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    Clinical Trial Results:
    Phase II Randomized Double-Blind Placebo-Controlled Trial of Combination of Pimasertib with SAR245409 or of Pimasertib with SAR245409 Placebo in Subjects with Previously Treated Unresectable Low-Grade Ovarian Cancer

    Summary
    EudraCT number
    2013-000902-40
    Trial protocol
    IT   BE   ES   PL  
    Global end of trial date
    30 Nov 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    13 Dec 2018
    First version publication date
    13 Dec 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    EMR200066_012
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01936363
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Merck KGaA
    Sponsor organisation address
    Frankfurter Strasse 250, Darmstadt, Germany, 64293, Darmstadt, Germany, 64293
    Public contact
    Communication Centre Merck KGaA, Merck KGaA, +49 6151725200, service@merckgroup.com
    Scientific contact
    Communication Centre Merck KGaA, Merck KGaA, +49 6151725200, service@merckgroup.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
    30 Nov 2017
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Nov 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this trial is to evaluate whether the objective tumor response of the combination therapy with pimasertib plus SAR245409 is superior to that of pimasertib plus SAR245409 placebo in subjects with previously treated unresectable low grade ovarian carcinoma according to Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) as determined by the Investigator.
    Protection of trial subjects
    Subject protection was ensured by following high medical and ethical standards in accordance with the principles laid down in the Declaration of Helsinki, and that are consistent with Good Clinical Practice and applicable regulations.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    30 Sep 2013
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 5
    Country: Number of subjects enrolled
    United States: 27
    Country: Number of subjects enrolled
    Australia: 8
    Country: Number of subjects enrolled
    Belgium: 7
    Country: Number of subjects enrolled
    Canada: 11
    Country: Number of subjects enrolled
    France: 1
    Country: Number of subjects enrolled
    Poland: 6
    Worldwide total number of subjects
    65
    EEA total number of subjects
    19
    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)
    53
    From 65 to 84 years
    12
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    First/last subject (informed consent): Sep 2013/Oct 2014. Clinical data cut off: Jan 2018.

    Pre-assignment
    Screening details
    Total 75 subjects were screened for this trial. Out of those subjects, 65 subjects were randomized to treatment in this trial.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Investigator, Carer, Assessor, Subject

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Pimasertib (Once Daily) Plus SAR245409
    Arm description
    Subejcts received Pimasertib oral capsule at a dose of 60 milligram (mg) once daily along with SAR245409 oral capsule at a dose of 70 mg once daily and placebo matched to pimasertib in evening until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.
    Arm type
    Experimental

    Investigational medicinal product name
    Pimasertib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Pimasertib oral capsule at a dose of 60 milligram (mg) administered once daily until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.

    Investigational medicinal product name
    SAR245409
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    SAR245409 oral capsule at a dose of 70 mg administered once daily until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.

    Investigational medicinal product name
    Placebo matched pimasertib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo matched pimasertib oral capsule at a dose of 60 mg administered once daily in evening until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.

    Arm title
    Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Arm description
    Subjects received pimasertib oral capsule at a dose of 60 mg twice daily along with placebo matched to SAR245409 once daily in morning until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.
    Arm type
    Experimental

    Investigational medicinal product name
    Pimasertib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Pimasertib oral capsule at a dose of 60 mg administered twice daily until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.

    Investigational medicinal product name
    Placebo matched SAR245409
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo matched SAR245409 administered once daily in morning until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.

    Number of subjects in period 1
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Started
    32
    33
    Completed
    32
    33

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Pimasertib (Once Daily) Plus SAR245409
    Reporting group description
    Subejcts received Pimasertib oral capsule at a dose of 60 milligram (mg) once daily along with SAR245409 oral capsule at a dose of 70 mg once daily and placebo matched to pimasertib in evening until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.

    Reporting group title
    Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Reporting group description
    Subjects received pimasertib oral capsule at a dose of 60 mg twice daily along with placebo matched to SAR245409 once daily in morning until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.

