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    Clinical Trial Results:
    A PHASE II, MULTICENTER, SINGLE-ARM STUDY OF ATEZOLIZUMAB IN PATIENTS WITH PD L1-POSITIVE LOCALLY ADVANCED OR METASTATIC NON-SMALL CELL LUNG CANCER

    Summary
    EudraCT number
    2013-003330-32
    Trial protocol
    SI   IT   BE   DE   GB   NL   FR   ES   BG  
    Global end of trial date

    Results information
    Results version number
    v1
    This version publication date
    20 Nov 2018
    First version publication date
    01 Jul 2016
    Other versions
    v2

    Trial information

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    Trial identification
    Sponsor protocol code
    GO28754
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02031458
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    F. Hoffmann-La Roche AG
    Sponsor organisation address
    Grenzacherstrasse 124, Basel, Switzerland, CH-4070
    Public contact
    F. Hoffmann-La Roche AG, Roche Trial Information Hotline, +41 61 6878333, global.trial_information@roche.com
    Scientific contact
    F. Hoffmann-La Roche AG, Roche Trial Information Hotline, +41 61 6878333, global.trial_information@roche.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Interim
    Date of interim/final analysis
    28 May 2015
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    28 May 2015
    Global end of trial reached?
    No
    General information about the trial
    Main objective of the trial
    The primary objective for this study is to evaluate the efficacy of atezolizumab in participants with programmed cell death−1 ligand 1 (PD-L1)−positive locally advanced or metastatic non−small cell lung cancer (NSCLC), as measured by: • Independent review facility (IRF)-assessed objective response rate (ORR) according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 (v1.1) .
    Protection of trial subjects
    The study was conducted in accordance with the principles of the “Declaration of Helsinki” and Good Clinical Practice.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    22 Jan 2014
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 21
    Country: Number of subjects enrolled
    Hong Kong: 6
    Country: Number of subjects enrolled
    Japan: 27
    Country: Number of subjects enrolled
    Singapore: 18
    Country: Number of subjects enrolled
    Bosnia and Herzegovina: 8
    Country: Number of subjects enrolled
    Switzerland: 41
    Country: Number of subjects enrolled
    Georgia: 20
    Country: Number of subjects enrolled
    Turkey: 18
    Country: Number of subjects enrolled
    Canada: 47
    Country: Number of subjects enrolled
    United States: 217
    Country: Number of subjects enrolled
    Netherlands: 28
    Country: Number of subjects enrolled
    Slovenia: 8
    Country: Number of subjects enrolled
    Spain: 48
    Country: Number of subjects enrolled
    United Kingdom: 11
    Country: Number of subjects enrolled
    Belgium: 20
    Country: Number of subjects enrolled
    Bulgaria: 4
    Country: Number of subjects enrolled
    France: 64
    Country: Number of subjects enrolled
    Germany: 29
    Country: Number of subjects enrolled
    Italy: 24
    Worldwide total number of subjects
    659
    EEA total number of subjects
    236
    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)
    331
    From 65 to 84 years
    323
    85 years and over
    5

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Screening was performed from Day -28 to Day -1.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Cohort 1: First Line Atezolizumab
    Arm description
    Participants received 1200 milligrams (mg) atezolizumab every 3 weeks (Day 1 of 21 day cycle) administered by intravenous (IV) infusion until intolerable toxicity, disease progression or death. Participants in this cohort received no prior chemotherapy in locally advanced or metastatic setting.
    Arm type
    Experimental

    Investigational medicinal product name
    Atezolizumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    1200 mg every 3 weeks

    Arm title
    Cohort 2: Second Line Atezolizumab
    Arm description
    Participants received 1200 mg atezolizumab every 3 weeks (Day 1 of 21-day cycle) administered by IV infusion until intolerable toxicity, disease progression or death. Participants were permitted to continue treatment after progressive disease, if the following criteria were met: evidence of clinical benefit as assessed by the investigator; absence of symptoms and signs indicating unequivocal progression of disease; no decline in Eastern Cooperative Oncology Group (ECOG) performance status; absence of tumor growth at critical anatomical sites that cannot be managed by protocol-allowed medical interventions; evidence of clinical benefit as assessed by the investigator. Participants in this cohort progressed during or after prior platinum-based chemotherapy in locally advanced or metastatic setting.
    Arm type
    Experimental

    Investigational medicinal product name
    Atezolizumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    1200 mg every 3 weeks

    Arm title
    Cohort 3: Third Line and Beyond Atezolizumab
    Arm description
    Participants received 1200 mg atezolizumab every 3 weeks ( Day 1 of 21-day cycle) administered by IV infusion until intolerable toxicity, disease progression or death. Participants were permitted to continue treatment after progressive disease, if the following criteria were met: absence of symptoms and signs indicating unequivocal progression of disease; no decline in ECOG performance status; absence of tumor growth at critical anatomical sites that cannot be managed by protocol-allowed medical interventions; evidence of clinical benefit as assessed by the investigator. Participants in this cohort progressed during or after prior platinum-based chemotherapy and at least one additional therapy in locally advanced or metastatic setting.
    Arm type
    Experimental

    Investigational medicinal product name
    Atezolizumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    1200 mg every 3 weeks

    Number of subjects in period 1
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab
    Started
    139
    267
    253
    Completed
    0
    0
    0
    Not completed
    139
    267
    253
         On treatment
    43
    81
    73
         Consent withdrawn by subject
    6
    9
    3
         Physician decision
    -
    1
    -
         On survival follow-up
    46
    83
    73
         Death
    36
    87
    100
         Unknown reason
    -
    1
    2
         Lost to follow-up
    1
    1
    2
         Protocol deviation
    7
    4
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Cohort 1: First Line Atezolizumab
    Reporting group description
    Participants received 1200 milligrams (mg) atezolizumab every 3 weeks (Day 1 of 21 day cycle) administered by intravenous (IV) infusion until intolerable toxicity, disease progression or death. Participants in this cohort received no prior chemotherapy in locally advanced or metastatic setting.

    Reporting group title
    Cohort 2: Second Line Atezolizumab
    Reporting group description
    Participants received 1200 mg atezolizumab every 3 weeks (Day 1 of 21-day cycle) administered by IV infusion until intolerable toxicity, disease progression or death. Participants were permitted to continue treatment after progressive disease, if the following criteria were met: evidence of clinical benefit as assessed by the investigator; absence of symptoms and signs indicating unequivocal progression of disease; no decline in Eastern Cooperative Oncology Group (ECOG) performance status; absence of tumor growth at critical anatomical sites that cannot be managed by protocol-allowed medical interventions; evidence of clinical benefit as assessed by the investigator. Participants in this cohort progressed during or after prior platinum-based chemotherapy in locally advanced or metastatic setting.

    Reporting group title
    Cohort 3: Third Line and Beyond Atezolizumab
    Reporting group description
    Participants received 1200 mg atezolizumab every 3 weeks ( Day 1 of 21-day cycle) administered by IV infusion until intolerable toxicity, disease progression or death. Participants were permitted to continue treatment after progressive disease, if the following criteria were met: absence of symptoms and signs indicating unequivocal progression of disease; no decline in ECOG performance status; absence of tumor growth at critical anatomical sites that cannot be managed by protocol-allowed medical interventions; evidence of clinical benefit as assessed by the investigator. Participants in this cohort progressed during or after prior platinum-based chemotherapy and at least one additional therapy in locally advanced or metastatic setting.

