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    Clinical Trial Results:
    An open label, randomized controlled prospective multicenter two arm phase IV trial to determine Patient preference for everolimus in combination with exemestane or capecitabine in combination with beeacizumab for advanced (inoperable or metastatic) HER2 -negative hormone receptor positive breast cancer

    Summary
    EudraCT number
    2013-005329-22
    Trial protocol
    DE  
    Global end of trial date
    30 Sep 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    14 Oct 2018
    First version publication date
    14 Oct 2018
    Other versions
    Summary report(s)
    IMPROVE CSR Synopsis

    Trial information

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    Trial identification
    Sponsor protocol code
    iOM-12293
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02248571
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    iOMEDICO AG
    Sponsor organisation address
    Hanferstr. 28, Freiburg i.Br., Germany, 79108
    Public contact
    Contract Research Organisation, iOMEDICO AG, 0049 761152420, info@iomedico.com
    Scientific contact
    Contract Research Organisation, iOMEDICO AG, 0049 761152420, info@iomedico.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    25 Jan 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    30 Sep 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Sep 2017
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    The objective of this trial is to compare patients’ preferences of the two treatment combinations everolimus plus exemestane or capecitabine in combination with bevacizumab after failure of standard antihormonal therapy in patients with advanced (inoperable or metastatic) Her2/neu-negative hormone receptor positive breast cancer
    Protection of trial subjects
    The study was conducted in accordance with all relevant laws and regulations relating to clinical studies and the protection of patients. Each participating site had to maintain appropriate records for this trial, in compliance with ICH E6 GCP, and regulatory requirements for the protection of confidentiality of patients. The investigator ensured pseudonymity of the patients; signed patient informed consent and patient enrollment log were kept strictly confidential to enable patient identification at the site.
    Background therapy
    N/A This is a crossover phase IV-trial to determine patients’ preference for everolimus in combination with exemestane or capecitabine in combination with bevacizumab for advanced breast cancer patients. This design was chosen to assess the patient reported preference for either treatment.
    Evidence for comparator
    N/A
    Actual start date of recruitment
    17 Oct 2014
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety, Efficacy
    Long term follow-up duration
    1 Months
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 77
    Worldwide total number of subjects
    77
    EEA total number of subjects
    77
    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)
    37
    From 65 to 84 years
    39
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    Patients will be randomized in a 1:1 fashion to receive capecitabine in combination with bevacizumab (Arm A) or everolimus in combination with exemestane (Arm B).

    Pre-assignment
    Screening details
    Eligibility of the patient has to be assessed within 28 days prior to randomization with the exception of Patient reported outcomes (PRO) questionnaires, which must be completed within 14 days before randomization. Randomization has strictly to be performed within 7 days prior to the first study treatment. In total, 86 patients were screened.

    Pre-assignment period milestones
    Number of subjects started
    77
    Number of subjects completed
    77

    Period 1
    Period 1 title
    Treatment period - overall period
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Arm A - Cap/Bev followed by Eve/Exe
    Arm description
    Arm A - 1st-line: Capecitabine/Bevacizumab (Cap/Bev); 2nd-line: Everolimus/Exemestane (Eve/Exe)
    Arm type
    Experimental

    Investigational medicinal product name
    Capecitabine/ Bevacizumab followed by Everolimus/ Exemestane
    Investigational medicinal product code
    L01BC06/ L01XC07 followed by L01XE10/ L02BG06
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion, Tablet
    Routes of administration
    Intravenous use, Oral use
    Dosage and administration details
    Capecitabine: 1000 mg/m² orally applied twice daily as combined 150 mg and 500 mg tablets on days 1 to 14 of each 21-day cycle, followed by a seven day rest period. Bevacizumab: 15 mg/kg intravenously applied once every three weeks. Everolimus: 10 mg/day orally applied tablet. Exemestane: 25 mg/day orally applied tablet.

    Arm title
    Arm B - Eve/Exe followed by Cap/Bev
    Arm description
    Arm B - 1st line: Everolimus/Exemestane (Eve/Exe); 2nd line: Capecitabine/Bevacizumab (Cap/Bev)
    Arm type
    Experimental

    Investigational medicinal product name
    Everolimus/ Exemestane followed by Capecitabine/ Bevacizumab
    Investigational medicinal product code
    L01XE10/ L02BG06 followed by L01BC06/ L01XC07
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion, Tablet
    Routes of administration
    Intravenous use, Oral use
    Dosage and administration details
    Everolimus: 10 mg/day orally applied tablet. Exemestane: 25 mg/day orally applied tablet. Capecitabine: 1000 mg/m² orally applied twice daily as combined 150 mg and 500 mg tablets on days 1 to 14 of each 21-day cycle, followed by a seven day rest period. Bevacizumab: 15 mg/kg intravenously applied once every three weeks.

    Number of subjects in period 1
    Arm A - Cap/Bev followed by Eve/Exe Arm B - Eve/Exe followed by Cap/Bev
    Started
    39
    38
    Completed
    37
    37
    Not completed
    2
    1
         Did not receive allocated intervention
    2
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Treatment period - overall period
    Reporting group description
    -

    Reporting group values
    Treatment period - overall period Total
    Number of subjects
    77 77
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    37 37
        From 65-84 years
    39 39
        85 years and over
    1 1
    Age continuous
    Age
    Units: years
        median (full range (min-max))
    65.5 (47.0 to 86.0) -
    Gender categorical
    Units: Subjects
        Female
    77 77
        Male
    0 0
    Menopausal Status
    Menopausal Status *postmenopausal *premenopausal
    Units: Subjects
        Postmenopausal
    77 77
        Premenopausal
    0 0
    ECOG Performance Status at baseline
    ECOG Performance Status at baseline
    Units: Subjects
        ECOG 0
    36 36
        ECOG 1
    39 39
        ECOG 2
    2 2
        missing
    0 0
    Location of primary tumor
    Localisation of primary tumor *left *right *unknown
    Units: Subjects
        left
    40 40
        right
    36 36
        unknown
    1 1
    HER2 status
    HER2/neu status *positive *negative
    Units: Subjects
        positive
    0 0
        negative
    77 77
    Hormone receptor status
    Hormone receptor status *positive *negative
    Units: Subjects
        negative
    0 0
        positive
    77 77
    Histology at primary diagnosis
    Histology at primary diagnosis
    Units: Subjects
        invasive ductal
    51 51
        invasive lobular
    19 19
        inflammatory Ca
    1 1
        not otherwise specified
    6 6
    DFI - non-visceral metastases only/ visceral metastases or local relapse
    Intervall groups comprise: * non-visceral metastases only / visercal metastases or local relaps * anthracycline-/taxane pretreated / non-anthracycline-/taxane pretreated *0-1 prior antihormonal therapies / >1 antihormonal therapies. (Analysis for mITT not available)
    Units: Subjects
        non-visceral metastases only <=2
    7 7
        non-visceral metastases only >2
    17 17
        visceral metastases or local relapse <=2
    17 17
        visceral metastases or local relapse >2
    36 36
    DFI - anthracycline/taxane pretreated / not anthracycline/taxane pretreated
    Intervall groups comprise: * non-visceral metastases only / visercal metastases or local relaps * anthracycline-/taxane pretreated / non-anthracycline-/taxane pretreated *0-1 prior antihormonal therapies / >1 antihormonal therapies. (Analysis for mITT not available)
    Units: Subjects
        anthracycline/taxane pretreated <=2
    9 9
        anthracycline/taxane pretreated >2
    39 39
        not anthracycline/taxane pretreated <=2
    15 15
        not anthracycline/taxane pretreated >2
    14 14
    DFI - 0-1 prior antihormonal therapies / >1 prior antihormonal therapies
    Intervall groups comprise: * non-visceral metastases only / visercal metastases or local relaps * anthracycline-/taxane pretreated / non-anthracycline-/taxane pretreated *0-1 prior antihormonal therapies / >1 antihormonal therapies. (Analysis for mITT not available)
    Units: Subjects
        0-1 prior antihormonal therapies <=2
    13 13
        0-1 prior antihormonal therapies >2
    42 42
        >1 prior antihormonal therapies <=2
    11 11
        >1 prior antihormonal therapies >2
    11 11
    Prior endocrine therapies by stratification variables
    Number of prior palliative endocrine therapies in subgroups Stratification variable: *non-visceral metastases only / visceral metastases or local relapse Number of prior palliative antihormonal therapies: *0-1 *>1 (Analysis for mITT not available)
    Units: Subjects
        non-visceral metastases only 0-1
    17 17
        non-visceral metastases only >1
    7 7
        visceral metastases or local relapse 0-1
    38 38
        visceral metastases or local relapse >1
    15 15
    Prior endocrine therapies by stratification variables
    Number of prior palliative endocrine therapies in subgroups Stratification variable: *AT / non-AT pretreatment Number of prior palliative antihormonal therapies: *0-1 *>1 (Analysis for mITT not available)
    Units: Subjects
        anthracycline/taxane pretreated 0-1
    41 41
        anthracycline/taxane pretreated >1
    7 7
        not anthracycline/taxane pretreated 0-1
    14 14
        not anthracycline/taxane pretreated >1
    15 15
    Prior endocrine therapies by stratification variables
    Number of prior palliative endocrine therapies in subgroups Stratification variable: *DFI <= 2 years / >2 years Number of prior palliative antihormonal therapies: *0-1 *>1 (Analysis for mITT not available)
    Units: Subjects
        disease free interval <=2 years 0-1
    13 13
        disease free interval <=2 years >1
    11 11
        disease free interval >2 years 0-1
    42 42
        disease free interval >2 years >1
    11 11
    Weight
    Weight at baseline
    Units: kg
        median (full range (min-max))
    69.0 (42.0 to 113.0) -
    Body Mass Index
    Units: kg/m²
        median (full range (min-max))
    25.5 (18.0 to 43.1) -
    DFI Disease-free interval
    Disease-free interval [years] (Data for reporting group 1 were not analysed; therefore data fields were completed with "0").
    Units: years
        median (full range (min-max))
    0 (0 to 0) -
    Time from initial diagnosis to start of treatment
    Times were calculated using the date of randomization as end date. (Data for reporting group 1 were not analysed; therefore data fields were completed with "0").
    Units: years
        median (full range (min-max))
    0 (0 to 0) -
    Time from relapse to start of treatment
    Times were calculated using the date of randomization as end date. (Data for reporting group 1 were not analysed; therefore data fields were completed with "0").
    Units: months
        median (full range (min-max))
    0 (0 to 0) -
    Number of metastatic sites at inclusion
    (Data for reporting group 1 were not analysed; therefore data fields were completed with "0").
    Units: number
        median (full range (min-max))
    0 (0 to 0) -
    Subject analysis sets

