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    Clinical Trial Results:
    A Phase II Clinical Trial of Pembrolizumab (MK-3475) in Subjects with Advanced/Unresectable or Metastatic Urothelial Cancer

    Summary
    EudraCT number
    2014-002206-20
    Trial protocol
    ES   DK   IT   IE   GB   HU   NL  
    Global end of trial date
    18 Feb 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    24 Feb 2023
    First version publication date
    24 Feb 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    3475-052
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02335424
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Merck Sharp & Dohme Street LLC
    Sponsor organisation address
    126 East Lincoln Avenue, P.O. Box 2000, Rahway, NJ, United States, 07065
    Public contact
    Clinical Trials Disclosure, Merck Sharp & Dohme Street LLC, ClinicalTrialsDisclosure@merck.com
    Scientific contact
    Clinical Trials Disclosure, Merck Sharp & Dohme Street LLC, ClinicalTrialsDisclosure@merck.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
    18 Feb 2022
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    19 Jun 2018
    Global end of trial reached?
    Yes
    Global end of trial date
    18 Feb 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    This is a study using pembrolizumab (MK-3475, KEYTRUDA®) for first-line treatment of participants with advanced/unresectable (inoperable) or metastatic urothelial cancer who are ineligible for cisplatin-based therapy. The primary study objective is to determine the objective response rate (ORR) in all participants and by programmed cell death ligand 1 (PD-L1) status. With Amendment 4, once a participant has achieved the study objective or the study has ended, the participant will be discontinued from this study and will be enrolled in an extension study to continue protocol-defined assessments and treatment.
    Protection of trial subjects
    This study was conducted in conformance with Good Clinical Practice standards and applicable country and/or local statutes and regulations regarding ethical committee review, informed consent, and the protection of human subjects participating in biomedical research.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    24 Feb 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
    Australia: 5
    Country: Number of subjects enrolled
    Canada: 29
    Country: Number of subjects enrolled
    Denmark: 7
    Country: Number of subjects enrolled
    Guatemala: 4
    Country: Number of subjects enrolled
    Hungary: 10
    Country: Number of subjects enrolled
    Ireland: 4
    Country: Number of subjects enrolled
    Israel: 33
    Country: Number of subjects enrolled
    Italy: 16
    Country: Number of subjects enrolled
    Korea, Republic of: 10
    Country: Number of subjects enrolled
    Malaysia: 1
    Country: Number of subjects enrolled
    Netherlands: 5
    Country: Number of subjects enrolled
    Singapore: 4
    Country: Number of subjects enrolled
    Spain: 52
    Country: Number of subjects enrolled
    Taiwan: 5
    Country: Number of subjects enrolled
    United Kingdom: 27
    Country: Number of subjects enrolled
    United States: 162
    Worldwide total number of subjects
    374
    EEA total number of subjects
    94
    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)
    68
    From 65 to 84 years
    265
    85 years and over
    41

    Subject disposition

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    Recruitment
    Recruitment details
    Participants were eligible to receive second course treatment with pembrolizumab if they met criteria for re-treatment. Per protocol, only data generated during the initial course of treatment contributed to efficacy and safety outcome measures.

    Pre-assignment
    Screening details
    The study enrolled 374 participants and 370 participants received ≥1 dose of study treatment.

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

    Arms
    Arm title
    Pembrolizumab 200 mg
    Arm description
    Participants received pembrolizumab 200 mg by intravenous (IV) infusion on Day 1 of each 21-day cycle (Q3W) for up to 2 years. Eligible participants who stopped the initial course of pembrolizumab due to complete response (CR) or completed initial course of pembrolizumab and had stable disease but progressed after discontinuation, initiated a second course of pembrolizumab at the investigator's discretion for up to an additional year.
    Arm type
    Experimental

    Investigational medicinal product name
    pembrolizumab
    Investigational medicinal product code
    Other name
    KEYTRUDA®, MK-3475
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    200 mg by intravenous infusion on Day 1 of each 21-day cycle

    Number of subjects in period 1
    Pembrolizumab 200 mg
    Started
    374
    Treated
    370
    Received Second Course Treatment
    13
    Completed
    0
    Not completed
    374
         Consent withdrawn by subject
    19
         Physician decision
    13
         Participation in study terminated by Sponsor
    39
         Adverse event, non-fatal
    25
         Death
    273
         Screen failure
    1
         Lost to follow-up
    3
         Protocol deviation
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Pembrolizumab 200 mg
    Reporting group description
    Participants received pembrolizumab 200 mg by intravenous (IV) infusion on Day 1 of each 21-day cycle (Q3W) for up to 2 years. Eligible participants who stopped the initial course of pembrolizumab due to complete response (CR) or completed initial course of pembrolizumab and had stable disease but progressed after discontinuation, initiated a second course of pembrolizumab at the investigator's discretion for up to an additional year.

    Reporting group values
    Pembrolizumab 200 mg Total
    Number of subjects
    374 374
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    68 68
        From 65-84 years
    265 265
        85 years and over
    41 41
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    73.0 ( 9.9 ) -
    Sex: Female, Male
    Units: Participants
        Female
    86 86
        Male
    288 288
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    2 2
        Asian
    26 26
        Native Hawaiian or Other Pacific Islander
    0 0
        Black or African American
    8 8
        White
    332 332
        More than one race
    2 2
        Unknown or Not Reported
    4 4
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    22 22
        Not Hispanic or Latino
    326 326
        Unknown or Not Reported
    26 26

    End points

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    End points reporting groups
    Reporting group title
    Pembrolizumab 200 mg
    Reporting group description
    Participants received pembrolizumab 200 mg by intravenous (IV) infusion on Day 1 of each 21-day cycle (Q3W) for up to 2 years. Eligible participants who stopped the initial course of pembrolizumab due to complete response (CR) or completed initial course of pembrolizumab and had stable disease but progressed after discontinuation, initiated a second course of pembrolizumab at the investigator's discretion for up to an additional year.

