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    Clinical Trial Results:
    A Randomized, Double-Blind, Phase 2 Study of Ruxolitinib or Placebo in Combination With Capecitabine in Subjects With Advanced or Metastatic HER2-Negative Breast Cancer

    Summary
    EudraCT number
    2014-002620-26
    Trial protocol
    IT   GB   PT   ES  
    Global end of trial date
    24 Jan 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    06 Jan 2018
    First version publication date
    06 Jan 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    INCB18424-268
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02120417
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Incyte Corporation
    Sponsor organisation address
    1801 Augustine Cut-Off, Wilmington, DE, United States, 19803
    Public contact
    Incyte Corporation Call Centre, Incyte Corporation, +44 (0)330 100 3677, globalmedinfo@incyte.com
    Scientific contact
    Incyte Corporation Call Centre, Incyte Corporation, +44 (0)330 100 3677, globalmedinfo@incyte.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
    13 Apr 2016
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    24 Jan 2017
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    This was a randomized, double-blind, placebo-controlled phase 2 clinical trial comparing the overall survival of women with advanced or metastatic HER2-negative breast cancer who received treatment with capecitabine in combination with ruxolitinib versus those who received treatment with capecitabine alone.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    23 May 2014
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Portugal: 2
    Country: Number of subjects enrolled
    Spain: 6
    Country: Number of subjects enrolled
    United Kingdom: 4
    Country: Number of subjects enrolled
    United States: 137
    Worldwide total number of subjects
    149
    EEA total number of subjects
    12
    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)
    114
    From 65 to 84 years
    35
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    This study was conducted at 72 study centers (65 in the United States and 7 in the European Union [3 in the United Kingdom, 3 in Spain, and 1 in Portugal]).

    Pre-assignment
    Screening details
    Subjects received study treatment in continuous 21-day cycles until they met withdrawal criteria or until study termination.

    Period 1
    Period 1 title
    Overall Period
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Treatment A - Capecitabine and ruxolitinib
    Arm description
    Capecitabine given as 1000 mg/m^2 twice a day (BID) on day 1 to day 14 of each 21-day cycle with the addition of Ruxolitinib 15 mg (three 5 mg tablets) BID to be administered by mouth on day 1 to day 21 of each 21-day cycle
    Arm type
    Experimental

    Investigational medicinal product name
    Ruxolitinib
    Investigational medicinal product code
    Other name
    Jakafi ®,Jakavi ®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    5 mg tablets to be administered by mouth; Ruxolitinib 15 mg BID (starting dose).

    Investigational medicinal product name
    Capecitabine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Capecitabine 2000 mg/m^2 daily given as 1000 mg/m^2 twice a day (BID) (starting dose) Day 1-14 of each 21 day cycle.

    Arm title
    Treatment B - Capecitabine and placebo
    Arm description
    Capecitabine given as 1000 mg/m^2 twice a day (BID) on day 1 to day 14 of each 21-day cycle with the addition of 15 mg (three 5 mg tablets) matching placebo BID to be administered by mouth on day 1 to day 21 of each 21-day cycle.
    Arm type
    Active comparator

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    5 mg matching placebo tablets to be administered by mouth.

    Investigational medicinal product name
    Capecitabine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Capecitabine 2000 mg/m^2 daily given as 1000 mg/m^2 twice a day (BID) (starting dose) Day 1-14 of each 21 day cycle.

    Number of subjects in period 1
    Treatment A - Capecitabine and ruxolitinib Treatment B - Capecitabine and placebo
    Started
    76
    73
    Completed
    16
    5
    Not completed
    60
    68
         Physician decision
    2
    3
         Participant decision
    4
    4
         Disease progression
    41
    45
         Other unspecified
    5
    4
         Adverse Event
    3
    9
         Death
    5
    1
         Noncompliance with study treatment
    -
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Treatment A - Capecitabine and ruxolitinib
    Reporting group description
    Capecitabine given as 1000 mg/m^2 twice a day (BID) on day 1 to day 14 of each 21-day cycle with the addition of Ruxolitinib 15 mg (three 5 mg tablets) BID to be administered by mouth on day 1 to day 21 of each 21-day cycle

    Reporting group title
    Treatment B - Capecitabine and placebo
    Reporting group description
    Capecitabine given as 1000 mg/m^2 twice a day (BID) on day 1 to day 14 of each 21-day cycle with the addition of 15 mg (three 5 mg tablets) matching placebo BID to be administered by mouth on day 1 to day 21 of each 21-day cycle.

