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    Clinical Trial Results:
    Phase II randomized study evaluation of FOLFIRINOX +/- LV5FU2 in maintenance and FIRGEM in 1rst line of metastatic pancreas cancer

    Summary
    EudraCT number
    2014-002574-36
    Trial protocol
    FR  
    Global end of trial date
    10 Aug 2021

    Results information
    Results version number
    v1(current)
    This version publication date
    05 Oct 2024
    First version publication date
    05 Oct 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    PRODIGE35
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Fédération Francophone de Cancérologie Digestive (FFCD)
    Sponsor organisation address
    7 Bd Jeanne d'Arc, Dijon, France, 21000
    Public contact
    Head of Biostatistics, Fédération Francophone de Cancérologie Digestive, +33 380393479, karine.le-malicot@u-bourgogne.fr
    Scientific contact
    Head of Biostatistics, Fédération Francophone de Cancérologie Digestive, +33 380393479, karine.le-malicot@u-bourgogne.fr
    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
    08 Feb 2019
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    01 Dec 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    10 Aug 2021
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    In this randomized phase II study, patients with metastatic pancreatic cancer were randomly assigned to receive either 6 months of FOLFIRINOX (arm A), 4 months of FOLFIRINOX followed by leucovorin plus fluorouracil maintenance treatment for controlled patients (arm B), or a sequential treatment alternating gemcitabine and fluorouracil, leucovorin, and irinotecan every 2 months (arm C). The primary end point was progression-free survival at 6 months. Main objective is to evaluate, in each arm, the patient rate in live and without radiological and or clinical progression at 6 months after randomization,
    Protection of trial subjects
    The study was done in accordance with the Declaration of Helsinki (amended 2000) and the International Conference on Harmonization of Technical Requirements of Pharmaceuticals for Human Use (ICH) Note for Guidance on Good Clinical Practice and approved by the appropriate Ethics Committees.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Dec 2014
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 273
    Worldwide total number of subjects
    273
    EEA total number of subjects
    273
    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)
    138
    From 65 to 84 years
    135
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Between January 2015 and November 2016, 276 patients were randomly assigned to either Folfirinox (Arm A), Folfirinox (8 cures) then LV5FU2 (maintenance) then Folfirinox if progression (Arm B) or FIRGEM (alternating 2 months of FOLFIRI and 2 months of GEMCITABINE) (Arm C)

    Pre-assignment
    Screening details
    Patients were eligible to be included in this study if they had histologically confirmed mPC and measurable metastases; had received no previous chemotherapy or radiotherapy; and had an ECOG performance status of 0 or 1, an adequate bone marrow reserve, and adequate liver and renal function.

    Pre-assignment period milestones
    Number of subjects started
    273
    Number of subjects completed
    273

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Arm A - FOLFIRINOX
    Arm description
    FOLFIRINOX, cures administered every 2 weeks up to a maximum of 12 cures.
    Arm type
    Active comparator

    Investigational medicinal product name
    FOLFIRINOX
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    - Oxaliplatin 85 mg/m2 D1 over 2h, then - Irinotecan 180 mg/m2 D1 over 90 min - Folinic acid 400 mg/m2, D1 in 2h (during irinotecan infusion) - 5-FU bolus 400 mg/m² D1 followed by continuous 5-FU 2400 mg/m2 in total over 46 hours, i.e. 1200 mg/m2 on D1 and 1200 mg/m² on D2.

    Arm title
    ARM B - FOLFIRINOX with simplified LV5FU2 maintenance
    Arm description
    FOLFIRINOX with simplified LV5FU2 maintenance (Arm B)
    Arm type
    Experimental

    Investigational medicinal product name
    FOLFIRINOX + LV5FU2
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    FOLFIRINOX for 4 months (8 courses, 1 course every 2 weeks), then if disease is controlled (stable or objective response (CR or PR)), simplified LV5FU2 (1 course every 2 weeks) in maintenance until progression. FOLFIRINOX at the same doses as described above for arm A. LV5FU2 simplified maintenance until progression: - Folinic acid 400 mg/m² (200 mg/m² if Elvorine), 2-hour infusion followed by - 5FU 400 mg/m² bolus over 10 min, followed by 5FU 2400 mg/m² infusion over 46 hours.