    Primary: Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%

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    End point title
    Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10% [1]
    End point description
    ORR was determined in participants who had a PD-L1 CPS of ≥10% as measured by immunohistochemistry assay. ORR was defined as the percentage of participants who had a confirmed Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR). Participants with missing data were considered non-responders. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥10% CPS.
    End point type
    Primary
    End point timeframe
    Up to approximately 80.5 months
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: There was no statistical analysis planned for this endpoint.
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    110
    Units: Percentage of participants
        number (confidence interval 95%)
    47.3 (37.7 to 57.0)
    No statistical analyses for this end point

    Primary: Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%

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    End point title
    Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1% [2]
    End point description
    ORR was determined in participants who had a PD-L1 CPS of ≥1% as measured by immunohistochemistry assay. ORR was defined as the percentage of participants who had a confirmed Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR). Participants with missing data were considered non-responders. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥1% CPS.
    End point type
    Primary
    End point timeframe
    Up to approximately 80.5 months
    Notes
    [2] - 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: There was no statistical analysis planned for this endpoint.
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    282
    Units: Percentage of participants
        number (confidence interval 95%)
    32.6 (27.2 to 38.4)
    No statistical analyses for this end point

    Primary: Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in All Participants

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    End point title
    Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in All Participants [3]
    End point description
    ORR was determined in all participants and was defined as the percentage of participants who had a confirmed Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR). Participants with missing data were considered non-responders. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment.
    End point type
    Primary
    End point timeframe
    Up to approximately 80.5 months
    Notes
    [3] - 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: There was no statistical analysis planned for this endpoint.
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    370
    Units: Percentage of participants
        number (confidence interval 95%)
    28.9 (24.3 to 33.8)
    No statistical analyses for this end point

    Secondary: Progression Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by Blinded Independent Central Review (BICR) in All Participants

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    End point title
    Progression Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by Blinded Independent Central Review (BICR) in All Participants
    End point description
    PFS was determined in all participants. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per RECIST 1.1 as assessed by BICR. Per RECIST 1.1, PD was a ≥20% increase in the sum of diameters of target lesions plus an absolute increase of ≥5 mm in the sum, or the appearance of ≥1 new lesions. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. PFS was calculated using the product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment.
    End point type
    Secondary
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    370
    Units: Months
        median (confidence interval 95%)
    2.5 (2.1 to 3.4)
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%

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    End point title
    Duration of Response (DOR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
    End point description
    DOR was determined in participants who demonstrated a confirmed CR (disappearance of all target lesions) or PR (≥30% decrease in the sum of diameters of target lesions) per RECIST 1.1 by BICR. DOR was the time from first evidence of CR or PR until PD or death and was calculated using the KM method. Participants who had not progressed or died at the time of analysis were censored at the date of last tumor assessment. Per RECIST 1.1, PD was a ≥20% increase in the SOD of target lesions plus an absolute increase of ≥5 mm in the sum, or the appearance of ≥1 new lesions. 9999 indicated that the upper limit of the 95% CI was not reached at time of data cut-off due to an insufficient number of responding participants with relapse. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment, had a PD-L1 positive expression of ≥1% CPS, and had a confirmed CR or PR.
    End point type
    Secondary
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    92
    Units: Months
        median (confidence interval 95%)
    35.8 (20.4 to 9999)
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by BICR in Participants with a PD-L1 CPS of ≥10%

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    End point title
    Duration of Response (DOR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by BICR in Participants with a PD-L1 CPS of ≥10%
    End point description
    DOR was determined in participants who demonstrated a confirmed CR (disappearance of all target lesions) or PR (≥30% decrease in the sum of diameters of target lesions) per RECIST 1.1 by BICR. DOR was the time from first evidence of CR or PR until PD or death and was calculated using the KM method. Participants who had not progressed or died at the time of analysis were censored at the date of last tumor assessment. Per RECIST 1.1, PD was a ≥20% increase in the SOD of target lesions plus an absolute increase of ≥5 mm in the sum, or the appearance of ≥1 new lesions. 9999 indicated that the median and upper limit of the 95% CI was not reached at time of data cut-off due to an insufficient number of responding participants with relapse Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment had a PD-L1 positive expression of ≥10% CPS and had a confirmed CR or PR.
    End point type
    Secondary
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    52
    Units: Months
        median (confidence interval 95%)
    9999 (18.1 to 9999)
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by Blinded Independent Central Review (BICR) in All Participants

    Close Top of page
    End point title
    Duration of Response (DOR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by Blinded Independent Central Review (BICR) in All Participants
    End point description
    DOR was determined in participants who demonstrated a confirmed Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: ≥30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by BICR. DOR was defined as the time from first documented evidence of a CR or PR until progressive disease (PD) or death and was calculated using the product-limit (Kaplan-Meier [KM]) method for censored data. Participants who had not progressed or died at the time of analysis were censored at the date of their last tumor assessment. Per RECIST 1.1, PD was a ≥20% increase in the sum of diameters (SOD) of target lesions plus an absolute increase of ≥5 mm in the sum, or the appearance of ≥1 new lesions. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a confirmed CR or PR.
    End point type
    Secondary
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    107
    Units: Months
        median (confidence interval 95%)
    33.4 (18.2 to 48.7)
    No statistical analyses for this end point