    Subject analysis set title
    Arm A - ITT (ITT)
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The ITT population comprises all patients to whom study treatment has been assigned by randomization. According to the intent to treat principle, patients will be analysed according to the study arm they have been assigned to during the randomization procedure. The ITT population is the relevant population for the efficacy evaluation including demographic and other baseline characteristics as well as study treatment evaluations. It serves as additional analysis population for all patient reported outcomes.

    Subject analysis set title
    Arm B - ITT (ITT)
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The ITT population comprises all patients to whom study treatment has been assigned by randomization. According to the intent to treat principle, patients will be analysed according to the study arm they have been assigned to during the randomization procedure. The ITT population is the relevant population for the efficacy evaluation including demographic and other baseline characteristics as well as study treatment evaluations. It serves as additional analysis population for all patient reported outcomes.

    Subject analysis set title
    Arm A - modified ITT (mITT)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The modified ITT (MITT) population comprises all patients who qualify for analysis of the primary endpoint, i.e. all patients who • receive at least 12 weeks of first-line treatment or less for other reasons than PD • cross over to second-line treatment within 12 weeks after termination of first-line treatment • receive at least 12 weeks of second-line treatment or less for other reasons than PD • answer preference question on patients’ preference questionnaire The modified ITT population is the relevant population for the analysis of the primary outcome and all patient reported outcomes. All secondary efficacy endpoints as well as the description of baseline characteristics will be repeated with the modified ITT population.

    Subject analysis set title
    Arm B - modified ITT (mITT)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The modified ITT (MITT) population comprises all patients who qualify for analysis of the primary endpoint, i.e. all patients who • receive at least 12 weeks of first-line treatment or less for other reasons than PD • cross over to second-line treatment within 12 weeks after termination of first-line treatment • receive at least 12 weeks of second-line treatment or less for other reasons than PD • answer preference question on patients’ preference questionnaire The modified ITT population is the relevant population for the analysis of the primary outcome and all patient reported outcomes. All secondary efficacy endpoints as well as the description of baseline characteristics will be repeated with the modified ITT population.