    Reporting group values
    Treatment A - Capecitabine and ruxolitinib Treatment B - Capecitabine and placebo Total
    Number of subjects
    76 73 149
    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)
    61 53 114
        From 65-84 years
    15 20 35
        85 years and over
    0 0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    54.3 ± 11.00 55.0 ± 12.75 -
    Gender categorical
    Units: Subjects
        Female
    76 73 149
        Male
    0 0 0

    End points

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    End points reporting groups
    Reporting group title
    Treatment A - Capecitabine and ruxolitinib
    Reporting group description
    Capecitabine given as 1000 mg/m^2 twice a day (BID) on day 1 to day 14 of each 21-day cycle with the addition of Ruxolitinib 15 mg (three 5 mg tablets) BID to be administered by mouth on day 1 to day 21 of each 21-day cycle

    Reporting group title
    Treatment B - Capecitabine and placebo
    Reporting group description
    Capecitabine given as 1000 mg/m^2 twice a day (BID) on day 1 to day 14 of each 21-day cycle with the addition of 15 mg (three 5 mg tablets) matching placebo BID to be administered by mouth on day 1 to day 21 of each 21-day cycle.

    Primary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    Overall survival is reported here as the number of days from randomization to death due to any cause until the data cutoff for the final analysis. The hazard ratio (80% CI) for ruxolitinib versus placebo was estimated using a Cox regression model stratified by hormone-receptor status.
    End point type
    Primary
    End point timeframe
    Randomization until death due to any cause up to the data cutoff 08FEB2016.
    End point values
    Treatment A - Capecitabine and ruxolitinib Treatment B - Capecitabine and placebo
    Number of subjects analysed
    76 [1]
    73 [2]
    Units: participants
    number (not applicable)
        Death events
    39
    38
        Censored events
    37
    35
    Notes
    [1] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    [2] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    Statistical analysis title
    Overall Survival (OS)
    Comparison groups
    Treatment B - Capecitabine and placebo v Treatment A - Capecitabine and ruxolitinib
    Number of subjects included in analysis
    149
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.762 [3]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.932
    Confidence interval
         level
    80%
         sides
    2-sided
         lower limit
    0.694
         upper limit
    1.252
    Notes
    [3] - The P-value was analyzed by Log-Rank Test stratified by Hormone Receptor Status.

    Primary: Median Survival

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    End point title
    Median Survival [4]
    End point description
    Survival was assessed by the time to death or censoring up until 08Feb2016. Participants with no observed death were treated as right-censored at their last date known to be alive. The median survival time was estimated by the Kaplan-Meier method.
    End point type
    Primary
    End point timeframe
    Randomization until death due to any cause up to the data cutoff 08FEB2016.
    Notes
    [4] - 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: No formal statistical analysis was planned or conducted for this primary endpoint.
    End point values
    Treatment A - Capecitabine and ruxolitinib Treatment B - Capecitabine and placebo
    Number of subjects analysed
    76 [5]
    73 [6]
    Units: months
        median (confidence interval 95%)
    11.2 (7.5 to 12.7)
    10.9 (6.0 to 13.1)
    Notes
    [5] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    [6] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    No statistical analyses for this end point