    Arm title
    Arm C - FIRGEM
    Arm description
    Alternate every 2 months with FOLFIRI.3 (4 courses, 1 course every 2 weeks) and gemcitabine 1000 mg/m2 (2 cycles of 3 courses, one course per week 3 weeks out of 4).
    Arm type
    Experimental

    Investigational medicinal product name
    FIRGEM
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Suspension for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    FOLFIRI.3 : - Irinotecan 90 mg/m² on D1 as a 60-minute infusion in Y of folinic acid, - Folinic acid 400 mg/m² (or 200 mg/m² Elvorine) on D1 as a 2-hour infusion - Continuous 5FU 2000 mg/m² for 46 hours - Then irinotecan 90 mg/m² (1h) on D3, at the end of the 5-FU infusion. GEMCITABINE: - 1000 mg/m² infused over 30 min on D1, D8, D15, D29, D36 and D43 for 2 months (1 injection per week for 3 weeks, followed by 7 days' rest (1 week) and resumption of 1 injection per week for 3 weeks). In the event of progression or limiting toxicity with one of the two treatments, it is recommended (unless contraindicated or refused) to continue with the other treatment until progression, unacceptable toxicity or patient refusal.

    Number of subjects in period 1
    Arm A - FOLFIRINOX ARM B - FOLFIRINOX with simplified LV5FU2 maintenance Arm C - FIRGEM
    Started
    91
    92
    90
    Treated Patient
    87
    91
    88
    Completed
    87
    91
    88
    Not completed
    4
    1
    2
         Adverse event, serious fatal
    1
    1
    -
         Adverse event, non-fatal
    3
    -
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Arm A - FOLFIRINOX
    Reporting group description
    FOLFIRINOX, cures administered every 2 weeks up to a maximum of 12 cures.

    Reporting group title
    ARM B - FOLFIRINOX with simplified LV5FU2 maintenance
    Reporting group description
    FOLFIRINOX with simplified LV5FU2 maintenance (Arm B)

    Reporting group title
    Arm C - FIRGEM
    Reporting group description
    Alternate every 2 months with FOLFIRI.3 (4 courses, 1 course every 2 weeks) and gemcitabine 1000 mg/m2 (2 cycles of 3 courses, one course per week 3 weeks out of 4).

    Reporting group values
    Arm A - FOLFIRINOX ARM B - FOLFIRINOX with simplified LV5FU2 maintenance Arm C - FIRGEM Total
    Number of subjects
    91 92 90 273
    Age categorical
    Units: Subjects
        In utero
    0 0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0 0
        Newborns (0-27 days)
    0 0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0 0
        Children (2-11 years)
    0 0 0 0
        Adolescents (12-17 years)
    0 0 0 0
        Adults (18-64 years)
    46 51 41 138
        From 65-84 years
    45 41 49 135
        85 years and over
    0 0 0 0
    Age continuous
    Units: years
        arithmetic mean (full range (min-max))
    62.57 (39.9 to 75.97) 63.52 (40.32 to 75.27) 64.07 (45.21 to 75.64) -
    Gender categorical
    Units: Subjects
        Female
    35 34 43 112
        Male
    56 58 47 161
    Subject analysis sets

    Subject analysis set title
    mITT for efficacy (Arm B)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    mITT for efficacy (Arm B) is defined as patients randomized in arm B whatever the inclusion and noninclusion criteria and who took at least one dose of treatment.

    Subject analysis set title
    mITT for efficacy (Arm C)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    mITT for efficacy (Arm C) is defined as patients randomized in arm C whatever the inclusion and noninclusion criteria and who took at least one dose of treatment.

    Subject analysis sets values
    mITT for efficacy (Arm B) mITT for efficacy (Arm C)
    Number of subjects
    91
    88
    Age categorical
    Units: Subjects
        In utero
        Preterm newborn infants (gestational age < 37 wks)
        Newborns (0-27 days)
        Infants and toddlers (28 days-23 months)
        Children (2-11 years)
        Adolescents (12-17 years)
        Adults (18-64 years)
    50
    40
        From 65-84 years
    41
    48
        85 years and over
    Age continuous
    Units: years
        arithmetic mean (full range (min-max))
    Gender categorical
    Units: Subjects
        Female
        Male

    End points

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    End points reporting groups
    Reporting group title
    Arm A - FOLFIRINOX
    Reporting group description
    FOLFIRINOX, cures administered every 2 weeks up to a maximum of 12 cures.