    Subject analysis sets values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects
    39
    38
    5
    8
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    20
    17
    3
    3
        From 65-84 years
    19
    20
    2
    5
        85 years and over
    0
    1
    0
    0
    Age continuous
    Age
    Units: years
        median (full range (min-max))
    64.4 (47.0 to 83.6)
    65.9 (49.8 to 86.0)
    59.8 (56.4 to 77.1)
    65.9 (51.1 to 77.6)
    Gender categorical
    Units: Subjects
        Female
    39
    38
    5
    8
        Male
    0
    0
    0
    0
    Menopausal Status
    Menopausal Status *postmenopausal *premenopausal
    Units: Subjects
        Postmenopausal
    39
    38
    5
    8
        Premenopausal
    0
    0
    0
    0
    ECOG Performance Status at baseline
    ECOG Performance Status at baseline
    Units: Subjects
        ECOG 0
    19
    17
    4
    3
        ECOG 1
    19
    20
    1
    5
        ECOG 2
    1
    1
    0
    0
        missing
    0
    0
    0
    0
    Location of primary tumor
    Localisation of primary tumor *left *right *unknown
    Units: Subjects
        left
    18
    22
    1
    4
        right
    21
    15
    4
    4
        unknown
    0
    1
    0
    0
    HER2 status
    HER2/neu status *positive *negative
    Units: Subjects
        positive
    0
    0
    0
    0
        negative
    39
    38
    5
    8
    Hormone receptor status
    Hormone receptor status *positive *negative
    Units: Subjects
        negative
    0
    0
    0
    0
        positive
    39
    38
    5
    8
    Histology at primary diagnosis
    Histology at primary diagnosis
    Units: Subjects
        invasive ductal
    27
    24
    3
    6
        invasive lobular
    7
    12
    1
    2
        inflammatory Ca
    1
    0
    0
    0
        not otherwise specified
    4
    2
    1
    0
    DFI - non-visceral metastases only/ visceral metastases or local relapse
    Intervall groups comprise: * non-visceral metastases only / visercal metastases or local relaps * anthracycline-/taxane pretreated / non-anthracycline-/taxane pretreated *0-1 prior antihormonal therapies / >1 antihormonal therapies. (Analysis for mITT not available)
    Units: Subjects
        non-visceral metastases only <=2
    4
    3
    0
    0
        non-visceral metastases only >2
    8
    9
    0
    0
        visceral metastases or local relapse <=2
    8
    9
    0
    0
        visceral metastases or local relapse >2
    19
    17
    0
    0
    DFI - anthracycline/taxane pretreated / not anthracycline/taxane pretreated
    Intervall groups comprise: * non-visceral metastases only / visercal metastases or local relaps * anthracycline-/taxane pretreated / non-anthracycline-/taxane pretreated *0-1 prior antihormonal therapies / >1 antihormonal therapies. (Analysis for mITT not available)
    Units: Subjects
        anthracycline/taxane pretreated <=2
    5
    4
    0
    0
        anthracycline/taxane pretreated >2
    17
    22
    0
    0
        not anthracycline/taxane pretreated <=2
    7
    8
    0
    0
        not anthracycline/taxane pretreated >2
    10
    4
    0
    0
    DFI - 0-1 prior antihormonal therapies / >1 prior antihormonal therapies
    Intervall groups comprise: * non-visceral metastases only / visercal metastases or local relaps * anthracycline-/taxane pretreated / non-anthracycline-/taxane pretreated *0-1 prior antihormonal therapies / >1 antihormonal therapies. (Analysis for mITT not available)
    Units: Subjects
        0-1 prior antihormonal therapies <=2
    6
    7
    0
    0
        0-1 prior antihormonal therapies >2
    21
    21
    0
    0
        >1 prior antihormonal therapies <=2
    6
    5
    0
    0
        >1 prior antihormonal therapies >2
    6
    5
    0
    0
    Prior endocrine therapies by stratification variables
    Number of prior palliative endocrine therapies in subgroups Stratification variable: *non-visceral metastases only / visceral metastases or local relapse Number of prior palliative antihormonal therapies: *0-1 *>1 (Analysis for mITT not available)
    Units: Subjects
        non-visceral metastases only 0-1
    7
    10
    0
    0
        non-visceral metastases only >1
    5
    2
    0
    0
        visceral metastases or local relapse 0-1
    20
    18
    0
    0
        visceral metastases or local relapse >1
    7
    8
    0
    0
    Prior endocrine therapies by stratification variables
    Number of prior palliative endocrine therapies in subgroups Stratification variable: *AT / non-AT pretreatment Number of prior palliative antihormonal therapies: *0-1 *>1 (Analysis for mITT not available)
    Units: Subjects
        anthracycline/taxane pretreated 0-1
    19
    22
    0
    0
        anthracycline/taxane pretreated >1
    3
    4
    0
    0
        not anthracycline/taxane pretreated 0-1
    8
    6
    0
    0
        not anthracycline/taxane pretreated >1
    9
    6
    0
    0
    Prior endocrine therapies by stratification variables
    Number of prior palliative endocrine therapies in subgroups Stratification variable: *DFI <= 2 years / >2 years Number of prior palliative antihormonal therapies: *0-1 *>1 (Analysis for mITT not available)
    Units: Subjects
        disease free interval <=2 years 0-1
    6
    7
    0
    0
        disease free interval <=2 years >1
    6
    5
    0
    0
        disease free interval >2 years 0-1
    21
    21
    0
    0
        disease free interval >2 years >1
    6
    5
    0
    0
    Weight
    Weight at baseline
    Units: kg
        median (full range (min-max))
    69.0 (45.0 to 113.0)
    68.5 (42.0 to 103.0)
    80.0 (62.0 to 113.0)
    67.5 (60.0 to 90.0)
    Body Mass Index
    Units: kg/m²
        median (full range (min-max))
    25.6 (18.0 to 43.1)
    24.9 (19.2 to 36.9)
    27.0 (22.3 to 43.1)
    24.1 (21.5 to 31.1)
    DFI Disease-free interval
    Disease-free interval [years] (Data for reporting group 1 were not analysed; therefore data fields were completed with "0").
    Units: years
        median (full range (min-max))
    4.7 (0.0 to 18.9)
    5.0 (0.0 to 12.3)
    5.2 (0.0 to 8.6)
    5.0 (0.0 to 10.2)
    Time from initial diagnosis to start of treatment
    Times were calculated using the date of randomization as end date. (Data for reporting group 1 were not analysed; therefore data fields were completed with "0").
    Units: years
        median (full range (min-max))
    9.6 (0.9 to 22.7)
    6.6 (0.8 to 19.1)
    5.4 (2.1 to 9.6)
    6.5 (2.0 to 19.1)
    Time from relapse to start of treatment
    Times were calculated using the date of randomization as end date. (Data for reporting group 1 were not analysed; therefore data fields were completed with "0").
    Units: months
        median (full range (min-max))
    8.4 (0.1 to 206.4)
    5.1 (0.6 to 158.9)
    0.6 (0.4 to 10.6)
    2.0 (0.7 to 100.7)
    Number of metastatic sites at inclusion
    (Data for reporting group 1 were not analysed; therefore data fields were completed with "0").
    Units: number
        median (full range (min-max))
    2.0 (1.0 to 4.0)
    2.0 (1.0 to 5.0)
    1.0 (1.0 to 2.0)
    2.0 (1.0 to 3.0)

    End points

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    End points reporting groups
    Reporting group title
    Arm A - Cap/Bev followed by Eve/Exe
    Reporting group description
    Arm A - 1st-line: Capecitabine/Bevacizumab (Cap/Bev); 2nd-line: Everolimus/Exemestane (Eve/Exe)

    Reporting group title
    Arm B - Eve/Exe followed by Cap/Bev
    Reporting group description
    Arm B - 1st line: Everolimus/Exemestane (Eve/Exe); 2nd line: Capecitabine/Bevacizumab (Cap/Bev)

    Subject analysis set title
    Arm A - ITT (ITT)
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The ITT population comprises all patients to whom study treatment has been assigned by randomization. According to the intent to treat principle, patients will be analysed according to the study arm they have been assigned to during the randomization procedure. The ITT population is the relevant population for the efficacy evaluation including demographic and other baseline characteristics as well as study treatment evaluations. It serves as additional analysis population for all patient reported outcomes.

    Subject analysis set title
    Arm B - ITT (ITT)
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The ITT population comprises all patients to whom study treatment has been assigned by randomization. According to the intent to treat principle, patients will be analysed according to the study arm they have been assigned to during the randomization procedure. The ITT population is the relevant population for the efficacy evaluation including demographic and other baseline characteristics as well as study treatment evaluations. It serves as additional analysis population for all patient reported outcomes.

    Subject analysis set title
    Arm A - modified ITT (mITT)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The modified ITT (MITT) population comprises all patients who qualify for analysis of the primary endpoint, i.e. all patients who • receive at least 12 weeks of first-line treatment or less for other reasons than PD • cross over to second-line treatment within 12 weeks after termination of first-line treatment • receive at least 12 weeks of second-line treatment or less for other reasons than PD • answer preference question on patients’ preference questionnaire The modified ITT population is the relevant population for the analysis of the primary outcome and all patient reported outcomes. All secondary efficacy endpoints as well as the description of baseline characteristics will be repeated with the modified ITT population.

    Subject analysis set title
    Arm B - modified ITT (mITT)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The modified ITT (MITT) population comprises all patients who qualify for analysis of the primary endpoint, i.e. all patients who • receive at least 12 weeks of first-line treatment or less for other reasons than PD • cross over to second-line treatment within 12 weeks after termination of first-line treatment • receive at least 12 weeks of second-line treatment or less for other reasons than PD • answer preference question on patients’ preference questionnaire The modified ITT population is the relevant population for the analysis of the primary outcome and all patient reported outcomes. All secondary efficacy endpoints as well as the description of baseline characteristics will be repeated with the modified ITT population.

    Primary: Rates of Patient Preference

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    End point title
    Rates of Patient Preference
    End point description
    The primary objective of the study is to compare patients’ preferences of the two treatment combinations everolimus plus exemestane or capecitabine in combination with bevacizumab after failure of standard antihormonal therapy in patients with advanced (inoperable or metastatic) Her2/neu-negative hormone receptor positive breast cancer. The preference will be ascertained using the patient preference questionnaire, assessed after 12 weeks of second line therapy.
    End point type
    Primary
    End point timeframe
    Assessed at week 12 of second-line therapy, or - in case of early (<12 weeks) treatment discontinuation of second-line - assessed two weeks after discontinuation for any other reason than PD.
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: number / %
    number (confidence interval 95%)
        Cap-Bev
    7.7 (1.6 to 20.9)
    26.3 (13.4 to 43.1)
    40.0 (5.3 to 85.3)
    75.0 (34.9 to 96.8)
        Eve-Exe
    12.8 (4.3 to 27.4)
    5.3 (0.6 to 17.7)
    20.0 (0.5 to 71.6)
    12.5 (0.3 to 52.7)
        Cannot decide
    7.7 (1.6 to 20.9)
    10.5 (2.9 to 24.8)
    40.0 (5.3 to 85.3)
    12.5 (0.3 to 52.7)
        not evaluable
    5.1 (0.6 to 17.3)
    5.3 (0.6 to 17.7)
    0 (0 to 0)
    0 (0 to 0)
        missing
    10.3 (2.9 to 24.2)
    2.6 (0.1 to 13.8)
    0 (0 to 0)
    0 (0 to 0)
        no second-line
    56.4 (39.6 to 72.2)
    50.0 (33.4 to 66.6)
    0 (0 to 0)
    0 (0 to 0)
    Statistical analysis title
    Asymptotic chi-square test
    Comparison groups
    Arm A - modified ITT (mITT) v Arm B - modified ITT (mITT)
    Number of subjects included in analysis
    13
    Analysis specification
    Pre-specified
    Analysis type
    other [1]
    P-value
    ≤ 0.05 [2]
    Method
    Chi-squared
    Confidence interval
    Notes
    [1] - p-value of Chi-square test according to Prescott's approach
    [2] - p-value of Chi-square test according to Prescott's approach

