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    Clinical Trial Results:
    An Expanded Access Protocol for Idelalisib in Combination with Rituximab for Relapsed, Previously Treated Subjects with Chronic Lymphocytic Leukemia

    Summary
    EudraCT number
    2013-005343-82
    Trial protocol
    IT   IE   GB  
    Global end of trial date
    15 Aug 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    30 Aug 2018
    First version publication date
    30 Aug 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    GS-US-312-1325
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02136511
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Gilead Sciences
    Sponsor organisation address
    333 Lakeside Drive, Foster City, CA, United States, 94404
    Public contact
    Gilead Clinical Study Information Center, Gilead Sciences, GileadClinicalTrials@gilead.com
    Scientific contact
    Gilead Clinical Study Information Center, Gilead Sciences, GileadClinicalTrials@gilead.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
    15 Aug 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    15 Aug 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    15 Aug 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To provide idelalisib in an open-label format to eligible participants with relapsed chronic lymphocytic leukemia (CLL) who have limited treatment options.
    Protection of trial subjects
    The protocol and consent/assent forms were submitted by each investigator to a duly constituted Independent Ethics Committee (IEC) or Institutional Review Board (IRB) for review and approval before study initiation. All revisions to the consent/assent forms (if applicable) after initial IEC/IRB approval were submitted by the investigator to the IEC/IRB for review and approval before implementation in accordance with regulatory requirements. This study was conducted in accordance with recognized international scientific and ethical standards, including but not limited to the International Conference on Harmonization guideline for Good Clinical Practice (ICH GCP) and the original principles embodied in the Declaration of Helsinki.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    19 May 2014
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 3
    Country: Number of subjects enrolled
    Ireland: 2
    Country: Number of subjects enrolled
    Italy: 20
    Country: Number of subjects enrolled
    United States: 6
    Worldwide total number of subjects
    31
    EEA total number of subjects
    25
    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)
    20
    From 65 to 84 years
    11
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Participants were enrolled at study sites in the United States and Europe. The first participant was screened on 19 May 2014. The last study visit occurred on 15 August 2017.

    Pre-assignment
    Screening details
    31 participants were screened.

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

    Arms
    Arm title
    Idelalisib + rituximab
    Arm description
    Idelalisib + rituximab until unacceptable toxicity, disease progression, study discontinuation, or death occurs.
    Arm type
    Experimental

    Investigational medicinal product name
    Idelalisib
    Investigational medicinal product code
    Other name
    GS-1101
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    150 mg twice per day (or 100 mg twice per day if dose was modified)

    Investigational medicinal product name
    Rituximab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Starting at a dose of 375 mg/m^2 on Week 0 and continuing with a dose of 500 mg/m^2 on Weeks 2, 4, 6, 8, 12, 16, and 20 for a total of 8 infusions

    Number of subjects in period 1
    Idelalisib + rituximab
    Started
    31
    Completed
    0
    Not completed
    31
         Adverse event, non-fatal
    6
         Protocol violation
    1
         Death
    9
         Study terminated by sponsor
    6
         Unacceptable toxicity
    1
         Progressive disease
    6
         Investigator's discretion
    1
         Lost to follow-up
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Idelalisib + rituximab
    Reporting group description
    Idelalisib + rituximab until unacceptable toxicity, disease progression, study discontinuation, or death occurs.

    Reporting group values
    Idelalisib + rituximab Total
    Number of subjects
    31 31
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    63 ( 9.8 ) -
    Gender categorical
    Units: Subjects
        Female
    10 10
        Male
    21 21
    Race
    Units: Subjects
        White
    30 30
        Other
    1 1
    Ethnicity
    Units: Subjects
        Not Hispanic or Latino
    31 31

    End points

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    End points reporting groups
    Reporting group title
    Idelalisib + rituximab
    Reporting group description
    Idelalisib + rituximab until unacceptable toxicity, disease progression, study discontinuation, or death occurs.

