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    Clinical Trial Results:
    A phase II trial to evaluate efficacy and safety of crizotinib treatment in advanced adenocarcinoma of the lung harbouring ROS1 translocations

    Summary
    EudraCT number
    2013-002737-38
    Trial protocol
    DE   AT  
    Global end of trial date
    29 Feb 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    28 Apr 2021
    First version publication date
    28 Apr 2021
    Other versions
    Summary report(s)
    Prefinal analysis publication 2019
    Prefinal analysis publication 2019 supplement

    Trial information

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    Trial identification
    Sponsor protocol code
    EUCROSS
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02183870
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    University of Cologne
    Sponsor organisation address
    Albertus-Magnus-Platz, Köln, Germany, 50923
    Public contact
    Lung Cancer Group Cologne, Lung Cancer Group Cologne, 0049 22147887008, juergen.wolf@uk-koeln.de
    Scientific contact
    Lung Cancer Group Cologne, Lung Cancer Group Cologne, 0049 22147887008, juergen.wolf@uk-koeln.de
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    31 Jan 2020
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    31 Jan 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    29 Feb 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate efficacy of crizotinib treatment in advanced adenocarcinoma of the lung harbouring ROS1 fusion genes as assessed by central testing; primary endpoint: objective response rate (ORR); evaluation criteria: investigator assessed RECIST v.1.1 analysis
    Protection of trial subjects
    Measures were prespecified for interruption of treatment and/or dose reduction if specific toxicities at specific grades occur.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    28 Apr 2014
    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: 9
    Country: Number of subjects enrolled
    Germany: 25
    Worldwide total number of subjects
    34
    EEA total number of subjects
    34
    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)
    25
    From 65 to 84 years
    9
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Recuitment from May 2014 to December 2015 in Germany and Spain.

    Pre-assignment
    Screening details
    Patients 18 years of age or older with locally advanced or metastatic histologically confirmed NSCLC and ROS1 rearrangement in local testing were allowed to enter screening after written informed consent, independent of the number of prior therapies.

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

    Arms
    Arm title
    Crizotinib
    Arm description
    Experimental study medication
    Arm type
    Experimental

    Investigational medicinal product name
    Crizotinib
    Investigational medicinal product code
    Other name
    Xalkori
    Pharmaceutical forms
    Capsule, hard
    Routes of administration
    Oral use
    Dosage and administration details
    250mg twice a day, will be administered orally at approximately the same time each day on a continuous daily dosing schedule, beginning at d1. Crizotinib can be dosed without regard to meals.

    Number of subjects in period 1
    Crizotinib
    Started
    34
    Completed
    34

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    baseline and treatment
    Reporting group description
    -

    Reporting group values
    baseline and treatment Total
    Number of subjects
    34 34
    Age categorical
    Age at informed consent
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    25 25
        From 65-84 years
    9 9
        85 years and over
    0 0
        Adults 18-64
    0 0
        Adults 65-84
    0 0
    Age continuous
    Age Median (Range)
    Units: years
        median (full range (min-max))
    56 (33 to 84) -
    Gender categorical
    Units: Subjects
        Female
    19 19
        Male
    15 15
    ECOG
    ECOG Score
    Units: Subjects
        Score 0
    12 12
        Score 1
    20 20
        Score 2
    2 2
    Ethnic group
    Ethnic group
    Units: Subjects
        Caucasian
    31 31
        Asian
    2 2
        other
    1 1
    Subject analysis sets

    Subject analysis set title
    Response-evaluable
    Subject analysis set type
    Per protocol
    Subject analysis set description
    The response-evaluable population will include all patients who are eligible and received at least one dose of study medication, who have an adequate baseline tumor assessment and whose NSCLC was ROS1 positive by FISH testing as assessed by the central laboratory selected by the sponsor. The response-evaluable population will be the primary population for the efficacy endpoints ORR, DCR, DR, TTR, PFS and OS.

    Subject analysis set title
    Valid-for-safety
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The vaild-for-safety analysis population will include all enrolled patients who received at least one dose of study medication. The vaild-for-safety analysis population will be the primary population for evaluating patient characteristics, treatment administration/compliance, toxicity and adverse events.

