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    Clinical Trial Results:
    An Open-label, Single arm, Multicenter Phase 2 Study of the Bruton's Tyrosine Kinase Inhibitor PCI-32765 (Ibrutinib) in Patients with Relapsed or Refractory Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma with 17p Deletion (RESONATE™-17)

    Summary
    EudraCT number
    2012-004476-19
    Trial protocol
    GB   SE   BE   DE  
    Global end of trial date

    Results information
    Results version number
    v1
    This version publication date
    01 May 2016
    First version publication date
    01 May 2016
    Other versions
    v2

    Trial information

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    Trial identification
    Sponsor protocol code
    PCYC-1117-CA
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01744691
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    provider NLM_DES study id: S0003WPS
    Sponsors
    Sponsor organisation name
    Pharmacyclics LLC
    Sponsor organisation address
    999 E Arques Ave, Sunnyvale, United States, 94085
    Public contact
    Kristin Russell (CTM), Pharmacyclics LLC, 001 408-215-3508, krussell@pcyc.com
    Scientific contact
    Dr. Alvina Chu, Pharmacyclics LLC, 001 855-427-8846, medinfo@pcyc.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
    Interim
    Date of interim/final analysis
    20 Jun 2014
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    20 Jun 2014
    Global end of trial reached?
    No
    General information about the trial
    Main objective of the trial
    The primary objective was to evaluate the efficacy of ibrutinib in terms of ORR per IWCLL 2008 criteria in subjects with relapsed or refractory CLL/SLL with documented del17p, who received a minimum of 1 prior line of systemic treatment.
    Protection of trial subjects
    The study was conducted in accordance with the Declaration of Helsinki and ICH GCP.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Jan 2013
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety
    Long term follow-up duration
    2 Years
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 14
    Country: Number of subjects enrolled
    Germany: 13
    Country: Number of subjects enrolled
    Turkey: 11
    Country: Number of subjects enrolled
    United States: 84
    Country: Number of subjects enrolled
    Sweden: 8
    Country: Number of subjects enrolled
    Australia: 7
    Country: Number of subjects enrolled
    Belgium: 3
    Country: Number of subjects enrolled
    Canada: 2
    Country: Number of subjects enrolled
    New Zealand: 2
    Worldwide total number of subjects
    144
    EEA total number of subjects
    38
    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
    67
    85 years and over
    2

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    One hundred forty-five subjects were enrolled and 144 subjects received at least 1 dose of Ibrutinib and constitute the all treated population and the safety analysis set.

    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
    Ibrutinib
    Arm description
    All subjects who received at least one dose of Ibrutinib 420 mg (3 x 140-mg capsules) orally once daily.
    Arm type
    Experimental

    Investigational medicinal product name
    Ibrutinib
    Investigational medicinal product code
    PCI-32765
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    All subjects received Ibrutinib 420 mg (3 x 140-mg capsules) orally once daily.

    Number of subjects in period 1
    Ibrutinib
    Started
    144
    Completed
    101
    Not completed
    43
         Unacceptable toxicity, AE or death
    18
         Physician decision
    4
         Progressive Disease
    18
         Withdrawal of consent for treatment
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Ibrutinib
    Reporting group description
    All subjects who received at least one dose of Ibrutinib 420 mg (3 x 140-mg capsules) orally once daily.

    Reporting group values
    Ibrutinib Total
    Number of subjects
    144 144
    Age Categorical
    Units: Subjects
        <=18 years
    0 0
        Between 18 and 65 years
    75 75
        >=65 years
    69 69
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    64.4 ( 9.9 ) -
    Gender, Male/Female
    Units: Subjects
        Female
    48 48
        Male
    96 96

    End points

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    End points reporting groups
    Reporting group title
    Ibrutinib
    Reporting group description
    All subjects who received at least one dose of Ibrutinib 420 mg (3 x 140-mg capsules) orally once daily.