    Reporting group title
    ARM B - FOLFIRINOX with simplified LV5FU2 maintenance
    Reporting group description
    FOLFIRINOX with simplified LV5FU2 maintenance (Arm B)

    Reporting group title
    Arm C - FIRGEM
    Reporting group description
    Alternate every 2 months with FOLFIRI.3 (4 courses, 1 course every 2 weeks) and gemcitabine 1000 mg/m2 (2 cycles of 3 courses, one course per week 3 weeks out of 4).

    Subject analysis set title
    mITT for efficacy (Arm B)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    mITT for efficacy (Arm B) is defined as patients randomized in arm B whatever the inclusion and noninclusion criteria and who took at least one dose of treatment.

    Subject analysis set title
    mITT for efficacy (Arm C)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    mITT for efficacy (Arm C) is defined as patients randomized in arm C whatever the inclusion and noninclusion criteria and who took at least one dose of treatment.

    Primary: rate of patients alive without progression at 6 months

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    End point title
    rate of patients alive without progression at 6 months [1]
    End point description
    The primary end point was 6-month PFS rate in each arm and served to determine the better treatment for further trials. In the 91 ittm patients in arm B: If 35 or more patients are alive without progression at 6 months, we conclude that the treatment is effective. In the 88 ittm patients in arm C: If 34 or more patients are alive without progression at 6 months, we conclude that the treatment is effective.
    End point type
    Primary
    End point timeframe
    At 6 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: This is a non-comparative study, so there are no inferential statistics.
    End point values
    mITT for efficacy (Arm B) mITT for efficacy (Arm C)
    Number of subjects analysed
    91
    88
    Units: Patients
    number (not applicable)
        Alive without progression
    39
    30
        Progression and/or death
    52
    58
    No statistical analyses for this end point

    Secondary: Overall Survival

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    End point title
    Overall Survival
    End point description
    End point type
    Secondary
    End point timeframe
    Until the end of the follow-up or death (Whatever the cause)
    End point values
    Arm A - FOLFIRINOX ARM B - FOLFIRINOX with simplified LV5FU2 maintenance Arm C - FIRGEM
    Number of subjects analysed
    91
    92
    90
    Units: Months
        median (confidence interval 95%)
    10.1 (8.5 to 12.2)
    11.2 (9.0 to 13.1)
    7.3 (5.7 to 9.5)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All AEs (related and unrelated, expected and unexpected) occurring in the course of the study, from the signature of the informed consent form and until 30 days after the last dose of the study drug were reported by the investigator.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    NCI CTC
    Dictionary version
    4.0
    Reporting groups
    Reporting group title
    Safety Population
    Reporting group description
    The safety population is defined as all patients included in the study, regardless of eligibility criteria, who actually received at least one dose of the treatment allocated to them.