    Reporting group values
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo Total
    Number of subjects
    32 33 65
    Age categorical
    Units: Subjects
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    47.3 ( 14.07 ) 50.6 ( 16.39 ) -
    Gender, Male/Female
    Units: Subjects
        Female
    32 33 65
        Male
    0 0 0

    End points

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    End points reporting groups
    Reporting group title
    Pimasertib (Once Daily) Plus SAR245409
    Reporting group description
    Subejcts received Pimasertib oral capsule at a dose of 60 milligram (mg) once daily along with SAR245409 oral capsule at a dose of 70 mg once daily and placebo matched to pimasertib in evening until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.

    Reporting group title
    Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Reporting group description
    Subjects received pimasertib oral capsule at a dose of 60 mg twice daily along with placebo matched to SAR245409 once daily in morning until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.

    Primary: Objective Tumor Response

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    End point title
    Objective Tumor Response [1]
    End point description
    Objective tumor response was defined as the presence of at least one Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to more than (<) 10 millimeter (mm). Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Intent-to Treat (ITT) analysis set included all subjects who had been randomized.
    End point type
    Primary
    End point timeframe
    From randomization until disease progression or death assessed every 8 weeks up to week 32, and thereafter every 12 weeks up to 52 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: Only descriptive statistics were reported.
    End point values
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Number of subjects analysed
    32
    33
    Units: percentage of subjects
        number (confidence interval 95%)
    12.5 (3.5 to 29.0)
    12.1 (3.4 to 28.2)
    No statistical analyses for this end point

    Secondary: Progression-Free Survival

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    End point title
    Progression-Free Survival
    End point description
    PFS: time from randomization to first documentation of objective tumor progression.CR:Disappearance of all target lesions.Any pathological lymph nodes(whether target or non-target)must have reduction in short axis to<10 mm.PR:At least 30% decrease in sum of diameters of target lesions,taking as reference baseline sum diameters.PD:At least a 20% increase in sum of diameters of target lesions,taking as reference smallest sum on study.In addition to relative increase of 20%,the sum also demonstrate absolute increase of at least 5 mm.SD:Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD,taking as reference smallest sum diameters while on study. Median PFS was computed using Kaplan-Meier estimates (product-limit estimates) and was presented with 95% confidence interval. ITT analysis set used. Here 99999=upper limit of 95% Confidence Interval for PFS could not be calculated because this upper limit was not reached due to limited number of events.
    End point type
    Secondary
    End point timeframe
    Time from randomization until first observation of progressive disease or death, assessed up to 52 months
    End point values
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Number of subjects analysed
    32
    33
    Units: months
        median (confidence interval 95%)
    9.99 (3.42 to 15.21)
    12.71 (4.21 to 99999)
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With Disease Control

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    End point title
    Percentage of Subjects With Disease Control
    End point description
    Disease control as per RECIST v.1.1 was defined as the proportion of subjects with stable disease (SD), for at least 16 weeks, PR or CR according to RECIST v1.1 criteria. SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. PD: At least a 20% increase in sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters). CR: Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. ITT analysis set included all subjects who had been randomized.
    End point type
    Secondary
    End point timeframe
    Randomization until disease progression or death assessed every 8 weeks up to week 32, and thereafter every 12 weeks up to 52 months
    End point values
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Number of subjects analysed
    32
    33
    Units: percentage of subjects
        number (confidence interval 95%)
    50.0 (31.9 to 68.1)
    39.4 (22.9 to 57.9)
    No statistical analyses for this end point

    Secondary: Overall Survival

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    End point title
    Overall Survival
    End point description
    Overall survival (OS) was defined as the time (in months) from randomization to death. Data has been presented in terms of number of subjects who died and number of censored subjects. ITT analysis set included all subjects who had been randomized.
    End point type
    Secondary
    End point timeframe
    Time from randomization until death, assessed up to 52 months
    End point values
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Number of subjects analysed
    32
    33
    Units: subjects
        Number of deaths|
    8
    6
        Number for censored|
    24
    27
    No statistical analyses for this end point

    Secondary: Health Related Quality of Life (HrQoL) assessed using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30)

