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    Clinical Trial Results:
    phase II study evaluating the interest of the re-introduction of pemetrexed and platinum (cisplatin or carboplatin) with prolonged angiogenic blocking by bevacizumab in non squamous non small cell lung cancer of advanced stage.

    Summary
    EudraCT number
    2012-002647-18
    Trial protocol
    FR  
    Global end of trial date
    13 Oct 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    13 Mar 2022
    First version publication date
    13 Mar 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    IFCT-1102
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01705184
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    IFCT
    Sponsor organisation address
    10 rue de la Grange-Batelière, PARIS, France, 75009
    Public contact
    Clinical trial informations, IFCT, 33 15681045, contact@ifct.fr
    Scientific contact
    Clinical trial informations, IFCT, 33 15681045, contact@ifct.fr
    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
    31 Dec 2015
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    13 Oct 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Feasibility of cisplatin re-introduction (stop-and-go strategy) in patients with advanced nonsquamous non-small cell lung cancer
    Protection of trial subjects
    Algorithms for management of adverse events were provided in the protocol.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    27 Dec 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: 120
    Worldwide total number of subjects
    120
    EEA total number of subjects
    120
    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)
    83
    From 65 to 84 years
    37
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    From December 2012 to August 2014, 14 hospital centres from the French Cooperative Thoracic Intergroup included 120 patients.

    Pre-assignment
    Screening details
    Adult patients with previously untreated documented advanced nsqNSCLC were eligible to if they presented with at least one measurable lesion according to the Response Evaluation Criteria in Solid Tumours (RECIST V.1.1). Patients had to be in good health condition (Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≤1.

    Period 1
    Period 1 title
    Sequence 1
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    cisplatin + pemetrexed + bevacizumab
    Arm description
    -
    Arm type
    Single ARM study

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    75 mg/m² every 3 weeks for 3 cycles

    Investigational medicinal product name
    Pemetrexed
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    500 mg/m² every 3 weeks for 3 cycles

    Investigational medicinal product name
    Carboplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    AUC 5 every 3 weeks Cisplatin could be switched to carboplatin according to investigator decision in case of unacceptable cisplatin toxicity.

    Investigational medicinal product name
    Bevacizumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    7,5 mg/kg every 3 weeks until progression or toxicity

    Number of subjects in period 1
    cisplatin + pemetrexed + bevacizumab
    Started
    120
    Completed
    68
    Not completed
    52
         Adverse event, serious fatal
    1
         Patient's choice
    1
         Treatment not started
    2
         Physician decision
    9
         Adverse event, non-fatal
    12
         Intercurrent disease
    4
         Related to cancer
    3
         Treatment completed but sequence 2 not started
    2
         Lack of efficacy
    13
         Protocol deviation
    5
    Period 2
    Period 2 title
    Sequence 2
    Is this the baseline period?
    No
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    cisplatin + pemetrexed + bevacizumab
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    75 mg/m² every 3 weeks for 3 cycles

    Investigational medicinal product name
    Pemetrexed
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    500 mg/m² every 3 weeks until progression or toxicity

    Investigational medicinal product name
    Carboplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    AUC 5 every 3 weeks Cisplatin could be switched to carboplatin according to investigator decision in case of unacceptable cisplatin toxicity.

    Investigational medicinal product name
    Bevacizumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    7,5 mg/kg every 3 weeks until progression or toxicity

    Number of subjects in period 2
    cisplatin + pemetrexed + bevacizumab
    Started
    68
    Completed
    37
    Not completed
    31
         withdrawal form sequence 2
    28
         Protocol deviation
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Sequence 1
    Reporting group description
    -

    Reporting group values
    Sequence 1 Total
    Number of subjects
    120 120
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    60.19 ± 8.54 -
    Gender categorical
    Units: Subjects
        Female
    43 43
        Male
    77 77
    Smoking status
    Units: Subjects
        Never smoker
    21 21
        former/current smoker
    99 99
    ECOG performance status
    Units: Subjects
        PS = 0
    60 60
        PS = 1
    60 60
    Disease stage at inclusion
    Units: Subjects
        M0
    1 1
        M1a
    39 39
        M1b
    80 80
    Pathological type
    Units: Subjects
        Adenocarcinoma without bronchioloalveolar componen
    113 113
        Adenocarcinoma with bronchioloalveolar component
    2 2
        Large cell carcinoma
    5 5
    No of pack-years
    Units: Pack-years
        median (full range (min-max))
    40.0 (5.0 to 160.0) -

    End points

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    End points reporting groups
    Reporting group title
    cisplatin + pemetrexed + bevacizumab
    Reporting group description
    -
    Reporting group title
    cisplatin + pemetrexed + bevacizumab
    Reporting group description
    -

    Subject analysis set title
    Efficacy population sequence 1
    Subject analysis set type
    Per protocol
    Subject analysis set description
    Patients without major deviation to inclusion or exclusion criteria

