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    Clinical Trial Results:
    Nab-paclitaxel (Abraxane) Plus Gemcitabine in Subjects With Locally Advanced Pancreatic Cancer (LAPC): An International, Open-label, Multi-center, Phase 2 Study (LAPACT).

    Summary
    EudraCT number
    2014-001408-23
    Trial protocol
    IT   ES  
    Global end of trial date
    21 Nov 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    29 Mar 2019
    First version publication date
    29 Mar 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    ABI-007-PANC-007
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02301143
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Celgene Corporation
    Sponsor organisation address
    86 Morris Avenue, Summit, United States, 07901
    Public contact
    Clinical Trial Disclosure, Celgene Corporation, 01 888-260-1599, ClinicalTrialDisclosure@Celgene.com
    Scientific contact
    Teng Jin Ong, Celgene Corporation, 01 908-673-9586, TOng@Celgene.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
    28 Jan 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    21 Nov 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    21 Nov 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the time to treatment failure (TTF) in locally advanced pancreatic cancer (LAPC) subjects treated with nab-paclitaxel plus gemcitabine as induction therapy followed by Investigator’s Choice of treatment
    Protection of trial subjects
    Patient Confidentiality, Personal Data Protection, Archiving of Essential Documents
    Background therapy
    Six cycles of nab-Paclitaxel 125 mg/m2 intravenous (IV) infusion over approximately 30 to 45 minutes on Days 1, 8, and 15, followed by gemcitabine 1000 mg/m2 IV infusion over approximately 30 minutes on Days 1, 8, and 15 of each 28-day cycle were administered as induction therapy. Once six cycles have been completed, subjects without disease progression or unacceptable toxicity will be eligible for Investigator choice phase, consisting of continuation of nab-paclitaxel and gemcitabine therapy, or chemoradiation therapy, or surgery.
    Evidence for comparator
    -
    Actual start date of recruitment
    21 Apr 2015
    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 States: 45
    Country: Number of subjects enrolled
    France: 28
    Country: Number of subjects enrolled
    Spain: 20
    Country: Number of subjects enrolled
    Canada: 8
    Country: Number of subjects enrolled
    Italy: 6
    Worldwide total number of subjects
    107
    EEA total number of subjects
    54
    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)
    44
    From 65 to 84 years
    62
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    152 patients were screened and 107 participants enrolled. First subject first visit was 21 April 2015. Last subject last visit was 26 April 2018

    Pre-assignment
    Screening details
    Subjects eligible for treatment with nab-paclitaxel and gemcitabine for 6 cycles were to be enrolled, provided all inclusion/exclusion criteria were met within a 14‑day Screening Period prior to Cycle 1 Day 1.

    Period 1
    Period 1 title
    Induction Period
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    nab-Paclitaxel plus Gemcitabine
    Arm description
    Participants received nab-Paclitaxel 125 mg/m^2 by intravenous (IV) infusion administered over approximately 30-45 minutes on Days 1, 8, and 15, followed by gemcitabine (Gem) 1000 mg/m^2 IV infusion over approximately 30 minutes on Days 1, 8, and 15 of each 28-day cycle for 6 cycles. For participants who completed 6 cycles of nab-paclitaxel and gemcitabine without disease progression or unacceptable toxicities, the Investigator then determined the best option for the participant in the Investigator's Choice Period.
    Arm type
    Experimental

    Investigational medicinal product name
    nab-Paclitaxel
    Investigational medicinal product code
    Other name
    Abraxane
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    nab-Paclitaxel 125 mg/m^2 by intravenous (IV) administration over approximately 30 to 45 minutes on Days 1, 8, and 15.

    Investigational medicinal product name
    Gemcitabine
    Investigational medicinal product code
    Other name
    Gemzar
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Gemcitabine 1000 mg/m^2 by IV administration over approximately 30 minutes on Days 1, 8, and 15

    Number of subjects in period 1
    nab-Paclitaxel plus Gemcitabine
    Started
    107
    Completed
    62
    Not completed
    45
         Adverse event, serious fatal
    1
         Consent withdrawn by subject
    3
         Physician decision
    4
         Adverse event, non-fatal
    22
         Progressive Disease
    8
         Enrolled But Not Treated
    1
         Not Specified
    1
         Symptomatic Deterioration
    2
         Noncompliance With Study Drug
    1
         Protocol deviation
    2
    Period 2
    Period 2 title
    Investigator's Choice (IC)
    Is this the baseline period?
    No
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    Investigator Choice (Overall)
    Arm description
    For participants who completed 6 cycles of nab-paclitaxel and gemcitabine without disease progression or unacceptable toxicities, the Investigator then determined the best option for the participant in the Investigator's Choice Period. Investigator Choice includes 3 options: 1. Continued on nab-Paclitaxel and gemcitabine (included 12 subjects) 2. Chemoradiation therapy consisting of capecitabine or gemcitabine with radiation according to institutional practice (included 18 subjects) 3. Surgical Intervention (included 17 subjects)
    Arm type
    Experimental

    Investigational medicinal product name
    nab-Paclitaxel
    Investigational medicinal product code
    Other name
    Abraxane
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    nab-Paclitaxel 125 mg/m^2 by intravenous (IV) administration over approximately 30 to 45 minutes on Days 1, 8, and 15 until disease progression or unacceptable toxicity.

    Investigational medicinal product name
    Gemcitabine
    Investigational medicinal product code
    Other name
    Gemzar
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Gemcitabine 1000 mg/m^2 by IV administration over approximately 30 minutes on Days 1, 8, and 15 disease progression or unacceptable toxicity.