    Subject analysis sets values
    Response-evaluable Valid-for-safety
    Number of subjects
    30
    34
    Age categorical
    Age at informed consent
    Units: Subjects
        In utero
    0
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
    0
        Newborns (0-27 days)
    0
    0
        Infants and toddlers (28 days-23 months)
    0
    0
        Children (2-11 years)
    0
    0
        Adolescents (12-17 years)
    0
    0
        Adults (18-64 years)
    21
    25
        From 65-84 years
    9
    9
        85 years and over
    0
    0
        Adults 18-64
    0
    0
        Adults 65-84
    0
    0
    Age continuous
    Age Median (Range)
    Units: years
        median (full range (min-max))
    60 (33 to 84)
    56 (33 to 84)
    Gender categorical
    Units: Subjects
        Female
    17
    19
        Male
    13
    15
    ECOG
    ECOG Score
    Units: Subjects
        Score 0
    12
    12
        Score 1
    17
    20
        Score 2
    1
    2
    Ethnic group
    Ethnic group
    Units: Subjects
        Caucasian
    27
    31
        Asian
    2
    2
        other
    1
    1

    End points

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    End points reporting groups
    Reporting group title
    Crizotinib
    Reporting group description
    Experimental study medication

    Subject analysis set title
    Response-evaluable
    Subject analysis set type
    Per protocol
    Subject analysis set description
    The response-evaluable population will include all patients who are eligible and received at least one dose of study medication, who have an adequate baseline tumor assessment and whose NSCLC was ROS1 positive by FISH testing as assessed by the central laboratory selected by the sponsor. The response-evaluable population will be the primary population for the efficacy endpoints ORR, DCR, DR, TTR, PFS and OS.

    Subject analysis set title
    Valid-for-safety
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The vaild-for-safety analysis population will include all enrolled patients who received at least one dose of study medication. The vaild-for-safety analysis population will be the primary population for evaluating patient characteristics, treatment administration/compliance, toxicity and adverse events.

    Primary: Overall response rate (local)

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    End point title
    Overall response rate (local) [1]
    End point description
    ORR is defined as the percentage of patients with CR or PR according to investigator assessed RECIST v.1.1 evaluation.
    End point type
    Primary
    End point timeframe
    During study treatment.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Single-arm trial - no statistical testing
    End point values
    Response-evaluable Valid-for-safety
    Number of subjects analysed
    30
    34
    Units: percent
        number (confidence interval 95%)
    70 (51 to 85)
    71 (53 to 85)
    No statistical analyses for this end point

    Secondary: Progression-free survival (local)

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    End point title
    Progression-free survival (local)
    End point description
    PFS is defined as the time from the date of first dose to first documentation of objective disease progression (local evaluation) or to death on study due to any cause, whichever occurs first.
    End point type
    Secondary
    End point timeframe
    During study treatment plus 28 days (deaths up to 14 weeks after end of study treatment)
    End point values
    Response-evaluable Valid-for-safety
    Number of subjects analysed
    30
    34
    Units: months
        median (confidence interval 95%)
    19.4 (10.1 to 32.2)
    19.4 (9.6 to 32.2)
    No statistical analyses for this end point

    Secondary: Overall survival at 24 months

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    End point title
    Overall survival at 24 months
    End point description
    OS is defined as the time from date of first dose to the date of death to any cause.
    End point type
    Secondary
    End point timeframe
    Durngi study treatment and follow-up
    End point values
    Response-evaluable Valid-for-safety
    Number of subjects analysed
    30
    34
    Units: percent
        number (confidence interval 95%)
    64 (47 to 82)
    64 (47 to 80)
    No statistical analyses for this end point

    Secondary: Overall survival at 36 months

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    End point title
    Overall survival at 36 months
    End point description
    OS is defined as the time from date of first dose to the date of death to any cause.
    End point type
    Secondary
    End point timeframe
    During studytreatment and follow-up
    End point values
    Response-evaluable Valid-for-safety
    Number of subjects analysed
    30
    34
    Units: percent
        number (confidence interval 95%)
    64 (47 to 82)
    64 (47 to 80)
    No statistical analyses for this end point