    Primary: Proportion of Participants Achieving Overall Survival

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    End point title
    Proportion of Participants Achieving Overall Survival [7]
    End point description
    Overall survival was assessed as the time to death or censoring up until 08Feb2016. Participants with no observed death were treated as right-censored at their last date known to be alive. The survival time was analyzed using the Kaplan-Meier method.
    End point type
    Primary
    End point timeframe
    Randomization until death due to any cause at month 3, 6, 9, 12 and 15 or the data cutoff 08FEB2016.
    Notes
    [7] - 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: No formal statistical analysis was planned or conducted for this primary endpoint.
    End point values
    Treatment A - Capecitabine and ruxolitinib Treatment B - Capecitabine and placebo
    Number of subjects analysed
    76 [8]
    73 [9]
    Units: percentage of participants
    number (confidence interval 95%)
        Month 3 Survival Rate
    0.855 (0.753 to 0.917)
    0.750 (0.633 to 0.835)
        Month 6 Survival Rate
    0.674 (0.554 to 0.769)
    0.635 (0.511 to 0.735)
        Month 9 Survival Rate
    0.537 (0.404 to 0.652)
    0.546 (0.417 to 0.657)
        Month 12 Survival Rate
    0.435 (0.289 to 0.573)
    0.427 (0.286 to 0.561)
        Month 15 Survival Rate
    0.319 (0.174 to 0.475)
    0.294 (0.148 to 0.456)
    Notes
    [8] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    [9] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    No statistical analyses for this end point

    Secondary: Progression-free Survival (PFS)

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    End point title
    Progression-free Survival (PFS)
    End point description
    Progression-free survival was defined as the time from the randomization date to the earliest date of disease progression, as measured by investigator assessment of objective radiographic disease assessments per RECIST (v1.1), or death from any cause if earlier. Progression-free survival time distribution and median survival for each treatment group were analyzed using the Kaplan-Meier method.
    End point type
    Secondary
    End point timeframe
    Randomization to disease progression, or death due to any cause if sooner up to the data cutoff 08FEB2016.
    End point values
    Treatment A - Capecitabine and ruxolitinib Treatment B - Capecitabine and placebo
    Number of subjects analysed
    76 [10]
    73 [11]
    Units: months
        median (confidence interval 95%)
    4.5 (2.3 to 6.1)
    2.5 (2.1 to 4.1)
    Notes
    [10] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    [11] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving Objective Response Rate

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    End point title
    Percentage of Participants Achieving Objective Response Rate
    End point description
    Objective response rate was determined by radiographic disease assessments per Response Evaluation Criteria in Solid Tumours (RECIST v1.1), by investigator assessment and was defined as the percentage of participants with Complete Response (CR) or Partial Response (PR) by RECIST at any post baseline visit. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) for target lesions and assessed by computed tomography (CT) and/or magnetic resonance imaging (MRI) : Complete Response (CR), Disappearance of all target and non-target lesions and no new lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
    End point type
    Secondary
    End point timeframe
    Randomization through end of study up to the data cutoff 08FEB2016.
    End point values
    Treatment A - Capecitabine and ruxolitinib Treatment B - Capecitabine and placebo
    Number of subjects analysed
    76 [12]
    73 [13]
    Units: percentage of participants
    number (not applicable)
        Complete Response rate
    0.0
    0.0
        Partial Response rate
    28.9
    13.7
    Notes
    [12] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    [13] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR)

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    End point title
    Duration of Response (DOR)
    End point description
    The DOR was defined as the difference (in number of months) between the end of response and the start of response for participants who had at least 1 response measurement. The start of a response was the first visit where the participant achieved a partial response or better based on RECIST (v1.1) criteria. The end of response was the earlier of death or progressive disease based on RECIST (v1.1) criteria. The date of progressive disease was the date on which progression was first recorded. Per RECIST for target lesions and assessed by computed tomography (CT) and/or magnetic resonance imaging (MRI) : Complete Response (CR), Disappearance of all target and non-target lesions and no new lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
    End point type
    Secondary
    End point timeframe
    Randomization through end of study up to the data cutoff 08FEB2016.
    End point values
    Treatment A - Capecitabine and ruxolitinib Treatment B - Capecitabine and placebo
    Number of subjects analysed
    76 [14]
    73 [15]
    Units: months
        median (confidence interval 80%)
    4.2 (3.5 to 4.6)
    4.4 (3.8 to 6.4)
    Notes
    [14] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    [15] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    No statistical analyses for this end point