    Reporting group values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Total
    Number of subjects
    139 267 253 659
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    66.7 ( 10.4 ) 62.4 ( 10.2 ) 63.6 ( 9.3 ) -
    Gender categorical
    Units: Subjects
        Female
    68 103 100 271
        Male
    71 164 153 388

    End points

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    End points reporting groups
    Reporting group title
    Cohort 1: First Line Atezolizumab
    Reporting group description
    Participants received 1200 milligrams (mg) atezolizumab every 3 weeks (Day 1 of 21 day cycle) administered by intravenous (IV) infusion until intolerable toxicity, disease progression or death. Participants in this cohort received no prior chemotherapy in locally advanced or metastatic setting.

    Reporting group title
    Cohort 2: Second Line Atezolizumab
    Reporting group description
    Participants received 1200 mg atezolizumab every 3 weeks (Day 1 of 21-day cycle) administered by IV infusion until intolerable toxicity, disease progression or death. Participants were permitted to continue treatment after progressive disease, if the following criteria were met: evidence of clinical benefit as assessed by the investigator; absence of symptoms and signs indicating unequivocal progression of disease; no decline in Eastern Cooperative Oncology Group (ECOG) performance status; absence of tumor growth at critical anatomical sites that cannot be managed by protocol-allowed medical interventions; evidence of clinical benefit as assessed by the investigator. Participants in this cohort progressed during or after prior platinum-based chemotherapy in locally advanced or metastatic setting.

    Reporting group title
    Cohort 3: Third Line and Beyond Atezolizumab
    Reporting group description
    Participants received 1200 mg atezolizumab every 3 weeks ( Day 1 of 21-day cycle) administered by IV infusion until intolerable toxicity, disease progression or death. Participants were permitted to continue treatment after progressive disease, if the following criteria were met: absence of symptoms and signs indicating unequivocal progression of disease; no decline in ECOG performance status; absence of tumor growth at critical anatomical sites that cannot be managed by protocol-allowed medical interventions; evidence of clinical benefit as assessed by the investigator. Participants in this cohort progressed during or after prior platinum-based chemotherapy and at least one additional therapy in locally advanced or metastatic setting.

    Subject analysis set title
    Cohorts 2 + 3
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    This sub-group included participants from cohorts 2 and 3.

    Subject analysis set title
    Pharmacokinetic Evaluable Population
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    All participants who were treated and had evaluable pharmacokinetic samples were included in this group.

    Primary: Percentage of Participants Achieving Objective Response (ORR) Per RECIST v1.1 as Assessed by IRF

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    End point title
    Percentage of Participants Achieving Objective Response (ORR) Per RECIST v1.1 as Assessed by IRF [1]
    End point description
    ORR was the percentage of participants whose confirmed best overall response was either a Partial Response (PR) or a Complete Response (CR) based upon the IRF assessment per RECIST v1.1. CR: disappearance of all target and non-target lesions. Any pathological lymph nodes (target or non-target) must have reduction in short axis to less than (<) 10 millimeters (mm); PR:greater than (>) or equal to (=) 30 percent (%) decrease from baseline in sum of diameters of target lesions, non-PD non-target lesions and no new lesions. Results were reported by line of therapy and PD-L1 Expression Subgroup (tumor cell [TC]3 [TC3] or tumor-infiltrating immune cell [IC] 3 [IC3], TC3 or IC2/3, TC2/3 or IC2/3). Analyses of objective response rate was performed on efficacy evaluable population which included all treated participants who received any dose of atezolizumab during study treatment period. Number (n) equals (=) number of participants analyzed within the specified group
    End point type
    Primary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 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: Statistical analyses are attached as a chart.
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: percentage of participants
    number (confidence interval 95%)
        TC3 or IC3 Responders (n= 65, 122, 115, 237)
    26.2 (16 to 38.5)
    23.8 (16.5 to 32.3)
    27 (19.1 to 36)
    25.35 (19.9 to 31.4)
        TC3 or IC2/3 Responders (n= 123, 247, 236, 483)
    21.1 (14.3 to 29.4)
    17.4 (12.9 to 22.7)
    18.2 (13.5 to 23.8)
    17.8 (14.5 to 21.5)
        TC2/3 or IC2/3 Responders (n= 139, 267, 253, 520)
    19.4 (13.2 to 27)
    17.2 (12.9 to 22.3)
    17.4 (12.9 to 22.6)
    17.3 (14.2 to 20.8)
    Attachments
    Untitled (Filename: Statistical analysis for Objective Response.pdf)
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving Objective Response Per RECIST v1.1 as Assessed by the Investigator (INV)

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    End point title
    Percentage of Participants Achieving Objective Response Per RECIST v1.1 as Assessed by the Investigator (INV)
    End point description
    Objective response rate was the percentage of participants whose confirmed best overall response was either a PR or a CR based upon the Investigator assessment per RECIST v1.1. CR: disappearance of all target and non-target lesions. Any pathological lymph nodes (target or non-target) must have reduction in short axis to <10mm; PR: > or = 30 % decrease from baseline in sum of diameters of target lesions, non-PD non-target lesions and no new lesions. Results were reported by line of therapy (reporting arms) and PD-L1 Expression Subgroup (TC3 or IC3, TC3 or IC2/3, TC2/3 or IC2/3). The analyses of objective response was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: percentage of participants
    number (confidence interval 95%)
        TC3 or IC3 Responders (n= 65, 122, 115, 237)
    30.8 (19.9 to 43.5)
    24.6 (17.3 to 33.2)
    28.7 (20.7 to 37.9)
    26.6 (21.1 to 32.7)
        TC3 or IC2/3 Responders (n= 123, 247, 236, 483)
    24.4 (17.1 to 33)
    19.4 (14.7 to 24.9)
    19.1 (14.3 to 24.7)
    19.3 (15.8 to 23.1)
        TC2/3 or IC2/3 Responders (n= 139, 267, 253, 520)
    22.3 (15.7 to 30.1)
    18.7 (14.2 to 23.9)
    18.2 (13.6 to 23.5)
    18.5 (15.2 to 22.1)
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving Objective Response Per Modified RECIST as Assessed by the INV