    Number of subjects in period 2 [1]
    Investigator Choice (Overall)
    Started
    47
    Completed
    37
    Not completed
    10
         Adverse event, non-fatal
    3
         Progressive Disease
    3
         Not Specified
    1
         Unresectable Surgery
    1
         Symptomatic Deterioration
    1
         Noncompliance With Study Drug
    1
    Notes
    [1] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: Not all 62 subjects who completed the induction period elected to be treated in the Investigator's Choice period of the study. Only 49 intended to start the Investigator's Choice period. Of these 47 started this period and two subjects who were chosen for surgery did not have surgery because of disease progression and unsuitability based on the assessment by the GI surgeon.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    nab-Paclitaxel plus Gemcitabine
    Reporting group description
    Participants received nab-Paclitaxel 125 mg/m^2 by intravenous (IV) infusion administered over approximately 30-45 minutes on Days 1, 8, and 15, followed by gemcitabine (Gem) 1000 mg/m^2 IV infusion over approximately 30 minutes on Days 1, 8, and 15 of each 28-day cycle for 6 cycles. For participants who completed 6 cycles of nab-paclitaxel and gemcitabine without disease progression or unacceptable toxicities, the Investigator then determined the best option for the participant in the Investigator's Choice Period.

    Reporting group values
    nab-Paclitaxel plus Gemcitabine Total
    Number of subjects
    107 107
    Age, Customized
    Units: Subjects
        <65 years
    44 44
        >=65 - 75 years
    50 50
        >75 years
    13 13
    Age Continuous
    Units: years
        median (full range (min-max))
    65.0 (42 to 85) -
    Sex: Female, Male
    Units: Subjects
        Female
    59 59
        Male
    48 48
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    1 1
        Not Hispanic or Latino
    78 78
        Unknown or Not Reported
    28 28
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0
        Asian
    3 3
        Native Hawaiian or Other Pacific Islander
    0 0
        Black or African American
    2 2
        White
    72 72
        More than one race
    0 0
        Unknown or Not Reported
    30 30
    Eastern Cooperative Oncology Group (ECOG) Performance Status
    ECOG performance status assesses how the disease affects the daily living activities of the participant and helps determine appropriate treatment and prognosis. - 0 = Fully Active (Most Favorable Activity); - 1 = Restricted activity but ambulatory; - 2 = Ambulatory but unable to carry out work activities; - 3 = Limited Self-Care; - 4 = Completely Disabled.
    Units: Subjects
        Grade 0
    50 50
        Grade 1
    57 57
        Grade 2
    0 0
        Grade 3
    0 0
        Grade 4
    0 0
    Physician Assessment of Peripheral Neuropathy
    Physician assessment for grading of peripheral neuropathy in participants receiving chemotherapy according to National Cancer Institute Common Toxicity Criteria (NCICTC): Grade 0 = None or no neuromotor or neurosensory loss; Grade 1 = Asymptomatic: loss of deep tendon reflexes or paresthesia; - Grade 2 = Moderate symptoms: limiting instrumental Activities of Daily Living (ADLs); - Grade 3 = Severe symptoms: limiting self-care ADL; assistance device indicated; - Grade 4 = Life-threatening consequences: urgent intervention indicated.
    Units: Subjects
        Grade 0
    101 101
        Grade 1
    6 6
        Grade 2
    0 0
        Grade 3
    0 0
        Grade 4
    0 0
    Baseline Neutrophil - to - Lymphocyte Ratio (NLR)
    Neutrophil to lymphocyte ratio (NLR) is used as a marker of subclinical inflammation. Increased NLR is associated with poor prognosis in advanced pancreatic cancer.
    Units: Subjects
        <= 5
    91 91
        > 5
    14 14
        Missing
    2 2
    Baseline Albumin
    Units: g/L
        median (full range (min-max))
    39.0 (28 to 50) -
    Carbohydrate Antigen 19-9 (CA19-9)
    Serum CA 19-9 concentrations may be elevated in patients with gastrointestinal malignancies such as pancreatic cancer. Measure Analysis Population Description: Baseline CA19-9 measures are missing for six participants.
    Units: U/mL
        median (full range (min-max))
    243.3 (0 to 20741) -
    Sum of Longest Diameter of Target Lesions
    Units: mm
        median (full range (min-max))
    44.0 (17 to 130) -
    Number of Target Lesions
    Units: lesions
        median (full range (min-max))
    1.0 (1 to 3) -
    Time from Primary Diagnosis to First Dose
    Units: days
        median (full range (min-max))
    27.0 (4 to 95) -
    Subject analysis sets

    Subject analysis set title
    Nab-Paclitaxel Plus Gemcitabine
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    nab-Paclitaxel 125 mg/m^2 intravenous (IV) infusion administered over approximately 30-45 minutes on Days 1, 8, and 15, followed by gemcitabine 1000 mg/m^2 IV infusion over approximately 30 minutes on Days 1,8, and 15 of each 28-day cycle. For participants who completed 6 cycles of nab-paclitaxel and gemcitabine without disease progression or unacceptable toxicities, the Investigator then determined the best option for the participant in the Investigator's Choice Period. - Continuation of nab-paclitaxel and gemcitabine therapy to disease progression or unacceptable toxicity OR - Chemoradiation therapy consisting of the concurrent use of capecitabine or gemcitabine with radiation according to institutional practice (included 18 subjects) OR - Surgical intervention (included 17 subjects)