    Secondary: Percentage of Participants Achieving Clinical Benefit Rate

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    End point title
    Percentage of Participants Achieving Clinical Benefit Rate
    End point description
    Clinical benefit rate was defined as a complete response, partial response, or stable disease, determined by investigator assessment of objective radiographic disease assessments per RECIST (v1.1) that lasted for ≥ 6 months. Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST) for target lesions and assessed by computed tomography (CT) and/or magnetic resonance imaging (MRI) : Complete Response (CR), Disappearance of all target and non-target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions with no worsening of non-target lesions and no new lesions; Overall Response (OR) = CR + PR.
    End point type
    Secondary
    End point timeframe
    Randomization through end of study up to the data cutoff 08FEB2016.
    End point values
    Treatment A - Capecitabine and ruxolitinib Treatment B - Capecitabine and placebo
    Number of subjects analysed
    76 [16]
    73 [17]
    Units: percentage of participants
        number (not applicable)
    13.2
    6.8
    Notes
    [16] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    [17] - The Intent-to-Treat (ITT) population consisted of all participants randomized to the study.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Participants received study treatment in continuous 21-day cycles until they met withdrawal criteria up to the second data cutoff 13APR2016.
    Adverse event reporting additional description
    The safety evaluable population consisted of all participants enrolled in the study who received at least 1 dose of any study treatment (ie, ruxolitinib, placebo, or capecitabine).
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    Treatment A - Capecitabine and Ruxolitinib
    Reporting group description
    Capecitabine given as 1000 mg/m^2 twice a day (BID) on day 1 to day 14 of each 21-day cycle with the addition of Ruxolitinib 15 mg (three 5 mg tablets) BID to be administered by mouth on day 1 to day 21 of each 21-day cycle

    Reporting group title
    Treatment B - Capecitabine and Placebo
    Reporting group description
    Capecitabine given as 1000 mg/m^2 twice a day (BID) on day 1 to day 14 of each 21-day cycle with the addition of 15 mg (three 5 mg tablets) matching placebo BID to be administered by mouth on day 1 to day 21 of each 21-day cycle