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    End point title
    Percentage of Participants Achieving Objective Response Per Modified RECIST as Assessed by the INV
    End point description
    Objective response rate was the percentage of participants whose confirmed best overall response was either a PR or a CR based upon the Investigator assessment per modified RECIST. CR: disappearance of all target lesions. Any pathological lymph nodes (target or non-target) must have reduction in short axis to <10mm; PR: At least a 30% decrease in the sum of the diameters of all target and all new measurable lesions, taking as reference the baseline sum of diameters, in the absence of CR. Results were reported by line of therapy (reporting arms) and PD-L1 Expression Subgroup (TC3 or IC3, TC3 or IC2/3, TC2/3 or IC2/3). The analyses of objective response was performed on the efficacy evaluable population; n= number of participants analyzed within the specified group.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: percentage of participants
    number (confidence interval 95%)
        TC3 or IC3 Responders (n= 65, 122, 115, 237)
    20 (11.1 to 31.8)
    27 (19.4 to 35.8)
    30.4 (22.2 to 39.7)
    28.7 (23 to 34.9)
        TC3 or IC2/3 Responders ( n= 123, 247, 236, 483)
    16.3 (10.2 to 24)
    21.9 (16.9 to 27.5)
    20.8 (15.8 to 26.5)
    21.3 (17.8 to 25.3)
        TC2/3 or IC2/3 Responders ( n= 139, 267, 253, 520)
    15.8 (10.2 to 23)
    21 (16.3 to 26.4)
    19.8 (15 to 25.2)
    20.4 (17 to 24.1)
    No statistical analyses for this end point

    Secondary: Duration of response (DOR) Assessed by IRF Per RECIST v1.1

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    End point title
    Duration of response (DOR) Assessed by IRF Per RECIST v1.1
    End point description
    DOR is interval between date of first occurrence of a CR or PR that is subsequently confirmed (whichever status is recorded first) and the first date that PD or death is documented, whichever occurs first as measured by RECIST v1.1. CR: disappearance of all target and non-target lesions. Any pathological lymph nodes (target or non-target) must have reduction in short axis to <10mm; PR: > or = 30 % decrease from baseline in sum of diameters of target lesions, non-PD non-target lesions and no new lesions; PD: one or more of the following: at least 20% increase from nadir in sum of diameters of target lesions (with an absolute increase of at least 5mm), appearance of new lesions, and/or unequivocal progression of non-target lesions. DOR was assessed by Kaplan-Meier estimates. The analyses of DOR was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group. 99999 = data not available.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: months
    median (confidence interval 95%)
        TC3 or IC3 DOR (n= 17, 29, 31, 60)
    99999 (5.8 to 99999)
    99999 (4.9 to 99999)
    7.2 (5.6 to 99999)
    7.2 (5.7 to 99999)
        TC3 or IC2/3 DOR (n = 26, 43, 43, 86)
    8.5 (5.6 to 99999)
    8.4 (6.9 to 99999)
    8.4 (5.7 to 99999)
    8.4 (6.9 to 99999)
        TC2/3 or IC2/3 DOR(n= 27, 46. 44, 90)
    8.5 (5.6 to 99999)
    8.4 (6.9 to 99999)
    8.4 (5.7 to 99999)
    8.4 (6.9 to 99999)
    No statistical analyses for this end point

    Secondary: DOR as Assessed by INV Per RECIST v1.1

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    End point title
    DOR as Assessed by INV Per RECIST v1.1
    End point description
    DOR is interval between date of the first occurrence of a CR or PR that is subsequently confirmed (whichever status is recorded first) and first date that PD or death is documented, whichever occurs first as measured by RECIST v1.1. CR: disappearance of all target and non-target lesions. Any pathological lymph nodes (target or non-target) must have reduction in short axis to <10mm; PR: > or = 30 % decrease from baseline in sum of diameters of target lesions, non-PD non-target lesions and no new lesions; PD: one or more of the following: at least 20% increase from nadir in sum of diameters of target lesions (with an absolute increase of at least 5mm), appearance of new lesions, and/or unequivocal progression of non-target lesions. DOR was assessed by Kaplan-Meier estimates. The analyses of DOR was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group. 99999 = data not available.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: months
    median (confidence interval 95%)
        TC3 or IC3 DOR (n= 20, 30, 33, 63)
    8.5 (5.6 to 8.5)
    99999 (8.1 to 99999)
    8.4 (6.4 to 99999)
    99999 (7.4 to 99999)
        TC3 or IC2/3 DOR (n = 30, 48, 45, 93)
    8.5 (8.5 to 99999)
    99999 (99999 to 99999)
    8.3 (7 to 99999)
    99999 (8.3 to 99999)
        TC2/3 or IC2/3 DOR (n= 31, 50, 46, 96)
    99999 (8.5 to 99999)
    99999 (99999 to 99999)
    8.3 (7 to 99999)
    99999 (8.3 to 99999)
    No statistical analyses for this end point

    Secondary: DOR as Assessed by INV Per Modified RECIST

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    End point title
    DOR as Assessed by INV Per Modified RECIST
    End point description
    DOR is the interval between the date of the first occurrence of a CR or PR that is subsequently confirmed (whichever status is recorded first) and the first date that PD or death is documented, whichever occurs first as measured by modified RECIST. CR: disappearance of all target lesions. Any pathological lymph nodes (target or non-target) must have reduction in short axis to <10mm; PR: at least a 30% decrease in the sum of the diameters of all target and all new measurable lesions, taking as reference the baseline sum of diameters, in the absence of CR; PD: one or more of the following: at least 20% increase from nadir in the sum of diameters of existing and/or new target lesions (with an absolute increase of at least 5mm). DOR was assessed by Kaplan-Meier estimates. The analyses of DOR was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group. 99999 = data not available.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: months
    median (confidence interval 95%)
        TC3 or IC3 DOR ( n= 13, 33, 35, 68)
    99999 (4.4 to 99999)
    99999 (8.1 to 99999)
    99999 (7.4 to 99999)
    99999 (8.1 to 99999)
        TC3 or IC2/3 DOR (n= 20, 54, 49, 103)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    99999 (7.4 to 99999)
    99999 (99999 to 99999)
        TC2/3 or IC2/3 DOR (n = 22, 56, 50, 106)
    99999 (4.5 to 99999)
    99999 (99999 to 99999)
    99999 (7.4 to 99999)
    99999 (99999 to 99999)
    No statistical analyses for this end point

    Secondary: Progression Free Survival (PFS) as Assessed by IRF Per RECIST v1.1

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    End point title
    Progression Free Survival (PFS) as Assessed by IRF Per RECIST v1.1
    End point description
    PFS is the interval between the first dose of atezolizumab and date of disease progression or death due to any cause, whichever occurred first as measured by RECIST v1.1. Progressive Disease (PD) is defined as one or more of the following: at least 20% increase from nadir in the sum of diameters of target lesions (with an absolute increase of at least 5mm), appearance of new lesions, and/or unequivocal progression of non-target lesions. PFS was assessed by Kaplan-Meier estimates. The analyses of PFS was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: months
    median (confidence interval 95%)
        TC3 or IC3 PFS (n = 65, 122, 115, 237)
    5.5 (2.7 to 8.3)
    4.1 (1.8 to 5.5)
    4.2 (2.8 to 5.6)
    4.1 (2.8 to 5.4)
        TC3 or IC2/3 PFS (n = 123, 247, 236, 483)
    5.6 (3.3 to 8.3)
    2.8 (1.5 to 4)
    2.8 (2.7 to 4)
    2.8 (2.7 to 3)
        TC2/3 or IC2/3 PFS (n= 139, 267, 253, 520)
    5.5 (3 to 6.9)
    2.8 (1.5 to 3.5)
    2.8 (2.7 to 3.7)
    2.8 (2.7 to 2.9)
    No statistical analyses for this end point