    Secondary: Progression Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%

    Close Top of page
    End point title
    Progression Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
    End point description
    PFS was determined in participants who had a PD-L1 CPS of ≥1% as measured by immunohistochemistry assay. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per RECIST 1.1 as assessed by BICR. Per RECIST 1.1, PD was a ≥20% increase in the sum of diameters of target lesions plus an absolute increase of ≥5 mm in the sum, or the appearance of ≥1 new lesions. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. PFS was calculated using the product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥1% CPS.
    End point type
    Secondary
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    282
    Units: Months
        median (confidence interval 95%)
    3.4 (2.3 to 4.0)
    No statistical analyses for this end point

    Secondary: Overall Survival (OS) in All Participants

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    End point title
    Overall Survival (OS) in All Participants
    End point description
    OS was determined for all participants and was defined as the time from randomization to death due to any cause. OS was calculated using the product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment.
    End point type
    Secondary
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    370
    Units: Months
        median (confidence interval 95%)
    11.3 (9.7 to 13.1)
    No statistical analyses for this end point

    Secondary: Progression Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%

    Close Top of page
    End point title
    Progression Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
    End point description
    PFS was determined in participants who had a PD-L1 CPS of ≥10% as measured by immunohistochemistry assay. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per RECIST 1.1 as assessed by BICR. Per RECIST 1.1, PD was a ≥20% increase in the sum of diameters of target lesions plus an absolute increase of ≥5 mm in the sum, or the appearance of ≥1 new lesions. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. PFS was calculated using the product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥10% CPS.
    End point type
    Secondary
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    110
    Units: Months
        median (confidence interval 95%)
    4.9 (3.8 to 10.8)
    No statistical analyses for this end point

    Secondary: Progression Free Survival Rate (PFS Rate) at Month 6 As Assessed by BICR in All Participants

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    End point title
    Progression Free Survival Rate (PFS Rate) at Month 6 As Assessed by BICR in All Participants
    End point description
    The PFS rate was determined in all participants at Month 6. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by BICR. Per RECIST 1.1, PD was a ≥20% increase in the sum of diameters of target lesions plus an absolute increase of ≥5 mm in the sum, or the appearance of ≥1 new lesions. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. PFS at Month 6 was calculated using product-limit (Kaplan-Meier [KM]) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment.
    End point type
    Secondary
    End point timeframe
    Month 6
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    370
    Units: Percentage of participants
        number (confidence interval 95%)
    34.0 (29.2 to 38.8)
    No statistical analyses for this end point

    Secondary: Overall Survival (OS) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%

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    End point title
    Overall Survival (OS) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
    End point description
    OS was determined in participants who had a PD-L1 CPS of ≥10% as measured by immunohistochemistry assay. OS was defined as the time from randomization to death due to any cause. OS was calculated using the product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥10% CPS.
    End point type
    Secondary
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    110
    Units: Months
        median (confidence interval 95%)
    18.5 (12.2 to 28.5)
    No statistical analyses for this end point

    Secondary: Overall Survival (OS) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%

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    End point title
    Overall Survival (OS) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
    End point description
    OS was determined in participants who had a PD-L1 CPS of ≥1%, as measured by immunohistochemistry assay. OS was defined as the time from randomization to death due to any cause. OS was calculated using the product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥1% CPS.
    End point type
    Secondary
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    282
    Units: Months
        median (confidence interval 95%)
    12.4 (10.8 to 15.0)
    No statistical analyses for this end point

    Secondary: Progression Free Survival Rate (PFS Rate) at Month 12 As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%

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    End point title
    Progression Free Survival Rate (PFS Rate) at Month 12 As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
    End point description
    The PFS rate was determined in participants who had a PD-L1 CPS of ≥1%, as measured by immunohistochemistry assay, at Month 12. PFS was defined as the time from randomization to the first documented PD or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by BICR. PD was a ≥20% increase in the sum of diameters of target lesions plus an absolute increase of ≥5 mm in the sum or the appearance of ≥1 new lesions. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. PFS at Month 12 was calculated using product-limit KM method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥1% CPS.
    End point type
    Secondary
    End point timeframe
    Month 12
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    282
    Units: Percentage of participants
        number (confidence interval 95%)
    25.8 (20.8 to 31.1)
    No statistical analyses for this end point

    Secondary: Progression Free Survival Rate (PFS Rate) at Month 12 As Assessed by BICR in All Participants

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    End point title
    Progression Free Survival Rate (PFS Rate) at Month 12 As Assessed by BICR in All Participants
    End point description
    The PFS rate was determined in all participants at Month 12. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by BICR. Per RECIST 1.1, PD was a ≥20% increase in the sum of diameters of target lesions plus an absolute increase of ≥5 mm in the sum, or the appearance of ≥1 new lesions. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. PFS at Month 12 was calculated using product-limit (Kaplan-Meier [KM]) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment.
    End point type
    Secondary
    End point timeframe
    Month 12
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    370
    Units: Percentage of participants
        number (confidence interval 95%)
    22.9 (18.7 to 27.3)
    No statistical analyses for this end point

    Secondary: Progression Free Survival Rate (PFS Rate) at Month 6 As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%