    Subject analysis sets values
    Nab-Paclitaxel Plus Gemcitabine
    Number of subjects
    107
    Age, Customized
    Units: Subjects
        <65 years
    44
        >=65 - 75 years
    50
        >75 years
    13
    Age Continuous
    Units: years
        median (full range (min-max))
    65.0 (42 to 85)
    Sex: Female, Male
    Units: Subjects
        Female
    59
        Male
    48
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    1
        Not Hispanic or Latino
    78
        Unknown or Not Reported
    28
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0
        Asian
    3
        Native Hawaiian or Other Pacific Islander
    0
        Black or African American
    2
        White
    72
        More than one race
    0
        Unknown or Not Reported
    30
    Eastern Cooperative Oncology Group (ECOG) Performance Status
    ECOG performance status assesses how the disease affects the daily living activities of the participant and helps determine appropriate treatment and prognosis. - 0 = Fully Active (Most Favorable Activity); - 1 = Restricted activity but ambulatory; - 2 = Ambulatory but unable to carry out work activities; - 3 = Limited Self-Care; - 4 = Completely Disabled.
    Units: Subjects
        Grade 0
    50
        Grade 1
    57
        Grade 2
    0
        Grade 3
    0
        Grade 4
    0
    Physician Assessment of Peripheral Neuropathy
    Physician assessment for grading of peripheral neuropathy in participants receiving chemotherapy according to National Cancer Institute Common Toxicity Criteria (NCICTC): Grade 0 = None or no neuromotor or neurosensory loss; Grade 1 = Asymptomatic: loss of deep tendon reflexes or paresthesia; - Grade 2 = Moderate symptoms: limiting instrumental Activities of Daily Living (ADLs); - Grade 3 = Severe symptoms: limiting self-care ADL; assistance device indicated; - Grade 4 = Life-threatening consequences: urgent intervention indicated.
    Units: Subjects
        Grade 0
    101
        Grade 1
    6
        Grade 2
    0
        Grade 3
    0
        Grade 4
    0
    Baseline Neutrophil - to - Lymphocyte Ratio (NLR)
    Neutrophil to lymphocyte ratio (NLR) is used as a marker of subclinical inflammation. Increased NLR is associated with poor prognosis in advanced pancreatic cancer.
    Units: Subjects
        <= 5
    91
        > 5
    14
        Missing
    2
    Baseline Albumin
    Units: g/L
        median (full range (min-max))
    39.0 (28 to 50)
    Carbohydrate Antigen 19-9 (CA19-9)
    Serum CA 19-9 concentrations may be elevated in patients with gastrointestinal malignancies such as pancreatic cancer. Measure Analysis Population Description: Baseline CA19-9 measures are missing for six participants.
    Units: U/mL
        median (full range (min-max))
    243.3 (0 to 20741)
    Sum of Longest Diameter of Target Lesions
    Units: mm
        median (full range (min-max))
    44.0 (17 to 130)
    Number of Target Lesions
    Units: lesions
        median (full range (min-max))
    1.0 (1 to 3)
    Time from Primary Diagnosis to First Dose
    Units: days
        median (full range (min-max))
    27.0 (4 to 95)

    End points

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    End points reporting groups
    Reporting group title
    nab-Paclitaxel plus Gemcitabine
    Reporting group description
    Participants received nab-Paclitaxel 125 mg/m^2 by intravenous (IV) infusion administered over approximately 30-45 minutes on Days 1, 8, and 15, followed by gemcitabine (Gem) 1000 mg/m^2 IV infusion over approximately 30 minutes on Days 1, 8, and 15 of each 28-day cycle for 6 cycles. For participants who completed 6 cycles of nab-paclitaxel and gemcitabine without disease progression or unacceptable toxicities, the Investigator then determined the best option for the participant in the Investigator's Choice Period.
    Reporting group title
    Investigator Choice (Overall)
    Reporting group description
    For participants who completed 6 cycles of nab-paclitaxel and gemcitabine without disease progression or unacceptable toxicities, the Investigator then determined the best option for the participant in the Investigator's Choice Period. Investigator Choice includes 3 options: 1. Continued on nab-Paclitaxel and gemcitabine (included 12 subjects) 2. Chemoradiation therapy consisting of capecitabine or gemcitabine with radiation according to institutional practice (included 18 subjects) 3. Surgical Intervention (included 17 subjects)

    Subject analysis set title
    Nab-Paclitaxel Plus Gemcitabine
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    nab-Paclitaxel 125 mg/m^2 intravenous (IV) infusion administered over approximately 30-45 minutes on Days 1, 8, and 15, followed by gemcitabine 1000 mg/m^2 IV infusion over approximately 30 minutes on Days 1,8, and 15 of each 28-day cycle. For participants who completed 6 cycles of nab-paclitaxel and gemcitabine without disease progression or unacceptable toxicities, the Investigator then determined the best option for the participant in the Investigator's Choice Period. - Continuation of nab-paclitaxel and gemcitabine therapy to disease progression or unacceptable toxicity OR - Chemoradiation therapy consisting of the concurrent use of capecitabine or gemcitabine with radiation according to institutional practice (included 18 subjects) OR - Surgical intervention (included 17 subjects)

    Primary: Kaplan-Meier Estimates for Time to Treatment Failure (TTF)

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    End point title
    Kaplan-Meier Estimates for Time to Treatment Failure (TTF) [1]
    End point description
    TTF was defined as the time after the first dose of study therapy to discontinuation of study therapy due to disease progression, death by any cause, or the start of a new non-protocol-defined anticancer therapy/surgery. If a subject does not progress, die or start a new non-protocol-defined anticancer therapy, the subject was censored on the last tumor assessment date. Tumor evaluations of CT or MRI scans were assessed and response determined according to Response Evaluation Criteria in Solid Tumors (RECIST) guidelines, version 1.1. The definition for progressive disease (PD) was >= 20% increase in the sum of diameters of target lesions from nadir, and the sum showed an absolute increase of >= 5 mm; the progression of a non-target lesion or the appearance of any new lesions is also considered progression. Median and its 90% confidence interval (CI) of TTF were estimated using the method of Brookmeyer and Crowley. Intent to Treat population = all subjects enrolled into the study.
    End point type
    Primary
    End point timeframe
    Day 1 of study treatment up to 28.75 months; (maximum time for the last tumor assessment)
    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: The primary goal of this study was to evaluate time to treatment failure (primary endpoint) with nab-paclitaxel plus gemcitabine as induction therapy. Therefore there was no statistical comparison to be made. Treatment choices in period 2 (investigator's choice period) were non-randomized and no comparisons were intended there either.
    End point values
    Nab-Paclitaxel Plus Gemcitabine
    Number of subjects analysed
    107
    Units: months
        median (confidence interval 90%)
    9.0 (7.26 to 10.05)
    No statistical analyses for this end point

    Secondary: Disease Control Rate (DCR): Percentage of Participants With Complete (CR) or Partial Response (PR), or Stable Disease (SD) for ≥ 16 Weeks According to RECIST Version 1.1