    Secondary: PFS first-line

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    End point title
    PFS first-line
    End point description
    Progression free survival is defined as the time between start of therapy and first documented tumor progression or death of any cause, whatever comes first.
    End point type
    Secondary
    End point timeframe
    The time from start of first-line therapy to progression or death of any cause before start of a new therapy. The PFS rate in first-line will be assessed after 12 weeks of therapy.
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: months
        median (confidence interval 95%)
    11.1 (7.8 to 18.0)
    3.5 (2.7 to 5.5)
    13.1 (8.3 to 18.0)
    3.1 (1.6 to 7.6)
    No statistical analyses for this end point

    Secondary: Reason for preference ... less tired and exhausted

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    End point title
    Reason for preference ... less tired and exhausted
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to all patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to all patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [3]
    7 [4]
    Units: Patients
        Yes
    7
    5
        No
    3
    1
        I didn't have this symptom
    3
    1
        missing
    0
    0
    Notes
    [3] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [4] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference ...less pain

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    End point title
    Reason for preference ...less pain
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [5]
    7 [6]
    Units: Patients
        Yes
    5
    3
        No
    3
    3
        I didn't have this symptom
    4
    1
        missing
    1
    0
    Notes
    [5] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [6] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference ...less irritation of taste

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    End point title
    Reason for preference ...less irritation of taste
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [7]
    7 [8]
    Units: Patients
        Yes
    3
    3
        No
    6
    3
        I didn't have this symptom
    4
    1
        missing
    0
    0
    Notes
    [7] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [8] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference ...less taking of blood samples

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    End point title
    Reason for preference ...less taking of blood samples
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [9]
    7 [10]
    Units: Patients
        Yes
    3
    2
        No
    10
    3
        I didn't have this symptom
    0
    1
        missing
    0
    1
    Notes
    [9] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [10] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference ...less infections

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    End point title
    Reason for preference ...less infections
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [11]
    7 [12]
    Units: Patients
        Yes
    4
    2
        No
    0
    2
        I didn't have this symptom
    8
    2
        missing
    1
    1
    Notes
    [11] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [12] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference ...less skin problems

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    End point title
    Reason for preference ...less skin problems
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [13]
    7 [14]
    Units: Patients
        Yes
    7
    1
        No
    3
    4
        I didn't have this symptom
    3
    2
        missing
    0
    0
    Notes
    [13] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [14] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference ...less sleeping disorders

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    End point title
    Reason for preference ...less sleeping disorders
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [15]
    7 [16]
    Units: Patients
        Yes
    4
    3
        No
    4
    3
        I didn't have this symptom
    4
    1
        missing
    1
    0
    Notes
    [15] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [16] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference ...less loss of appetite

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    End point title
    Reason for preference ...less loss of appetite
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [17]
    7 [18]
    Units: Patients
        Yes
    5
    4
        No
    4
    1
        I didn't have this symptom
    2
    2
        missing
    2
    0
    Notes
    [17] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [18] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference ...other reasons

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    End point title
    Reason for preference ...other reasons
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [19]
    7 [20]
    Units: Patients
        No other reasons specified
    10
    6
        heavy fatigue "starke Müdikeit"
    1
    0
        less toxicity "weniger Nebenwirkungen"
    1
    0
        Infusion more effective "Infusion wirkungsvoller"
    1
    0
        less alopecia, skin and nail problems
    0
    1
    Notes
    [19] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [20] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference ...did not spend so much time in practice

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    End point title
    Reason for preference ...did not spend so much time in practice
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [21]
    7 [22]
    Units: Patients
        Yes
    3
    5
        No
    8
    2
        missing
    2
    0
    Notes
    [21] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [22] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference ...quality of life generally better

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    End point title
    Reason for preference ...quality of life generally better
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [23]
    7 [24]
    Units: Patients
        Yes
    11
    3
        No
    2
    4
        missing
    0
    0
    Notes
    [23] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [24] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference ...main reasons

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    End point title
    Reason for preference ...main reasons
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [25]
    7 [26]
    Units: Patients
        less numbness on hands and feet
    0
    1
        less tired and exhausted
    1
    0
        Quality of life generally better
    9
    3
        other reasons
    2
    1
        less sleeping disorders
    1
    0
        less diarrhea
    0
    1
        less time in the oncological practice
    0
    1
    Notes
    [25] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [26] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: PFS second-line

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    End point title
    PFS second-line
    End point description
    Progression free survival is defined as the time between start of therapy and first documented tumor progression or death of any cause, whatever comes first. (Please note: 95% CI upper values marked as N/A in the statistical analysis were set to "100" in the data enty fields due to data base entry requirements).
    End point type
    Secondary
    End point timeframe
    The time from start of second-line therapy to progression or death of any cause before start of a new therapy. The PFS rate in second-line will be assessed after 12 weeks of therapy in the second-line treatment.
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    17
    19
    5
    8
    Units: months
        median (inter-quartile range (Q1-Q3))
    3.7 (2.4 to 7.8)
    3.6 (2.3 to 5.5)
    7.8 (3.7 to 100)
    4.6 (2.3 to 13.7)
    No statistical analyses for this end point

    Secondary: Overall Survival

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    End point title
    Overall Survival
    End point description
    (Please note: 95% CI upper values marked as N/A in the statistical analysis were set to "100" in the data enty fields due to data base entry requirements).
    End point type
    Secondary
    End point timeframe
    Time from randomization to death of any cause
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: months
        median (confidence interval 95%)
    28.8 (19.7 to 100)
    24.7 (13.9 to 28.8)
    100 (28.8 to 100)
    28.8 (16.6 to 100)
    No statistical analyses for this end point

    Secondary: Best Response first-line

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    End point title
    Best Response first-line
    End point description
    Best Response for patients with measurable disease and non-measurable disease
    End point type
    Secondary
    End point timeframe
    Time from start of study treatment until the end of treatment
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: Percentage of patients
    number (confidence interval 95%)
        CR
    7.7 (1.6 to 20.9)
    2.6 (0.1 to 13.8)
    0 (0 to 0)
    0 (0 to 0)
        PR
    15.4 (5.9 to 30.5)
    7.9 (1.7 to 21.4)
    0 (0 to 0)
    12.5 (0.3 to 52.7)
        PD
    20.5 (9.3 to 36.5)
    42.1 (26.3 to 59.2)
    0 (0 to 0)
    50.0 (15.7 to 84.3)
        SD
    48.7 (32.4 to 65.2)
    39.5 (24.0 to 56.6)
    100.0 (47.8 to 100.0)
    37.5 (8.5 to 75.5)
        missing
    7.7 (1.6 to 20.9)
    7.9 (1.7 to 21.4)
    0 (0 to 0)
    0 (0 to 0)
    No statistical analyses for this end point

    Secondary: Objective Response Rate - First-line (ORR-1)