    Secondary: PFS as Assessed by INV Per RECIST v1.1

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    End point title
    PFS as Assessed by INV Per RECIST v1.1
    End point description
    PFS is the interval between the first dose of atezolizumab and date of disease progression or death due to any cause, whichever occurred first as measured by RECIST v1.1. PD: one or more of the following: at least 20% increase from nadir in the sum of diameters of target lesions (with an absolute increase of at least 5mm), appearance of new lesions, and/or unequivocal progression of non-target lesions. PFS was assessed by Kaplan-Meier estimates. The analyses of PFS was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group. 99999 = data not available.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: months
    median (confidence interval 95%)
        TC3 or IC3 PFS (n= 65, 122, 115, 237)
    7.1 (4.9 to 99999)
    4.1 (2.7 to 6.5)
    4.2 (3 to 6.2)
    4.2 (2.9 to 5.6)
        TC3 or IC2/3 PFS (n= 123, 247, 236, 483)
    7.6 (5.9 to 9.9)
    3 (2.7 to 4.2)
    3.5 (2.8 to 4.2)
    3.2 (2.8 to 4.1)
        TC2/3 or IC2/3 PFS (n= 139, 267, 253, 520)
    7.1 (5.6 to 8.4)
    2.8 (2.6 to 4.1)
    3 (2.8 to 4.1)
    3 (2.8 to 4.1)
    No statistical analyses for this end point

    Secondary: PFS as Assessed by INV Per Modified RECIST

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    End point title
    PFS as Assessed by INV Per Modified RECIST
    End point description
    PFS is the interval between the first dose of atezolizumab and date of disease progression or death due to any cause, whichever occurred first as measured by modified RECIST. PD: at least 20% increase from nadir in the sum of diameters of new and/or existing target lesions (with an absolute increase of at least 5mm). PFS was assessed by Kaplan-Meier estimates. The analyses of PFS was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group. 99999 = data not available.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: months
    median (confidence interval 95%)
        TC3 or IC3 PFS (n= 65, 122, 115, 237)
    7.1 (4.7 to 99999)
    5.7 (4.1 to 8.4)
    6.3 (4.1 to 8.1)
    5.8 (4.3 to 7.1)
        TC3 or IC2/3 PFS (n= 123, 247, 236, 483 )
    7.9 (5.7 to 10)
    4.5 (4 to 6)
    4.9 (4.1 to 6.8)
    4.6 (4.1 to 5.7)
        TC2/3 or IC2/3 PFS (n= 139, 267, 253, 520)
    7.6 (5.6 to 9.9)
    4.2 (3.9 to 5.7)
    4.6 (4.1 to 6.3)
    4.4 (4.1 to 5.5)
    No statistical analyses for this end point

    Secondary: Overall Survival : Percentage of Participants Without Event (Death)

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    End point title
    Overall Survival : Percentage of Participants Without Event (Death)
    End point description
    The analyses was performed on the efficacy evaluable populationn = number of participants analyzed within the specified group.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: percentage of participants
    number (not applicable)
        TC3 or IC3 (n=65, 122, 115, 237)
    70.8
    70.5
    67
    68.8
        TC3 or IC2/3 (n= 123, 247, 236, 483)
    75.6
    69.2
    60.6
    65
        TC2/3 or IC2/3 (n= 139, 267, 253, 520)
    74.1
    67.4
    60.5
    64
    No statistical analyses for this end point

    Secondary: Overall Survival : Median Time to Event (Death)

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    End point title
    Overall Survival : Median Time to Event (Death)
    End point description
    Overall survival is measured as interval between the first dose of atezolizumab and date of death from any cause. The analyses was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group. 99999 = data not available.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: months
    median (confidence interval 95%)
        TC3 or IC3 (n= 65, 122, 115, 237)
    99999 (10.4 to 99999)
    99999 (10.6 to 99999)
    99999 (99999 to 99999)
    99999 (12.1 to 99999)
        TC3 or IC2/3 (n= 123, 247, 236, 483)
    14 (14 to 99999)
    99999 (12.1 to 99999)
    99999 (8.4 to 99999)
    99999 (12.1 to 99999)
        TC2/3 or IC2/3 (n= 139, 267, 253, 520)
    14 (14 to 99999)
    99999 (11.2 to 99999)
    99999 (8.4 to 99999)
    99999 (11.2 to 99999)
    No statistical analyses for this end point

    Secondary: Percentage of Participants Without an Event (Death) at 6 Months

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    End point title
    Percentage of Participants Without an Event (Death) at 6 Months
    End point description
    It is event-free rate (rate of survival) from the first dose of atezolizumab at 6 months. The analyses was performed on the efficacy evaluable population; n=number of participants analyzed within the specified group.
    End point type
    Secondary
    End point timeframe
    Screening and 6 months
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: percentage of participants
    number (confidence interval 95%)
        TC3 or IC3 (n= 65, 122, 115, 237)
    79.2 (69.1 to 89.3)
    79.7 (72.5 to 87)
    75.1 (67.1 to 83.1)
    77.4 (72 to 82.8)
        TC3 or IC2/3 (n= 123, 247, 236, 483)
    83.9 (77.2 to 90.5)
    78.1 (72.8 to 83.4)
    71 (65.2 to 76.9)
    74.6 (70.6 to 78.5)
        TC2/3 or IC2/3 (n= 139, 267, 253, 520)
    81.7 (75.1 to 88.4)
    76.2 (71 to 81.5)
    70.5 (64.9 to 76.2)
    73.4 (69.5 to 77.3)
    No statistical analyses for this end point

    Secondary: Percentage of Participants Without an Event (Death) at 12 Months

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    End point title
    Percentage of Participants Without an Event (Death) at 12 Months
    End point description
    The analyses was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group.
    End point type
    Secondary
    End point timeframe
    Screening and 12 months
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: percentage of participants
    number (confidence interval 95%)
        TC3 or IC3 (n= 65, 122, 115, 237)
    58.6 (40.7 to 76.5)
    61.5 (49 to 74)
    62.6 (52.8 to 72.5)
    61.3 (52.7 to 69.8)
        TC3 or IC2/3 (n= 123, 247, 236, 483)
    67.1 (55.7 to 78.4)
    59.3 (50.5 to 68.1)
    54.9 (47.7 to 62.2)
    56.5 (50.6 to 62.5)
        TC2/3 or IC2/3 (n=139, 267, 253, 520)
    65 (54 to 76.1)
    57.2 (48.6 to 65.7)
    54.4 (47.3 to 61.5)
    55.3 (49.5 to 61.1)
    No statistical analyses for this end point

    Secondary: PFS: Pertcentage of Participants Alive and Progression Free at 6 Months