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    End point title
    Disease Control Rate (DCR): Percentage of Participants With Complete (CR) or Partial Response (PR), or Stable Disease (SD) for ≥ 16 Weeks According to RECIST Version 1.1
    End point description
    DCR was defined as the percentage of participants with a CR or PR or SD from of date of first treatment to 16 weeks. Tumor assessments after start of non-protocol-defined anticancer therapy were excluded. RECIST 1.1 Definition: - CR: disappearance of all target and non-target lesions; any pathological lymph nodes (target or non-target) must have reduction in short axis to < 10 mm and no new lesions diagnosed. - PR: a >= 30% decrease in the sum of diameters of target lesions from baseline; no evidence of progression in any of the non-target lesions diagnosed at baseline; and no new lesions diagnosed. - SD: neither sufficient shrinkage to qualify for PR nor sufficient increase of lesions to qualify for PD. The two-sided 90% binomial confidence intervals (CIs) were estimated by Wilson score method. Intent to treat population was defined as all participants enrolled into the study. Intent to treat population was defined as all participants enrolled into the study.
    End point type
    Secondary
    End point timeframe
    Day 1 of study treatment up to the end of investigator choice period plus 28 days; up to 76.9 weeks
    End point values
    Nab-Paclitaxel Plus Gemcitabine
    Number of subjects analysed
    107
    Units: percentage of participants
        number (confidence interval 90%)
    77.6 (70.3 to 83.5)
    No statistical analyses for this end point

    Secondary: Overall Response Rate (ORR): Percentage of Participants With Complete (CR) or Partial Response (PR) According to RECIST Version 1.1

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    End point title
    Overall Response Rate (ORR): Percentage of Participants With Complete (CR) or Partial Response (PR) According to RECIST Version 1.1
    End point description
    ORR was defined as the percentage of participants that achieved a combined incidence of complete (CR) and partial response (PR) using RECIST 1.1 guidelines as assessed by the investigator at baseline, every 56 (-3/+7 days) and at the 28-day follow-up visit . Assessments after new non-protocol-defined anticancer therapy are excluded. For participants who had resectable surgery in Investigator Choice period, assessments after surgical intervention are excluded. RECIST 1.1 Definition: - CR: disappearance of all target and non-target lesions; any pathological lymph nodes (target or non-target) must have reduction in short axis to < 10 mm and no new lesions diagnosed. - PR: a >= 30% decrease in the sum of diameters of target lesions from baseline; no evidence of progression in any of the non-target lesions diagnosed at baseline; and no new lesions diagnosed. Intent to treat population was defined as all participants enrolled into the study.
    End point type
    Secondary
    End point timeframe
    Day 1 of study treatment up to the end of investigator choice period plus 28 days; up to 76.9 weeks
    End point values
    Nab-Paclitaxel Plus Gemcitabine
    Number of subjects analysed
    107
    Units: percentage of participants
        number (confidence interval 90%)
    39.3 (31.8 to 47.2)
    No statistical analyses for this end point

    Secondary: Kaplan-Meier Estimate of Progression-Free Survival (PFS)

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    End point title
    Kaplan-Meier Estimate of Progression-Free Survival (PFS)
    End point description
    Progression-free Survival was determined based on RECIST 1.1. criteria and was defined as the time from the date of the first dose to the date of disease progression or death (by any cause), whichever is earlier. The analysis day was calculated from enrollment date for one participant who was not treated. Participants who have no disease progression or have not died were censored to last tumor assessment date with progression-free. The definition for progressive disease (PD) was at least a 20% increase in the sum of diameters of target lesions from nadir; the sum must also demonstrate an absolute increase of >= 5 mm; the progression of a non-target lesion or the appearance of any new lesions is also considered progression. Median and its 90% confidence interval of PFS were estimated using the method of Brookmeyer and Crowley. Intent to treat population was defined as all participants enrolled into the study.
    End point type
    Secondary
    End point timeframe
    Day 1 of study treatment up to 28.75 months (maximum time for the last tumor assessment)
    End point values
    Nab-Paclitaxel Plus Gemcitabine
    Number of subjects analysed
    107
    Units: months
        median (confidence interval 90%)
    10.9 (9.26 to 11.63)
    No statistical analyses for this end point

    Secondary: Kaplan-Meier Estimates for Overall Survival (OS)

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    End point title
    Kaplan-Meier Estimates for Overall Survival (OS)
    End point description
    Overall survival was defined as the time from the date of first dose of study therapy to the date of death (by any cause). Participants who were alive at the end of study or clinical data cut were censored on the last known time that the participant was alive or the clinical cutoff date, whichever was earlier. Median and its 90% confidence interval of OS were estimated using the method of Brookmeyer and Crowley. Intent to treat population was defined as all participants enrolled into the study.
    End point type
    Secondary
    End point timeframe
    Day 1 of study treatment up to 31.34 months (maximum time for survival follow-up)
    End point values
    Nab-Paclitaxel Plus Gemcitabine
    Number of subjects analysed
    107
    Units: months
        median (confidence interval 90%)
    18.8 (14.95 to 24.02)
    No statistical analyses for this end point

    Secondary: Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): Global Health Status and 5 Functioning Scales