    Serious adverse events
    Treatment A - Capecitabine and Ruxolitinib Treatment B - Capecitabine and Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    28 / 71 (39.44%)
    29 / 71 (40.85%)
         number of deaths (all causes)
    5
    7
         number of deaths resulting from adverse events
    1
    1
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Malignant pleural effusion
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metastases to meninges
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    0 / 71 (0.00%)
    3 / 71 (4.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Embolism
         subjects affected / exposed
    1 / 71 (1.41%)
    2 / 71 (2.82%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypertension
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Non-cardiac chest pain
         subjects affected / exposed
    2 / 71 (2.82%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oedema
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    2 / 71 (2.82%)
    2 / 71 (2.82%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory failure
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    3 / 71 (4.23%)
    4 / 71 (5.63%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoxia
         subjects affected / exposed
    2 / 71 (2.82%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    3 / 71 (4.23%)
    6 / 71 (8.45%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Pleuritic pain
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         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
    1 / 71 (1.41%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory distress
         subjects affected / exposed
    0 / 71 (0.00%)
    2 / 71 (2.82%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Respiratory failure
         subjects affected / exposed
    0 / 71 (0.00%)
    2 / 71 (2.82%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mental status changes
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Blood bilirubin increased
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Blood creatinine increased
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    2 / 71 (2.82%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    1 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Accidental overdose
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hip fracture
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Humerus fracture
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Cardiac arrest
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         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
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tachycardia
         subjects affected / exposed
    1 / 71 (1.41%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Embolic stroke
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Encephalopathy
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic encephalopathy
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal cord compression
         subjects affected / exposed
    0 / 71 (0.00%)
    2 / 71 (2.82%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 71 (1.41%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 71 (1.41%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    2 / 71 (2.82%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    2 / 71 (2.82%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain lower
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ascites
         subjects affected / exposed
    0 / 71 (0.00%)
    2 / 71 (2.82%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 71 (1.41%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 71 (1.41%)
    2 / 71 (2.82%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    2 / 71 (2.82%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterocolitis haemorrhagic
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    5 / 71 (7.04%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    4 / 5
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stomatitis
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    4 / 71 (5.63%)
    4 / 71 (5.63%)
         occurrences causally related to treatment / all
    2 / 4
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Hepatic failure
         subjects affected / exposed
    2 / 71 (2.82%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Hyperbilirubinaemia
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Hydronephrosis
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure acute
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bone pain
         subjects affected / exposed
    2 / 71 (2.82%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain in extremity
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    3 / 71 (4.23%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Sepsis
         subjects affected / exposed
    2 / 71 (2.82%)
    2 / 71 (2.82%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 2
         deaths causally related to treatment / all
    1 / 1
    0 / 1
    Urinary tract infection
         subjects affected / exposed
    2 / 71 (2.82%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    3 / 71 (4.23%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    1 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    0 / 71 (0.00%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    1 / 71 (1.41%)
    1 / 71 (1.41%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lactic acidosis
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolic acidosis
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolic disorder
         subjects affected / exposed
    1 / 71 (1.41%)
    0 / 71 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Treatment A - Capecitabine and Ruxolitinib Treatment B - Capecitabine and Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    71 / 71 (100.00%)
    69 / 71 (97.18%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    6 / 71 (8.45%)
    4 / 71 (5.63%)
         occurrences all number
    6
    4
    Aspartate aminotransferase increased
         subjects affected / exposed
    10 / 71 (14.08%)
    5 / 71 (7.04%)
         occurrences all number
    12
    8
    Blood alkaline phosphatase increased
         subjects affected / exposed
    5 / 71 (7.04%)
    4 / 71 (5.63%)
         occurrences all number
    5
    4
    Blood creatinine increased
         subjects affected / exposed
    4 / 71 (5.63%)
    3 / 71 (4.23%)
         occurrences all number
    4
    4
    Lymphocyte count decreased
         subjects affected / exposed
    4 / 71 (5.63%)
    2 / 71 (2.82%)
         occurrences all number
    7
    3
    Neutrophil count decreased
         subjects affected / exposed
    6 / 71 (8.45%)
    2 / 71 (2.82%)
         occurrences all number
    14
    3
    Platelet count decreased
         subjects affected / exposed
    5 / 71 (7.04%)
    0 / 71 (0.00%)
         occurrences all number
    5
    0
    Weight decreased
         subjects affected / exposed
    4 / 71 (5.63%)
    5 / 71 (7.04%)
         occurrences all number
    4
    5
    Weight increased
         subjects affected / exposed
    6 / 71 (8.45%)
    4 / 71 (5.63%)