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    End point title
    Health Related Quality of Life (HrQoL) assessed using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30)
    End point description
    EORTC QLQ-C30: 30-item questionnaire comprising of five functional scales(physical, role, cognitive, emotional, and social), 3 symptom scales (fatigue, pain, and nausea/vomiting), 6 single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial impact) and a global quality of life (QoL) scale summarized from two 7-point scales (overall QoL and overall general health).Each of multi-item scales includes a different set of items-no item occurs in more than one scale.All of the scales and individual single-items ranged in score from 0 to 100.A high scale score=higher response level.High score for a functional scale=high/healthy level of functioning, a high score for the global health status/ QoL=high QoL, but a high score for a symptom scale/item=high level of symptomatology/problems. Data was not collected for this endpoint because as per Protocol Amendment4 (13 March 2015),collection of patient-reported health-related quality of life outcomes was discontinued.
    End point type
    Secondary
    End point timeframe
    Baseline up to disease progression or withdrawal, assessed up to 52 months
    End point values
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Number of subjects analysed
    0 [2]
    0 [3]
    Units: units on scale
    Notes
    [2] - Data was not collected due to the reason provided in description.
    [3] - Data was not collected due to the reason provided in description.
    No statistical analyses for this end point

    Secondary: Health Related Quality of Life (HrQoL) Assessed Using European Organization for Research and Treatment of Cancer (EORTC) Ovarian-Specific Module Quality of Life Questionnaire Ovarian Cancer Module (QLQ-OV28)

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    End point title
    Health Related Quality of Life (HrQoL) Assessed Using European Organization for Research and Treatment of Cancer (EORTC) Ovarian-Specific Module Quality of Life Questionnaire Ovarian Cancer Module (QLQ-OV28)
    End point description
    EORTC QLQ-OV28 assesses disease and treatment-related symptoms of ovarian cancer. The 28-item module comprises of 6 symptom scales (abdominal/gastrointestinal symptoms, peripheral neuropathy, other chemotherapy side-effects, hormonal symptoms, body image, attitude to disease and treatment), and sexual functioning. All of the scales and the individual single-items ranged in score from 0 to 100. Higher scores indicate a better quality of life. Data was not collected for this outcome because as per Protocol Amendment 4 (dated 13 March 2015), the collection of patient-reported health-related quality of life outcomes was discontinued.
    End point type
    Secondary
    End point timeframe
    Baseline up to disease progression or withdrawal, assessed up to 52 months
    End point values
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Number of subjects analysed
    0 [4]
    0 [5]
    Units: units on scale
    Notes
    [4] - Data was not collected due to the reason provided in description.
    [5] - Data was not collected due to the reason provided in description.
    No statistical analyses for this end point

    Secondary: Number of Subjects with Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, TEAEs Leading to Discontinuation of Treatment and Death

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    End point title
    Number of Subjects with Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, TEAEs Leading to Discontinuation of Treatment and Death
    End point description
    TEAEs, Serious TEAEs and AEs were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) Version 4.0. An adverse event was any untoward medical occurrence in a subject who received study drug without regard to possibility of causal relationship. A Serious Adverse Event was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent are events between first dose of study drug and up to data cut-off that were absent before treatment or that worsened relative to pretreatment state. Safety population (SAF) analysis set included all subjects who received at least one dose of any trial treatment.
    End point type
    Secondary
    End point timeframe
    First dose of study drug up to 52 months
    End point values
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Number of subjects analysed
    32
    32
    Units: subjects
        TEAE
    32
    32
        Serious TEAE
    16
    18
        TEAE leading to discontinuation of study treatment
    16
    12
        Death
    2
    3
    No statistical analyses for this end point

    Secondary: Maximum Plasma Concentration (Cmax) After Dose of pimasertib and SAR245409

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    End point title
    Maximum Plasma Concentration (Cmax) After Dose of pimasertib and SAR245409
    End point description
    As per changed in planned analysis the endpoint related to pharmacokinetic parameters was not assessed.
    End point type
    Secondary
    End point timeframe
    Pre-dose Hour 0.5, 1.5, 4.5 8 post dose on Day 15, 29, 43
    End point values
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Number of subjects analysed
    0 [6]
    0 [7]
    Units: nanogram/milliliter (ng/mL)
        arithmetic mean (standard deviation)
    ( )
    ( )
    Notes
    [6] - Data was not assessed as per change in planned analysis.
    [7] - Data was not assessed as per change in planned analysis.
    No statistical analyses for this end point