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    End point title
    PFS: Pertcentage of Participants Alive and Progression Free at 6 Months
    End point description
    PD is defined as one or more of the following: at least 20% increase from nadir in the sum of diameters of target lesions (with an absolute increase of at least 5mm), appearance of new lesions, and/or unequivocal progression of non-target lesions. The analyses was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group.
    End point type
    Secondary
    End point timeframe
    Screening and 6 months
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: percentage of participants
    number (confidence interval 95%)
        TC3 or IC3 (n= 65, 122, 115, 237)
    57.4 (44.7 to 70.1)
    41.3 (32.3 to 50.4)
    42.1 (33.1 to 51.2)
    41.8 (35.4 to 48.2)
        TC3 or IC2/3 (n= 123, 247, 236, 483)
    58.6 (49.5 to 67.8)
    36.1 (29.9 to 42.2)
    35.8 (29.6 to 41.9)
    35.9 (31.6 to 40.3)
        TC2/3 or IC2/3 (n= 139, 267, 253, 520)
    56.4 (47.8 to 65.1)
    34.8 (29 to 40.7)
    34.7 (28.7 to 40.6)
    34.8 (30.6 to 38.9)
    No statistical analyses for this end point

    Secondary: PFS: Percentage of Participants Alive and Progression Free at 12 Months

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    End point title
    PFS: Percentage of Participants Alive and Progression Free at 12 Months
    End point description
    PD is defined as one or more of the following: at least 20% increase from nadir in the sum of diameters of target lesions (with an absolute increase of at least 5mm), appearance of new lesions, and/or unequivocal progression of non-target lesions. The analyses was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group.
    End point type
    Secondary
    End point timeframe
    Screening and 12 months
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: percentage of participants
    number (confidence interval 95%)
        TC3 or IC3 (n= 65, 122, 115, 237)
    33.1 (14.9 to 51.3)
    27.8 (17.6 to 37.9)
    16.1 (3.8 to 28.5)
    23.1 (15.4 to 30.8)
        TC3 or IC2/3 (n= 123, 247, 236, 483)
    29 (13.1 to 45)
    22.7 (16.1 to 29.3)
    15.1 (8.3 to 21.8)
    19.1 (14.4 to 23.8)
        TC2/3 or IC2/3 (n= 139, 267, 253, 520)
    26.9 (12.1 to 41.7)
    21.8 (15.5 to 28.1)
    14.7 (8.1 to 21.3)
    18.5 (14 to 23.1)
    No statistical analyses for this end point

    Secondary: Time in Response ( TIR) as Assessed by INV Per RECIST v1.1

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    End point title
    Time in Response ( TIR) as Assessed by INV Per RECIST v1.1
    End point description
    For responders, TIR was the same as DOR; for non-responders, TIR was considered as an event and defined as the date of first treatment plus one day. The analyses were performed on the efficacy evaluable population. -9999 and 99999 = data not available.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: months
        median (confidence interval 95%)
    0.033 (-99999 to 99999)
    0.033 (-99999 to 99999)
    0.033 (-99999 to 99999)
    0.033 (-99999 to 99999)
    No statistical analyses for this end point

    Secondary: TIR as Assessed by INV Per Modified RECIST

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    End point title
    TIR as Assessed by INV Per Modified RECIST
    End point description
    For responders, TIR was the same as DOR; for non-responders, TIR was considered as an event and defined as the date of first treatment plus one day. The analyses were performed on the efficacy evaluable population. -99999 and 99999 = data not available.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: months
        median (confidence interval 95%)
    0.033 (-99999 to 99999)
    0.033 (-99999 to 99999)
    0.033 (-99999 to 99999)
    0.033 (-99999 to 99999)
    No statistical analyses for this end point

    Secondary: TIR as Assessed by IRF Per RECIST v1.1

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    End point title
    TIR as Assessed by IRF Per RECIST v1.1
    End point description
    For responders, TIR was the same as DOR; for non-responders, TIR was considered as an event and defined as the date of first treatment plus one day. The analyses were performed on the efficacy evaluable population. -99999 and 99999 = data not available.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: months
        median (confidence interval 95%)
    0.033 (-99999 to 99999)
    0.033 (-99999 to 99999)
    0.033 (-99999 to 99999)
    0.033 (-99999 to 99999)
    No statistical analyses for this end point

    Secondary: Atezolizumab Serum Concentrations

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    End point title
    Atezolizumab Serum Concentrations
    End point description
    Serum concentrations were determined for all participants after administration of atezolizumab up to Cycle 8. Time (T) = time from first dose in days. The analyses was performed on the efficacy evaluable population; n = number of participants analyzed for the specified time point.
    End point type
    Secondary
    End point timeframe
    Pre-dose and 0.5 hours post dose on Cycle 1 Day 1, Cycle 1 Days 2, 4, 8, 15, and 21, Cycle 2 Day 21, Cycle 3 Day 21, Cycle 7 Day 21
    End point values
    Pharmacokinetic Evaluable Population
    Number of subjects analysed
    646
    Units: micrograms per milliliter (µg/mL)
    arithmetic mean (standard deviation)
        Cycle 1 Day 1 T=0 (n=646)
    0.285 ( 4.35 )
        Cycle 1 Day 1 T=0.021 (n=624)
    429 ( 218 )
        Cycle 1 Day 2 T=1 (n=47)
    299 ( 65.3 )
        Cycle 1 Day 4 T=3 (n=44)
    220 ( 48.4 )
        Cycle 1 Day 8 T=7 (n=38)
    155 ( 35.4 )
        Cycle 1 Day 15 T=14 (n=36)
    106 ( 32.1 )
        Cycle 1 Day 21 T=21 (n=596)
    87.8 ( 41.7 )
        Cycle 2 Day 21 T=42 (n=518)
    134 ( 57.2 )
        Cycle 3 Day 21 T=63 (n=467)
    163 ( 70.7 )
        Cycle 7 Day 21 T=147 (n=275)
    212 ( 88.5 )
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Positive Anti-Therapeutic Antibody (Anti-Atezolizumab Antibody) Status

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    End point title
    Percentage of Participants with Positive Anti-Therapeutic Antibody (Anti-Atezolizumab Antibody) Status
    End point description
    Anti-therapeutic antibodies is a measurement to explore the potential relationship of immunogenicity response with pharmocokinetics, safety and efficacy. The analyses was performed on the efficacy evaluable population; n = number of participants analyzed at the specified time point.
    End point type
    Secondary
    End point timeframe
    Day 1 (± 2 Days for Cycles ≥ 2) and at treatment discontinuation visit (≤ 30 Days after last dose)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    135
    257
    247
    504
    Units: percentage of participants
    number (not applicable)
        Baseline (n=135,257,247,504)
    7.4
    3.5
    6.1
    4.8
        Post-Baseline (n=133,253,238,491)
    45.1
    36
    37.4
    36.7
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Event (Disease Progression or Death) as Assessed by IRF Per RECIST v1.1

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    End point title
    Percentage of Participants with Event (Disease Progression or Death) as Assessed by IRF Per RECIST v1.1
    End point description
    PD was defined as one or more of the following: at least 20% increase from nadir in the sum of diameters of target lesions (with an absolute increase of at least 5mm), appearance of new lesions, and/or unequivocal progression of non-target lesions. The analyses was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: percentage of participants
    number (not applicable)
        TC3 or IC3 (n= 65, 122, 115, 237)
    58.5
    68
    73
    70.5
        TC3 or IC2/3 (n= 123, 247, 236, 483)
    61.8
    73.7
    79.2
    76.4
        TC2/3 or IC2/3 (n= 139, 27, 253, 520)
    63.3
    75.3
    79.1
    77.1
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Event (Disease Progression or Death) as Assessed by INV Per RECIST v1.1