         occurrences all number
    7
    4
    White blood cell count decreased
         subjects affected / exposed
    7 / 71 (9.86%)
    1 / 71 (1.41%)
         occurrences all number
    16
    1
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    6 / 71 (8.45%)
    3 / 71 (4.23%)
         occurrences all number
    6
    3
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    13 / 71 (18.31%)
    13 / 71 (18.31%)
         occurrences all number
    17
    13
    Dysgeusia
         subjects affected / exposed
    1 / 71 (1.41%)
    5 / 71 (7.04%)
         occurrences all number
    1
    5
    Headache
         subjects affected / exposed
    16 / 71 (22.54%)
    9 / 71 (12.68%)
         occurrences all number
    20
    9
    Hypoaesthesia
         subjects affected / exposed
    4 / 71 (5.63%)
    4 / 71 (5.63%)
         occurrences all number
    4
    5
    Neuropathy peripheral
         subjects affected / exposed
    3 / 71 (4.23%)
    5 / 71 (7.04%)
         occurrences all number
    3
    6
    Peripheral sensory neuropathy
         subjects affected / exposed
    4 / 71 (5.63%)
    5 / 71 (7.04%)
         occurrences all number
    4
    5
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    34 / 71 (47.89%)
    18 / 71 (25.35%)
         occurrences all number
    50
    18
    Neutropenia
         subjects affected / exposed
    9 / 71 (12.68%)
    5 / 71 (7.04%)
         occurrences all number
    11
    7
    Thrombocytopenia
         subjects affected / exposed
    6 / 71 (8.45%)
    1 / 71 (1.41%)
         occurrences all number
    7
    1
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    40 / 71 (56.34%)
    31 / 71 (43.66%)
         occurrences all number
    45
    35
    Oedema
         subjects affected / exposed
    4 / 71 (5.63%)
    3 / 71 (4.23%)
         occurrences all number
    4
    3
    Oedema peripheral
         subjects affected / exposed
    10 / 71 (14.08%)
    14 / 71 (19.72%)
         occurrences all number
    12
    14
    Pyrexia
         subjects affected / exposed
    12 / 71 (16.90%)
    10 / 71 (14.08%)
         occurrences all number
    12
    11
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    5 / 71 (7.04%)
    6 / 71 (8.45%)
         occurrences all number
    5
    6
    Abdominal pain
         subjects affected / exposed
    12 / 71 (16.90%)
    6 / 71 (8.45%)
         occurrences all number
    14
    6
    Constipation
         subjects affected / exposed
    18 / 71 (25.35%)
    17 / 71 (23.94%)
         occurrences all number
    20
    20
    Diarrhoea
         subjects affected / exposed
    32 / 71 (45.07%)
    19 / 71 (26.76%)
         occurrences all number
    47
    25
    Dyspepsia
         subjects affected / exposed
    6 / 71 (8.45%)
    4 / 71 (5.63%)
         occurrences all number
    7
    4
    Gastrooesophageal reflux disease
         subjects affected / exposed
    4 / 71 (5.63%)
    4 / 71 (5.63%)
         occurrences all number
    4
    4
    Nausea
         subjects affected / exposed
    38 / 71 (53.52%)
    34 / 71 (47.89%)
         occurrences all number
    47
    37
    Stomatitis
         subjects affected / exposed
    18 / 71 (25.35%)
    12 / 71 (16.90%)
         occurrences all number
    20
    15
    Vomiting
         subjects affected / exposed
    27 / 71 (38.03%)
    19 / 71 (26.76%)
         occurrences all number
    45
    26
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    14 / 71 (19.72%)
    9 / 71 (12.68%)
         occurrences all number
    15
    9
    Dyspnoea
         subjects affected / exposed
    21 / 71 (29.58%)
    19 / 71 (26.76%)
         occurrences all number
    23
    20
    Epistaxis
         subjects affected / exposed
    5 / 71 (7.04%)
    2 / 71 (2.82%)
         occurrences all number
    6
    2
    Oropharyngeal pain
         subjects affected / exposed
    4 / 71 (5.63%)
    1 / 71 (1.41%)
         occurrences all number
    4
    1
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    4 / 71 (5.63%)
    0 / 71 (0.00%)
         occurrences all number
    4
    0
    Dry skin
         subjects affected / exposed
    3 / 71 (4.23%)
    5 / 71 (7.04%)
         occurrences all number
    3
    5
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    33 / 71 (46.48%)
    27 / 71 (38.03%)
         occurrences all number
    52
    31
    Skin hyperpigmentation
         subjects affected / exposed
    6 / 71 (8.45%)
    2 / 71 (2.82%)
         occurrences all number
    6
    2
    Hot flush
         subjects affected / exposed
    5 / 71 (7.04%)
    1 / 71 (1.41%)
         occurrences all number
    5
    1
    Hypertension
         subjects affected / exposed
    4 / 71 (5.63%)
    2 / 71 (2.82%)
         occurrences all number
    6
    2
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    2 / 71 (2.82%)
    6 / 71 (8.45%)
         occurrences all number
    3
    6
    Insomnia
         subjects affected / exposed
    8 / 71 (11.27%)
    9 / 71 (12.68%)
         occurrences all number
    8
    9
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    7 / 71 (9.86%)
    9 / 71 (12.68%)
         occurrences all number
    8
    9
    Back pain
         subjects affected / exposed
    11 / 71 (15.49%)
    5 / 71 (7.04%)
         occurrences all number
    11
    5
    Muscle spasms
         subjects affected / exposed
    5 / 71 (7.04%)
    3 / 71 (4.23%)
         occurrences all number
    5
    3
    Muscular weakness
         subjects affected / exposed
    5 / 71 (7.04%)
    2 / 71 (2.82%)
         occurrences all number
    5
    2
    Musculoskeletal chest pain
         subjects affected / exposed
    4 / 71 (5.63%)
    5 / 71 (7.04%)
         occurrences all number
    4
    5
    Musculoskeletal pain
         subjects affected / exposed
    4 / 71 (5.63%)
    5 / 71 (7.04%)
         occurrences all number
    4
    6
    Myalgia
         subjects affected / exposed
    5 / 71 (7.04%)
    2 / 71 (2.82%)
         occurrences all number
    5
    2
    Neck pain
         subjects affected / exposed
    4 / 71 (5.63%)
    2 / 71 (2.82%)
         occurrences all number
    4
    2
    Pain in extremity
         subjects affected / exposed
    9 / 71 (12.68%)
    5 / 71 (7.04%)
         occurrences all number
    10
    5
    Infections and infestations
    Upper respiratory tract infection
         subjects affected / exposed
    4 / 71 (5.63%)
    2 / 71 (2.82%)
         occurrences all number
    4
    3
    Urinary tract infection
         subjects affected / exposed
    6 / 71 (8.45%)
    6 / 71 (8.45%)
         occurrences all number
    8
    7
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    21 / 71 (29.58%)
    19 / 71 (26.76%)
         occurrences all number
    22
    21
    Dehydration
         subjects affected / exposed
    11 / 71 (15.49%)
    3 / 71 (4.23%)
         occurrences all number
    15
    3
    Hypocalcaemia
         subjects affected / exposed
    8 / 71 (11.27%)
    0 / 71 (0.00%)
         occurrences all number
    9
    0
    Hypokalaemia
         subjects affected / exposed
    10 / 71 (14.08%)
    4 / 71 (5.63%)
         occurrences all number
    11
    7