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    End point title
    Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): Global Health Status and 5 Functioning Scales
    End point description
    The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire (EORTC QLQ-C30) is a validated health-related quality of life (HRQoL) measure. The EORTC QLQ-C30 is composed of both multi-item scales and single-item measures, including 5 functional scales, 3 symptom scales, 6 single symptom items, and 1 global health status / quality of life scale. All reported measures are transformed to a 0 - 100 scale. In the Global Health Status and 5 functional scales, 0 = worst possible quality of life/health status and 100 = best possible quality of life/health status. The best score on treatment is the best score from all post-baseline visits and is compared to the baseline to get the following responder categories. Responder categories: - Improved: >=10 increase from baseline - Stable: neither increase nor decrease >10 - Worsened: >=10 decrease from baseline. ITT population = all participants enrolled into the study with both baseline and post baseline values.
    End point type
    Secondary
    End point timeframe
    Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit
    End point values
    Nab-Paclitaxel Plus Gemcitabine
    Number of subjects analysed
    95
    Units: Participants
        Global Health Status: Improved
    43
        Global Health Status: Stable
    34
        Global Health Status: Worsened
    18
        Physical Functioning Scale: Improved
    20
        Physical Functioning Scale: Stable
    66
        Physical Functioning Scale: Worsened
    9
        Role Functioning Scale: Improved
    36
        Role Functioning Scale: Stable
    46
        Role Functioning Scale: Worsened
    13
        Emotional Functioning Scale: Improved
    50
        Emotional Functioning Scale: Stable
    40
        Emotional Functioning Scale: Worsened
    5
        Cognitive Functioning Scale: Improved
    33
        Cognitive Functioning Scale: Stable
    51
        Cognitive Functioning Scale: Worsened
    11
        Social Functioning Scale: Improved
    38
        Social Functioning Scale: Stable
    43
        Social Functioning Scale: Worsened
    14
    No statistical analyses for this end point

    Secondary: Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): Symptom Scales and Single Symptom Items

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    End point title
    Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): Symptom Scales and Single Symptom Items
    End point description
    The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire (EORTC QLQ-C30) is a validated health-related quality of life (HRQoL) measure. The EORTC QLQ-C30 is composed of both multi-item scales and single-item measures, including 5 functional scales, 3 symptom scales, 6 single symptom items, and 1 global health status / quality of life scale. All reported measures are transformed to a 0 to 100 scale. In the symptom scales and single symptom items, 0 = optimal health state and 100 = worst possible health state. The best score on treatment is the best score from all post-baseline visits and is compared to the baseline to get the following responder categories. Responder categories: - Improved: >=10 decrease from baseline - Stable: neither increase nor decrease >10 - Worsened: >=10 increase from baseline. ITT population = all participants enrolled into the study with both baseline and post baseline values.
    End point type
    Secondary
    End point timeframe
    Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit
    End point values
    Nab-Paclitaxel Plus Gemcitabine
    Number of subjects analysed
    95
    Units: Participants
        Symptom Scale-Fatigue: Improved
    46
        Symptom Scale-Fatigue: Stable
    24
        Symptom Scale-Fatigue: Worsened
    25
        Scale-Nausea+Vomiting: Improved
    29
        Scale-Nausea+Vomiting: Stable
    64
        Scale-Nausea+Vomiting: Worsened
    2
        Symptom Scale-Pain: Improved
    62
        Symptom Scale-Pain: Stable
    29
        Symptom Scale-Pain: Worsened
    4
        Symptom - Dyspnoea: Improved
    12
        Symptom - Dyspnoea: Stable
    74
        Symptom - Dyspnoea: Worsened
    9
        Symptom - Insomnia: Improved
    53
        Symptom - Insomnia: Stable
    35
        Symptom - Insomnia: Worsened
    7
        Symptom - Appetite loss: Improved
    48
        Symptom - Appetite loss: Stable
    39
        Symptom - Appetite loss: Worsened
    8
        Symptom - Constipation: Improved
    46
        Symptom - Constipation: Stable
    45
        Symptom - Constipation: Worsened
    4
        Symptom - Diarrhoea: Improved
    18
        Symptom - Diarrhoea: Stable
    69
        Symptom - Diarrhoea: Worsened
    8
        Symptom - Financial difficulties: Improved
    17
        Symptom - Financial difficulties: stable:
    74
        Symptom - Financial difficulties: Worsened
    4
    No statistical analyses for this end point

    Secondary: Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): Six Summary Scales

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    End point title
    Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): Six Summary Scales
    End point description
    The EORTC pancreatic cancer module is a validated tool intended for patients at all disease stages undergoing surgical resection, palliative surgical intervention, endoscopic palliation or palliative chemotherapy. The module includes 26 questions, organized into 7 scales and 10 individual item scores. All reported measures are transformed to a 0 to 100 scale. Six summary scales reported are: - Pancreatic Pain - Digestive Symptoms - Altered Bowel Habits - Hepatic Scale - Body Image - Sexuality Scores of 0 = optimal health state and 100 = worst possible health state. The best score on treatment is the best score from all post-baseline visits and is compared to the baseline. Responder categories: - Improved: >=MID decrease from baseline - Stable: no increase or decrease >MID - Worsened: >=MID increase from baseline MID = half the baseline standard deviation. Intent to treat population was defined as all participants enrolled into the study with both baseline and post baseline values.
    End point type
    Secondary
    End point timeframe
    Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit
    End point values
    Nab-Paclitaxel Plus Gemcitabine
    Number of subjects analysed
    95
    Units: Participants
        Pancreatic Pain Scale: Improved
    62
        Pancreatic Pain Scale: Stable
    33
        Pancreatic Pain Scale: Worsened
    0
        Digestive Symptom Scale: Improved
    49
        Digestive Symptom Scale: Stable
    36
        Digestive Symptom Scale: Worsened
    10
        Altered Bowel Habits Scale: Improved
    28
        Altered Bowel Habits Scale: Stable
    53
        Altered Bowel Habits Scale: Worsened
    14
        Hepatic Scale: Improved
    25
        Hepatic Scale: Stable
    66
        Hepatic Scale: Worsened
    4
        Body Image Scale: Improved
    22
        Body Image Scale: Stable
    50
        Body Image Scale: Worsened
    23
        Sexuality Scale: Improved
    31
        Sexuality Scale: Stable
    51
        Sexuality Scale: Worsened
    13
    No statistical analyses for this end point

    Secondary: Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): Satisfaction with Health Care Scale