    Primary: Progression-Free Survival

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    End point title
    Progression-Free Survival [1]
    End point description
    Progression-free survival (PFS) was defined as the interval from the initial study dosing date to the first documentation of disease progression or death from any cause. The primary analysis of PFS was performed using the Kaplan-Meier method. Participants in the Full Analysis Set (participants who took at least 1 dose of study drug) were analyzed. 99999 = Not reached.
    End point type
    Primary
    End point timeframe
    Baseline to end of study (maximum exposure to idelalisib: 156.1 weeks)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Because there was only one treatment arm, no statistical comparison was planned or performed.
    End point values
    Idelalisib + rituximab
    Number of subjects analysed
    31
    Units: months
        median (confidence interval 95%)
    21.8 (7.2 to 99999)
    No statistical analyses for this end point

    Secondary: Safety as Assessed by the Incidence of Serious Adverse Events (SAEs) ≥ Grade 3 and Deaths

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    End point title
    Safety as Assessed by the Incidence of Serious Adverse Events (SAEs) ≥ Grade 3 and Deaths
    End point description
    The percentage of participants experiencing SAEs ≥ Grade 3 and the percentage of participants that died during the study are presented. Participants in the Full Analysis Set were analyzed.
    End point type
    Secondary
    End point timeframe
    First dose date to end of study (maximum exposure to idelalisib: 156.1 weeks)
    End point values
    Idelalisib + rituximab
    Number of subjects analysed
    31
    Units: percentage of participants
    number (not applicable)
        SAEs ≥ Grade 3
    64.5
        Death (all causes)
    32.3
        Death (treatment-emergent AE leading to death)
    25.8
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    First dose date to end of study (maximum exposure to idelalisib: 156.1 weeks)
    Adverse event reporting additional description
    Full Analysis Set: participants who took at least 1 dose of study drug
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    20.1
    Reporting groups
    Reporting group title
    Idelalisib + rituximab
    Reporting group description
    Idelalisib + rituximab until unacceptable toxicity, disease progression, study discontinuation, or death occurs.