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    End point title
    Progression Free Survival Rate (PFS Rate) at Month 6 As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
    End point description
    The PFS rate was determined in participants who had a PD-L1 CPS of ≥10%, as measured by immunohistochemistry assay, at Month 6. PFS was defined as the time from randomization to the first documented PD or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by BICR. PD was a ≥20% increase in the sum of diameters of target lesions plus an absolute increase of ≥5 mm in the sum or the appearance of ≥1 new lesions. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. PFS at Month 6 was calculated using product-limit KM method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥10% CPS.
    End point type
    Secondary
    End point timeframe
    Month 6
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    110
    Units: Percentage of participants
        number (confidence interval 95%)
    49.0 (39.4 to 57.9)
    No statistical analyses for this end point

    Secondary: Progression Free Survival Rate (PFS Rate) at Month 6 As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%

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    End point title
    Progression Free Survival Rate (PFS Rate) at Month 6 As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
    End point description
    The PFS rate was determined in participants who had a PD-L1 CPS of ≥1%, as measured by immunohistochemistry assay, at Month 6. PFS was defined as the time from randomization to the first documented PD or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by BICR. PD was a ≥20% increase in the sum of diameters of target lesions plus an absolute increase of ≥5 mm in the sum or the appearance of ≥1 new lesions. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. PFS at Month 6 was calculated using product-limit KM method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥1% CPS.
    End point type
    Secondary
    End point timeframe
    Month 6
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    282
    Units: Percentage of participants
        number (confidence interval 95%)
    37.9 (32.2 to 43.5)
    No statistical analyses for this end point

    Secondary: Progression Free Survival Rate (PFS Rate) at Month 12 As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%

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    End point title
    Progression Free Survival Rate (PFS Rate) at Month 12 As Assessed by BICR in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
    End point description
    The PFS rate was determined in participants who had a PD-L1 CPS of ≥10%, as measured by immunohistochemistry assay, at Month 12. PFS was defined as the time from randomization to the first documented PD or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by BICR. PD was a ≥20% increase in the sum of diameters of target lesions plus an absolute increase of ≥5 mm in the sum or the appearance of ≥1 new lesions. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. PFS at Month 12 was calculated using product-limit KM method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥10% CPS.
    End point type
    Secondary
    End point timeframe
    Month 12
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    110
    Units: Percentage of participants
        number (confidence interval 95%)
    38.6 (29.5 to 47.7)
    No statistical analyses for this end point

    Secondary: Overall Survival Rate (OS Rate) at Month 6 in All Participants

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    End point title
    Overall Survival Rate (OS Rate) at Month 6 in All Participants
    End point description
    The OS rate was determined for all participants at Month 6 and was defined as the time from randomization to death due to any cause. OS at Month 6 was calculated using product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment.
    End point type
    Secondary
    End point timeframe
    Month 6
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    370
    Units: Percentage of participants
        number (confidence interval 95%)
    67.0 (62.0 to 71.5)
    No statistical analyses for this end point

    Secondary: Overall Survival Rate (OS Rate) at Month 6 in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%

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    End point title
    Overall Survival Rate (OS Rate) at Month 6 in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
    End point description
    The OS rate was determined in participants who had a PD-L1 CPS of ≥1%, as measured by immunohistochemistry assay, at Month 6. OS was defined as the time from randomization to death due to any cause. OS at Month 6 was calculated using product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥1% CPS.
    End point type
    Secondary
    End point timeframe
    Month 6
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    282
    Units: Percentage of participants
        number (confidence interval 95%)
    71.3 (65.6 to 76.2)
    No statistical analyses for this end point

    Secondary: Overall Survival Rate (OS Rate) at Month 12 in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%

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    End point title
    Overall Survival Rate (OS Rate) at Month 12 in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
    End point description
    The OS rate was determined in participants who had a PD-L1 CPS of ≥1%, as measured by immunohistochemistry assay, at Month 12. OS was defined as the time from randomization to death due to any cause. OS at Month 12 was calculated using product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥1% CPS.
    End point type
    Secondary
    End point timeframe
    Month 12
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    282
    Units: Percentage of participants
        number (confidence interval 95%)
    50.9 (45.0 to 56.6)
    No statistical analyses for this end point

    Secondary: Overall Survival Rate (OS Rate) at Month 12 in All Participants

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    End point title
    Overall Survival Rate (OS Rate) at Month 12 in All Participants
    End point description
    The OS rate was determined for all participants at Month 12 and was defined as the time from randomization to death due to any cause. OS at Month 12 was calculated using product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment.
    End point type
    Secondary
    End point timeframe
    Month 12
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    370
    Units: Percentage of participants
        number (confidence interval 95%)
    46.9 (41.8 to 51.9)
    No statistical analyses for this end point

    Secondary: Overall Survival Rate (OS Rate) at Month 6 in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%

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    End point title
    Overall Survival Rate (OS Rate) at Month 6 in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
    End point description
    The OS rate was determined in participants who had a PD-L1 CPS of ≥10%, as measured by immunohistochemistry assay, at Month 6. OS was defined as the time from randomization to death due to any cause. OS at Month 6 was calculated using product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥10% CPS.
    End point type
    Secondary
    End point timeframe
    Month 6
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    110
    Units: Percentage of participants
        number (confidence interval 95%)
    76.3 (67.2 to 83.2)
    No statistical analyses for this end point

    Secondary: Overall Survival Rate (OS Rate) at Month 12 in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%

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    End point title
    Overall Survival Rate (OS Rate) at Month 12 in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
    End point description
    The OS rate was determined in participants who had a PD-L1 CPS of ≥10%, as measured by immunohistochemistry assay, at Month 12. OS was defined as the time from randomization to death due to any cause. OS at Month 12 was calculated using product-limit (Kaplan-Meier) method for censored data. Participants were censored at the date of their last assessment. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥1% CPS.
    End point type
    Secondary
    End point timeframe
    Month 12
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    110
    Units: Percentage of participants
        number (confidence interval 95%)
    60.7 (50.9 to 69.1)
    No statistical analyses for this end point