    Secondary: Duration of response

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    End point title
    Duration of response
    End point description
    DR is defined as the time from the first documentation of objective tumor response (CR or PR) that is subsequently confirmed to the first documentation of objective disease progression or to death due to any cause, whichever occurs first. DR will be calculated for the response evaluable population in the subgroup of patients with a confirmed objective response.
    End point type
    Secondary
    End point timeframe
    During study treatment vand follow-up
    End point values
    Response-evaluable
    Number of subjects analysed
    30
    Units: months
        median (confidence interval 95%)
    21 (8.3 to 99999)
    No statistical analyses for this end point

    Secondary: Overall response rate (central blind review)

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    End point title
    Overall response rate (central blind review)
    End point description
    Calculated based on all patients in the response-evaluable population. ORR is defined as the percentage of patients with CR or PR according to central blind RECIST v.1.1 evaluation.
    End point type
    Secondary
    End point timeframe
    During study treatment
    End point values
    Response-evaluable Valid-for-safety
    Number of subjects analysed
    30
    34
    Units: percent
        number (confidence interval 95%)
    73 (54 to 88)
    74 (56 to 87)
    No statistical analyses for this end point

    Secondary: Disease control rate (local)

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    End point title
    Disease control rate (local)
    End point description
    DCR is defined as the percentage of patients with CR, PR or SD according to RECIST v.1.1 (investigator assessed)
    End point type
    Secondary
    End point timeframe
    During study treatment.
    End point values
    Response-evaluable Valid-for-safety
    Number of subjects analysed
    30
    34
    Units: percent
        number (confidence interval 95%)
    90 (74 to 98)
    88 (73 to 97)
    No statistical analyses for this end point

    Secondary: Progression free survival (central blind review)

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    End point title
    Progression free survival (central blind review)
    End point description
    PFS is defined as the time from the date of first dose to first documentation of objective disease progression (central blind review evaluation) or to death on study due to any cause, whichever occurs first.
    End point type
    Secondary
    End point timeframe
    During study treatment plus 28 days (deaths up to 14 weeks after end of study treatment)
    End point values
    Response-evaluable
    Number of subjects analysed
    30
    Units: months
        median (confidence interval 95%)
    20.0 (9.6 to 99999)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Timeframe for AE
    Adverse event reporting additional description
    AE additional description
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.0
    Reporting groups
    Reporting group title
    Valid-for-Safety
    Reporting group description
    -