    Secondary: Area under the curve (AUC) After Dose of pimasertib and SAR245409

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    End point title
    Area under the curve (AUC) After Dose of pimasertib and SAR245409
    End point description
    As per changed in planned analysis the outcome measure related to pharmacokinetic parameters was not assessed.
    End point type
    Secondary
    End point timeframe
    Pre-dose Hour 0.5, 1.5, 4.5 8 post dose on Day 15, 29, 43
    End point values
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Number of subjects analysed
    0 [8]
    0 [9]
    Units: mg*min/dL
        arithmetic mean (standard deviation)
    ( )
    ( )
    Notes
    [8] - Data was not assessed as per change in planned analysis.
    [9] - Data was not assessed as per change in planned analysis.
    No statistical analyses for this end point

    Secondary: Molecular Alterations in MAPK and/or PI3K Signaling Pathway Components/Modulators in Tumor Tissue and Blood

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    End point title
    Molecular Alterations in MAPK and/or PI3K Signaling Pathway Components/Modulators in Tumor Tissue and Blood
    End point description
    As per changed in planned analysis the outcome measure related to pharmacodynamics parameters was not assessed.
    End point type
    Secondary
    End point timeframe
    Screening visit (day -28 to 1)
    End point values
    Pimasertib (Once Daily) Plus SAR245409 Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Number of subjects analysed
    0 [10]
    0 [11]
    Units: Not available
        arithmetic mean (standard deviation)
    ( )
    ( )
    Notes
    [10] - Data was not assessed as per change in planned analysis.
    [11] - Data was not assessed as per change in planned analysis.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    First dose of study drug up to 52 months
    Adverse event reporting additional description
    SAF for “Pimasertib (Once Daily) Plus SAR245409” = 32 subjects and “Pimasertib (Twice Daily) Plus SAR245409 Placebo” = 32 subjects. Adverse events analysis was based on the SAF which includes 64 subjects. One subject was randomized by error and not treated therefore adverse event analysis was not performed.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    20.1
    Reporting groups
    Reporting group title
    Pimasertib (Twice Daily) Plus SAR245409 Placebo
    Reporting group description
    subjects received pimasertib oral capsule at a dose of 60 mg twice daily along with placebo matched SAR245409 once daily in morning until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.

    Reporting group title
    Pimasertib (Once Daily) Plus SAR245409
    Reporting group description
    subjects received Pimasertib oral capsule at a dose of 60 milligram (mg) once daily along with SAR245409 oral capsule at a dose of 70 mg once daily and placebo matched pimasertib in evening until disease progression, death, intolerable toxicity or withdrawal of informed consent, whichever came first.