    Secondary: Programmed Cell Death Ligand 1 (PD-L1) Expression Status

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    End point title
    Programmed Cell Death Ligand 1 (PD-L1) Expression Status
    End point description
    PD-L1 expression status was determined as the percent of disease tumor cells, from newly obtained tumor biopsies, demonstrating plasma membrane PD-L1 staining of any intensity using an immunohistochemistry (IHC) assay. The assay uses a Combined Positive Score (CPS) as a measure of PD-L1 positivity. The CPS is calculated as the number of PD-L1-positive cells divided by the number of viable tumor cells analyzed multiplied by 100. A CPS of <1%=negative; ≥1%=positive; and ≥10%=strongly positive. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment.
    End point type
    Secondary
    End point timeframe
    Day 1
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    370
    Units: Participants
        PD-L1 CPS <1%
    79
        PD-L1 CPS ≥1% to <10%
    172
        PD-L1 CPS ≥10%
    110
        Unknown
    9
    No statistical analyses for this end point

    Secondary: Number of Participants Who Experienced At Least One Adverse Event (AE)

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    End point title
    Number of Participants Who Experienced At Least One Adverse Event (AE)
    End point description
    An AE was defined as any untoward medical occurrence in a participant administered a study treatment and did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the study treatment or protocol-specified procedure. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition that was temporally associated with the use of study treatment, was also an AE. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment.
    End point type
    Secondary
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    370
    Units: Participants
    361
    No statistical analyses for this end point

    Secondary: Number of Participants Who Discontinued Study Treatment Due to an Adverse Event (AE)

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    End point title
    Number of Participants Who Discontinued Study Treatment Due to an Adverse Event (AE)
    End point description
    An AE was defined as any untoward medical occurrence in a participant administered a study treatment and did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the study treatment or protocol-specified procedure. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition that was temporally associated with the use of study treatment, was also an AE. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment.
    End point type
    Secondary
    End point timeframe
    Up to approximately 26 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    370
    Units: Participants
    62
    No statistical analyses for this end point

    Other pre-specified: Objective Response Rate (ORR) Per Modified Response Evaluation Criteria in Solid Tumors (modified RECIST) in All Participants

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    End point title
    Objective Response Rate (ORR) Per Modified Response Evaluation Criteria in Solid Tumors (modified RECIST) in All Participants
    End point description
    ORR was determined in all participants and was defined as the percentage of participants who had a confirmed Complete Response (CR: complete disappearance of all lesions and no new lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per modified RECIST as assessed by Blinded Independent Central Review (BICR). Modified RECIST differs from RECIST 1.1 in that progressive disease requires confirmation by a repeat radiological assessment no less than 4 weeks from the date of first documented progressive disease. Participants with missing data were considered non-responders. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment.
    End point type
    Other pre-specified
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    370
    Units: Percentage of participants
        number (confidence interval 95%)
    30.5 (25.9 to 35.5)
    No statistical analyses for this end point

    Other pre-specified: Objective Response Rate (ORR) Per Modified Response Evaluation Criteria in Solid Tumors (modified RECIST) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%

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    End point title
    Objective Response Rate (ORR) Per Modified Response Evaluation Criteria in Solid Tumors (modified RECIST) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
    End point description
    ORR was determined in participants who had a PD-L1 CPS of ≥1% as measured by immunohistochemistry assay. ORR was defined as the percentage of participants who had a confirmed Complete Response (CR: complete disappearance of all lesions and no new lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per modified RECIST as assessed by Blinded Independent Central Review (BICR). Modified RECIST differs from RECIST 1.1 in that progressive disease requires confirmation by a repeat radiological assessment no less than 4 weeks from the date of first documented progressive disease. Participants with missing data were considered non-responders. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥1% CPS.
    End point type
    Other pre-specified
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    282
    Units: Percentage of participants
        number (confidence interval 95%)
    34.4 (28.9 to 40.3)
    No statistical analyses for this end point

    Other pre-specified: Objective Response Rate (ORR) Per Modified Response Evaluation Criteria in Solid Tumors (modified RECIST) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%

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    End point title
    Objective Response Rate (ORR) Per Modified Response Evaluation Criteria in Solid Tumors (modified RECIST) in Participants with a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
    End point description
    ORR was determined in participants who had a PD-L1 CPS of ≥10% as measured by immunohistochemistry assay. ORR was defined as the percentage of participants who had a confirmed Complete Response (CR: complete disappearance of all lesions and no new lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per modified RECIST as assessed by Blinded Independent Central Review (BICR). Modified RECIST differs from RECIST 1.1 in that progressive disease requires confirmation by a repeat radiological assessment no less than 4 weeks from the date of first documented progressive disease. Participants with missing data were considered non-responders. Per protocol, only data generated during the initial course of treatment contributed to the analysis. The analysis included all participants that received ≥1 dose of study treatment and had a PD-L1 positive expression of ≥10% CPS.
    End point type
    Other pre-specified
    End point timeframe
    Up to approximately 80.5 months
    End point values
    Pembrolizumab 200 mg
    Number of subjects analysed
    110
    Units: Percentage of participants
        number (confidence interval 95%)
    49.1 (39.4 to 58.8)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to approximately 80.5 months
    Adverse event reporting additional description
    AEs=all participants who received ≥1 dose of study treatment; all-cause mortality=all allocated participants. Per protocol, progression of cancer under study was not considered an AE unless related to study drug. MedDRA preferred terms "Neoplasm progression (NP)", "Malignant NP" & "Disease progression" not related to study drug are excluded as AEs.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    24.1
    Reporting groups
    Reporting group title
    Second Course Pembrolizumab
    Reporting group description
    Participants who met the criteria for retreatment received pembrolizumab 200 mg by IV infusion on Day 1 of each 21-day cycle for up to 1 year of treatment.