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    End point title
    Percentage of Participants with Event (Disease Progression or Death) as Assessed by INV Per RECIST v1.1
    End point description
    PD was defined as one or more of the following: at least 20% increase from nadir in the sum of diameters of target lesions (with an absolute increase of at least 5mm), appearance of new lesions, and/or unequivocal progression of non-target lesions.The analyses was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: percentage of participants
    number (not applicable)
        TC3 or IC3 (n= 65, 122, 115, 237)
    50.8
    63.1
    68.7
    65.8
        TC3 or IC2/3 (n= 123, 247, 236, 483)
    50.4
    68.8
    74.6
    71.6
        TC2/3 or IC2/3 (n= 139, 267, 253, 520)
    52.5
    70
    74.7
    72.3
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Event (Disease Progression or Death) as Assessed by INV Per Modified RECIST v1.1

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    End point title
    Percentage of Participants with Event (Disease Progression or Death) as Assessed by INV Per Modified RECIST v1.1
    End point description
    PD was defined as at least 20% increase from nadir in the sum of diameters of new and/or existing target lesions (with an absolute increase of at least 5mm). The analyses was performed on the efficacy evaluable population; n = number of participants analyzed within the specified group.
    End point type
    Secondary
    End point timeframe
    Screening, Every 6 weeks (± 3 days) for 12 months following Cycle 1, Day 1 and every 9 weeks (± 1 week) thereafter until disease progression, intolerable toxicity or death until data cut-off on 28 May 2015 (Up to 16 months)
    End point values
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab Cohorts 2 + 3
    Number of subjects analysed
    139
    267
    253
    520
    Units: percentage of participants
    number (not applicable)
        TC3 or IC3 (n= 65, 122, 115, 237)
    36.9
    56.6
    60
    58.2
        TC3 or IC2/3 (n= 123, 247, 236, 483)
    38.2
    61.5
    66.1
    63.8
        TC2/3 or IC2/3 (n= 139, 267, 253, 520)
    39.6
    62.9
    66.4
    64.6
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were recorded from the date of Screening until 30 days after the final follow-up visit until data cut-off on 28 May 2015 (Up to 16 months)
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.0
    Reporting groups
    Reporting group title
    Cohort 1: First Line Atezolizumab
    Reporting group description
    Participants received 1200 mg atezolizumab every 3 weeks (Day 1 of 21 day cycle) administered by IV infusion until intolerable toxicity, disease progression or death. Participants in this cohort received no prior chemotherapy in locally advanced or metastatic setting.

    Reporting group title
    Cohort 2: Second Line Atezolizumab
    Reporting group description
    Participants received 1200 mg atezolizumab every 3 weeks (Day 1 of 21-day cycle) administered by IV infusion until intolerable toxicity, disease progression or death. Participants were permitted to continue treatment after progressive disease, if the following criteria were met: evidence of clinical benefit as assessed by the investigator; absence of symptoms and signs indicating unequivocal progression of disease; no decline in ECOG performance status; absence of tumor growth at critical anatomical sites that cannot be managed by protocol-allowed medical interventions; evidence of clinical benefit as assessed by the investigator. Participants in this cohort progressed during or after prior platinum-based chemotherapy in locally advanced or metastatic setting.

    Reporting group title
    Cohort 3: Third Line and Beyond Atezolizumab
    Reporting group description
    Participants received 1200 mg atezolizumab every 3 weeks ( Day 1 of 21-day cycle) administered by IV infusion until intolerable toxicity, disease progression or death. Participants were permitted to continue treatment after progressive disease, if the following criteria were met: absence of symptoms and signs indicating unequivocal progression of disease; no decline in ECOG performance status; absence of tumor growth at critical anatomical sites that cannot be managed by protocol-allowed medical interventions; evidence of clinical benefit as assessed by the investigator. Participants in this cohort progressed during or after prior platinum-based chemotherapy and at least one additional therapy in locally advanced or metastatic setting.