    Serious adverse events
    Pimasertib (Twice Daily) Plus SAR245409 Placebo Pimasertib (Once Daily) Plus SAR245409
    Total subjects affected by serious adverse events
         subjects affected / exposed
    18 / 32 (56.25%)
    16 / 32 (50.00%)
         number of deaths (all causes)
    6
    8
         number of deaths resulting from adverse events
    Vascular disorders
    Circulatory collapse
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    1 / 32 (3.13%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Embolism
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypertension
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    2 / 32 (6.25%)
    3 / 32 (9.38%)
         occurrences causally related to treatment / all
    0 / 2
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chills
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Disease progression
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Fatigue
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    2 / 32 (6.25%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cough
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Aspiration
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    1 / 32 (3.13%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Product issues
    Device malfunction
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Blood creatine phosphokinase increased
         subjects affected / exposed
    1 / 32 (3.13%)
    2 / 32 (6.25%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intraocular pressure increased
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Weight decreased
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Overdose
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Feeding tube complication
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac arrest
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Cardio-respiratory arrest
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Presyncope
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Retinal detachment
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    4 / 32 (12.50%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    4 / 4
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    2 / 32 (6.25%)
    2 / 32 (6.25%)
         occurrences causally related to treatment / all
    2 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    2 / 32 (6.25%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    2 / 32 (6.25%)
    2 / 32 (6.25%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ascites
         subjects affected / exposed
    2 / 32 (6.25%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Large intestinal obstruction
         subjects affected / exposed
    1 / 32 (3.13%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric haemorrhage
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Proctalgia
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stomatitis
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subileus
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Portal vein thrombosis
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Dermatitis acneiform
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rash maculo-papular
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Calculus urinary
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic kidney disease
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hydronephrosis
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Muscular weakness
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain in extremity
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Cellulitis
         subjects affected / exposed
    1 / 32 (3.13%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 32 (3.13%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peritonitis bacterial
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pharyngitis
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Streptococcal bacteraemia
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 32 (3.13%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Wound infection
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Klebsiella infection
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    3 / 32 (9.38%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acidosis
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    1 / 32 (3.13%)
    0 / 32 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypophosphataemia
         subjects affected / exposed
    0 / 32 (0.00%)
    1 / 32 (3.13%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Pimasertib (Twice Daily) Plus SAR245409 Placebo Pimasertib (Once Daily) Plus SAR245409
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    32 / 32 (100.00%)
    32 / 32 (100.00%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    4 / 32 (12.50%)
    3 / 32 (9.38%)
         occurrences all number
    4
    3
    Deep vein thrombosis
         subjects affected / exposed
    1 / 32 (3.13%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    14 / 32 (43.75%)
    19 / 32 (59.38%)
         occurrences all number
    14