    Serious adverse events
    Valid-for-Safety
    Total subjects affected by serious adverse events
         subjects affected / exposed
    21 / 34 (61.76%)
         number of deaths (all causes)
    15
         number of deaths resulting from adverse events
    7
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasm progression
    Additional description: Neoplasm progression
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Injury, poisoning and procedural complications
    Vascular access complication
    Additional description: Vascular access complication
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Haematoma
    Additional description: Haematoma
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism and thrombosis
    Additional description: Pulmonary embolism and thrombosis
         subjects affected / exposed
    3 / 34 (8.82%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    1 / 2
    Cardiac disorders
    Bradycardia
    Additional description: Bradycardia
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Dizziness
    Additional description: Dizziness
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Epilepsy
    Additional description: Epilepsy
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Seizure
    Additional description: Seizure
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Blood and lymphatic system disorders
    Thrombocytopenia
    Additional description: Thrombocytopenia
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Chest pain
    Additional description: Chest pain
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
    Additional description: General physical health deterioration
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Eye disorders
    Visual disturbances
    Additional description: Visual disturbances
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
    Additional description: Abdominal pain
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
    Additional description: Diarrhoea
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Vomiting
    Additional description: Vomiting
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
    Additional description: Dyspnoea
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Haemoptysis
    Additional description: Haemoptysis
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
    Additional description: Pleural effusion
         subjects affected / exposed
    3 / 34 (8.82%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Pneumonitis
    Additional description: Pneumonitis
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumothorax
    Additional description: Pneumothorax
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal cyst
    Additional description: Renal cyst
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Erysipelas
    Additional description: Erysipelas
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung abscess
    Additional description: Lung abscess
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pneumonia
    Additional description: Pneumonia
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Respiratory tract infection
    Additional description: Respiratory tract infection
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Viral infection
    Additional description: Viral infection
         subjects affected / exposed
    1 / 34 (2.94%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Valid-for-Safety
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    33 / 34 (97.06%)
    Vascular disorders
    Deep vein thrombosis
    Additional description: Deep vein thrombosis
         subjects affected / exposed
    3 / 34 (8.82%)
         occurrences all number
    3
    Hypotension
    Additional description: Hypotension
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences all number
    2
    Orthostatic hypotension
    Additional description: Orthostatic hypotension
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences all number
    2
    Pulmonary embolism and thrombosis
    Additional description: Pulmonary embolism and thrombosis
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences all number
    2
    General disorders and administration site conditions
    Asthenia and fatigue
    Additional description: Asthenia and fatigue
         subjects affected / exposed
    11 / 34 (32.35%)
         occurrences all number
    13
    Chest pain
    Additional description: Chest pain
         subjects affected / exposed
    4 / 34 (11.76%)
         occurrences all number
    4
    Mucosal inflammation
    Additional description: Mucosal inflammation
         subjects affected / exposed
    3 / 34 (8.82%)
         occurrences all number
    4
    Oedema
    Additional description: Oedema
         subjects affected / exposed
    22 / 34 (64.71%)
         occurrences all number
    35
    Pyrexia
    Additional description: Pyrexia
         subjects affected / exposed
    3 / 34 (8.82%)
         occurrences all number
    3
    Immune system disorders
    Seasonal allergy
    Additional description: Seasonal allergy
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences all number
    3
    Respiratory, thoracic and mediastinal disorders
    Cough
    Additional description: Cough
         subjects affected / exposed
    8 / 34 (23.53%)
         occurrences all number
    12
    Dyspnoea
    Additional description: Dyspnoea
         subjects affected / exposed
    6 / 34 (17.65%)
         occurrences all number
    6
    Investigations
    Alanine aminotransferase increased
    Additional description: Alanine aminotransferase increased
         subjects affected / exposed
    12 / 34 (35.29%)
         occurrences all number
    27
    Aspartate aminotransferase increased
    Additional description: Aspartate aminotransferase increased
         subjects affected / exposed
    9 / 34 (26.47%)
         occurrences all number
    24
    Blood albumin decreased and protein total decreased
    Additional description: Blood albumin decreased and protein total decreased
         subjects affected / exposed
    4 / 34 (11.76%)
         occurrences all number
    11
    Blood alkaline phosphatase increased
    Additional description: Blood alkaline phosphatase increased
         subjects affected / exposed
    4 / 34 (11.76%)
         occurrences all number
    10
    Blood creatinine increased
    Additional description: Blood creatinine increased
         subjects affected / exposed
    9 / 34 (26.47%)
         occurrences all number
    20
    Blood magnesium decreased
    Additional description: Blood magnesium decreased