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    End point title
    Objective Response Rate - First-line (ORR-1)
    End point description
    Overall response rate (ORR=CR+PR) for patients with measurable disease.
    End point type
    Secondary
    End point timeframe
    Time from start of 1st line study treatment until the end of 1st line treatment
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: Percentage of patients
    number (confidence interval 95%)
        Yes
    23.1 (11.1 to 39.3)
    10.5 (2.9 to 24.8)
    0 (0 to 0)
    12.5 (0.3 to 52.7)
        missing
    7.7 (1.6 to 20.9)
    7.9 (1.7 to 21.4)
    0 (0 to 0)
    0 (0 to 0)
    No statistical analyses for this end point

    Secondary: Disease Control Rate (DCR) - First-line

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    End point title
    Disease Control Rate (DCR) - First-line
    End point description
    Disease control rate (DCR=CR+PR+SD) for all patients
    End point type
    Secondary
    End point timeframe
    Time from start of study treatment until the end of treatment
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: Percentage of patients
    number (confidence interval 95%)
        Yes
    71.8 (55.1 to 85.0)
    50.0 (33.4 to 66.6)
    100.0 (47.8 to 100.0)
    50.0 (15.7 to 84.3)
        missing
    7.7 (1.6 to 20.9)
    7.9 (1.7 to 21.4)
    0 (0 to 0)
    0 (0 to 0)
    No statistical analyses for this end point

    Secondary: Disease Control Rate (DCR) - Second-line

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    End point title
    Disease Control Rate (DCR) - Second-line
    End point description
    Disease control rate (DCR=CR+PR+SD) for all patients
    End point type
    Secondary
    End point timeframe
    Time from start of study treatment until the end of treatment
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: Percentage of patients
    number (confidence interval 95%)
        Yes
    17.9 (7.5 to 33.5)
    26.3 (13.4 to 43.1)
    100.0 (47.8 to 100.0)
    62.5 (24.5 to 91.5)
        missing
    66.7 (49.8 to 80.9)
    57.9 (40.8 to 73.7)
    0 (0 to 0)
    12.5 (0.3 to 52.7)
    No statistical analyses for this end point

    Secondary: Best Response second-line

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    End point title
    Best Response second-line
    End point description
    Best Response for patients with measurable disease and non-measurable disease
    End point type
    Secondary
    End point timeframe
    Time from start of study treatment until the end of treatment
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: Percentage of patients
    number (confidence interval 95%)
        CR
    0 (0 to 0)
    0 (0 to 0)
    0 (0 to 0)
    0 (0 to 0)
        PR
    0 (0 to 0)
    7.9 (1.7 to 21.4)
    0 (0 to 0)
    12.5 (0.3 to 52.7)
        PD
    15.4 (5.9 to 30.5)
    15.8 (6.0 to 31.3)
    0 (0 to 0)
    25.0 (3.2 to 65.1)
        SD
    17.9 (7.5 to 33.5)
    18.4 (7.7 to 34.3)
    100.0 (47.8 to 100.0)
    50.0 (15.7 to 84.3)
        missing
    66.7 (49.8 to 80.9)
    57.9 (40.8 to 73.7)
    0 (0 to 0)
    12.5 (0.3 to 52.7)
    No statistical analyses for this end point

    Secondary: Overall Response Rate - Second-line (ORR-2)

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    End point title
    Overall Response Rate - Second-line (ORR-2)
    End point description
    Overall response rate (ORR=CR+PR) for patients with measurable disease
    End point type
    Secondary
    End point timeframe
    Time from start of study treatment until the end of treatment
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: Percentage of patients
    number (confidence interval 95%)
        Yes
    0 (0 to 0)
    7.9 (1.7 to 21.4)
    0 (0 to 0)
    12.5 (0.3 to 52.7)
        missing
    66.7 (49.8 to 80.9)
    57.9 (40.8 to 73.7)
    0 (0 to 0)
    12.5 (0.3 to 52.7)
    No statistical analyses for this end point

    Secondary: Overall Treatment Satisfaction First-line

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    End point title
    Overall Treatment Satisfaction First-line
    End point description
    A satisfaction with therapy questionnaire will be administered 12 weeks after Day 1 of first cycle of Treatment Phase 1 and 12 weeks after Day 1 of first cycle of Treatment Phase 2 (or 2 weeks after early stopping in each phase). Missing: Item not answered or not evaluable. Discrepancies between the sum of answers and the total n reported are due to patients who did not answer the whole questionnaire. Answers 'correct' and 'rather correct' were classified as 'satisfied', answers 'rather not correct' and 'not correct at all' were classified as 'not satisfied'.
    End point type
    Secondary
    End point timeframe
    12 weeks after start of Treatment Phase 1
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: number
        satisfied
    30
    24
    4
    5
        not satisfied
    5
    7
    1
    3
        missing
    0
    2
    0
    0
    No statistical analyses for this end point

    Secondary: Overall Treatment Satisfaction Second-line

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    End point title
    Overall Treatment Satisfaction Second-line
    End point description
    A satisfaction with therapy questionnaire will be administered 12 weeks after Day 1 of first cycle of Treatment Phase 1 and 12 weeks after Day 1 of first cycle of Treatment Phase 2 (or 2 weeks after early stopping in each phase). Missing: Item not answered or not evaluable. Discrepancies between the sum of answers and the total n reported are due to patients who did not answer the whole questionnaire. Answers 'correct' and 'rather correct' were classified as 'satisfied', answers 'rather not correct' and 'not correct at all' were classified as 'not satisfied'.
    End point type
    Secondary
    End point timeframe
    12 weeks after start of Treatment Phase 2
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    17
    19
    5
    8
    Units: number
        satisfied
    10
    11
    3
    8
        not satisfied
    3
    5
    2
    0
        missing
    1
    2
    0
    0
    No statistical analyses for this end point

    Secondary: Rate of Physician Preference

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    End point title
    Rate of Physician Preference
    End point description
    Physicians’ preference for therapy combination EE or CB or no preference will be assessed using the same questions as used in the patients’ preference questionnaire. Physicians additionally have the opportunity to say “I treat the patient for a short time and have no preference” in case they didn’t attend the whole study with the patient.
    End point type
    Secondary
    End point timeframe
    Time from start of study treatment until the end of treatment. Assessed at week 12 of second-line therapy, or - in case of early (<12 weeks) treatment discontinuation of second-line - assessed two weeks after discontinuation for any other reason than PD.
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: number (%)
    number (confidence interval 95%)
        Cap-Bev
    25.6 (13.0 to 42.1)
    26.3 (13.4 to 43.1)
    60.0 (14.7 to 94.7)
    37.5 (8.5 to 75.5)
        Eve-Exe
    12.8 (4.3 to 27.4)
    13.2 (4.4 to 28.1)
    40.0 (5.3 to 85.3)
    25.0 (3.2 to 65.1)
        I cannot decide
    5.1 (0.6 to 17.3)
    10.5 (2.9 to 24.8)
    0 (0 to 0)
    37.5 (8.5 to 75.5)
    No statistical analyses for this end point

    Secondary: PFS-rate 1 (week 12)

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    End point title
    PFS-rate 1 (week 12)
    End point description
    (Please note: 95% CI upper values marked as N/A in the statistical analysis were set to "100" in the data enty fields due to data base entry requirements).
    End point type
    Secondary
    End point timeframe
    Progression free survival rate after 12 weeks of 1st line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    39
    38
    5
    8
    Units: Percentage of patients
        number (confidence interval 95%)
    11.1 (7.8 to 18.0)
    3.5 (2.7 to 5.5)
    13.1 (8.3 to 18.0)
    3.1 (1.6 to 7.6)
    No statistical analyses for this end point

    Secondary: PFS-rate 2 (week 12)

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    End point title
    PFS-rate 2 (week 12)
    End point description
    (Please note: 95% CI upper values marked as N/A in the statistical analysis were set to "100" in the data enty fields due to data base entry requirements).
    End point type
    Secondary
    End point timeframe
    Progression free survival rate after 12 weeks of 2nd line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT) Arm A - modified ITT (mITT) Arm B - modified ITT (mITT)
    Number of subjects analysed
    17
    19
    5
    8
    Units: Percentage of patients
        number (confidence interval 95%)
    3.7 (2.4 to 7.8)
    3.6 (2.3 to 5.5)
    7.8 (3.7 to 100)
    4.6 (2.3 to 13.7)
    No statistical analyses for this end point