    19
    Oedema peripheral
         subjects affected / exposed
    15 / 32 (46.88%)
    11 / 32 (34.38%)
         occurrences all number
    15
    11
    Pyrexia
         subjects affected / exposed
    8 / 32 (25.00%)
    6 / 32 (18.75%)
         occurrences all number
    8
    6
    Chills
         subjects affected / exposed
    2 / 32 (6.25%)
    9 / 32 (28.13%)
         occurrences all number
    2
    9
    Asthenia
         subjects affected / exposed
    8 / 32 (25.00%)
    0 / 32 (0.00%)
         occurrences all number
    8
    0
    Face oedema
         subjects affected / exposed
    3 / 32 (9.38%)
    4 / 32 (12.50%)
         occurrences all number
    3
    4
    Peripheral swelling
         subjects affected / exposed
    2 / 32 (6.25%)
    2 / 32 (6.25%)
         occurrences all number
    2
    2
    Influenza like illness
         subjects affected / exposed
    1 / 32 (3.13%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2
    Mucosal inflammation
         subjects affected / exposed
    0 / 32 (0.00%)
    3 / 32 (9.38%)
         occurrences all number
    0
    3
    Malaise
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Mass
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Reproductive system and breast disorders
    Pelvic pain
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Vulvovaginal dryness
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    4 / 32 (12.50%)
    8 / 32 (25.00%)
         occurrences all number
    4
    8
    Dyspnoea
         subjects affected / exposed
    6 / 32 (18.75%)
    7 / 32 (21.88%)
         occurrences all number
    6
    7
    Dyspnoea exertional
         subjects affected / exposed
    3 / 32 (9.38%)
    3 / 32 (9.38%)
         occurrences all number
    3
    3
    Epistaxis
         subjects affected / exposed
    1 / 32 (3.13%)
    4 / 32 (12.50%)
         occurrences all number
    1
    4
    Nasal congestion
         subjects affected / exposed
    1 / 32 (3.13%)
    4 / 32 (12.50%)
         occurrences all number
    1
    4
    Oropharyngeal pain
         subjects affected / exposed
    0 / 32 (0.00%)
    3 / 32 (9.38%)
         occurrences all number
    0
    3
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    0 / 32 (0.00%)
    5 / 32 (15.63%)
         occurrences all number
    0
    5
    Insomnia
         subjects affected / exposed
    1 / 32 (3.13%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2
    Investigations
    Blood creatine phosphokinase increased
         subjects affected / exposed
    19 / 32 (59.38%)
    19 / 32 (59.38%)
         occurrences all number
    19
    19
    Aspartate aminotransferase increased
         subjects affected / exposed
    4 / 32 (12.50%)
    7 / 32 (21.88%)
         occurrences all number
    4
    7
    Alanine aminotransferase increased
         subjects affected / exposed
    3 / 32 (9.38%)
    7 / 32 (21.88%)
         occurrences all number
    3
    7
    Blood alkaline phosphatase increased
         subjects affected / exposed
    0 / 32 (0.00%)
    4 / 32 (12.50%)
         occurrences all number
    0
    4
    Weight increased
         subjects affected / exposed
    2 / 32 (6.25%)
    1 / 32 (3.13%)
         occurrences all number
    2
    1
    Neutrophil count decreased
         subjects affected / exposed
    1 / 32 (3.13%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2
    Injury, poisoning and procedural complications
    Laceration
         subjects affected / exposed
    2 / 32 (6.25%)
    0 / 32 (0.00%)
         occurrences all number
    2
    0
    Fall
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Ligament sprain
         subjects affected / exposed
    2 / 32 (6.25%)
    0 / 32 (0.00%)
         occurrences all number
    2
    0
    Cardiac disorders
    Palpitations
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Tachycardia
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    7 / 32 (21.88%)
    11 / 32 (34.38%)
         occurrences all number
    7
    11
    Headache
         subjects affected / exposed
    6 / 32 (18.75%)
    3 / 32 (9.38%)
         occurrences all number
    6
    3
    Paraesthesia
         subjects affected / exposed
    2 / 32 (6.25%)
    5 / 32 (15.63%)
         occurrences all number
    2
    5
    Dysgeusia
         subjects affected / exposed
    3 / 32 (9.38%)
    2 / 32 (6.25%)
         occurrences all number
    3
    2
    Migraine
         subjects affected / exposed
    1 / 32 (3.13%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2
    Peripheral sensory neuropathy
         subjects affected / exposed
    0 / 32 (0.00%)
    3 / 32 (9.38%)
         occurrences all number
    0
    3
    Syncope
         subjects affected / exposed
    0 / 32 (0.00%)
    3 / 32 (9.38%)
         occurrences all number
    0
    3
    Hypoaesthesia
         subjects affected / exposed
    0 / 32 (0.00%)
    3 / 32 (9.38%)
         occurrences all number
    0
    3
    Lethargy
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Tremor
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    5 / 32 (15.63%)
