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    Clinical Trial Results:
    A Randomized, Multic enter, Double-Blind, Multinational, Phase 3 Trial Comparing the Efficacy of Ipilimumab in Addition to Paclitaxel and Carboplatin versus Placebo in Addition to Paclitaxel and Carboplatin in Subjects with Stage IV/Recurrent Non-Small Cell Lung Cancer (NSCLC) with Squamous Histology

    Summary
    EudraCT number
    2014-002604-25
    Trial protocol
    HU   DE   PL  
    Global end of trial date
    03 May 2018

    Results information
    Results version number
    v1(current)
    This version publication date
    05 Jun 2019
    First version publication date
    05 Jun 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CA184-153
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02279732
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Bristol-Myers Squibb Research and Development
    Sponsor organisation address
    1717 West Nanjing Road, Shanghai, China, 200040
    Public contact
    Bristol-Myers Squibb Study Director, Bristol-Myers Squibb Research and Development, Clinical.Trials@bms.com
    Scientific contact
    Bristol-Myers Squibb Study Director, Bristol-Myers Squibb Research and Development, Clinical.Trials@bms.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
    03 May 2018
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    03 May 2018
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    The main objective of this study was to compare overall survival (OS) of subjects with Stage IV/recurrent NSCLC of squamous histology who have been randomized to ipilimumab in addition to paclitaxel and carboplatin versus placebo in addition to paclitaxel and carboplatin and have received at least one dose of blinded study therapy.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and in compliance with all International Conference on Harmonization Good Clinical Practice Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were followed.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    15 Oct 2014
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety, Efficacy
    Long term follow-up duration
    5 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    China: 268
    Country: Number of subjects enrolled
    Korea, Republic of: 18
    Country: Number of subjects enrolled
    Germany: 15
    Country: Number of subjects enrolled
    Poland: 12
    Country: Number of subjects enrolled
    Hungary: 27
    Country: Number of subjects enrolled
    Singapore: 2
    Worldwide total number of subjects
    342
    EEA total number of subjects
    54
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    0
    From 65 to 84 years
    229
    85 years and over
    113

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    342 participants enrolled, 295 were randomized to ipilimumab (148) and placebo arms (147). After chemotherapy, double blinded study treatment, which was the focus of the study, was started.Of all randomized participants, only 98 (ipilimumab arm) and 106 (placebo arm) participants received at least one dose of blinded study therapy.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Investigator, Monitor, Subject, Carer, Data analyst, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Ipi + PAC/CAR
    Arm description
    Ipilumumab + paclitaxel/Carboplatin
    Arm type
    Experimental

    Investigational medicinal product name
    Paclitaxel
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received a dose of paclitaxel 175 mg/m^2 as IV solution.

    Investigational medicinal product name
    Carboplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate and solvent for solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received a dose of Carboplatin AUC = 6 as IV solution.

    Investigational medicinal product name
    Ipilimumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received Ipilimumab 10 mg/kg as IV solution.

    Arm title
    Placebo + PAC/CAR
    Arm description
    Placebo + paclitaxel/Carboplatin
    Arm type
    Placebo

    Investigational medicinal product name
    Paclitaxel
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received a dose of paclitaxel 175 mg/m^2 as IV solution.

    Investigational medicinal product name
    Carboplatin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate and solvent for solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received a dose of Carboplatin AUC = 6 as IV solution.

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received placebo matched to Ipilimumab as IV solution.

    Number of subjects in period 1 [1]
    Ipi + PAC/CAR Placebo + PAC/CAR
    Started
    98
    106
    Completed
    0
    0
    Not completed
    98
    106
         Adverse event, serious fatal
    23
    20
         Disease progression
    13
    3
         Adverse event, non-fatal
    1
    2
         Maximum clinical benefit
    1
    -
         Unknown
    3
    3
         Unspecified
    53
    67
         Study Drug Toxicity
    2
    -
         Lost to follow-up
    -
    1
         Subject requested to discontinue
    -
    1
         Withdrawal by subject
    2
    7
         Administrative reason by sponsor
    -
    2
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: 342 subjects enrolled, 295 were randomized to ipilimumab (148) and placebo arms (147). After chemotherapy, double blinded study treatment was started. Of all randomized subjects, only 98 (ipilimumab arm) and 106 (placebo arm) participants received at least one dose of blinded study therapy.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Ipi + PAC/CAR
    Reporting group description
    Ipilumumab + paclitaxel/Carboplatin