    Subject analysis set title
    Ibrutinib
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    All subjects who received at least one dose of ibrutinib 420 mg (3 x 140-mg capsules) orally once daily.

    Primary: Overall Response Rate

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    End point title
    Overall Response Rate [1]
    End point description
    The primary objective of this study is to evaluate the efficacy of Ibrutinib in terms of ORR according to an Independent Review Committee (IRC). ORR based upon IRC assessment is the proportion of responders in the all treated population. Responders were subjects who achieved partial response (PR) or better, ie, complete response (CR), complete response with incomplete marrow recovery (CRi), nodule partial response (nPR) or PR, per IWCLL 2008 criteria with the clarification for treatment-related lymphocytosis.
    End point type
    Primary
    End point timeframe
    The median time on study for all treated participants is 11.5 (range 0.5 - 16.6) months
    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: Response rate and its 95% CI was calculated based on normal approximation with Wilson’s score method.
    End point values
    Ibrutinib
    Number of subjects analysed
    144
    Units: % of participants with response by IRC
        number (confidence interval 95%)
    63.9 (55.8 to 71.3)
    No statistical analyses for this end point

    Secondary: Number of Participants With Treatment Emergent Adverse Events (AEs)

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    End point title
    Number of Participants With Treatment Emergent Adverse Events (AEs)
    End point description
    Number of participants who had experienced at least one treatment emergent AE
    End point type
    Secondary
    End point timeframe
    From first dose of Ibrutinib to within 30 days of last dose for each participant or until study closure
    End point values
    Ibrutinib
    Number of subjects analysed
    144
    Units: participants
        number (not applicable)
    144
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first dose of Ibrutinib to within 30 days of last dose
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    Ibrutinib
    Reporting group description
    All subjects received Ibrutinib 420 mg (3 x 140-mg capsules) orally once daily.