    7 / 32 (21.88%)
         occurrences all number
    5
    7
    Anaemia of chronic disease
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Eye disorders
    Vision blurred
         subjects affected / exposed
    11 / 32 (34.38%)
    16 / 32 (50.00%)
         occurrences all number
    11
    16
    Macular detachment
         subjects affected / exposed
    5 / 32 (15.63%)
    6 / 32 (18.75%)
         occurrences all number
    5
    6
    Visual impairment
         subjects affected / exposed
    3 / 32 (9.38%)
    7 / 32 (21.88%)
         occurrences all number
    3
    7
    Retinal detachment
         subjects affected / exposed
    6 / 32 (18.75%)
    3 / 32 (9.38%)
         occurrences all number
    6
    3
    Eyelid oedema
         subjects affected / exposed
    4 / 32 (12.50%)
    2 / 32 (6.25%)
         occurrences all number
    4
    2
    Subretinal fluid
         subjects affected / exposed
    2 / 32 (6.25%)
    1 / 32 (3.13%)
         occurrences all number
    2
    1
    Visual acuity reduced
         subjects affected / exposed
    2 / 32 (6.25%)
    1 / 32 (3.13%)
         occurrences all number
    2
    1
    Eye disorder
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Periorbital oedema
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Dry eye
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    26 / 32 (81.25%)
    26 / 32 (81.25%)
         occurrences all number
    26
    26
    Nausea
         subjects affected / exposed
    13 / 32 (40.63%)
    22 / 32 (68.75%)
         occurrences all number
    13
    22
    Vomiting
         subjects affected / exposed
    14 / 32 (43.75%)
    16 / 32 (50.00%)
         occurrences all number
    14
    16
    Stomatitis
         subjects affected / exposed
    9 / 32 (28.13%)
    13 / 32 (40.63%)
         occurrences all number
    9
    13
    Abdominal pain
         subjects affected / exposed
    8 / 32 (25.00%)
    8 / 32 (25.00%)
         occurrences all number
    8
    8
    Constipation
         subjects affected / exposed
    5 / 32 (15.63%)
    6 / 32 (18.75%)
         occurrences all number
    5
    6
    Dry mouth
         subjects affected / exposed
    3 / 32 (9.38%)
    8 / 32 (25.00%)
         occurrences all number
    3
    8
    Abdominal distension
         subjects affected / exposed
    2 / 32 (6.25%)
    6 / 32 (18.75%)
         occurrences all number
    2
    6
    Dyspepsia
         subjects affected / exposed
    4 / 32 (12.50%)
    5 / 32 (15.63%)
         occurrences all number
    4
    5
    Abdominal pain upper
         subjects affected / exposed
    3 / 32 (9.38%)
    1 / 32 (3.13%)
         occurrences all number
    3
    1
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 32 (3.13%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2
    Proctalgia
         subjects affected / exposed
    2 / 32 (6.25%)
    1 / 32 (3.13%)
         occurrences all number
    2
    1
    Abdominal pain lower
         subjects affected / exposed
    0 / 32 (0.00%)
    3 / 32 (9.38%)
         occurrences all number
    0
    3
    Cheilitis
         subjects affected / exposed
    2 / 32 (6.25%)
    0 / 32 (0.00%)
         occurrences all number
    2
    0
    Hypoaesthesia oral
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Skin and subcutaneous tissue disorders
    Dermatitis acneiform
         subjects affected / exposed
    19 / 32 (59.38%)
    12 / 32 (37.50%)
         occurrences all number
    19
    12
    Dry skin
         subjects affected / exposed
    11 / 32 (34.38%)
    9 / 32 (28.13%)
         occurrences all number
    11
    9
    Alopecia
         subjects affected / exposed
    4 / 32 (12.50%)
    12 / 32 (37.50%)
         occurrences all number
    4
    12
    Rash
         subjects affected / exposed
    9 / 32 (28.13%)
    6 / 32 (18.75%)
         occurrences all number
    9
    6
    Rash maculo-papular
         subjects affected / exposed
    5 / 32 (15.63%)
    7 / 32 (21.88%)
         occurrences all number
    5
    7
    Pruritus
         subjects affected / exposed
    4 / 32 (12.50%)
    8 / 32 (25.00%)
         occurrences all number
    4
    8
    Erythema
         subjects affected / exposed
    0 / 32 (0.00%)
    4 / 32 (12.50%)
         occurrences all number
    0
    4
    Skin fissures
         subjects affected / exposed
    3 / 32 (9.38%)
    1 / 32 (3.13%)
         occurrences all number
    3
    1
    Acne
         subjects affected / exposed
    1 / 32 (3.13%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2
    Hyperhidrosis
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    9
    2
    Hypertrichosis
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    0 / 32 (0.00%)
    4 / 32 (12.50%)
         occurrences all number
    0
    4
    Haematuria
         subjects affected / exposed
    2 / 32 (6.25%)
    1 / 32 (3.13%)
         occurrences all number
    2
    1
    Endocrine disorders
    Hyperthyroidism
         subjects affected / exposed
    2 / 32 (6.25%)
    0 / 32 (0.00%)
         occurrences all number
    2
    0
    Musculoskeletal and connective tissue disorders