    Subject analysis set title
    Safety population sequence 1
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Patients who received at least one treatment

    Subject analysis set title
    Efficacy population sequence 2
    Subject analysis set type
    Per protocol
    Subject analysis set description
    Patients without major deviation to inclusion or exclusion criteria

    Subject analysis set title
    ITT population sequence 1
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    All registered

    Subject analysis set title
    Safety population for sequence 2
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Patients who received at least one treatment

    Primary: Proportion of patients who received three cycles of chemotherapy without dose reduction of platinum-based chemotherapy during sequence 2

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    End point title
    Proportion of patients who received three cycles of chemotherapy without dose reduction of platinum-based chemotherapy during sequence 2 [1]
    End point description
    End point type
    Primary
    End point timeframe
    9 weeks after starting sequence 2
    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: Single arm study
    End point values
    Efficacy population sequence 2
    Number of subjects analysed
    65
    Units: percent
        number (confidence interval 95%)
    56.9 (45.1 to 73.6)
    No statistical analyses for this end point

    Secondary: PFS sequence 1

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    End point title
    PFS sequence 1
    End point description
    time from inclusion to the first disease progression or death
    End point type
    Secondary
    End point timeframe
    Up to 25 months
    End point values
    cisplatin + pemetrexed + bevacizumab Efficacy population sequence 1
    Number of subjects analysed
    113 [2]
    113
    Units: month
        median (confidence interval 95%)
    5.6 (5.0 to 6.3)
    5.6 (5.0 to 6.3)
    Notes
    [2] - Per protocol population
    No statistical analyses for this end point

    Secondary: PFS sequence 2

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    End point title
    PFS sequence 2
    End point description
    time from first to second disease progression or death
    End point type
    Secondary
    End point timeframe
    Up to 25 months
    End point values
    Efficacy population sequence 2
    Number of subjects analysed
    65
    Units: month
        median (confidence interval 95%)
    6.8 (5.8 to 8.8)
    No statistical analyses for this end point

    Secondary: Disease control duration

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    End point title
    Disease control duration
    End point description
    PFS sequence 1 + PFS sequence 2
    End point type
    Secondary
    End point timeframe
    Up to 24 months
    End point values
    Efficacy population sequence 2
    Number of subjects analysed
    65
    Units: month
        median (confidence interval 95%)
    12.4 (11.2 to 14.9)
    No statistical analyses for this end point

    Secondary: Disease control rate after sequence 2

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    End point title
    Disease control rate after sequence 2
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 24 months
    End point values
    Efficacy population sequence 2
    Number of subjects analysed
    65
    Units: percent
        number (confidence interval 95%)
    75.4 (64.9 to 85.9)
    No statistical analyses for this end point

    Secondary: Disease response rate after sequence 2

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    End point title
    Disease response rate after sequence 2
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 24 months
    End point values
    Efficacy population sequence 2
    Number of subjects analysed
    65
    Units: percent
        number (confidence interval 95%)
    15.4 (6.6 to 24.2)
    No statistical analyses for this end point

    Secondary: Overall survival

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    End point title
    Overall survival
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 24 months
    End point values
    Efficacy population sequence 1
    Number of subjects analysed
    113
    Units: month
        median (confidence interval 95%)
    17.7 (13.1 to 21.6)
    No statistical analyses for this end point

    Post-hoc: Overall survival from sequence 2

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    End point title
    Overall survival from sequence 2
    End point description
    End point type
    Post-hoc
    End point timeframe
    Up to 24 months
    End point values
    Efficacy population sequence 2
    Number of subjects analysed
    65
    Units: month
        median (confidence interval 95%)
    20.5 (16.9 to 26.9)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From informed consent signature until 30 days after the last received treatment
    Adverse event reporting additional description
    The maximal grade of adverse events was collected by cycle of treatment. Occurence of non-serious adverse events non available in the statistical report. Only non-serious adverse events related to study treatment are available in the statistical report.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21.0
    Reporting groups
    Reporting group title
    Safety population sequence 1
    Reporting group description
    -

    Reporting group title
    Safety population sequence 2
    Reporting group description
    -