    Serious adverse events
    Ibrutinib
    Total subjects affected by serious adverse events
         subjects affected / exposed
    58 / 144 (40.28%)
         number of deaths (all causes)
    23
         number of deaths resulting from adverse events
    2
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Chronic lymphocytic leukaemia
         subjects affected / exposed
    3 / 144 (2.08%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 2
    Hodgkin's disease
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lymphoma transformation
    alternative assessment type: Non-systematic
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Richter's syndrome
         subjects affected / exposed
    4 / 144 (2.78%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 1
    Skin papilloma
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Arterial haemorrhage
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Localised oedema
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    3 / 144 (2.08%)
         occurrences causally related to treatment / all
    3 / 7
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Alveolitis allergic
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemoptysis
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Interstitial lung disease
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    3 / 144 (2.08%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Femoral neck fracture
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Muscle rupture
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Post procedural haematuria
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Traumatic haematoma
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    2 / 144 (1.39%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Atrial fibrillation
         subjects affected / exposed
    6 / 144 (4.17%)
         occurrences causally related to treatment / all
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Nervous system disorders
    Critical illness polyneuropathy
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemorrhage intracranial
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
    alternative assessment type: Non-systematic
         subjects affected / exposed
    3 / 144 (2.08%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Autoimmune haemolytic anaemia
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Coagulopathy
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    2 / 144 (1.39%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Haemolytic anaemia
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Immune thrombocytopenic purpura
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Iron deficiency anaemia
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spontaneous haematoma
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Iritis
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Colitis
         subjects affected / exposed
    2 / 144 (1.39%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Anal fissure
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colitis ischaemic
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric ulcer haemorrhage
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastritis
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Oral mucosal blistering
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholecystitis
         subjects affected / exposed
    2 / 144 (1.39%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Cholecystitis acute
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Skin erosion
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Stevens-Johnson syndrome
         subjects affected / exposed
    1 / 144 (0.69%)
         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
    2 / 144 (1.39%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Renal infarct
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Musculoskeletal and connective tissue disorders
    Arthritis
         subjects affected / exposed
    2 / 144 (1.39%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Dactylitis
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Muscular weakness
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myalgia
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Osteoporosis
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Aspergillus infection
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bacteraemia
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Atypical pneumonia
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Bronchitis
         subjects affected / exposed
    2 / 144 (1.39%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Campylobacter gastroenteritis
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cystitis
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cellulitis
         subjects affected / exposed
    3 / 144 (2.08%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis clostridial
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Groin abscess
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes simplex
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lobar pneumonia
         subjects affected / exposed
    2 / 144 (1.39%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Lower respiratory tract infection viral
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Lymphadenitis bacterial
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Oropharyngeal candidiasis
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumocystis jirovecii pneumonia
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    17 / 144 (11.81%)
         occurrences causally related to treatment / all
    12 / 26
         deaths causally related to treatment / all
    0 / 4
    Pneumonia parainfluenzae viral
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    2 / 144 (1.39%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Septic shock
         subjects affected / exposed
    2 / 144 (1.39%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 1
    Sinusitis fungal
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    3 / 144 (2.08%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Hypercalcaemia
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    1 / 144 (0.69%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    1 / 144 (0.69%)
         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
    Ibrutinib
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    144 / 144 (100.00%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    28 / 144 (19.44%)
         occurrences all number
    34
    General disorders and administration site conditions
    Chills
         subjects affected / exposed
    8 / 144 (5.56%)
         occurrences all number
    8
    Fatigue
         subjects affected / exposed
    44 / 144 (30.56%)
         occurrences all number
    48
    Oedema peripheral
         subjects affected / exposed
    21 / 144 (14.58%)
         occurrences all number
    27
    Pyrexia
         subjects affected / exposed
    25 / 144 (17.36%)
         occurrences all number
    32
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    34 / 144 (23.61%)
         occurrences all number
    45
    Dyspnoea
         subjects affected / exposed
    16 / 144 (11.11%)
         occurrences all number
    21
    Epistaxis
         subjects affected / exposed
    10 / 144 (6.94%)
         occurrences all number
    11
    Nasal congestion
         subjects affected / exposed
    9 / 144 (6.25%)
         occurrences all number
    12
    Oropharyngeal pain
         subjects affected / exposed
    11 / 144 (7.64%)
         occurrences all number
    12
    Psychiatric disorders
    Depression
         subjects affected / exposed
    10 / 144 (6.94%)
         occurrences all number
    10
    Insomnia
         subjects affected / exposed
    11 / 144 (7.64%)
         occurrences all number
    11
    Investigations
    Weight decreased
    alternative assessment type: Non-systematic
         subjects affected / exposed
    12 / 144 (8.33%)
         occurrences all number
    15
    Weight increased
         subjects affected / exposed
    12 / 144 (8.33%)
         occurrences all number
    15
    Injury, poisoning and procedural complications
    Contusion
         subjects affected / exposed
    9 / 144 (6.25%)
         occurrences all number
    11
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    12 / 144 (8.33%)
         occurrences all number
    17
    Headache
         subjects affected / exposed
    14 / 144 (9.72%)
         occurrences all number
    15
    Peripheral sensory neuropathy
         subjects affected / exposed
    11 / 144 (7.64%)
         occurrences all number
    13
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    27 / 144 (18.75%)
         occurrences all number
    32
    Increased tendency to bruise
         subjects affected / exposed
    20 / 144 (13.89%)
         occurrences all number
    22
    Neutropenia
         subjects affected / exposed
    24 / 144 (16.67%)
         occurrences all number
    64
    Thrombocytopenia
         subjects affected / exposed
    16 / 144 (11.11%)
         occurrences all number
    31
    Eye disorders
    Lacrimation increased
         subjects affected / exposed
    9 / 144 (6.25%)
         occurrences all number
    11
    Vision blurred
         subjects affected / exposed
    10 / 144 (6.94%)
         occurrences all number
    11
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    11 / 144 (7.64%)
         occurrences all number
    12
    Constipation
    alternative assessment type: Non-systematic
         subjects affected / exposed
    17 / 144 (11.81%)
         occurrences all number
    17
    Diarrhoea
         subjects affected / exposed
    52 / 144 (36.11%)
         occurrences all number
    67
    Dyspepsia
         subjects affected / exposed
    15 / 144 (10.42%)
         occurrences all number
    22
    Nausea
         subjects affected / exposed
    28 / 144 (19.44%)
         occurrences all number
    36
    Stomatitis
         subjects affected / exposed
    9 / 144 (6.25%)
         occurrences all number
    12
    Vomiting
         subjects affected / exposed
    13 / 144 (9.03%)
         occurrences all number
    13
    Skin and subcutaneous tissue disorders
    Night sweats
         subjects affected / exposed
    15 / 144 (10.42%)
         occurrences all number
    18
    Pruritus
         subjects affected / exposed
    8 / 144 (5.56%)
         occurrences all number
    8
    Rash
         subjects affected / exposed
    9 / 144 (6.25%)
         occurrences all number
    10
    Rash erythematous
         subjects affected / exposed
    10 / 144 (6.94%)
         occurrences all number
    12
    Rash maculo-papular
         subjects affected / exposed
    12 / 144 (8.33%)
         occurrences all number
    14
    Skin lesion
         subjects affected / exposed
    10 / 144 (6.94%)
         occurrences all number
    12
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    32 / 144 (22.22%)
         occurrences all number
    43
    Back pain
         subjects affected / exposed
    18 / 144 (12.50%)
         occurrences all number
    22
    Muscle spasms
         subjects affected / exposed
    24 / 144 (16.67%)
         occurrences all number
    26
    Myalgia
         subjects affected / exposed
    15 / 144 (10.42%)
         occurrences all number
    15
    Pain in extremity
         subjects affected / exposed
    11 / 144 (7.64%)
         occurrences all number
    17
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    9 / 144 (6.25%)
         occurrences all number
    10
    Nasopharyngitis
         subjects affected / exposed
    13 / 144 (9.03%)
         occurrences all number
    15
    Sinusitis
         subjects affected / exposed
    13 / 144 (9.03%)
         occurrences all number
    16
    Upper respiratory tract infection
         subjects affected / exposed
    15 / 144 (10.42%)
         occurrences all number
    16
    Urinary tract infection
         subjects affected / exposed
    17 / 144 (11.81%)
         occurrences all number
    20
    Metabolism and nutrition disorders
    Decreased appetite
    alternative assessment type: Non-systematic
         subjects affected / exposed
    25 / 144 (17.36%)
         occurrences all number
    28
    Hyperuricaemia
         subjects affected / exposed
    14 / 144 (9.72%)
         occurrences all number
    15