    Reporting group title
    Placebo + PAC/CAR
    Reporting group description
    Placebo + paclitaxel/Carboplatin

    Reporting group values
    Ipi + PAC/CAR Placebo + PAC/CAR Total
    Number of subjects
    98 106 204
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    68 75 143
        From 65-84 years
    30 31 61
        85 years and over
    0 0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    60.9 ± 6.89 59.8 ± 8.22 -
    Gender categorical
    Units: Subjects
        Female
    11 13 24
        Male
    87 93 180
    Race/Ethnicity, Customized
    Units: Subjects
        Chinese
    81 80 161
        Non-Chinese
    17 26 43

    End points

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    End points reporting groups
    Reporting group title
    Ipi + PAC/CAR
    Reporting group description
    Ipilumumab + paclitaxel/Carboplatin

    Reporting group title
    Placebo + PAC/CAR
    Reporting group description
    Placebo + paclitaxel/Carboplatin

    Primary: Overall Survival (OS) of all Randomized Subjects Who Received at Least one Dose of Blinded Study Therapy

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    End point title
    Overall Survival (OS) of all Randomized Subjects Who Received at Least one Dose of Blinded Study Therapy [1]
    End point description
    OS is defined as the time from the date of randomization until the date of death. For those subjects who have not died, OS was censored on the last date the subject was known to be alive. Analysis population included all enrolled subjects who were randomized and received at least 1 dose of blinded study therapy. Here'99999' signifies data not available. The sponsor decided to discontinue enrollment and randomization in the study CA184-153 effective 25-Sep-2015. As a result, the primary endpoint was not analyzed for study CA184-153.
    End point type
    Primary
    End point timeframe
    Approximately 43 months post study start
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The sponsor decided to discontinue enrollment and randomization in the study effective 25-Sep-2015. As a result, the primary endpoint was not analyzed for study.
    End point values
    Ipi + PAC/CAR Placebo + PAC/CAR
    Number of subjects analysed
    98
    106
    Units: months
        median (confidence interval 95%)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    No statistical analyses for this end point

    Secondary: Overall Survival of all Randomized Subjects

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    End point title
    Overall Survival of all Randomized Subjects
    End point description
    OS is defined as the time from the date of randomization until the date of death. For those participants who have not died, OS was censored on the last date the participant was known to be alive. All randomized subjects included all enrolled subjects who were randomized to a treatment arm. Here'99999' signifies data not available. The sponsor decided to discontinue enrollment and randomization in the study CA184-153 effective 25-Sep-2015. As a result, the primary endpoint was not analyzed for study CA184-153.
    End point type
    Secondary
    End point timeframe
    Approximately 43 months post study start
    End point values
    Ipi + PAC/CAR Placebo + PAC/CAR
    Number of subjects analysed
    98
    98
    Units: months
        median (confidence interval 95%)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    No statistical analyses for this end point

    Secondary: Progression-free Survival (PFS) Among all Randomized Subjects who Received at Least one Dose of Blinded Study Therapy Using Modified World Health Organization (mWHO) Criteria

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    End point title
    Progression-free Survival (PFS) Among all Randomized Subjects who Received at Least one Dose of Blinded Study Therapy Using Modified World Health Organization (mWHO) Criteria
    End point description
    PFS is defined as the time between the date of randomization and the date of progression per mWHO criteria or death, whichever occurs first. A subject who died without reported progression per mWHO criteria was considered to have progressed on the date of death. For those subjects who remained alive and had not progressed, PFS was censored on the date of last evaluable tumor assessment. For those subjects who remained alive and had no recorded post-baseline tumor assessment, PFS was censored on the day of randomization. Analysis population included all enrolled subjects who were randomized and received at least 1 dose of blinded study therapy. Here'99999' signifies data not available. The sponsor decided to discontinue enrollment and randomization in the study CA184-153 effective 25-Sep-2015. As a result, the primary endpoint was not analyzed for study CA184-153.
    End point type
    Secondary
    End point timeframe
    Up to 43 months
    End point values
    Ipi + PAC/CAR Placebo + PAC/CAR
    Number of subjects analysed
    98
    106
    Units: months
        median (confidence interval 95%)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first dose of blinded study therapy and 90 days after last dose of blinded study therapy (Approximately 43 months assessed up to May 2018)
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21.0
    Reporting groups
    Reporting group title
    Ipilimumab + Carboplatin/Paclitaxel
    Reporting group description
    Participants received a dose of paclitaxel 175 milligram per meter square (mg/m^2) and Carboplatin area under the curve (AUC) equal to (=) 6 as intravenous (IV) solution for up to 6 doses starting at randomization. Participants received Ipilimumab 10 milligram per kilogram (mg/kg) as IV solution every 3 weeks (Q3W) for up to 4 doses starting at cycle 3 during induction phase and every 12 weeks (Q12W) during maintenance phase beginning 9 weeks after last ipilimumab induction dose for a maximum treatment period of 3 years from the first dose of blinded study therapy.