    Reporting group title
    Pembrolizumab
    Reporting group description
    Participants received pembrolizumab 200 mg by IV infusion on Day 1 of each 21-day cycle (Q3W) for up to 2 years. Eligible participants who stopped the initial course of pembrolizumab due to complete response (CR) or completed initial course of pembrolizumab and had stable disease but progressed after discontinuation, initiated a second course of pembrolizumab at the investigator's discretion for up to an additional year.

    Serious adverse events
    Second Course Pembrolizumab Pembrolizumab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    6 / 13 (46.15%)
    190 / 370 (51.35%)
         number of deaths (all causes)
    8
    305
         number of deaths resulting from adverse events
    0
    1
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Cancer pain
         subjects affected / exposed
    0 / 13 (0.00%)
    4 / 370 (1.08%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Plasma cell myeloma
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metastases to central nervous system
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malignant neoplasm progression
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malignant melanoma in situ
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lymphoma
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Squamous cell carcinoma
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour pain
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour associated fever
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Angiopathy
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Embolism
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Hypertensive crisis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypovolaemic shock
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Asthenia
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac complication associated with device
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Death
         subjects affected / exposed
    0 / 13 (0.00%)
    3 / 370 (0.81%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 3
    General physical health deterioration
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Oedema peripheral
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    0 / 13 (0.00%)
    5 / 370 (1.35%)
         occurrences causally related to treatment / all
    0 / 0
    3 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Aspiration
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Emphysema
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    0 / 13 (0.00%)
    5 / 370 (1.35%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoxia
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Pulmonary embolism
         subjects affected / exposed
    0 / 13 (0.00%)
    3 / 370 (0.81%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    0 / 13 (0.00%)
    6 / 370 (1.62%)
         occurrences causally related to treatment / all
    0 / 0
    5 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Panic attack
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Delirium
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Product issues
    Device occlusion
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Alanine aminotransferase increased
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood creatinine increased
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    0 / 13 (0.00%)
    4 / 370 (1.08%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Incisional hernia
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urostomy complication
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract stoma complication
         subjects affected / exposed
    0 / 13 (0.00%)
    3 / 370 (0.81%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stoma obstruction
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Overdose
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intentional overdose
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Acute left ventricular failure
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute myocardial infarction
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrioventricular block
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ischaemic cardiomyopathy
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Angina pectoris
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocarditis
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pericarditis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Encephalopathy
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    2 / 13 (15.38%)
    3 / 370 (0.81%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Central nervous system haemorrhage
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Facial paralysis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal cord compression
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anaemia
         subjects affected / exposed
    0 / 13 (0.00%)
    6 / 370 (1.62%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Immune thrombocytopenia
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Ascites
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    0 / 13 (0.00%)
    4 / 370 (1.08%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal motility disorder
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Duodenal obstruction
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 13 (7.69%)
    5 / 370 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ileus
         subjects affected / exposed
    0 / 13 (0.00%)
    3 / 370 (0.81%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal ischaemia
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    0 / 13 (0.00%)
    3 / 370 (0.81%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Large intestine perforation
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Nausea
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Large intestinal obstruction
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Proctitis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rectal haemorrhage
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    0 / 13 (0.00%)
    3 / 370 (0.81%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Liver injury
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystitis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Drug-induced liver injury
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatitis
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Autoimmune hepatitis
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash pruritic
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 13 (7.69%)
    13 / 370 (3.51%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 14
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Haematuria
         subjects affected / exposed
    0 / 13 (0.00%)
    12 / 370 (3.24%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 13
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic kidney disease
         subjects affected / exposed
    0 / 13 (0.00%)
    3 / 370 (0.81%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Hydronephrosis
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    0 / 13 (0.00%)
    5 / 370 (1.35%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Urinary incontinence
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary retention
         subjects affected / exposed
    0 / 13 (0.00%)