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    21 Jul 2014
    The primary purpose of the amendment was to add/clarify several items in the original protocol. • Clarified eligibility criteria • Clarified that the most recent available result prior to randomization would be used to determine subject eligibility. • Clarified that the total daily capecitabine dose (2000 mg/m^2) was to be administered in approximately equal doses BID, in the morning and evening, approximately 12 hours apart, and that the dose was to be calculated according to BSA. • Added that subjects would continue receiving study treatment until they met withdrawal criteria. • Added that subjects who required the use of a potent cytochrome P450 3A4 inhibitor should have their ruxolitinib dose reduced from BID to once daily with frequent complete blood count monitoring during the period of coadministration. • Clarified that informed consent was to be obtained before performing any study-specific procedures that were not considered standard of care for the treatment of breast cancer and that screening assessments performed per standard of care did not need to be repeated after the ICF was signed if performed within 28 days of the Cycle 1 Day 1 visit. • Changed the frequency of radiological assessments to every 9 weeks until subjects had received 12 months of treatment. Thereafter, the frequency of scans was reduced to every 12 weeks. Screening CT scan or MRI of the brain was only to be performed if brain metastases or CNS symptoms were present. Bone scans were to be done at screening or if clinically indicated. Nontarget bone lesions (per RECIST v1.1) were followed every 9 weeks by CT scan with bone window or MRI. • Clarified that subjects who discontinued treatment because of disease progression did not need to repeat radiographic assessments at the EOT visit. • Clarified that subjects should bring all study-related medications with them to each study visit to assess study drug compliance.
    23 Sep 2014
    The primary purpose of the amendment was to provide clarification regarding inclusion/exclusion criteria and acceptable forms of effective contraception. The clinically important changes included: • A new exclusion criterion was added to exclude pregnant and breastfeeding women. • Revised wording and updated the acceptable forms of effective contraception listed in the Protocol.
    20 Oct 2014
    The primary purpose of the amendment was to update information regarding contraceptive methods in the Protocol, to be consistent with contraception recommendations from the 15 SEP 2014 Clinical Trial Facilitation Group meeting in Rome. Only highly effective methods of birth control (ie, failure rate < 1% per year when used consistently and correctly) were considered acceptable.

    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.
    The study was terminated as other related studies of ruxolitinib did not provide sufficient efficacy to warrant continuation.
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