    Secondary: Reason for preference...less burning sensation on hands or feet

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    End point title
    Reason for preference...less burning sensation on hands or feet
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [27]
    7 [28]
    Units: Patients
        yes
    2
    2
        no
    5
    3
        I didn't have this symptom
    6
    2
        missing
    0
    0
    Notes
    [27] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [28] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference...less numbness on hands or feet

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    End point title
    Reason for preference...less numbness on hands or feet
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [29]
    7 [30]
    Units: Patients
        yes
    2
    1
        no
    4
    4
        I didn't have this symptom
    7
    2
        missing
    0
    0
    Notes
    [29] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [30] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference......less inflamed mucosa, e.g. orally

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    End point title
    Reason for preference......less inflamed mucosa, e.g. orally
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [31]
    7 [32]
    Units: Patients
        yes
    4
    0
        no
    3
    6
        I didn't have this symptom
    6
    1
        missing
    0
    0
    Notes
    [31] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [32] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference...less diarrhea

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    End point title
    Reason for preference...less diarrhea
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [33]
    7 [34]
    Units: Patients
        yes
    4
    2
        no
    3
    1
        I didn't have this symptom
    5
    4
        not evaluable
    1
    0
    Notes
    [33] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [34] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: Reason for preference...less nausea and/or vomiting

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    End point title
    Reason for preference...less nausea and/or vomiting
    End point description
    The patient preference questionnaire asks not only for the preference itself but also for the reasons, if a clear preference was stated. Additionally, patients are asked to name one of the reasons the main reason for the preference. The reasons for patient's preference (Cap/Bev or Eve/Exe) are shown for all patients with relevant information available (ITT population). In total, 13 patients and 7 patients reported Cap/Bev and Eve/Exe as their preferred treatment regimen, respectively. *****PLEASE NOTE: For this endpoint, subject analysis set named "Arm A - ITT (ITT)"refers to patients with preference for Cap/Bev [n=13], and "Arm B - ITT (ITT)" refers to patients with preference for Eve/Exe [n= 7].*****
    End point type
    Secondary
    End point timeframe
    After 12 weeks of second line therapy
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    13 [35]
    7 [36]
    Units: Patients
        yes
    2
    2
        no
    5
    0
        I didn't have this problem
    6
    4
        not evaluable
    0
    1
    Notes
    [35] - (All patients with preference for Cap/Bev treatment (ITT); n=13)
    [36] - (All patients with preference for Eve/Exe treatment (ITT); n=7)
    No statistical analyses for this end point

    Secondary: EORTC QLQC30 global health score - Treatment phase 1 (Baseline and week 12)

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    End point title
    EORTC QLQC30 global health score - Treatment phase 1 (Baseline and week 12)
    End point description
    The EORTC QLQ-C30 questionnaire provides five functional scales, three symptom scales two global items and several single items. Each item is answered with “not at all”, “a little”, “quite a bit” and “very much”, rated as 1 (not at all), 2, 3 or 4 (very much).
    End point type
    Secondary
    End point timeframe
    Baseline (before start of Treatment Phase 1) and at week 12 of Treatment Phase 1
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    38 [37]
    38 [38]
    Units: score value (0-100)
    median (full range (min-max))
        Baseline
    50 (16.7 to 83.3)
    50 (16.7 to 100)
        Week 12
    50 (0.0 to 91.7)
    50 (0.0 to 91.7)
    Notes
    [37] - N = 38 refers to the number of questionnaires available at baseline (week 12: n = 36)
    [38] - N = 38 refers to the number of questionnaires available at baseline (week 12: n = 32)
    No statistical analyses for this end point

    Secondary: EORTC QLQC30 global health score - Treatment phase 2 (Baseline and week 12)

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    End point title
    EORTC QLQC30 global health score - Treatment phase 2 (Baseline and week 12)
    End point description
    The EORTC QLQ-C30 questionnaire provides five functional scales, three symptom scales two global items and several single items. Each item is answered with “not at all”, “a little”, “quite a bit” and “very much”, rated as 1 (not at all), 2, 3 or 4 (very much).
    End point type
    Secondary
    End point timeframe
    Baseline (before start of Treatment Phase 2) and at week 12 of Treatment Phase 2
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    17 [39]
    19 [40]
    Units: score value (0-100)
    median (full range (min-max))
        Baseline
    41.7 (0.0 to 83.3)
    50.0 (25.0 to 66.7)
        Week 12
    50.0 (0.0 to 66.7)
    50.0 (16.7 to 66.7)
    Notes
    [39] - N = 17 refers to the number of questionnaires available at baseline (week 12: n = 13)
    [40] - N = 19 refers to the number of questionnaires available at baseline (week 12: n = 18)
    No statistical analyses for this end point

    Secondary: EORTC-QLQ-FA13 Treatment Phase 1 (Baseline and week 12)

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    End point title
    EORTC-QLQ-FA13 Treatment Phase 1 (Baseline and week 12)
    End point description
    The EORTC QLQ-FA13 provides three subscales. Each item is answered with “not at all”, “a little”, “quite a bit” and “very much”, rated as 1 (not at all), 2, 3 or 4 (very much).
    End point type
    Secondary
    End point timeframe
    Baseline (before start of Treatment Phase 1) and at week 12 of Treatment Phase 1
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    38 [41]
    38 [42]
    Units: units on a scale
    median (full range (min-max))
        Cognitive Fatigue - Baseline
    22.2 (0.0 to 77.8)
    11.1 (0.0 to 100)
        Cognitive Fatigue - Week 12
    11.1 (0.0 to 66.7)
    11.1 (0.0 to 100)
        Emotional Fatigue - Baseline
    45.5 (0.0 to 100)
    33.3 (0.0 to 100)
        Emotional Fatigue - Week 12
    33.3 (0.0 to 100)
    41.7 (0.0 to 100)
        Physical Fatigue - Baseline
    58.3 (0.0 to 100)
    45.8 (0.0 to 100)
        Physical Fatigue - Week 12
    54.2 (16.7 to 100)
    58.3 (0.0 to 100)
    Notes
    [41] - N = 38 refers to the number of questionnaires available at baseline (week 12: n = 36)
    [42] - N = 38 refers to the number of questionnaires available at baseline (week 12: n = 33)
    No statistical analyses for this end point

    Secondary: EORTC-QLQ-FA13 Treatment Phase 2 (Baseline and week 12)

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    End point title
    EORTC-QLQ-FA13 Treatment Phase 2 (Baseline and week 12)
    End point description
    The EORTC QLQ-FA13 provides three subscales. Each item is answered with “not at all”, “a little”, “quite a bit” and “very much”, rated as 1 (not at all), 2, 3 or 4 (very much).
    End point type
    Secondary
    End point timeframe
    Baseline (before start of Treatment Phase 2) and at week 12 of Treatment Phase 2
    End point values
    Arm A - ITT (ITT) Arm B - ITT (ITT)
    Number of subjects analysed
    17 [43]
    19 [44]
    Units: units on a scale
    median (full range (min-max))
        Cognitive Fatigue - Baseline
    33.3 (0.0 to 77.8)
    16.7 (0.0 to 88.9)
        Cognitive Fatigue - Week 12
    22.2 (0.0 to 100)
    16.7 (0.0 to 100)
        Emotional Fatigue - Baseline
    58.3 (0.0 to 100)
    41.7 (0.0 to 91.7)
        Emotional Fatigue - Week 12
    50.0 (16.7 to 100)
    50.0 (0.0 to 100)
        Physical Fatigue - Baseline
    66.7 (8.3 to 100)
    66.7 (0.0 to 100)
        Physical Fatigue - Week 12
    66.7 (25.0 to 100)
    58.3 (0.0 to 100)
    Notes
    [43] - N = 17 refers to the number of questionnaires available at baseline (week 12: n = 13)
    [44] - N = 19 refers to the number of questionnaires available at baseline (week 12: n = 16)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Overall trial (Arm A vs. Arm B; per treatment line)
    Adverse event reporting additional description
    (S)AE are reported per Arm and treatment line.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.4
    Reporting groups
    Reporting group title
    Arm A - Cap/Bev (1st Line)
    Reporting group description
    Arm A Cap/Bev (1st line): 4 SAR (Capecitabine) and 2 SAR (Bevacizumab) were observed; no SAR with fatal outcome was reported. Total number of deaths (all causes, n=13) represent all fatalities occurred in Arm A (1st + 2nd line) until LPLV.