    5 / 370 (1.35%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract obstruction
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tubulointerstitial nephritis
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endocrine disorders
    Thyroiditis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Adrenal insufficiency
         subjects affected / exposed
    0 / 13 (0.00%)
    5 / 370 (1.35%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypophysitis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypopituitarism
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Addison's disease
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Crystal arthropathy
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Autoimmune arthritis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Back pain
         subjects affected / exposed
    0 / 13 (0.00%)
    4 / 370 (1.08%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bone pain
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Arthritis
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myositis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Musculoskeletal pain
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Muscular weakness
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Abscess neck
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute sinusitis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atypical pneumonia
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Escherichia sepsis
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 13 (7.69%)
    3 / 370 (0.81%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Diverticulitis
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Candida infection
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infected skin ulcer
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Influenza
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyelonephritis acute
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 13 (7.69%)
    15 / 370 (4.05%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 15
         deaths causally related to treatment / all
    0 / 0
    0 / 3
    Pyelonephritis
         subjects affected / exposed
    0 / 13 (0.00%)
    3 / 370 (0.81%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Kidney infection
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal abscess
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    0 / 13 (0.00%)
    9 / 370 (2.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 9
         deaths causally related to treatment / all
    0 / 0
    0 / 3
    Septic shock
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    0 / 13 (0.00%)
    26 / 370 (7.03%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 31
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    0 / 13 (0.00%)
    14 / 370 (3.78%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 14
         deaths causally related to treatment / all
    0 / 0
    0 / 4
    Metabolism and nutrition disorders
    Hypocalcaemia
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperuricaemia
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gout
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diabetic ketoacidosis
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    0 / 13 (0.00%)
    4 / 370 (1.08%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypercalcaemia
         subjects affected / exposed
    0 / 13 (0.00%)
    4 / 370 (1.08%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Type 1 diabetes mellitus
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    0 / 13 (0.00%)
    2 / 370 (0.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ketoacidosis
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Type 2 diabetes mellitus
         subjects affected / exposed
    0 / 13 (0.00%)
    1 / 370 (0.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Second Course Pembrolizumab Pembrolizumab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    12 / 13 (92.31%)
    342 / 370 (92.43%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    0 / 13 (0.00%)
    20 / 370 (5.41%)
         occurrences all number
    0
    21
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    0 / 13 (0.00%)
    20 / 370 (5.41%)
         occurrences all number
    0
    22
    Asthenia
         subjects affected / exposed
    0 / 13 (0.00%)
    44 / 370 (11.89%)
         occurrences all number
    0
    49
    Chills
         subjects affected / exposed
    0 / 13 (0.00%)
    27 / 370 (7.30%)
         occurrences all number
    0
    31
    Oedema
         subjects affected / exposed
    1 / 13 (7.69%)
    6 / 370 (1.62%)
         occurrences all number
    1
    6
    Influenza like illness
         subjects affected / exposed
    0 / 13 (0.00%)
    19 / 370 (5.14%)
         occurrences all number
    0
    21
    Fatigue
         subjects affected / exposed
    0 / 13 (0.00%)
    129 / 370 (34.86%)
         occurrences all number
    0
    156
    Oedema peripheral
         subjects affected / exposed
    1 / 13 (7.69%)
    63 / 370 (17.03%)
         occurrences all number
    1
    74
    Peripheral swelling
         subjects affected / exposed
    1 / 13 (7.69%)
    7 / 370 (1.89%)
         occurrences all number
    1
    7
    Pyrexia
         subjects affected / exposed
    0 / 13 (0.00%)
    51 / 370 (13.78%)
         occurrences all number
    0
    64
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    1 / 13 (7.69%)
    48 / 370 (12.97%)
         occurrences all number
    1
    57
    Cough
         subjects affected / exposed
    1 / 13 (7.69%)
    76 / 370 (20.54%)
         occurrences all number
    1
    92
    Atelectasis
         subjects affected / exposed
    1 / 13 (7.69%)
    3 / 370 (0.81%)
         occurrences all number
    1
    3
    Emphysema
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences all number
    1
    0
    Productive cough
         subjects affected / exposed
    1 / 13 (7.69%)
    17 / 370 (4.59%)
         occurrences all number
    2
    19
    Pleural effusion
         subjects affected / exposed
    1 / 13 (7.69%)
    12 / 370 (3.24%)
         occurrences all number
    1
    15
    Nasal congestion
         subjects affected / exposed
    1 / 13 (7.69%)
    12 / 370 (3.24%)
         occurrences all number
    1
    14
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    0 / 13 (0.00%)
    29 / 370 (7.84%)
         occurrences all number
    0
    29
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    0 / 13 (0.00%)
    27 / 370 (7.30%)
         occurrences all number
    0
    31
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 13 (0.00%)
    27 / 370 (7.30%)
         occurrences all number
    0
    31
    Blood alkaline phosphatase increased
         subjects affected / exposed
    0 / 13 (0.00%)
    27 / 370 (7.30%)
         occurrences all number
    0
    30
    Blood creatinine increased
         subjects affected / exposed
    0 / 13 (0.00%)
    53 / 370 (14.32%)
         occurrences all number
    0
    67
    Inspiratory capacity decreased
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences all number
    1
    0
    Weight decreased
         subjects affected / exposed
    2 / 13 (15.38%)
    44 / 370 (11.89%)
         occurrences all number
    2
    47
    White blood cell count decreased
         subjects affected / exposed
    1 / 13 (7.69%)
    2 / 370 (0.54%)
         occurrences all number