    Serious adverse events
    Idelalisib + rituximab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    22 / 31 (70.97%)
         number of deaths (all causes)
    10
         number of deaths resulting from adverse events
    8
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Adenocarcinoma of colon
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    4 / 31 (12.90%)
         occurrences causally related to treatment / all
    3 / 5
         deaths causally related to treatment / all
    1 / 1
    Anaemia
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancytopenia
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Condition aggravated
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hernia
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    4 / 31 (12.90%)
         occurrences causally related to treatment / all
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Enteritis
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Enterocolitis
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Intestinal haemorrhage
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Large intestinal obstruction
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Vomiting
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Respiratory failure
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Renal and urinary disorders
    Nephrolithiasis
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    5 / 31 (16.13%)
         occurrences causally related to treatment / all
    1 / 6
         deaths causally related to treatment / all
    0 / 2
    Sepsis
         subjects affected / exposed
    4 / 31 (12.90%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 2
    Escherichia sepsis
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Bacterial sepsis
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cytomegalovirus infection
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infective exacerbation of bronchiectasis
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Lower respiratory tract infection bacterial
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Periorbital cellulitis
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumococcal sepsis
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumocystis jirovecii pneumonia
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia pneumococcal
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Progressive multifocal leukoencephalopathy
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    1 / 1
    Staphylococcal sepsis
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    1 / 31 (3.23%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Idelalisib + rituximab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    29 / 31 (93.55%)
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    21 / 31 (67.74%)
         occurrences all number
    47
    Asthenia
         subjects affected / exposed
    6 / 31 (19.35%)
         occurrences all number
    7
    Oedema peripheral
         subjects affected / exposed
    6 / 31 (19.35%)
         occurrences all number
    7
    Fatigue
         subjects affected / exposed
    4 / 31 (12.90%)
         occurrences all number
    6
    Pain
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    3
    Chest pain
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Malaise
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    10 / 31 (32.26%)
         occurrences all number
    12
    Rhinorrhoea
         subjects affected / exposed
    5 / 31 (16.13%)
         occurrences all number
    6
    Dyspnoea
         subjects affected / exposed
    4 / 31 (12.90%)
         occurrences all number
    6
    Productive cough
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    4
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    4 / 31 (12.90%)
         occurrences all number
    4
    Investigations
    Platelet count decreased
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    5
    Weight decreased
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    3
    Alanine aminotransferase increased
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Aspartate aminotransferase increased
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Neutrophil count decreased
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Transaminases increased
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    4
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    3
    Cardiac disorders
    Palpitations
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    3
    Nervous system disorders
    Headache
         subjects affected / exposed
    5 / 31 (16.13%)
         occurrences all number
    6
    Dysgeusia
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Neuralgia
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Presyncope
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    13 / 31 (41.94%)
         occurrences all number
    46
    Anaemia
         subjects affected / exposed
    9 / 31 (29.03%)
         occurrences all number
    15
    Febrile neutropenia
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Thrombocytopenia
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Eye disorders
    Cataract
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    19 / 31 (61.29%)
         occurrences all number
    42
    Nausea
         subjects affected / exposed
    11 / 31 (35.48%)
         occurrences all number
    12
    Vomiting
         subjects affected / exposed
    9 / 31 (29.03%)
         occurrences all number
    10
    Abdominal pain
         subjects affected / exposed
    8 / 31 (25.81%)
         occurrences all number
    15
    Constipation
         subjects affected / exposed
    7 / 31 (22.58%)
         occurrences all number
    8
    Abdominal pain upper
         subjects affected / exposed
    5 / 31 (16.13%)
         occurrences all number
    7
    Stomatitis
         subjects affected / exposed
    4 / 31 (12.90%)
         occurrences all number
    5
    Inguinal hernia
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    3
    Odynophagia
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Oral pain
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    7 / 31 (22.58%)
         occurrences all number
    8
    Night sweats
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    4
    Dry skin
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    4
    Back pain
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    4
    Musculoskeletal pain
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Osteoporosis
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Pain in extremity
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Infections and infestations
    Herpes zoster
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    3
    Urinary tract infection
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    5
    Bronchitis
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    4
    Helicobacter infection
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Herpes virus infection
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Influenza
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Nasopharyngitis
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Oesophageal candidiasis
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Oral fungal infection
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Oral herpes
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Sinusitis
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Skin infection
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Upper respiratory tract infection
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    2
    Metabolism and nutrition disorders
    Hypokalaemia
         subjects affected / exposed
    5 / 31 (16.13%)
         occurrences all number
    10
    Hypocalcaemia
         subjects affected / exposed
    4 / 31 (12.90%)
         occurrences all number
    4
    Decreased appetite
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    3
    Hyperglycaemia
         subjects affected / exposed
    3 / 31 (9.68%)
         occurrences all number
    4
    Hyperuricaemia
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    3
    Hypoglycaemia
         subjects affected / exposed
    2 / 31 (6.45%)
         occurrences all number
    3

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    26 Feb 2014
    Specified safety monitoring for ALT, AST, and total bilirubin as occurring in all patients every 2 weeks for the first 3 months of treatment, then every 2 to 3 months thereafter and clarified the medications listed to treat AE diarrhea.
    10 Oct 2014
    Updated the general information on idelalisib to reflect approval status in the US and EU; Updated information on guidance to investigators for evaluation, intervention, and drug interruption/discontinuation for specific adverse events and information on the interaction of idelalisib with CYP3A inhibitors, inducers, and substrates
    25 Mar 2016
    Updated the safety information and guidelines for toxicity management. These changes include mandated prophylaxis for PJP, CMV surveillance and increased monitoring.
    23 Aug 2016
    Updated to align with Urgent Safety Measures, clarification on the definition of recommended vs. required treatment for adverse events, and added safety measure for subjects to be monitored for PJP prophylaxis 2-6 months after last idelalisib dose.
    24 Oct 2016
    In order to provide clear guidance for idelalisib administration in the event of pneumonitis, the language around actions to be taken was revised. Based on clinical trial data indicating the risk for PJP infection exceeds the time of idelalisib dosing, modification was made to the protocol instructions implementing PJP prophylaxis for a period of 2-6 months following discontinuation of idelalisib.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

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