    Serious adverse events
    Safety Population
    Total subjects affected by serious adverse events
         subjects affected / exposed
    141 / 266 (53.01%)
         number of deaths (all causes)
    245
         number of deaths resulting from adverse events
    2
    Vascular disorders
    Thromboembolic event
         subjects affected / exposed
    14 / 266 (5.26%)
         occurrences causally related to treatment / all
    14 / 14
         deaths causally related to treatment / all
    0 / 0
    Hematoma
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypertension
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Superior vena cava syndrome
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Pain
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Non-cardiac chest pain
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Fatigue
         subjects affected / exposed
    39 / 266 (14.66%)
         occurrences causally related to treatment / all
    39 / 39
         deaths causally related to treatment / all
    0 / 0
    fever
         subjects affected / exposed
    10 / 266 (3.76%)
         occurrences causally related to treatment / all
    10 / 10
         deaths causally related to treatment / all
    0 / 0
    Chills
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Flu symptoms
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Respiratory, thoracic and mediastinal disorders
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Laryngospasm
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Mental confusion
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Depression
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Bilirubin conjugated increased
         subjects affected / exposed
    7 / 266 (2.63%)
         occurrences causally related to treatment / all
    7 / 7
         deaths causally related to treatment / all
    0 / 0
    Creatinine urine increased
         subjects affected / exposed
    2 / 266 (0.75%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    white blood cells decreased
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    anemia
         subjects affected / exposed
    6 / 266 (2.26%)
         occurrences causally related to treatment / all
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    6 / 266 (2.26%)
         occurrences causally related to treatment / all
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    Weight loss
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    platelet decreased
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Injury, poisoning and procedural complication, other
         subjects affected / exposed
    2 / 266 (0.75%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Cardiac arrest
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Acute coronary syndrome
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Sinus tachycardia
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Transient ischaemic attack
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Neurotoxicity
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cognitive disorder
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Hypocellular bone marrow
         subjects affected / exposed
    2 / 266 (0.75%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Gastrointestinal disorder
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Ascites
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    5 / 266 (1.88%)
         occurrences causally related to treatment / all
    5 / 5
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    22 / 266 (8.27%)
         occurrences causally related to treatment / all
    22 / 22
         deaths causally related to treatment / all
    0 / 0
    Stomach ache
         subjects affected / exposed
    4 / 266 (1.50%)
         occurrences causally related to treatment / all
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    24 / 266 (9.02%)
         occurrences causally related to treatment / all
    24 / 24
         deaths causally related to treatment / all
    0 / 0
    Lower gastrointestinal haemorrhage
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Rectal haemorrhage
         subjects affected / exposed
    2 / 266 (0.75%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Inflammation of the mucosa of the small intestine
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Oral mucosa
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    10 / 266 (3.76%)
         occurrences causally related to treatment / all
    10 / 10
         deaths causally related to treatment / all
    0 / 0
    Obstruction of the small intestine
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Colon obstruction
         subjects affected / exposed
    13 / 266 (4.89%)
         occurrences causally related to treatment / all
    13 / 13
         deaths causally related to treatment / all
    0 / 0
    Duodenal occlusion
         subjects affected / exposed
    5 / 266 (1.88%)
         occurrences causally related to treatment / all
    5 / 5
         deaths causally related to treatment / all
    0 / 0
    Oesophagitis
         subjects affected / exposed
    2 / 266 (0.75%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Pancreatitis
         subjects affected / exposed
    2 / 266 (0.75%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Small intestinal perforation
         subjects affected / exposed
    2 / 266 (0.75%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastric perforation
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Duodenal stenosis
         subjects affected / exposed
    2 / 266 (0.75%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    26 / 266 (9.77%)
         occurrences causally related to treatment / all
    26 / 26
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    hepatobiliary disorder
         subjects affected / exposed
    11 / 266 (4.14%)
         occurrences causally related to treatment / all
    11 / 11
         deaths causally related to treatment / all
    0 / 0
    hepatalgia
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gallbladder obstruction
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    hematuria
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Acute renal lesion
         subjects affected / exposed
    2 / 266 (0.75%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Urinary retention
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthritis
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Back pain
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Bone pain
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Catheter-related infection