    1
    2
    Injury, poisoning and procedural complications
    Stoma site haemorrhage
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences all number
    1
    0
    Fall
         subjects affected / exposed
    0 / 13 (0.00%)
    22 / 370 (5.95%)
         occurrences all number
    0
    26
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 13 (7.69%)
    20 / 370 (5.41%)
         occurrences all number
    1
    23
    Dizziness
         subjects affected / exposed
    2 / 13 (15.38%)
    35 / 370 (9.46%)
         occurrences all number
    2
    41
    Cognitive disorder
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences all number
    1
    0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    3 / 13 (23.08%)
    73 / 370 (19.73%)
         occurrences all number
    3
    84
    Ear and labyrinth disorders
    Ear swelling
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences all number
    1
    0
    Eye disorders
    Diplopia
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences all number
    1
    0
    Gastrointestinal disorders
    Abdominal pain lower
         subjects affected / exposed
    1 / 13 (7.69%)
    6 / 370 (1.62%)
         occurrences all number
    1
    6
    Abdominal pain
         subjects affected / exposed
    1 / 13 (7.69%)
    47 / 370 (12.70%)
         occurrences all number
    1
    57
    Ascites
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences all number
    1
    0
    Constipation
         subjects affected / exposed
    3 / 13 (23.08%)
    87 / 370 (23.51%)
         occurrences all number
    3
    100
    Vomiting
         subjects affected / exposed
    0 / 13 (0.00%)
    56 / 370 (15.14%)
         occurrences all number
    0
    79
    Nausea
         subjects affected / exposed
    1 / 13 (7.69%)
    77 / 370 (20.81%)
         occurrences all number
    1
    89
    Dry mouth
         subjects affected / exposed
    0 / 13 (0.00%)
    23 / 370 (6.22%)
         occurrences all number
    0
    23
    Diarrhoea
         subjects affected / exposed
    0 / 13 (0.00%)
    82 / 370 (22.16%)
         occurrences all number
    0
    121
    Hepatobiliary disorders
    Hepatitis acute
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences all number
    1
    0
    Skin and subcutaneous tissue disorders
    Stasis dermatitis
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences all number
    1
    0
    Rash
         subjects affected / exposed
    0 / 13 (0.00%)
    59 / 370 (15.95%)
         occurrences all number
    0
    83
    Pruritus
         subjects affected / exposed
    1 / 13 (7.69%)
    87 / 370 (23.51%)
         occurrences all number
    1
    114
    Renal and urinary disorders
    Proteinuria
         subjects affected / exposed
    1 / 13 (7.69%)
    21 / 370 (5.68%)
         occurrences all number
    1
    23
    Pollakiuria
         subjects affected / exposed
    1 / 13 (7.69%)
    16 / 370 (4.32%)
         occurrences all number
    1
    16
    Haematuria
         subjects affected / exposed
    0 / 13 (0.00%)
    53 / 370 (14.32%)
         occurrences all number
    0
    63
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    1 / 13 (7.69%)
    42 / 370 (11.35%)
         occurrences all number
    1
    42
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    0 / 13 (0.00%)
    54 / 370 (14.59%)
         occurrences all number
    0
    74
    Pain in extremity
         subjects affected / exposed
    0 / 13 (0.00%)
    30 / 370 (8.11%)
         occurrences all number
    0
    31
    Joint stiffness
         subjects affected / exposed
    1 / 13 (7.69%)
    3 / 370 (0.81%)
         occurrences all number
    1
    3
    Muscular weakness
         subjects affected / exposed
    0 / 13 (0.00%)
    26 / 370 (7.03%)
         occurrences all number
    0
    29
    Myalgia
         subjects affected / exposed
    0 / 13 (0.00%)
    20 / 370 (5.41%)
         occurrences all number
    0
    22
    Neck pain
         subjects affected / exposed
    1 / 13 (7.69%)
    5 / 370 (1.35%)
         occurrences all number
    1
    5
    Back pain
         subjects affected / exposed
    1 / 13 (7.69%)
    47 / 370 (12.70%)
         occurrences all number
    1
    55
    Vertebral lesion
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences all number
    1
    0
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    1 / 13 (7.69%)
    16 / 370 (4.32%)
         occurrences all number
    1
    17
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 13 (0.00%)
    19 / 370 (5.14%)
         occurrences all number
    0
    23
    Urinary tract infection
         subjects affected / exposed
    1 / 13 (7.69%)
    76 / 370 (20.54%)
         occurrences all number
    1
    98
    Tooth infection
         subjects affected / exposed
    1 / 13 (7.69%)
    2 / 370 (0.54%)
         occurrences all number
    1
    3
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 13 (7.69%)
    102 / 370 (27.57%)
         occurrences all number
    1
    116
    Dehydration
         subjects affected / exposed
    0 / 13 (0.00%)
    19 / 370 (5.14%)
         occurrences all number
    0
    19
    Hyperglycaemia
         subjects affected / exposed
    1 / 13 (7.69%)
    37 / 370 (10.00%)
         occurrences all number
    1
    51
    Hyperkalaemia
         subjects affected / exposed
    1 / 13 (7.69%)
    24 / 370 (6.49%)
         occurrences all number
    1
    29
    Hypoalbuminaemia
         subjects affected / exposed
    0 / 13 (0.00%)
    19 / 370 (5.14%)
         occurrences all number
    0
    26
    Type 2 diabetes mellitus
         subjects affected / exposed
    1 / 13 (7.69%)
    0 / 370 (0.00%)
         occurrences all number
    1
    0
    Hyponatraemia
         subjects affected / exposed
    0 / 13 (0.00%)
    41 / 370 (11.08%)
         occurrences all number
    0
    53
    Hypokalaemia
         subjects affected / exposed
    1 / 13 (7.69%)
    14 / 370 (3.78%)
         occurrences all number
    1
    20

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    15 Oct 2014
    Amendment 1 revised text in the inclusion criteria section to clearly state that participants must be refractory to available or standard therapy for treatment of their bladder cancer to participate in the biomarker cut-point determination part of the study if they do not meet cisplatin-ineligible criteria. The amendment also revised the safety and tolerability objective to state that safety and tolerability will be evaluated in all subjects regardless of programmed cell death ligand 1(PD-L1) status.
    16 Mar 2016
    Amendment 2 added objectives for programmed cell death ligand 1 (PD-L1) positive and PD-L1 strongly positive populations and removed hypotheses testing. Revisions were made to the statistical methods to adjust for the removal of the hypotheses testing.
    19 Dec 2017
    Amendment 3 added guidelines for dose modification in the event of myocarditis and updated guidelines for several other conditions.
    20 Sep 2019
    Amendment 4 added language regarding the potential for participants to be enrolled in an extension study if one becomes available.
    21 May 2021
    Amendment 5 updated the dose modification and toxicity management guidelines for immune-related adverse events (irAEs).

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

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