    Reporting group title
    Placebo + Carboplatin/Paclitaxel
    Reporting group description
    Participants received a dose of paclitaxel 175 mg/m^2 and Carboplatin AUC = 6 as IV solution for up to 6 doses starting at randomization. Participants received placebo matched to Ipilimumab as IV solution Q3W for up to 4 doses starting at cycle 3 during induction phase and Q12W during maintenance phase beginning 9 weeks after last placebo induction dose for a maximum treatment period of 3 years from the first dose of blinded study therapy.

    Serious adverse events
    Ipilimumab + Carboplatin/Paclitaxel Placebo + Carboplatin/Paclitaxel
    Total subjects affected by serious adverse events
         subjects affected / exposed
    40 / 98 (40.82%)
    33 / 106 (31.13%)
         number of deaths (all causes)
    15
    9
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Cancer pain
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malignant neoplasm progression
         subjects affected / exposed
    7 / 98 (7.14%)
    4 / 106 (3.77%)
         occurrences causally related to treatment / all
    0 / 7
    0 / 4
         deaths causally related to treatment / all
    0 / 7
    0 / 4
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Venous thrombosis limb
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 98 (1.02%)
    2 / 106 (1.89%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Death
         subjects affected / exposed
    1 / 98 (1.02%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    General physical health deterioration
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Oedema peripheral
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    3 / 98 (3.06%)
    2 / 106 (1.89%)
         occurrences causally related to treatment / all
    1 / 3
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sudden cardiac death
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    4 / 98 (4.08%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 1
         deaths causally related to treatment / all
    1 / 2
    0 / 1
    Epistaxis
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    1 / 98 (1.02%)
    4 / 106 (3.77%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 5
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Pneumonitis
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory disorder
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Respiratory failure
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    2 / 98 (2.04%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Investigations
    Glomerular filtration rate decreased
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoglobin decreased
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Influenza a virus test positive
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac failure
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Left ventricular failure
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Myocardial infarction
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nodal arrhythmia
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pericardial effusion
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Supraventricular extrasystoles
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Cerebellar ischaemia
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebral haemorrhage
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Paraplegia
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Somnolence
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    3 / 98 (3.06%)
    4 / 106 (3.77%)
         occurrences causally related to treatment / all
    4 / 5
    4 / 5
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Bone marrow failure
         subjects affected / exposed
    1 / 98 (1.02%)
    3 / 106 (2.83%)
         occurrences causally related to treatment / all
    1 / 1
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    0 / 98 (0.00%)
    3 / 106 (2.83%)
         occurrences causally related to treatment / all
    0 / 0
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Leukopenia
         subjects affected / exposed
    1 / 98 (1.02%)
    2 / 106 (1.89%)
         occurrences causally related to treatment / all
    2 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    2 / 98 (2.04%)
    2 / 106 (1.89%)
         occurrences causally related to treatment / all
    2 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    1 / 98 (1.02%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    2 / 98 (2.04%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 98 (1.02%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    2 / 98 (2.04%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Swelling face
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endocrine disorders
    Adrenal insufficiency
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypophysitis
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypopituitarism
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypothalamo-Pituitary disorder
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Secondary hypothyroidism
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain in extremity
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pathological fracture
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Bacterial toxaemia
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    0 / 98 (0.00%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 98 (1.02%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung infection
         subjects affected / exposed
    4 / 98 (4.08%)
    0 / 106 (0.00%)
         occurrences causally related to treatment / all
    2 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Pneumonia
         subjects affected / exposed
    6 / 98 (6.12%)
    2 / 106 (1.89%)
         occurrences causally related to treatment / all
    3 / 6
    1 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 98 (1.02%)
    1 / 106 (0.94%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Ipilimumab + Carboplatin/Paclitaxel Placebo + Carboplatin/Paclitaxel
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    92 / 98 (93.88%)
    89 / 106 (83.96%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    14 / 98 (14.29%)
    14 / 106 (13.21%)
         occurrences all number
    16
    15
    Aspartate aminotransferase increased
         subjects affected / exposed
    12 / 98 (12.24%)
    10 / 106 (9.43%)
         occurrences all number
    12
    12
    Blood albumin decreased
         subjects affected / exposed
    6 / 98 (6.12%)
    2 / 106 (1.89%)
         occurrences all number
    7
    2
    Blood alkaline phosphatase increased
         subjects affected / exposed
    5 / 98 (5.10%)
    0 / 106 (0.00%)
         occurrences all number
    5
    0
    Gamma-Glutamyltransferase increased
         subjects affected / exposed
    6 / 98 (6.12%)
    1 / 106 (0.94%)
         occurrences all number
    6
    1
    Haemoglobin decreased
         subjects affected / exposed
    35 / 98 (35.71%)
    28 / 106 (26.42%)
         occurrences all number
    53
    44
    Neutrophil count decreased
         subjects affected / exposed
    7 / 98 (7.14%)
    7 / 106 (6.60%)
         occurrences all number
    21
    15
    Platelet count decreased
         subjects affected / exposed
    16 / 98 (16.33%)
    8 / 106 (7.55%)
         occurrences all number
    28
    11
    Red blood cell count decreased
         subjects affected / exposed
    11 / 98 (11.22%)
    2 / 106 (1.89%)
         occurrences all number
    15
    2
    Weight decreased
         subjects affected / exposed
    12 / 98 (12.24%)
    3 / 106 (2.83%)
         occurrences all number
    13
    3
    White blood cell count decreased
         subjects affected / exposed
    14 / 98 (14.29%)
    15 / 106 (14.15%)
         occurrences all number
    31
    28
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    6 / 98 (6.12%)
    6 / 106 (5.66%)
         occurrences all number
    6
    6
    Hypoaesthesia
         subjects affected / exposed
    12 / 98 (12.24%)
    7 / 106 (6.60%)
         occurrences all number
    13
    8
    Neuropathy peripheral
         subjects affected / exposed
    7 / 98 (7.14%)
    4 / 106 (3.77%)
         occurrences all number
    7
    4
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    34 / 98 (34.69%)
    35 / 106 (33.02%)
         occurrences all number
    53
    46
    Erythropenia
         subjects affected / exposed
    10 / 98 (10.20%)
    8 / 106 (7.55%)
         occurrences all number
    12
    9
    Leukopenia
         subjects affected / exposed
    36 / 98 (36.73%)
    42 / 106 (39.62%)
         occurrences all number
    64
    107
    Lymphopenia
         subjects affected / exposed
    4 / 98 (4.08%)
    7 / 106 (6.60%)
         occurrences all number
    4
    13
    Neutropenia
         subjects affected / exposed
    36 / 98 (36.73%)
    47 / 106 (44.34%)
         occurrences all number
    72
    102
    Thrombocytopenia
         subjects affected / exposed
    27 / 98 (27.55%)
    30 / 106 (28.30%)
         occurrences all number
    37
    49
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    6 / 98 (6.12%)
    9 / 106 (8.49%)
         occurrences all number
    7
    10
    Chest pain
         subjects affected / exposed
    4 / 98 (4.08%)
    6 / 106 (5.66%)
         occurrences all number
    5
    9
    Fatigue
         subjects affected / exposed
    17 / 98 (17.35%)
    16 / 106 (15.09%)
         occurrences all number
    24
    21
    Pain
         subjects affected / exposed
    6 / 98 (6.12%)
    3 / 106 (2.83%)
         occurrences all number
    6
    5
    Pyrexia
         subjects affected / exposed
    14 / 98 (14.29%)
    6 / 106 (5.66%)
         occurrences all number
    21
    7
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    11 / 98 (11.22%)