    Serious adverse events
    Safety population sequence 1 Safety population sequence 2
    Total subjects affected by serious adverse events
         subjects affected / exposed
    36 / 118 (30.51%)
    24 / 68 (35.29%)
         number of deaths (all causes)
    40
    35
         number of deaths resulting from adverse events
    10
    6
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Bronchial carcinoma
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Coronary artery stenosis
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Embolism arterial
         subjects affected / exposed
    0 / 118 (0.00%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epistaxis
         subjects affected / exposed
    0 / 118 (0.00%)
    2 / 68 (2.94%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    2 / 118 (1.69%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 118 (0.85%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Death
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    7 / 118 (5.93%)
    9 / 68 (13.24%)
         occurrences causally related to treatment / all
    5 / 9
    14 / 20
         deaths causally related to treatment / all
    0 / 2
    0 / 3
    Malaise
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    2 / 118 (1.69%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Haemoptysis
         subjects affected / exposed
    1 / 118 (0.85%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    1 / 1
    Lung disorder
         subjects affected / exposed
    2 / 118 (1.69%)
    3 / 68 (4.41%)
         occurrences causally related to treatment / all
    1 / 2
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary congestion
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Haemoglobin decreased
         subjects affected / exposed
    1 / 118 (0.85%)
    2 / 68 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    3 / 118 (2.54%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    1 / 118 (0.85%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Coronary artery thrombosis
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Cerebrovascular accident
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Peripheral motor neuropathy
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Speech disorder
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Confusional state
         subjects affected / exposed
    0 / 118 (0.00%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Bone marrow failure
         subjects affected / exposed
    4 / 118 (3.39%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    4 / 4
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    1 / 118 (0.85%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anaemia
         subjects affected / exposed
    0 / 118 (0.00%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile bone marrow aplasia
         subjects affected / exposed
    0 / 118 (0.00%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    0 / 118 (0.00%)
    2 / 68 (2.94%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Eye disorder
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    2 / 118 (1.69%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    2 / 118 (1.69%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal perforation
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    3 / 118 (2.54%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    3 / 3
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stomatitis
         subjects affected / exposed
    1 / 118 (0.85%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    2 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    2 / 118 (1.69%)
    3 / 68 (4.41%)
         occurrences causally related to treatment / all
    2 / 2
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Dysphagia
         subjects affected / exposed
    0 / 118 (0.00%)
    4 / 68 (5.88%)
         occurrences causally related to treatment / all
    0 / 0
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infectious colitis
         subjects affected / exposed
    0 / 118 (0.00%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Jaundice cholestatic
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Renal and urinary disorders
    Renal failure
         subjects affected / exposed
    3 / 118 (2.54%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    3 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal colic
         subjects affected / exposed
    0 / 118 (0.00%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary retention
         subjects affected / exposed
    0 / 118 (0.00%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Musculoskeletal chest pain
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Pain in extremity
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bone pain
         subjects affected / exposed
    0 / 118 (0.00%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Osteonecrosis
         subjects affected / exposed
    0 / 118 (0.00%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Device related infection
         subjects affected / exposed
    1 / 118 (0.85%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    3 / 118 (2.54%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    2 / 3
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    1 / 1
    Infection
         subjects affected / exposed
    0 / 118 (0.00%)
    3 / 68 (4.41%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    0 / 118 (0.00%)
    1 / 68 (1.47%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Cachexia
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Decreased appetite
         subjects affected / exposed
    5 / 118 (4.24%)
    2 / 68 (2.94%)
         occurrences causally related to treatment / all
    3 / 5
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    1 / 118 (0.85%)
    0 / 68 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Safety population sequence 1 Safety population sequence 2
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    118 / 118 (100.00%)
    66 / 68 (97.06%)
    Vascular disorders
    Epistaxis
         subjects affected / exposed
    39 / 118 (33.05%)
    22 / 68 (32.35%)
         occurrences all number
    39
    22
    Hypertension
         subjects affected / exposed
    38 / 118 (32.20%)
    16 / 68 (23.53%)