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    End point title
    Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): Satisfaction with Health Care Scale
    End point description
    The EORTC pancreatic cancer module is a validated tool intended for patients at all disease stages undergoing surgical resection, palliative surgical intervention, endoscopic palliation or palliative chemotherapy. The module includes 26 questions, organized into 7 scales and 10 individual item scores. The summary scale for Satisfaction with Health Care is reported. All reported measures are transformed to a 0 to 100 scale. Scores of 0 = not satisfied, worst possible health state and 100 = extremely satisfied, best possible health state. The best score on treatment is the best score from all post-baseline visits and is compared to the baseline to get the following responder categories. Responder categories: - Improved: >=MID increase from baseline - Stable: no increase or decrease >MID - Worsened: >=MID decrease from baseline MID = half the baseline standard deviation. ITT population = all participants enrolled into the study with both baseline and post baseline values.
    End point type
    Secondary
    End point timeframe
    Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit
    End point values
    Nab-Paclitaxel Plus Gemcitabine
    Number of subjects analysed
    95
    Units: Participants
        Satisfaction with Health Care Scale: Improved
    42
        Satisfaction with Health Care Scale: Stable
    40
        Satisfaction with Health Care Scale: Worsened
    13
    No statistical analyses for this end point

    Secondary: Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): 10 Individual Item Scores

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    End point title
    Participant Counts in Response Categories Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire For Pancreatic Cancer (EORTC-QLQ PAN26): 10 Individual Item Scores
    End point description
    The EORTC pancreatic cancer module is a validated tool intended for patients at all disease stages undergoing surgical resection, palliative surgical intervention, endoscopic palliation or palliative chemotherapy. The module includes 26 questions, organized into 7 scales and 10 individual item scores. The 10 individual item scores are reported. All reported measures are transformed to a 0 to 100 scale. Scores of 0 = best possible health state and 100 = worst possible health state. The best score on treatment is the best score from all post-baseline visits and is compared to the baseline to get the following responder categories. Responder categories: - Improved: >=MID decrease from baseline - Stable: no increase or decrease >MID - Worsened: >=MID increase from baseline MID = half the baseline standard deviation. Intent to treat population was defined as all participants enrolled into the study with both baseline and post baseline values.
    End point type
    Secondary
    End point timeframe
    Baseline (Day -1), Day 1 of each cycle, for up to 19 cycles each cycle consisting of 28 days and the 28-day follow-up visit
    End point values
    Nab-Paclitaxel Plus Gemcitabine
    Number of subjects analysed
    95
    Units: Participants
        Abdominal Bloating: Improved
    50
        Abdominal Bloating: Stable
    42
        Abdominal Bloating: Worsened
    3
        Taste Changes: Improved
    20
        Taste Changes: Stable
    54
        Taste Changes: Worsened
    21
        Indigestion: Improved
    41
        Indigestion: Stable
    47
        Indigestion: Worsened
    7
        Flatulence: Improved
    47
        Flatulence: Stable
    37
        Flatulence: Worsened
    11
        Weight Loss: Improved
    36
        Weight Loss: Stable
    56
        Weight Loss: Worsened
    3
        Limb Weakness: Improved
    22
        Limb Weakness: Stable
    55
        Limb Weakness: Worsened
    18
        Dry Mouth: Improved
    37
        Dry Mouth: Stable
    45
        Dry Mouth: Worsened
    13
        Treatment Side-Effects: Improved
    8
        Treatment Side-Effects: Stable
    48
        Treatment Side-Effects: Worsened
    39
        Worry About Future Health: Improved
    42
        Worry About Future Health: Stable
    45
        Worry About Future Health: Worsened
    8
        Limits on Activity Planning: Improved
    42
        Limits on Activity Planning: Stable
    42
        Limits on Activity Planning: Worsened
    11
    No statistical analyses for this end point

    Secondary: Number of Participants with Treatment Emergent Adverse Events (TEAEs)

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    End point title
    Number of Participants with Treatment Emergent Adverse Events (TEAEs)
    End point description
    TEAEs are defined as any adverse event (AE) that begin or worsen on or after the start of study drug or procedure of the study period through the maximum duration of the period plus 28 days. The severity of AEs was graded based on National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), Version 4.0 and the scale: Grade 1 = Mild Grade 2 = Moderate Grade 3 = Severe Grade 4 = Life threatening Grade 5 = Death. Relation to study drug was determined by the investigator. A treatment-related TEAE is defined as TEAE which was considered to be related to one or both of the study drugs and reported as 'Suspected' on the case report form. AEs with a missing relationship were treated as 'treatment-related' in data summaries. IP (investigational product) refers to nab-Paclitaxel and/or Gemcitabine. "Related" TEAE refers to relation to study drug (IP). The Treated population consists of all participants who received at least 1 dose of nab-paclitaxel or gemcitabine.
    End point type
    Secondary
    End point timeframe
    Day 1 of study drug up to end of the study; up to 31.3 months
    End point values
    nab-Paclitaxel plus Gemcitabine Nab-Paclitaxel Plus Gemcitabine
    Number of subjects analysed
    106 [2]
    106 [3]
    Units: Participants
        >= 1 TEAE
    105
    105
        >=1 related TEAE
    102
    103
        >=1 TEAE of severity grade 3 or higher
    85
    90
        >=1 related TEAE of severity grade 3 or higher
    72
    75
        >=1 serious TEAE
    38
    39
        >= 1 related serious TEAE
    14
    14
        >=1 TEAE leading to discontinuation of IP
    25
    28
        >=1 related TEAE leading to discontinuation of IP
    15
    18
        >=1 TEAE leading to dose reduction of IP
    69
    72
        >=1 related TEAE leading to dose reduction of IP
    68
    71
        >=1 TEAE leading to interruption of IP
    66
    68
        >=1 related TEAE leading to interruption of IP
    48
    50
        >= TEAE leading to death
    2
    2
        >=1 related TEAE leading to death
    0
    0
    Notes
    [2] - nab-Paclitaxel Plus Gemcitabine in the Induction period
    [3] - Overall = nab-pac + Gem in the Induction priod plus a subset who continued regimen in the IC period
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Day 1 of study drug up to end of the study; up to 31.3 months
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    20.0
    Reporting groups
    Reporting group title
    nab-Paclitaxel plus Gemcitabine (Induction Period)
    Reporting group description
    nab-Paclitaxel 125 mg/m^2 intravenous (IV) infusion administered over approximately 30-45 minutes on Days 1, 8, and 15, followed by gemcitabine 1000 mg/m^2 IV infusion over approximately 30 minutes on Days 1, 8, and 15 of each 28-day cycle.