         subjects affected / exposed
    3 / 34 (8.82%)
         occurrences all number
    6
    Blood phosphorus decreased
    Additional description: Blood phosphorus decreased
         subjects affected / exposed
    5 / 34 (14.71%)
         occurrences all number
    8
    Blood potassium increased
    Additional description: Blood potassium increased
         subjects affected / exposed
    3 / 34 (8.82%)
         occurrences all number
    10
    Blood sodium decreased
    Additional description: Blood sodium decreased
         subjects affected / exposed
    4 / 34 (11.76%)
         occurrences all number
    4
    Gamma-glutamyltransferase increased
    Additional description: Gamma-glutamyltransferase increased
         subjects affected / exposed
    3 / 34 (8.82%)
         occurrences all number
    5
    Cardiac disorders
    Bradycardia
    Additional description: Bradycardia
         subjects affected / exposed
    17 / 34 (50.00%)
         occurrences all number
    44
    Nervous system disorders
    Dizziness
    Additional description: Dizziness
         subjects affected / exposed
    10 / 34 (29.41%)
         occurrences all number
    11
    Dysgeusia
    Additional description: Dysgeusia
         subjects affected / exposed
    3 / 34 (8.82%)
         occurrences all number
    3
    Headache
    Additional description: Headache
         subjects affected / exposed
    5 / 34 (14.71%)
         occurrences all number
    6
    Neuropathy peripheral
    Additional description: Neuropathy peripheral
         subjects affected / exposed
    4 / 34 (11.76%)
         occurrences all number
    8
    Blood and lymphatic system disorders
    Anaemia
    Additional description: Anaemia
         subjects affected / exposed
    10 / 34 (29.41%)
         occurrences all number
    18
    Leukopenia/neutropenia
    Additional description: Leukopenia/neutropenia
         subjects affected / exposed
    11 / 34 (32.35%)
         occurrences all number
    31
    Thrombocytopenia
    Additional description: Thrombocytopenia
         subjects affected / exposed
    4 / 34 (11.76%)
         occurrences all number
    6
    Ear and labyrinth disorders
    Vertigo
    Additional description: Vertigo
         subjects affected / exposed
    3 / 34 (8.82%)
         occurrences all number
    4
    Eye disorders
    Eye pain
    Additional description: Eye pain
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences all number
    2
    Visual disturbances
    Additional description: Visual disturbances
         subjects affected / exposed
    22 / 34 (64.71%)
         occurrences all number
    26
    Gastrointestinal disorders
    Abdominal pain
    Additional description: Abdominal pain
         subjects affected / exposed
    6 / 34 (17.65%)
         occurrences all number
    8
    Constipation
    Additional description: Constipation
         subjects affected / exposed
    9 / 34 (26.47%)
         occurrences all number
    10
    Diarrhoea
    Additional description: Diarrhoea
         subjects affected / exposed
    20 / 34 (58.82%)
         occurrences all number
    28
    Dyspepsia
    Additional description: Dyspepsia
         subjects affected / exposed
    5 / 34 (14.71%)
         occurrences all number
    5
    Nausea
    Additional description: Nausea
         subjects affected / exposed
    16 / 34 (47.06%)
         occurrences all number
    22
    Stomatitis
    Additional description: Stomatitis
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences all number
    3
    Vomiting
    Additional description: Vomiting
         subjects affected / exposed
    12 / 34 (35.29%)
         occurrences all number
    14
    Skin and subcutaneous tissue disorders
    Eczema
    Additional description: Eczema
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences all number
    2
    Nail disorders
    Additional description: Nail disorders
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences all number
    2
    Rash
    Additional description: Rash
         subjects affected / exposed
    4 / 34 (11.76%)
         occurrences all number
    5
    Musculoskeletal and connective tissue disorders
    Arthralgia
    Additional description: Arthralgia
         subjects affected / exposed
    4 / 34 (11.76%)
         occurrences all number
    4
    Muscle cramps
    Additional description: Muscle cramps
         subjects affected / exposed
    5 / 34 (14.71%)
         occurrences all number
    6
    Musculoskeletal pain
    Additional description: Musculoskeletal pain
         subjects affected / exposed
    13 / 34 (38.24%)
         occurrences all number
    17
    Musculoskeletal chest pain
    Additional description: Musculoskeletal chest pain
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences all number
    2
    Infections and infestations
    Gastroenteritis
    Additional description: Gastroenteritis
         subjects affected / exposed
    2 / 34 (5.88%)
         occurrences all number
    4
    Influenza
    Additional description: Influenza
         subjects affected / exposed
    3 / 34 (8.82%)
         occurrences all number
    3
    Respiratory tract infection
    Additional description: Respiratory tract infection
         subjects affected / exposed
    14 / 34 (41.18%)
         occurrences all number
    21
    Urinary tract infection
    Additional description: Urinary tract infection
         subjects affected / exposed
    6 / 34 (17.65%)
         occurrences all number
    6
    Metabolism and nutrition disorders
    Decreased appetite
    Additional description: Decreased appetite
         subjects affected / exposed
    5 / 34 (14.71%)
         occurrences all number
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    01 Aug 2015
    Amendment 2: Clarification of primary objectives and addition of secondary objectives; implementation of patient diary.
    15 Mar 2016
    Amendment 3: New definition of “end of study”; implementation of an additional blood sample collection for ctDNA analysis; extension of the intervals for tumour assessment in the efficacy follow-up; implementation of a pre-final analysis.
    04 Apr 2018
    Amendment 5: Premature termination of trial therapy and new definition of “end of study”.
    04 Sep 2019
    Amendment 6: Termination of the trial; Survival follow-up will be performed not later than January 31st 2020. The study data base will be closed and the study will be terminated on February 29th 2020

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/30978502
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