         subjects affected / exposed
    6 / 266 (2.26%)
         occurrences causally related to treatment / all
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    Peritoneal infection
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    pulmonary infection
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    renal infection
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Biliary tract infection
         subjects affected / exposed
    5 / 266 (1.88%)
         occurrences causally related to treatment / all
    5 / 5
         deaths causally related to treatment / all
    0 / 0
    Infections and infestation, other
         subjects affected / exposed
    2 / 266 (0.75%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Septicemia
         subjects affected / exposed
    15 / 266 (5.64%)
         occurrences causally related to treatment / all
    15 / 15
         deaths causally related to treatment / all
    1 / 1
    Metabolism and nutrition disorders
    anorexia
         subjects affected / exposed
    13 / 266 (4.89%)
         occurrences causally related to treatment / all
    13 / 13
         deaths causally related to treatment / all
    0 / 0
    Dehydration
         subjects affected / exposed
    4 / 266 (1.50%)
         occurrences causally related to treatment / all
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypernatraemia
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    3 / 266 (1.13%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders, other
         subjects affected / exposed
    1 / 266 (0.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Safety Population
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    266 / 266 (100.00%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    168 / 266 (63.16%)
         occurrences all number
    168
    Aspartate aminotransferase increased
         subjects affected / exposed
    174 / 266 (65.41%)
         occurrences all number
    174
    Bilirubin conjugated increased
         subjects affected / exposed
    69 / 266 (25.94%)
         occurrences all number
    69
    Creatine urine increased
         subjects affected / exposed
    25 / 266 (9.40%)
         occurrences all number
    25
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    142 / 266 (53.38%)
         occurrences all number
    142
    White blood cell count decreased
         subjects affected / exposed
    54 / 266 (20.30%)
         occurrences all number
    54
    Anaemia
         subjects affected / exposed
    254 / 266 (95.49%)
         occurrences all number
    254
    Neutrophil count decreased
         subjects affected / exposed
    152 / 266 (57.14%)
         occurrences all number
    152
    Lymphocyte count decreased
         subjects affected / exposed
    62 / 266 (23.31%)
         occurrences all number
    62
    alkaline phosphatase increased
         subjects affected / exposed
    222 / 266 (83.46%)
         occurrences all number
    222
    Weight decreased
         subjects affected / exposed
    57 / 266 (21.43%)
         occurrences all number
    57
    Platelet count decreased
         subjects affected / exposed
    170 / 266 (63.91%)
         occurrences all number
    170
    Vascular disorders
    thromboembolic event
         subjects affected / exposed
    22 / 266 (8.27%)
         occurrences all number
    22
    Nervous system disorders
    Dysgeusia
         subjects affected / exposed
    15 / 266 (5.64%)
         occurrences all number
    15
    Neurotoxicity
         subjects affected / exposed
    146 / 266 (54.89%)
         occurrences all number
    146
    General disorders and administration site conditions
    Fever
         subjects affected / exposed
    66 / 266 (24.81%)
         occurrences all number
    66
    Fatigue
         subjects affected / exposed
    226 / 266 (84.96%)
         occurrences all number
    226
    Oedema of the limbs
         subjects affected / exposed
    25 / 266 (9.40%)
         occurrences all number
    25
    Immune system disorders
    allergic reaction
         subjects affected / exposed
    14 / 266 (5.26%)
         occurrences all number
    14
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    87 / 266 (32.71%)
         occurrences all number
    87
    Diarrhoea
         subjects affected / exposed
    204 / 266 (76.69%)
         occurrences all number
    204
    Stomach pain
         subjects affected / exposed
    25 / 266 (9.40%)
         occurrences all number
    25
    Abdominal pain
         subjects affected / exposed
    116 / 266 (43.61%)
         occurrences all number
    116
    Oral Mucositis
         subjects affected / exposed
    79 / 266 (29.70%)
         occurrences all number
    79
    Nausea
         subjects affected / exposed
    203 / 266 (76.32%)
         occurrences all number
    203
    Vomiting
         subjects affected / exposed
    144 / 266 (54.14%)
         occurrences all number
    144
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    20 / 266 (7.52%)
         occurrences all number
    20
    Skin and subcutaneous tissue disorders
    Skin disorder
         subjects affected / exposed
    18 / 266 (6.77%)
         occurrences all number
    18
    Alopecia
         subjects affected / exposed
    61 / 266 (22.93%)
         occurrences all number
    61
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    26 / 266 (9.77%)
         occurrences all number
    26
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    23 / 266 (8.65%)
         occurrences all number
    23
    Myalgia
         subjects affected / exposed
    18 / 266 (6.77%)
         occurrences all number
    18
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    146 / 266 (54.89%)
         occurrences all number
    146
    Hyperglycaemia
         subjects affected / exposed
    36 / 266 (13.53%)
         occurrences all number
    36
    Hyperkalaemia
         subjects affected / exposed
    34 / 266 (12.78%)
         occurrences all number
    34
    Hypoalbuminaemia
         subjects affected / exposed
    63 / 266 (23.68%)
         occurrences all number
    63
    Hypocalcaemia
         subjects affected / exposed
    29 / 266 (10.90%)
         occurrences all number
    29
    Hypokalaemia
         subjects affected / exposed
    41 / 266 (15.41%)
         occurrences all number
    41
    Hyponatraemia
         subjects affected / exposed
    40 / 266 (15.04%)
         occurrences all number
    40

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

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