    Reporting group title
    nab-Paclitaxel plus Gemcitabine (Overall)
    Reporting group description
    nab-Paclitaxel 125 mg/m^2 intravenous (IV) infusion administered over approximately 30-45 minutes on Days 1, 8, and 15, followed by gemcitabine 1000 mg/m^2 IV infusion over approximately 30 minutes on Days 1, 8, and 15 of each 28-day cycle. Overall includes nab-Paclitaxel plus Gemcitabine treatment cycles during the Induction Period, as well as the subset of participants who continued the regimen during the Investigator Choice Period.

    Serious adverse events
    nab-Paclitaxel plus Gemcitabine (Induction Period) nab-Paclitaxel plus Gemcitabine (Overall)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    38 / 106 (35.85%)
    39 / 106 (36.79%)
         number of deaths (all causes)
    2
    2
         number of deaths resulting from adverse events
    0
    0
    Vascular disorders
    Hypotension
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Jugular vein thrombosis
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Death
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    General physical health deterioration
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Generalised oedema
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Influenza like illness
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malaise
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    5 / 106 (4.72%)
    5 / 106 (4.72%)
         occurrences causally related to treatment / all
    3 / 6
    3 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Interstitial lung disease
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Blood bilirubin increased
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Peripancreatic fluid collection
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Acute coronary syndrome
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    2 / 106 (1.89%)
    2 / 106 (1.89%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Nervous system disorders
    Presyncope
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    3 / 106 (2.83%)
    3 / 106 (2.83%)
         occurrences causally related to treatment / all
    3 / 3
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    2 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    2 / 106 (1.89%)
    2 / 106 (1.89%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Obstruction gastric
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatitis
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    0 / 106 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholangitis
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystitis
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystitis acute
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic cirrhosis
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Jaundice cholestatic
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Obstructive uropathy
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Cellulitis
         subjects affected / exposed
    2 / 106 (1.89%)
    2 / 106 (1.89%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Escherichia sepsis
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis Escherichia coli
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Liver abscess
         subjects affected / exposed
    0 / 106 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenic sepsis
         subjects affected / exposed
    2 / 106 (1.89%)
    2 / 106 (1.89%)
         occurrences causally related to treatment / all
    2 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreas infection
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Parainfluenzae virus infection
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    5 / 106 (4.72%)
    5 / 106 (4.72%)
         occurrences causally related to treatment / all
    2 / 5
    2 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    2 / 106 (1.89%)
    2 / 106 (1.89%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    1 / 106 (0.94%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    nab-Paclitaxel plus Gemcitabine (Induction Period) nab-Paclitaxel plus Gemcitabine (Overall)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    104 / 106 (98.11%)
    104 / 106 (98.11%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    21 / 106 (19.81%)
    23 / 106 (21.70%)
         occurrences all number
    46
    51
    Aspartate aminotransferase increased
         subjects affected / exposed
    16 / 106 (15.09%)
    17 / 106 (16.04%)
         occurrences all number
    43
    46
    Blood alkaline phosphatase increased
         subjects affected / exposed
    14 / 106 (13.21%)
    16 / 106 (15.09%)
         occurrences all number
    21
    26
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    6 / 106 (5.66%)
    6 / 106 (5.66%)
         occurrences all number
    8
    8
    Neutrophil count decreased
         subjects affected / exposed
    22 / 106 (20.75%)
    23 / 106 (21.70%)
         occurrences all number
    57
    67
    Platelet count decreased
         subjects affected / exposed
    25 / 106 (23.58%)
    27 / 106 (25.47%)
         occurrences all number
    72
    85
    Weight decreased
         subjects affected / exposed
    12 / 106 (11.32%)
    12 / 106 (11.32%)
         occurrences all number
    16
    16
    White blood cell count decreased
         subjects affected / exposed
    14 / 106 (13.21%)
    14 / 106 (13.21%)
         occurrences all number
    40
    45
    Vascular disorders
    Hypotension
         subjects affected / exposed
    8 / 106 (7.55%)
    8 / 106 (7.55%)
         occurrences all number
    10
    10
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    10 / 106 (9.43%)
    12 / 106 (11.32%)
         occurrences all number
    12
    14
    Dysgeusia
         subjects affected / exposed
    32 / 106 (30.19%)
    33 / 106 (31.13%)
         occurrences all number
    38
    40
    Headache
         subjects affected / exposed
    17 / 106 (16.04%)
    17 / 106 (16.04%)
         occurrences all number
    18
    19
    Neuropathy peripheral
         subjects affected / exposed
    23 / 106 (21.70%)
    25 / 106 (23.58%)
         occurrences all number
    37
    41
    Paraesthesia
         subjects affected / exposed
    11 / 106 (10.38%)
    11 / 106 (10.38%)
         occurrences all number
    24
    24
    Peripheral sensory neuropathy
         subjects affected / exposed
    29 / 106 (27.36%)
    30 / 106 (28.30%)
         occurrences all number
    60
    74
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    49 / 106 (46.23%)
    49 / 106 (46.23%)
         occurrences all number
    155
    173