         occurrences all number
    38
    16
    Haemoptysis
         subjects affected / exposed
    6 / 118 (5.08%)
    4 / 68 (5.88%)
         occurrences all number
    6
    4
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    74 / 118 (62.71%)
    48 / 68 (70.59%)
         occurrences all number
    74
    48
    Fatigue
         subjects affected / exposed
    7 / 118 (5.93%)
    4 / 68 (5.88%)
         occurrences all number
    7
    4
    General physical health deterioration
         subjects affected / exposed
    5 / 118 (4.24%)
    9 / 68 (13.24%)
         occurrences all number
    5
    9
    Oedema peripheral
         subjects affected / exposed
    4 / 118 (3.39%)
    6 / 68 (8.82%)
         occurrences all number
    4
    6
    Pyrexia
         subjects affected / exposed
    2 / 118 (1.69%)
    5 / 68 (7.35%)
         occurrences all number
    2
    5
    Respiratory, thoracic and mediastinal disorders
    Dysphonia
         subjects affected / exposed
    7 / 118 (5.93%)
    4 / 68 (5.88%)
         occurrences all number
    7
    4
    Rhinorrhoea
         subjects affected / exposed
    2 / 118 (1.69%)
    6 / 68 (8.82%)
         occurrences all number
    2
    6
    Dyspnoea
         subjects affected / exposed
    1 / 118 (0.85%)
    4 / 68 (5.88%)
         occurrences all number
    1
    4
    Investigations
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    9 / 118 (7.63%)
    10 / 68 (14.71%)
         occurrences all number
    9
    10
    Weight decreased
         subjects affected / exposed
    8 / 118 (6.78%)
    3 / 68 (4.41%)
         occurrences all number
    8
    3
    Alanine aminotransferase increased
         subjects affected / exposed
    7 / 118 (5.93%)
    8 / 68 (11.76%)
         occurrences all number
    7
    8
    Aspartate aminotransferase increased
         subjects affected / exposed
    4 / 118 (3.39%)
    7 / 68 (10.29%)
         occurrences all number
    4
    7
    Blood alkaline phosphatase increased
         subjects affected / exposed
    2 / 118 (1.69%)
    6 / 68 (8.82%)
         occurrences all number
    2
    6
    Nervous system disorders
    Dysgeusia
         subjects affected / exposed
    11 / 118 (9.32%)
    3 / 68 (4.41%)
         occurrences all number
    11
    3
    Paraesthesia
         subjects affected / exposed
    11 / 118 (9.32%)
    7 / 68 (10.29%)
         occurrences all number
    11
    7
    Headache
         subjects affected / exposed
    9 / 118 (7.63%)
    6 / 68 (8.82%)
         occurrences all number
    9
    6
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    62 / 118 (52.54%)
    46 / 68 (67.65%)
         occurrences all number
    62
    46
    Neutropenia
         subjects affected / exposed
    56 / 118 (47.46%)
    31 / 68 (45.59%)
         occurrences all number
    56
    31
    Thrombocytopenia
         subjects affected / exposed
    30 / 118 (25.42%)
    21 / 68 (30.88%)
         occurrences all number
    30
    21
    Febrile neutropenia
         subjects affected / exposed
    1 / 118 (0.85%)
    4 / 68 (5.88%)
         occurrences all number
    1
    4
    Ear and labyrinth disorders
    Tinnitus
         subjects affected / exposed
    7 / 118 (5.93%)
    3 / 68 (4.41%)
         occurrences all number
    7
    3
    Eye disorders
    Lacrimation increased
         subjects affected / exposed
    8 / 118 (6.78%)
    11 / 68 (16.18%)
         occurrences all number
    8
    11
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    64 / 118 (54.24%)
    38 / 68 (55.88%)
         occurrences all number
    64
    35
    Stomatitis
         subjects affected / exposed
    26 / 118 (22.03%)
    13 / 68 (19.12%)
         occurrences all number
    26
    13
    Vomiting
         subjects affected / exposed
    24 / 118 (20.34%)
    14 / 68 (20.59%)
         occurrences all number
    24
    14
    Constipation
         subjects affected / exposed
    15 / 118 (12.71%)
    12 / 68 (17.65%)
         occurrences all number
    15
    12
    Diarrhoea
         subjects affected / exposed
    14 / 118 (11.86%)
    13 / 68 (19.12%)
         occurrences all number
    14
    13
    Gastrooesophageal reflux disease
         subjects affected / exposed
    8 / 118 (6.78%)
    1 / 68 (1.47%)
         occurrences all number
    8
    1
    Dysphagia
         subjects affected / exposed
    2 / 118 (1.69%)
    4 / 68 (5.88%)
         occurrences all number
    2
    4
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    8 / 118 (6.78%)
    4 / 68 (5.88%)
         occurrences all number
    8
    4
    Renal and urinary disorders
    Proteinuria
         subjects affected / exposed
    17 / 118 (14.41%)
    12 / 68 (17.65%)
         occurrences all number
    17
    12
    Renal failure
         subjects affected / exposed
    1 / 118 (0.85%)
    6 / 68 (8.82%)
         occurrences all number
    1
    6
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    7 / 118 (5.93%)
    1 / 68 (1.47%)
         occurrences all number
    7
    1
    Myalgia
         subjects affected / exposed
    6 / 118 (5.08%)
    1 / 68 (1.47%)
         occurrences all number
    6
    1
    Infections and infestations
    Conjunctivitis
         subjects affected / exposed
    15 / 118 (12.71%)
    7 / 68 (10.29%)
         occurrences all number
    15
    7
    Oral candidiasis
         subjects affected / exposed
    2 / 118 (1.69%)
    4 / 68 (5.88%)
         occurrences all number
    2
    4
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    23 / 118 (19.49%)
    22 / 68 (32.35%)
         occurrences all number
    23
    22
    Hypercreatinaemia
         subjects affected / exposed
    18 / 118 (15.25%)
    28 / 68 (41.18%)
         occurrences all number
    18
    28

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    05 Mar 2013
    Clarification of inclusion criteria (only patient with metastatic disease are eligible). Correction of the timing of blood sample for ancillary study
    09 Sep 2014
    Increased in patients number

    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

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/30094074
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    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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