment period’ (From the first dose of treatment to 30 days after the last dose of treatment [either aflibercept or FOLFIRI]).
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.1
    Reporting groups
    Reporting group title
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin)
    Reporting group description
    Aflibercept 4 mg/kg followed by Irinotecan 180 mg/m^2 and Leucovorin 400 mg/m^2 at the same time followed by 5-FU 400 mg/m^2 followed by 5-FU 2400 mg/m^2 on Day 1 of each cycle (1 Cycle = 2 weeks), until disease progression (DP), unacceptable toxicity, death, Investigator's decision or subject's refusal of further treatment (maximum exposure: Week 99).

    Serious adverse events
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    71 / 175 (40.57%)
         number of deaths (all causes)
    9
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Infected Neoplasm
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metastases To Central Nervous System
         subjects affected / exposed
    2 / 175 (1.14%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Metastatic Pain
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Phlebitis
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombosis
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Varicose Ulceration
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Hepatectomy
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intraperitoneal Hyperthermic Chemotherapy
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Disease Progression
         subjects affected / exposed
    9 / 175 (5.14%)
         occurrences causally related to treatment / all
    0 / 9
         deaths causally related to treatment / all
    0 / 6
    Fatigue
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General Physical Health Deterioration
         subjects affected / exposed
    8 / 175 (4.57%)
         occurrences causally related to treatment / all
    6 / 9
         deaths causally related to treatment / all
    1 / 2
    Influenza Like Illness
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    3 / 175 (1.71%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Priapism
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural Effusion
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumothorax
         subjects affected / exposed
    2 / 175 (1.14%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pulmonary Embolism
         subjects affected / exposed
    4 / 175 (2.29%)
         occurrences causally related to treatment / all
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    Pulmonary Oedema
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Confusional State
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Depression
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Blood Alkaline Phosphatase Increased
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Laparoscopy
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Head Injury
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Cerebellar Ischaemia
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Cerebrovascular Accident
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Dizziness
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Headache
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Neuropathy Peripheral
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile Neutropenia
         subjects affected / exposed
    2 / 175 (1.14%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Pancytopenia
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Vitreous Haemorrhage
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal Pain
         subjects affected / exposed
    3 / 175 (1.71%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Anal Fistula
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    8 / 175 (4.57%)
         occurrences causally related to treatment / all
    9 / 9
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal Fistula
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Gastrointestinal Haemorrhage
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    2 / 175 (1.14%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Intestinal Obstruction
         subjects affected / exposed
    3 / 175 (1.71%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 1
    Pancreatitis
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rectal Haemorrhage
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Rectourethral Fistula
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Small Intestinal Perforation
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Stomatitis
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Subileus
         subjects affected / exposed
    2 / 175 (1.14%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Tooth Loss
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Hepatic Failure
         subjects affected / exposed
    2 / 175 (1.14%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    1 / 1
    Renal and urinary disorders
    Renal Colic
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal Failure
         subjects affected / exposed
    2 / 175 (1.14%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Urinary Retention
         subjects affected / exposed
    1 / 175 (0.57%)
         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 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Device Related Infection
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal Wall Abscess
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Device Related Sepsis
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Escherichia Infection
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infection
         subjects affected / exposed
    2 / 175 (1.14%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Lung Infection
         subjects affected / exposed
    2 / 175 (1.14%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pelvic Abscess
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Septic Shock
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Tooth Infection
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Decreased Appetite
         subjects affected / exposed
    2 / 175 (1.14%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Dehydration
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    1 / 175 (0.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    1 / 175 (0.57%)
         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
    Aflibercept + FOLFIRI (Irinotecan, 5-FU & Leucovorin)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    172 / 175 (98.29%)
    Investigations
    Weight Decreased
         subjects affected / exposed
    68 / 175 (38.86%)
         occurrences all number
    77
    Vascular disorders
    Hypertension
         subjects affected / exposed
    74 / 175 (42.29%)
         occurrences all number
    106
    Nervous system disorders
    Dysgeusia
         subjects affected / exposed
    13 / 175 (7.43%)
         occurrences all number
    14
    Headache
         subjects affected / exposed
    32 / 175 (18.29%)
         occurrences all number
    44
    Neuropathy Peripheral
         subjects affected / exposed
    19 / 175 (10.86%)
         occurrences all number
    19
    Paraesthesia
         subjects affected / exposed
    9 / 175 (5.14%)
         occurrences all number
    10
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    39 / 175 (22.29%)
         occurrences all number
    48
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    98 / 175 (56.00%)
         occurrences all number
    149
    Fatigue
         subjects affected / exposed
    33 / 175 (18.86%)
         occurrences all number
    43
    Pyrexia
         subjects affected / exposed
    14 / 175 (8.00%)
         occurrences all number
    15
    Gastrointestinal disorders
    Abdominal Pain Upper
         subjects affected / exposed
    14 / 175 (8.00%)
         occurrences all number
    14
    Abdominal Pain
         subjects affected / exposed
    36 / 175 (20.57%)
         occurrences all number
    45
    Diarrhoea
         subjects affected / exposed
    121 / 175 (69.14%)
         occurrences all number
    246
    Constipation
         subjects affected / exposed
    39 / 175 (22.29%)
         occurrences all number
    44
    Gastrooesophageal Reflux Disease
         subjects affected / exposed
    10 / 175 (5.71%)
         occurrences all number
    11
    Rectal Haemorrhage
         subjects affected / exposed
    11 / 175 (6.29%)
         occurrences all number
    11
    Proctalgia
         subjects affected / exposed
    10 / 175 (5.71%)
         occurrences all number
    13
    Nausea
         subjects affected / exposed
    86 / 175 (49.14%)
         occurrences all number
    139
    Stomatitis
         subjects affected / exposed
    83 / 175 (47.43%)
         occurrences all number
    122
    Vomiting
         subjects affected / exposed
    47 / 175 (26.86%)
         occurrences all number
    61
    Respiratory, thoracic and mediastinal disorders
    Dysphonia
         subjects affected / exposed
    22 / 175 (12.57%)
         occurrences all number
    22
    Dyspnoea
         subjects affected / exposed
    17 / 175 (9.71%)
         occurrences all number
    21
    Epistaxis
         subjects affected / exposed
    43 / 175 (24.57%)
         occurrences all number
    49
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    36 / 175 (20.57%)
         occurrences all number
    39
    Palmar-Plantar Erythrodysaesthesia Syndrome
         subjects affected / exposed
    23 / 175 (13.14%)
         occurrences all number
    23
    Renal and urinary disorders
    Proteinuria
         subjects affected / exposed
    25 / 175 (14.29%)
         occurrences all number
    32
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    10 / 175 (5.71%)
         occurrences all number
    10
    Back Pain
         subjects affected / exposed
    18 / 175 (10.29%)
         occurrences all number
    20
    Myalgia
         subjects affected / exposed
    11 / 175 (6.29%)
         occurrences all number
    13
    Metabolism and nutrition disorders
    Decreased Appetite
         subjects affected / exposed
    59 / 175 (33.71%)
         occurrences all number
    71

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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 reported
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    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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