    Reporting group title
    Arm A - Eve/Exe (2nd Line)
    Reporting group description
    Arm A Eve/Exe (2nd line): 4 SAR (Everolimus) and no SAR (Exemestane) were observed; no SAR with fatal outcome was reported. Total number of deaths (all causes; n = 13) represent all fatalities occurred in Arm A (1st + 2nd line) until LPLV.

    Reporting group title
    Arm B - Eve/Exe (1st line)
    Reporting group description
    Arm B Eve/Exe (1st line): 6 SAR (Everolimus) and 2 SAR (Exemestane) occurred; no SAR with fatal outcome was reported. Total number of deaths (all causes, n=18) represent all fatalities occurred in Arm A (1st + 2nd line) until LPLV.

    Reporting group title
    Arm B - Cap/Bev (2nd line)
    Reporting group description
    Arm B Cap/Bev (2nd line): No SAR (Capecitabine) and 3 SAR (Bevacizumab) were observed; no SAR with fatal outcome was reported. Total number of deaths (all causes, n=18) represent all fatalities occurred in Arm A (1st + 2nd line) until LPLV.

    Serious adverse events
    Arm A - Cap/Bev (1st Line) Arm A - Eve/Exe (2nd Line) Arm B - Eve/Exe (1st line) Arm B - Cap/Bev (2nd line)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    13 / 37 (35.14%)
    9 / 17 (52.94%)
    17 / 37 (45.95%)
    8 / 19 (42.11%)
         number of deaths (all causes)
    13
    13
    18
    18
         number of deaths resulting from adverse events
    0
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Cancer pain
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Malignant neoplasm progression
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    Metastases to central nervous system
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Metastases to meninges
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Neoplasm progression
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypertension
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypertensive crisis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Thrombosis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Impaired healing
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pain
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Food allergy
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    3 / 19 (15.79%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Delirium
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Depression
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Major depression
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Blood test abnormal
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Contusion
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ligament sprain
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Overdose
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Radiation oesophagitis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Arrhythmia
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiomyopathy
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pericardial effusion
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Sinus node dysfunction
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tachycardia
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Paralysis
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Somnolence
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Ascites
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Diverticulum intestinal haemorrhagic
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Enteritis
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastric perforation
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ileus
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Stomatitis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis acute
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nephrotic syndrome
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bacterial sepsis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Oesophageal candidiasis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Peritonitis
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    0 / 37 (0.00%)
    2 / 17 (11.76%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Skin infection
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hypercalcaemia
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Arm A - Cap/Bev (1st Line) Arm A - Eve/Exe (2nd Line) Arm B - Eve/Exe (1st line) Arm B - Cap/Bev (2nd line)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    36 / 37 (97.30%)
    12 / 17 (70.59%)
    36 / 37 (97.30%)
    15 / 19 (78.95%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Metastases to meninges
         subjects affected / exposed
    1 / 37 (2.70%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    1
    1
    0
    0
    Vascular disorders
    Hypertension
         subjects affected / exposed
    11 / 37 (29.73%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    3 / 19 (15.79%)
         occurrences all number
    14
    0
    6
    4
    Lymphoedema
         subjects affected / exposed
    2 / 37 (5.41%)
    1 / 17 (5.88%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    2
    1
    2
    0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    0
    1
    Fatigue
         subjects affected / exposed
    13 / 37 (35.14%)
    2 / 17 (11.76%)
    6 / 37 (16.22%)
    2 / 19 (10.53%)
         occurrences all number
    15
    2
    7
    2
    General physical health deterioration
         subjects affected / exposed
    3 / 37 (8.11%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    1 / 19 (5.26%)
         occurrences all number
    3
    0
    2
    1
    Mucosal inflammation
         subjects affected / exposed
    4 / 37 (10.81%)
    2 / 17 (11.76%)
    7 / 37 (18.92%)
    0 / 19 (0.00%)
         occurrences all number
    4
    2
    7
    0
    Non-cardiac chest pain
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    0
    1
    Oedema
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    1
    Oedema peripheral
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    6 / 37 (16.22%)
    2 / 19 (10.53%)
         occurrences all number
    2
    0
    7
    2
    Pain
         subjects affected / exposed
    2 / 37 (5.41%)
    1 / 17 (5.88%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences all number
    2
    1
    1
    0
    Peripheral swelling
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    3 / 37 (8.11%)
    0 / 19 (0.00%)
         occurrences all number
    0
    0
    5
    0
    Reproductive system and breast disorders
    Pelvic pain
         subjects affected / exposed
    2 / 37 (5.41%)
    2 / 17 (11.76%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences all number
    2
    2
    1
    1
    Respiratory, thoracic and mediastinal disorders
    Atelectasis
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Cough
         subjects affected / exposed
    5 / 37 (13.51%)
    3 / 17 (17.65%)
    6 / 37 (16.22%)
    2 / 19 (10.53%)
         occurrences all number
    5
    4
    6
    2
    Dysphonia
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences all number
    3
    0
    1
    0
    Dyspnoea
         subjects affected / exposed
    6 / 37 (16.22%)
    3 / 17 (17.65%)
    4 / 37 (10.81%)
    3 / 19 (15.79%)
         occurrences all number
    7
    3
    5
    3
    Dyspnoea exertional
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    2
    1
    Epistaxis
         subjects affected / exposed
    1 / 37 (2.70%)
    2 / 17 (11.76%)
    4 / 37 (10.81%)
    1 / 19 (5.26%)
         occurrences all number
    1
    2
    4
    1
    Oropharyngeal pain
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    5 / 37 (13.51%)
    0 / 19 (0.00%)
         occurrences all number
    0
    0
    5
    0
    Pneumonitis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    0
    0
    2
    0
    Pulmonary embolism
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Psychiatric disorders
    Depression
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    0
    0
    2
    0
    Insomnia
         subjects affected / exposed
    3 / 37 (8.11%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    3
    0
    0
    0
    Investigations
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    0
    1
    Blood creatine increased
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    1
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    2
    1
    C-reactive protein increased
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    4 / 37 (10.81%)
    2 / 19 (10.53%)
         occurrences all number
    0
    0
    4
    2
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences all number
    1
    0
    1
    1
    Haemoglobin decreased
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    1
    Weight decreased
         subjects affected / exposed
    4 / 37 (10.81%)
    1 / 17 (5.88%)
    5 / 37 (13.51%)
    1 / 19 (5.26%)
         occurrences all number
    4
    1
    6
    1
    Injury, poisoning and procedural complications
    Rib fracture
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    2
    0
    Cardiac disorders
    Cyanosis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    0
    1
    Tachyarrhythmia
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    1
    Nervous system disorders
    Dysgeusia
         subjects affected / exposed
    2 / 37 (5.41%)
    1 / 17 (5.88%)
    4 / 37 (10.81%)
    0 / 19 (0.00%)
         occurrences all number
    2
    1
    4
    0
    Headache
         subjects affected / exposed
    6 / 37 (16.22%)
    0 / 17 (0.00%)
    6 / 37 (16.22%)
    0 / 19 (0.00%)
         occurrences all number
    7
    0
    10
    0
    Peripheral sensory neuropathy
         subjects affected / exposed
    6 / 37 (16.22%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    2 / 19 (10.53%)