    Serious adverse events
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    43 / 139 (30.94%)
    96 / 267 (35.96%)
    94 / 253 (37.15%)
         number of deaths (all causes)
    36
    87
    100
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Bladder cancer
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Glioblastoma multiforme
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lymphangiosis carcinomatosa
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Malignant pleural effusion
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pericardial effusion malignant
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Tumour pain
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    1 / 139 (0.72%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Embolism
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haematoma
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Internal haemorrhage
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Jugular vein thrombosis
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Orthostatic hypotension
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral arterial occlusive disease
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Superior vena cava syndrome
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Surgical and medical procedures
    Alcohol detoxification
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 139 (0.72%)
    1 / 267 (0.37%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    0 / 139 (0.00%)
    2 / 267 (0.75%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Chills
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Death
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Fatigue
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hyperthermia
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Influenza like illness
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Malaise
         subjects affected / exposed
    0 / 139 (0.00%)
    2 / 267 (0.75%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Non-cardiac chest pain
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pain
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    0 / 139 (0.00%)
    8 / 267 (3.00%)
    7 / 253 (2.77%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 8
    3 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sudden death
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    Reproductive system and breast disorders
    Pelvic pain
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Bronchial haemorrhage
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchial obstruction
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 139 (0.72%)
    2 / 267 (0.75%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cough
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    3 / 139 (2.16%)
    4 / 267 (1.50%)
    11 / 253 (4.35%)
         occurrences causally related to treatment / all
    0 / 3
    2 / 5
    0 / 12
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    0 / 139 (0.00%)
    2 / 267 (0.75%)
    4 / 253 (1.58%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypoxia
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Interstitial lung disease
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Laryngeal haemorrhage
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    2 / 139 (1.44%)
    1 / 267 (0.37%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonia aspiration
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Pneumonitis
         subjects affected / exposed
    2 / 139 (1.44%)
    8 / 267 (3.00%)
    5 / 253 (1.98%)
         occurrences causally related to treatment / all
    2 / 2
    5 / 10
    3 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Pneumothorax
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    2 / 139 (1.44%)
    2 / 267 (0.75%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary haemorrhage
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory distress
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Respiratory failure
         subjects affected / exposed
    1 / 139 (0.72%)
    2 / 267 (0.75%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Tracheal stenosis
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    0 / 139 (0.00%)
    2 / 267 (0.75%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Disorientation
         subjects affected / exposed
    0 / 139 (0.00%)
    2 / 267 (0.75%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Mental status changes
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatic enzyme increased
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Allergic transfusion reaction
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Incisional hernia
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infusion related reaction
         subjects affected / exposed
    0 / 139 (0.00%)
    2 / 267 (0.75%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Traumatic haemothorax
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Congenital, familial and genetic disorders
    Tracheo-oesophageal fistula
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute coronary syndrome
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Acute myocardial infarction
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrial flutter
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrioventricular block complete
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Cardiac failure
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac tamponade
         subjects affected / exposed
    1 / 139 (0.72%)
    2 / 267 (0.75%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiopulmonary failure
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Tachycardia
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Cerebral haemorrhage
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cerebral infarction
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    3 / 253 (1.19%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Dysarthria
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Motor dysfunction
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myelopathy
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Paraplegia
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Presyncope
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Somnolence
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal cord compression
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Subarachnoid haemorrhage
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    VIIth nerve paralysis
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vocal cord paralysis
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    3 / 253 (1.19%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lymphadenitis
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Splenic infarction
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ascites
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 139 (0.72%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 139 (0.72%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    2 / 139 (1.44%)
    1 / 267 (0.37%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 1
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dysphagia
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastric ulcer haemorrhage
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastritis
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrooesophageal reflux disease
         subjects affected / exposed
    0 / 139 (0.00%)
    2 / 267 (0.75%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haematemesis
         subjects affected / exposed
    0 / 139 (0.00%)
    2 / 267 (0.75%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 139 (0.72%)
    3 / 267 (1.12%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    1 / 1
    3 / 5
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Oesophageal perforation
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Oesophageal stenosis
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Oesophageal varices haemorrhage
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pancreatitis
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    0 / 139 (0.00%)
    4 / 267 (1.50%)
    3 / 253 (1.19%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 7
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatic failure
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Hepatic haemorrhage
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatomegaly
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Dermatomyositis
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal infarct
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Endocrine disorders
    Adrenal insufficiency
         subjects affected / exposed
    1 / 139 (0.72%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypothyroidism
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    2 / 139 (1.44%)
    1 / 267 (0.37%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bone pain
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intervertebral disc compression
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Muscular weakness
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal chest pain
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pathological fracture
         subjects affected / exposed
    0 / 139 (0.00%)
    2 / 267 (0.75%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal pain
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Bacteraemia
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    2 / 139 (1.44%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchopneumonia
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Catheter site infection
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Empyema
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Encephalitis
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Febrile infection
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal infection
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infectious colitis
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infectious pleural effusion
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Influenza
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lobar pneumonia
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lung abscess
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 139 (0.72%)
    3 / 267 (1.12%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Osteomyelitis
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peritonitis
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    3 / 139 (2.16%)
    7 / 267 (2.62%)
    12 / 253 (4.74%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 9
    1 / 12
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    1 / 2
    Pneumonia bacterial
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyelonephritis
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Subcutaneous abscess
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 139 (0.72%)
    1 / 267 (0.37%)
    2 / 253 (0.79%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vestibular neuronitis
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Viral upper respiratory tract infection
         subjects affected / exposed
    1 / 139 (0.72%)
    0 / 267 (0.00%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    0 / 139 (0.00%)
    0 / 267 (0.00%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Failure to thrive
         subjects affected / exposed
    0 / 139 (0.00%)
    1 / 267 (0.37%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypercalcaemia
         subjects affected / exposed
    0 / 139 (0.00%)
    5 / 267 (1.87%)
    1 / 253 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 5
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    0 / 139 (0.00%)
    2 / 267 (0.75%)
    0 / 253 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Cohort 1: First Line Atezolizumab Cohort 2: Second Line Atezolizumab Cohort 3: Third Line and Beyond Atezolizumab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    115 / 139 (82.73%)
    219 / 267 (82.02%)
    224 / 253 (88.54%)
    Investigations
    Weight decreased
         subjects affected / exposed
    6 / 139 (4.32%)
    17 / 267 (6.37%)
    23 / 253 (9.09%)
         occurrences all number
    6
    20
    29
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    6 / 139 (4.32%)
    16 / 267 (5.99%)
    20 / 253 (7.91%)
         occurrences all number
    6
    21
    21
    Headache
         subjects affected / exposed
    12 / 139 (8.63%)
    18 / 267 (6.74%)
    28 / 253 (11.07%)
         occurrences all number
    15
    24
    32
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    11 / 139 (7.91%)
    22 / 267 (8.24%)
    14 / 253 (5.53%)
         occurrences all number
    16
    41
    27
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    12 / 139 (8.63%)
    23 / 267 (8.61%)
    33 / 253 (13.04%)
         occurrences all number
    12
    33
    48
    Chest pain
         subjects affected / exposed
    5 / 139 (3.60%)
    13 / 267 (4.87%)
    21 / 253 (8.30%)
         occurrences all number
    5
    14
    25
    Chills
         subjects affected / exposed
    4 / 139 (2.88%)
    15 / 267 (5.62%)
    14 / 253 (5.53%)
         occurrences all number
    4
    18
    15
    Fatigue
         subjects affected / exposed
    45 / 139 (32.37%)
    74 / 267 (27.72%)
    83 / 253 (32.81%)
         occurrences all number
    54
    107
    115
    Influenza like illness
         subjects affected / exposed
    11 / 139 (7.91%)
    17 / 267 (6.37%)
    13 / 253 (5.14%)
         occurrences all number
    11
    22
    15
    Malaise
         subjects affected / exposed
    8 / 139 (5.76%)
    6 / 267 (2.25%)
    8 / 253 (3.16%)
         occurrences all number
    9
    7
    8
    Oedema peripheral
         subjects affected / exposed
    5 / 139 (3.60%)
    20 / 267 (7.49%)
    18 / 253 (7.11%)
         occurrences all number
    5
    27
    19
    Pain
         subjects affected / exposed
    10 / 139 (7.19%)
    12 / 267 (4.49%)
    8 / 253 (3.16%)
         occurrences all number
    14
    13
    9
    Pyrexia
         subjects affected / exposed
    18 / 139 (12.95%)
    38 / 267 (14.23%)
    39 / 253 (15.42%)
         occurrences all number
    20
    54
    46
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    8 / 139 (5.76%)
    15 / 267 (5.62%)
    15 / 253 (5.93%)
         occurrences all number
    8
    16
    17
    Constipation
         subjects affected / exposed
    17 / 139 (12.23%)
    35 / 267 (13.11%)
    39 / 253 (15.42%)
         occurrences all number
    20
    41
    48
    Diarrhoea
         subjects affected / exposed
    23 / 139 (16.55%)
    50 / 267 (18.73%)
    36 / 253 (14.23%)
         occurrences all number
    29
    67
    57
    Dry mouth
         subjects affected / exposed
    8 / 139 (5.76%)
    13 / 267 (4.87%)
    10 / 253 (3.95%)
         occurrences all number
    8
    14
    11
    Nausea
         subjects affected / exposed
    26 / 139 (18.71%)
    59 / 267 (22.10%)
    53 / 253 (20.95%)
         occurrences all number
    37
    77
    70
    Vomiting
         subjects affected / exposed
    16 / 139 (11.51%)
    34 / 267 (12.73%)
    33 / 253 (13.04%)
         occurrences all number
    19
    44
    39
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    33 / 139 (23.74%)
    45 / 267 (16.85%)
    66 / 253 (26.09%)
         occurrences all number
    45
    51
    82
    Dyspnoea
         subjects affected / exposed
    34 / 139 (24.46%)
    38 / 267 (14.23%)
    56 / 253 (22.13%)
         occurrences all number
    44
    45
    69
    Haemoptysis
         subjects affected / exposed
    9 / 139 (6.47%)
    12 / 267 (4.49%)
    9 / 253 (3.56%)
         occurrences all number
    10
    15
    12
    Nasal congestion
         subjects affected / exposed
    7 / 139 (5.04%)
    2 / 267 (0.75%)
    2 / 253 (0.79%)
         occurrences all number
    8
    2
    2
    Productive cough
         subjects affected / exposed
    6 / 139 (4.32%)
    14 / 267 (5.24%)
    9 / 253 (3.56%)
         occurrences all number
    11
    17
    10
    Skin and subcutaneous tissue disorders
    Dry skin
         subjects affected / exposed
    12 / 139 (8.63%)
    15 / 267 (5.62%)
    13 / 253 (5.14%)
         occurrences all number
    12
    15
    13
    Hyperhidrosis
         subjects affected / exposed
    5 / 139 (3.60%)
    15 / 267 (5.62%)
    5 / 253 (1.98%)
         occurrences all number
    5
    16
    7
    Pruritus
         subjects affected / exposed
    16 / 139 (11.51%)
    31 / 267 (11.61%)
    29 / 253 (11.46%)
         occurrences all number
    20
    40
    39
    Rash
         subjects affected / exposed
    12 / 139 (8.63%)
    27 / 267 (10.11%)
    21 / 253 (8.30%)
         occurrences all number
    19
    37
    28
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    4 / 139 (2.88%)
    16 / 267 (5.99%)
    12 / 253 (4.74%)
         occurrences all number
    4
    19
    13
    Insomnia
         subjects affected / exposed
    9 / 139 (6.47%)
    13 / 267 (4.87%)
    16 / 253 (6.32%)
         occurrences all number
    9
    16
    19
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    14 / 139 (10.07%)
    30 / 267 (11.24%)
    31 / 253 (12.25%)
         occurrences all number
    24
    47
    39
    Back pain
         subjects affected / exposed
    15 / 139 (10.79%)
    24 / 267 (8.99%)
    27 / 253 (10.67%)
         occurrences all number
    18
    31
    32
    Musculoskeletal chest pain
         subjects affected / exposed
    9 / 139 (6.47%)
    12 / 267 (4.49%)
    10 / 253 (3.95%)
         occurrences all number
    9
    13
    12
    Musculoskeletal pain
         subjects affected / exposed
    6 / 139 (4.32%)
    13 / 267 (4.87%)
    24 / 253 (9.49%)
         occurrences all number
    6
    13
    30
    Myalgia
         subjects affected / exposed
    2 / 139 (1.44%)
    14 / 267 (5.24%)
    13 / 253 (5.14%)
         occurrences all number
    2
    18
    13
    Pain in extremity
         subjects affected / exposed
    11 / 139 (7.91%)
    20 / 267 (7.49%)
    14 / 253 (5.53%)
         occurrences all number
    13
    25
    22
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    11 / 139 (7.91%)
    5 / 267 (1.87%)
    10 / 253 (3.95%)
         occurrences all number
    12
    5
    11
    Upper respiratory tract infection
         subjects affected / exposed
    9 / 139 (6.47%)
    14 / 267 (5.24%)
    14 / 253 (5.53%)
         occurrences all number
    9
    17
    15
    Urinary tract infection
         subjects affected / exposed
    3 / 139 (2.16%)
    17 / 267 (6.37%)
    9 / 253 (3.56%)
         occurrences all number
    9
    17
    11
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    32 / 139 (23.02%)
    47 / 267 (17.60%)
    68 / 253 (26.88%)
         occurrences all number
    35
    55
    81
    Hypokalaemia
         subjects affected / exposed
    10 / 139 (7.19%)
    4 / 267 (1.50%)
    9 / 253 (3.56%)
         occurrences all number
    11
    4
    10