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    22 Feb 2013
    • Changed the exclusion criteria governing number of prior lines of systemic therapy for CLL from 4 or more to 5 or more due to rapidity by which subjects with del17p CLL become relapsed or refractory to historical therapies. • Updated text for the management of ibrutinib with concomitant CYP3A4/5 inhibitors. • Updated text for the management of ibrutinib with concomitant anticoagulation therapy. Provided further clarification for restart of ibrutinib after anticoagulation therapy. • Provided guidance on perioperative holding of ibrutinib that was not previously available. • Clarified that ophthalmologic examination should be performed by an ophthalmologist. • Clarified that CT scans needed to be obtained for neck, chest, abdomen, and pelvis. • Except in the UK, PROs were no longer collected in the study.
    16 Dec 2013
    • Aligned the efficacy and safety populations to subjects who have received at least 1 dose of ibrutinib. • Delayed timing of the primary analysis to at least 12 months after the last subject’s first dose of ibrutinib. Provided clarification that any updates to the timing of the primary or final analysis would be pre-specified in the SAP and would not warrant another protocol amendment as long as study conduct was not impacted. • Updated guideline for the use of concomitant QT-prolonging agents. • Updated guideline for concomitant use of anticoagulation and antiplatelet agents and included precautions for commonly used supplements such as fish oil and Vitamin E.

    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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