         occurrences all number
    6
    0
    1
    2
    Polyneuropathy
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    2
    0
    0
    0
    Somnolence
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    2
    0
    0
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 37 (2.70%)
    4 / 17 (23.53%)
    5 / 37 (13.51%)
    0 / 19 (0.00%)
         occurrences all number
    1
    4
    5
    0
    Thrombocytopenia
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences all number
    2
    0
    1
    1
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    2
    0
    2
    0
    Eye disorders
    Eyelid oedema
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    0
    0
    2
    0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    4 / 37 (10.81%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    4
    0
    2
    0
    Abdominal pain upper
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    4 / 37 (10.81%)
    1 / 19 (5.26%)
         occurrences all number
    3
    0
    4
    1
    Aphthous ulcer
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    4 / 37 (10.81%)
    0 / 19 (0.00%)
         occurrences all number
    0
    1
    4
    0
    Constipation
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    0
    1
    2
    0
    Diarrhoea
         subjects affected / exposed
    12 / 37 (32.43%)
    2 / 17 (11.76%)
    10 / 37 (27.03%)
    5 / 19 (26.32%)
         occurrences all number
    20
    2
    15
    5
    Dry mouth
         subjects affected / exposed
    2 / 37 (5.41%)
    1 / 17 (5.88%)
    4 / 37 (10.81%)
    0 / 19 (0.00%)
         occurrences all number
    3
    1
    4
    0
    Dyspepsia
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    0
    0
    2
    0
    Flatulence
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences all number
    2
    0
    1
    0
    Nausea
         subjects affected / exposed
    15 / 37 (40.54%)
    1 / 17 (5.88%)
    8 / 37 (21.62%)
    5 / 19 (26.32%)
         occurrences all number
    20
    1
    8
    5
    Stomatitis
         subjects affected / exposed
    9 / 37 (24.32%)
    1 / 17 (5.88%)
    4 / 37 (10.81%)
    1 / 19 (5.26%)
         occurrences all number
    11
    1
    6
    1
    Toothache
         subjects affected / exposed
    3 / 37 (8.11%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    3
    0
    0
    0
    Vomiting
         subjects affected / exposed
    5 / 37 (13.51%)
    1 / 17 (5.88%)
    5 / 37 (13.51%)
    1 / 19 (5.26%)
         occurrences all number
    7
    1
    5
    1
    Skin and subcutaneous tissue disorders
    Dry skin
         subjects affected / exposed
    3 / 37 (8.11%)
    0 / 17 (0.00%)
    3 / 37 (8.11%)
    0 / 19 (0.00%)
         occurrences all number
    3
    0
    3
    0
    Erythema
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    3 / 37 (8.11%)
    0 / 19 (0.00%)
         occurrences all number
    0
    0
    3
    0
    Hyperhidrosis
         subjects affected / exposed
    1 / 37 (2.70%)
    1 / 17 (5.88%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences all number
    1
    1
    1
    0
    Onychoclasis
         subjects affected / exposed
    1 / 37 (2.70%)
    0 / 17 (0.00%)
    3 / 37 (8.11%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    3
    0
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    21 / 37 (56.76%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    6 / 19 (31.58%)
         occurrences all number
    26
    0
    1
    6
    Pruritus
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    3 / 37 (8.11%)
    0 / 19 (0.00%)
         occurrences all number
    0
    1
    3
    0
    Rash
         subjects affected / exposed
    2 / 37 (5.41%)
    1 / 17 (5.88%)
    5 / 37 (13.51%)
    0 / 19 (0.00%)
         occurrences all number
    2
    1
    6
    0
    Rash pruritic
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Skin atrophy
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    1
    Skin discolouration
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    0
    1
    Skin fissures
         subjects affected / exposed
    2 / 37 (5.41%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    3
    1
    0
    1
    Renal and urinary disorders
    Micturition urgency
         subjects affected / exposed
    1 / 37 (2.70%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    1
    1
    0
    0
    Proteinuria
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    2
    0
    0
    0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    5 / 37 (13.51%)
    0 / 17 (0.00%)
    4 / 37 (10.81%)
    1 / 19 (5.26%)
         occurrences all number
    5
    0
    5
    1
    Back pain
         subjects affected / exposed
    4 / 37 (10.81%)
    1 / 17 (5.88%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    4
    1
    2
    0
    Bone pain
         subjects affected / exposed
    3 / 37 (8.11%)
    0 / 17 (0.00%)
    6 / 37 (16.22%)
    0 / 19 (0.00%)
         occurrences all number
    3
    0
    7
    0
    Musculoskeletal chest pain
         subjects affected / exposed
    2 / 37 (5.41%)
    1 / 17 (5.88%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences all number
    2
    1
    1
    0
    Musculoskeletal pain
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    4 / 37 (10.81%)
    0 / 19 (0.00%)
         occurrences all number
    0
    1
    4
    0
    Myalgia
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    0
    0
    2
    0
    Neck pain
         subjects affected / exposed
    1 / 37 (2.70%)
    1 / 17 (5.88%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences all number
    1
    1
    1
    0
    Pain in extremity
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    5
    0
    2
    0
    Polyarthritis
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Rotator cuff syndrome
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    0 / 37 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    0
    1
    Spinal pain
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences all number
    2
    0
    1
    0
    Infections and infestations
    Device related infection
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    1
    Gastrointestinal infection
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    2
    1
    Infection
         subjects affected / exposed
    1 / 37 (2.70%)
    2 / 17 (11.76%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences all number
    1
    2
    1
    0
    Oral herpes
         subjects affected / exposed
    2 / 37 (5.41%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    2
    0
    2
    0
    Parotitis
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    0
    0
    3
    0
    Pneumonia
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    1 / 37 (2.70%)
    0 / 19 (0.00%)
         occurrences all number
    0
    1
    1
    0
    Urinary tract infection
         subjects affected / exposed
    4 / 37 (10.81%)
    1 / 17 (5.88%)
    2 / 37 (5.41%)
    1 / 19 (5.26%)
         occurrences all number
    4
    1
    2
    1
    Viral upper respiratory tract infection
         subjects affected / exposed
    6 / 37 (16.22%)
    1 / 17 (5.88%)
    2 / 37 (5.41%)
    0 / 19 (0.00%)
         occurrences all number
    6
    1
    2
    0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    6 / 37 (16.22%)
    1 / 17 (5.88%)
    5 / 37 (13.51%)
    0 / 19 (0.00%)
         occurrences all number
    6
    1
    5
    0
    Hypoalbuminaemia
         subjects affected / exposed
    0 / 37 (0.00%)
    1 / 17 (5.88%)
    0 / 37 (0.00%)
    0 / 19 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Selenium deficiency
         subjects affected / exposed
    0 / 37 (0.00%)
    0 / 17 (0.00%)
    1 / 37 (2.70%)
    1 / 19 (5.26%)
         occurrences all number
    0
    0
    1
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    23 Sep 2014
    Amendment 1 - substantial (Amendment date is the favourable opinion of the EC or the approval of the relevant CA)
    17 Feb 2015
    Amendment 2 - substantial (Amendment date is the favourable opinion of the EC or the approval of the relevant CA)
    24 Apr 2015
    Amendment 3 - substantial (Amendment date is the favourable opinion of the EC or the approval of the relevant CA)
    06 Nov 2015
    Amendment 4 - substantial (Amendment date is the favourable opinion of the EC or the approval of the relevant CA)
    23 Mar 2016
    Amendment 5 - substantial (Amendment date is the favourable opinion of the EC or the approval of the relevant CA)
    05 Sep 2016
    Amendment 6 - substantial (Amendment date is the favourable opinion of the EC or the approval of the relevant CA)
    02 Aug 2017
    Amendment 7 - substantial (Amendment date is the favourable opinion of the EC or the approval of the relevant CA)

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    10 Feb 2016
    Specification of safety references (SmPC capecitabine) for the occurence of adverse events for known DPD-deficiency. The genetic assessment for the exclusion of an (unknown) DPD-deficiency was demanded to be a requirement for patient recruitment by the central ethics committee. During the clarification process with the ethics committee patient recruitment was temporarily stopped. The official requirements of the ethics committee have been taken back.
    23 Mar 2016

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    The primary endpoint was not reached when considering the small analytical population (mITT) (due to low number of evaluable patients and premature termination of study) used for evaluation of the primary endpoint.)
    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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