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    30 Jan 2014
    The protocol was amended in response to the Voluntary Harmonisation Procedure (VHP), and the major clarifications were as follows: The description of eligible participants with locally advanced and metastatic non-small cell lung cancer in Cohort 1 in the inclusion criteria was further clarified. The exclusion criterion for participants with a positive Human Immunodeficiency Virus (HIV) test was updated. The timing of vital signs with the intravenous infusion of atezolizumab was clarified and made consistent throughout the protocol.
    30 May 2014
    Phase Ia study PCD4989g clinical data were updated. Inclusion criteria permitted participants with EGFR sensitizing mutations and anaplastic lymphoma kinase (ALK) translocations to be eligible for Cohort 1 after appropriate treatment and subsequent progression on an EGFR tyrosine kinase inhibitor or ALK inhibitor, respectively. Inclusion criteria regarding adequate hematologic and end organ function were revised as follows: the upper limit of 15,000 µL was removed from the white blood cell (WBC) count and creatinine clearance allowance was modified from greater than and equal to (≥) 50 to ≥ 30 milliliters per minute (mL/min). Treatment duration was modified to allow participants to be as long as they are experiencing clinical benefit; accordingly the 1-year initial treatment period, follow-up, and re-treatment periods no longer applied. The frequency of tumor assessments after 1 year of study treatment was increased from every 12 weeks to every 9 weeks. The total number of participants required for the study was increased from 300 to 635 to ensure a robust data set that allows for reliable evaluation of efficacy and safety, and to reflect the revision on the definition of positivity for PD-L1. In addition, the number of participants in each cohort was adjusted to reflect the new total number. The definition of positivity for PD-L1 was revised in Appendix 10 of the protocol to reflect the implementation introduced in the laboratory manual. The number of participants needed for Cohort 3 was clarified to require at least 75 participants with PD-L1 IHC 3. The plan to manage safety concerns was provided to reflect changes in the general guidelines. The Medical Monitor was changed.
    23 Dec 2014
    The Phase Ia Study PCD4989g clinical data were updated in the background section of the protocol. The description of eligible participants with positive PD-L1 was further clarified. The number of participants needed for Cohort 3 was updated to require approximately 100 participants with PD-L1 expression defined as TC3 or IC3 to support the primary efficacy analysis. The primary efficacy endpoint of ORR was revised to be analyzed by IRF assessment per RECIST v1.1. The INV-assessed ORR per modified RECIST would be analyzed as a secondary efficacy endpoint. The statistical plan was modified to reflect changes in the primary efficacy endpoint and the emerging information on subpopulations. The plan to manage safety concerns was revised to reflect changes in the general guidelines.
    29 Oct 2015
    The name of the test product, MPDL3280A, was changed to atezolizumab throughout the document. Additional/updated background information regarding previous and ongoing atezolizumab clinical studies was provided to align with Version 7 of the atezolizumab Investigator’s Brochure (IB). The management of gastrointestinal, dermatologic, endocrine, pulmonary toxicity, hepatotoxicity, potential pancreatic or eye toxicity, and other immunemediated adverse events has been deleted from this protocol and reference was made to the atezolizumab IB. Systemic immune activation (SIA) has been identified as a potential risk of atezolizumab when given in combination with other immunomodulating agents. The management recommendations regarding early identification and management of SIA have been added. Clarifications have been made to the instructions for recording diagnosis versus signs and symptoms on the Adverse Event electronic case report form (eCRF).

    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.
    The data was up to primary completion date.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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