    Leukopenia
         subjects affected / exposed
    7 / 106 (6.60%)
    7 / 106 (6.60%)
         occurrences all number
    20
    20
    Lymphopenia
         subjects affected / exposed
    6 / 106 (5.66%)
    6 / 106 (5.66%)
         occurrences all number
    14
    14
    Neutropenia
         subjects affected / exposed
    44 / 106 (41.51%)
    45 / 106 (42.45%)
         occurrences all number
    92
    94
    Thrombocytopenia
         subjects affected / exposed
    25 / 106 (23.58%)
    27 / 106 (25.47%)
         occurrences all number
    46
    49
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    36 / 106 (33.96%)
    36 / 106 (33.96%)
         occurrences all number
    106
    109
    Chills
         subjects affected / exposed
    18 / 106 (16.98%)
    18 / 106 (16.98%)
         occurrences all number
    23
    24
    Fatigue
         subjects affected / exposed
    53 / 106 (50.00%)
    53 / 106 (50.00%)
         occurrences all number
    127
    137
    Influenza like illness
         subjects affected / exposed
    7 / 106 (6.60%)
    8 / 106 (7.55%)
         occurrences all number
    13
    14
    Oedema peripheral
         subjects affected / exposed
    45 / 106 (42.45%)
    47 / 106 (44.34%)
         occurrences all number
    75
    81
    Pain
         subjects affected / exposed
    5 / 106 (4.72%)
    6 / 106 (5.66%)
         occurrences all number
    5
    6
    Pyrexia
         subjects affected / exposed
    39 / 106 (36.79%)
    40 / 106 (37.74%)
         occurrences all number
    75
    79
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    19 / 106 (17.92%)
    19 / 106 (17.92%)
         occurrences all number
    23
    25
    Abdominal pain upper
         subjects affected / exposed
    9 / 106 (8.49%)
    10 / 106 (9.43%)
         occurrences all number
    13
    14
    Constipation
         subjects affected / exposed
    30 / 106 (28.30%)
    32 / 106 (30.19%)
         occurrences all number
    49
    52
    Diarrhoea
         subjects affected / exposed
    48 / 106 (45.28%)
    48 / 106 (45.28%)
         occurrences all number
    93
    95
    Dry mouth
         subjects affected / exposed
    7 / 106 (6.60%)
    7 / 106 (6.60%)
         occurrences all number
    7
    7
    Dyspepsia
         subjects affected / exposed
    7 / 106 (6.60%)
    8 / 106 (7.55%)
         occurrences all number
    8
    9
    Nausea
         subjects affected / exposed
    46 / 106 (43.40%)
    47 / 106 (44.34%)
         occurrences all number
    89
    92
    Stomatitis
         subjects affected / exposed
    20 / 106 (18.87%)
    20 / 106 (18.87%)
         occurrences all number
    26
    26
    Vomiting
         subjects affected / exposed
    30 / 106 (28.30%)
    30 / 106 (28.30%)
         occurrences all number
    44
    44
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    24 / 106 (22.64%)
    25 / 106 (23.58%)
         occurrences all number
    36
    38
    Dyspnoea
         subjects affected / exposed
    14 / 106 (13.21%)
    15 / 106 (14.15%)
         occurrences all number
    16
    17
    Epistaxis
         subjects affected / exposed
    9 / 106 (8.49%)
    9 / 106 (8.49%)
         occurrences all number
    12
    12
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    57 / 106 (53.77%)
    57 / 106 (53.77%)
         occurrences all number
    73
    74
    Dermatitis acneiform
         subjects affected / exposed
    9 / 106 (8.49%)
    9 / 106 (8.49%)
         occurrences all number
    11
    11
    Dry skin
         subjects affected / exposed
    8 / 106 (7.55%)
    9 / 106 (8.49%)
         occurrences all number
    8
    9
    Pruritus
         subjects affected / exposed
    11 / 106 (10.38%)
    12 / 106 (11.32%)
         occurrences all number
    12
    13
    Rash maculo-papular
         subjects affected / exposed
    9 / 106 (8.49%)
    9 / 106 (8.49%)
         occurrences all number
    19
    19
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    15 / 106 (14.15%)
    15 / 106 (14.15%)
         occurrences all number
    19
    19
    Depression
         subjects affected / exposed
    6 / 106 (5.66%)
    6 / 106 (5.66%)
         occurrences all number
    6
    6
    Insomnia
         subjects affected / exposed
    11 / 106 (10.38%)
    11 / 106 (10.38%)
         occurrences all number
    12
    12
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    9 / 106 (8.49%)
    10 / 106 (9.43%)
         occurrences all number
    14
    15
    Back pain
         subjects affected / exposed
    16 / 106 (15.09%)
    17 / 106 (16.04%)
         occurrences all number
    17
    18
    Bone pain
         subjects affected / exposed
    6 / 106 (5.66%)
    6 / 106 (5.66%)
         occurrences all number
    9
    9
    Muscular weakness
         subjects affected / exposed
    6 / 106 (5.66%)
    7 / 106 (6.60%)
         occurrences all number
    9
    10
    Myalgia
         subjects affected / exposed
    12 / 106 (11.32%)
    12 / 106 (11.32%)
         occurrences all number
    16
    17
    Infections and infestations
    Upper respiratory tract infection
         subjects affected / exposed
    6 / 106 (5.66%)
    7 / 106 (6.60%)
         occurrences all number
    7
    8
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    46 / 106 (43.40%)
    46 / 106 (43.40%)
         occurrences all number
    56
    56
    Dehydration
         subjects affected / exposed
    11 / 106 (10.38%)
    11 / 106 (10.38%)
         occurrences all number
    13
    13
    Hyperglycaemia
         subjects affected / exposed
    12 / 106 (11.32%)
    12 / 106 (11.32%)
         occurrences all number
    17
    17
    Hyperkalaemia
         subjects affected / exposed
    6 / 106 (5.66%)
    6 / 106 (5.66%)
         occurrences all number
    9
    9
    Hypoalbuminaemia
         subjects affected / exposed
    11 / 106 (10.38%)
    11 / 106 (10.38%)
         occurrences all number
    18
    18
    Hypokalaemia
         subjects affected / exposed
    14 / 106 (13.21%)
    14 / 106 (13.21%)
         occurrences all number
    29
    31
    Hypomagnesaemia
         subjects affected / exposed
    7 / 106 (6.60%)
    7 / 106 (6.60%)
         occurrences all number
    10
    11
    Hyponatraemia
         subjects affected / exposed
    10 / 106 (9.43%)
    10 / 106 (9.43%)
         occurrences all number
    16
    16
    Iron deficiency
         subjects affected / exposed
    7 / 106 (6.60%)
    7 / 106 (6.60%)
         occurrences all number
    7
    7

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    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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