    10 / 106 (9.43%)
         occurrences all number
    15
    13
    Diarrhoea
         subjects affected / exposed
    22 / 98 (22.45%)
    11 / 106 (10.38%)
         occurrences all number
    26
    15
    Nausea
         subjects affected / exposed
    11 / 98 (11.22%)
    17 / 106 (16.04%)
         occurrences all number
    14
    25
    Vomiting
         subjects affected / exposed
    10 / 98 (10.20%)
    10 / 106 (9.43%)
         occurrences all number
    10
    14
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    12 / 98 (12.24%)
    9 / 106 (8.49%)
         occurrences all number
    16
    9
    Dyspnoea
         subjects affected / exposed
    7 / 98 (7.14%)
    4 / 106 (3.77%)
         occurrences all number
    8
    4
    Haemoptysis
         subjects affected / exposed
    2 / 98 (2.04%)
    7 / 106 (6.60%)
         occurrences all number
    2
    7
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    3 / 98 (3.06%)
    8 / 106 (7.55%)
         occurrences all number
    3
    9
    Pruritus
         subjects affected / exposed
    13 / 98 (13.27%)
    0 / 106 (0.00%)
         occurrences all number
    15
    0
    Rash
         subjects affected / exposed
    17 / 98 (17.35%)
    2 / 106 (1.89%)
         occurrences all number
    20
    2
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    8 / 98 (8.16%)
    4 / 106 (3.77%)
         occurrences all number
    8
    5
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    3 / 98 (3.06%)
    8 / 106 (7.55%)
         occurrences all number
    4
    9
    Back pain
         subjects affected / exposed
    5 / 98 (5.10%)
    3 / 106 (2.83%)
         occurrences all number
    5
    3
    Pain in extremity
         subjects affected / exposed
    10 / 98 (10.20%)
    7 / 106 (6.60%)
         occurrences all number
    14
    11
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    27 / 98 (27.55%)
    17 / 106 (16.04%)
         occurrences all number
    35
    20
    Hyperglycaemia
         subjects affected / exposed
    5 / 98 (5.10%)
    1 / 106 (0.94%)
         occurrences all number
    6
    1
    Hypokalaemia
         subjects affected / exposed
    7 / 98 (7.14%)
    9 / 106 (8.49%)
         occurrences all number
    8
    13
    Hyponatraemia
         subjects affected / exposed
    5 / 98 (5.10%)
    3 / 106 (2.83%)
         occurrences all number
    5
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    19 May 2014
    The main reason for of this amendment was to align the CA184-153 protocol with the CA184-104 protocol that is to update the study primary endpoint, modify secondary endpoints, implement a dosing limit of ipilimumab in the study to 3 years, and incorporate other minor changes for consistency and clarity.
    11 Dec 2014
    The main reason of this amendment was to include the Neutralizing AntiBody (NAb) test in this study.
    24 Nov 2015
    The CA184104 study achieved Database Lock on 01-Sep-2015 for the analysis of the primary endpoint of Overall Survival (OS) among subjects who received at least one dose of blinded study therapy. Unfortunately, the trial did not meet the primary endpoint, failing to demonstrate a statistically significant improvement in OS among subjects who received at least one dose of ipilimumab in combination with chemotherapy compared to those receiving at least one dose of placebo in combination with chemotherapy. As CA184153 study has exactly the same study design, including the study population, the treatment schedule and the primary endpoint, it is unlikely the study result will show any overall survival benefit. In order to prevent exposure of additional subjects to ipilimumab-related toxicity in the absence of clinical benefit, the sponsor has decided to discontinue enrolment and randomization in the CA184153 trial.

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    25 Sep 2015
    Global study CA184104 did not meet the primary endpoint, failing to demonstrate a statistically significant improvement in overall survival (OS) among subjects who received at least one dose of ipilimumab in combination with chemotherapy compared to those receiving at least one dose of placebo in combination with chemotherapy. As study CA184153 has exactly the same study design, including the study population, the treatment schedule and the primary end point, it was unlikely that the study would show any overall survival benefit, therefore, the sponsor decided to discontinue enrollment and randomization in the study CA184153 effective 25-Sep-2015.
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Due to early termination of the study, the efficacy endpoints were not analyzed for this study. The final clinical study report (CSR) is in synoptic format and reports safety data.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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