    Myalgia
         subjects affected / exposed
    7 / 32 (21.88%)
    9 / 32 (28.13%)
         occurrences all number
    7
    9
    Arthralgia
         subjects affected / exposed
    2 / 32 (6.25%)
    7 / 32 (21.88%)
         occurrences all number
    2
    7
    Muscular weakness
         subjects affected / exposed
    1 / 32 (3.13%)
    4 / 32 (12.50%)
         occurrences all number
    1
    4
    Pain in extremity
         subjects affected / exposed
    2 / 32 (6.25%)
    4 / 32 (12.50%)
         occurrences all number
    2
    4
    Back pain
         subjects affected / exposed
    1 / 32 (3.13%)
    3 / 32 (9.38%)
         occurrences all number
    1
    3
    Muscle spasms
         subjects affected / exposed
    1 / 32 (3.13%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2
    Musculoskeletal chest pain
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    8 / 32 (25.00%)
    5 / 32 (15.63%)
         occurrences all number
    8
    5
    Conjunctivitis
         subjects affected / exposed
    3 / 32 (9.38%)
    1 / 32 (3.13%)
         occurrences all number
    3
    1
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 32 (3.13%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2
    Nasopharyngitis
         subjects affected / exposed
    0 / 32 (0.00%)
    2 / 32 (6.25%)
         occurrences all number
    0
    2
    Rash pustular
         subjects affected / exposed
    2 / 32 (6.25%)
    1 / 32 (3.13%)
         occurrences all number
    2
    1
    Cellulitis
         subjects affected / exposed
    2 / 32 (6.25%)
    0 / 32 (0.00%)
         occurrences all number
    2
    0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    6 / 32 (18.75%)
    11 / 32 (34.38%)
         occurrences all number
    6
    11
    Hypomagnesaemia
         subjects affected / exposed
    4 / 32 (12.50%)
    5 / 32 (15.63%)
         occurrences all number
    4
    5
    Dehydration
         subjects affected / exposed
    3 / 32 (9.38%)
    5 / 32 (15.63%)
         occurrences all number
    3
    5
    Hypokalaemia
         subjects affected / exposed
    6 / 32 (18.75%)
    3 / 32 (9.38%)
         occurrences all number
    6
    3
    Hypoalbuminaemia
         subjects affected / exposed
    3 / 32 (9.38%)
    3 / 32 (9.38%)
         occurrences all number
    3
    3
    Hypocalcaemia
         subjects affected / exposed
    4 / 32 (12.50%)
    1 / 32 (3.13%)
         occurrences all number
    4
    1
    Glucose tolerance impaired
         subjects affected / exposed
    1 / 32 (3.13%)
    2 / 32 (6.25%)
         occurrences all number
    1
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    24 Oct 2013
    1- Included “Benefits and Risks Assessment” section. 2- Extended the period for using an adequate method of contraception after discontinuation of trial medication. 3- Extended the reporting period of adverse events for female subjects.
    03 Jul 2014
    The purpose of this amendment was to make the following updates: 1- Amend the inclusion and exclusion criteria. 2- Extend the period for using an adequate method of contraception after discontinuation of trial treatment. 3- Clarify the creatine phosphokinase (CPK) criterion for withdrawal of the trial treatment. 4- Amend the guidance for the monitoring and recording of AEs. 5- Introduce further guidance on trial treatment modifications and amend the management of specific trial treatment related AEs. 6- Clarify the assessment of pharmacogenetics (PGx) and biomarkers and to specify informed consent procedures for the collection of PGx samples. 7- Add an administrative interim analysis. 8- Clarify instructions for the collection of tumor tissue samples and initial stratification based on histology. 9- Specify that the corrected QT interval will be calculated using Fredericia’s formula. 10- Clarify the list of prohibited medicines.
    14 Nov 2014
    The purpose of this amendment was to make the following updates: 1- Include a newly planned futility analysis, including the scope of analysis and related parameters such as number of subjects included in the futility analysis and impact on power of primary analysis. 2- Introduce the temporary enrollment stop between at least 50 subjects being enrolled and the conclusions derived from the outcome of the futility analysis. 3- Update the end of trial definition.
    13 Mar 2015
    The purpose of this amendment was to make the following updates: 1- Update the overall trial design to allow subjects to continue treatment, however, for subjects who had a placebo component for their treatment assignment, placebo was to be withdrawn after approval of this amendment. 2- Modify the planned trial period (first enrollment-last subject out). 3- Modify the primary and secondary endpoint analyses. 4- Modify collection of subject data and endpoint analysis. 5- Provide information to the Investigator on awareness of dehydration and renal failure secondary to gastrointestinal toxicity.

    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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