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    Clinical Trial Results:
    A Multicenter, Double-Blind, Randomized, Placebo-Controlled, Phase III Study of Idasanutlin, an MDM2 Antagonist, with Cytarabine Versus Cytarabine Plus Placebo in Patients with Relapsed or Refractory Acute Myeloid Leukemia (AML)

    Summary
    EudraCT number
    2014-003065-15
    Trial protocol
    AT   FI   GB   NO   BE   NL   ES   FR   IT  
    Global end of trial date
    03 Jul 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    07 May 2021
    First version publication date
    07 May 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    WO29519
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    F. Hoffmann- La Roche AG
    Sponsor organisation address
    Grenzacherstrasse 124, Basel, Switzerland, CH-4070
    Public contact
    Roche Trial Information Hotline, F. Hoffmann- La Roche AG, +41 61 6878333, global.trial_information@roche.com
    Scientific contact
    Roche Trial Information Hotline, F. Hoffmann- La Roche AG, +41 61 6878333, global-roche-genentech-trials@gene.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 Jul 2020
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    03 Jul 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To compare OS in patients with relapsed or refractory (R/R) acute myeloid leukemia (AML) who had been randomized to idasanutlin in combination with cytarabine versus those who had been randomized to cytarabine and placebo
    Protection of trial subjects
    The study was conducted in accordance with the principles of the “Declaration of Helsinki” and Good Clinical Practice (GCP) guidelines according to the regulations and procedures described in the protocol.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    09 Sep 2015
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 23
    Country: Number of subjects enrolled
    Austria: 2
    Country: Number of subjects enrolled
    Belgium: 14
    Country: Number of subjects enrolled
    Canada: 2
    Country: Number of subjects enrolled
    Germany: 60
    Country: Number of subjects enrolled
    Switzerland: 7
    Country: Number of subjects enrolled
    Spain: 82
    Country: Number of subjects enrolled
    Finland: 5
    Country: Number of subjects enrolled
    France: 68
    Country: Number of subjects enrolled
    United Kingdom: 34
    Country: Number of subjects enrolled
    Israel: 19
    Country: Number of subjects enrolled
    Italy: 76
    Country: Number of subjects enrolled
    Korea, Republic of: 19
    Country: Number of subjects enrolled
    Netherlands: 2
    Country: Number of subjects enrolled
    Norway: 1
    Country: Number of subjects enrolled
    New Zealand: 4
    Country: Number of subjects enrolled
    Panama: 3
    Country: Number of subjects enrolled
    Russian Federation: 13
    Country: Number of subjects enrolled
    United States: 13
    Worldwide total number of subjects
    447
    EEA total number of subjects
    310
    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)
    252
    From 65 to 84 years
    195
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A total of 612 participants were screened, of which 447 patients were randomized.

    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
    Subject, Investigator, Monitor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo plus Cytarabine
    Arm description
    Participants will receive induction therapy idasanutlin matching placebo and cytarabine for 5 days followed by 23 days of rest in Cycle 1 (treatment cycle length=28 days). Responding participants may continue with consolidation therapy for a maximum of 2 additional cycles including idasanutlin matching placebo and cytarabine for 5 days followed by 23 days of rest in each cycle (treatment cycle length=28 days). After each cycle, for participants achieving CRp or CRi, up to 28 additional days are allowed for blood count recovery, if needed.
    Arm type
    Placebo

    Investigational medicinal product name
    Matching Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Idasanutlin matching placebo for 5 days followed by 23 days of rest in Cycle 1 (treatment cycle length=28 days). Responding participants may continue with consolidation therapy for a maximum of 2 additional cycles including idasanutlin matching placebo and cytarabine for 5 days followed by 23 days of rest in each cycle (treatment cycle length=28 days).

    Arm title
    Idasanutlin plus Cytarabine
    Arm description
    Participants will receive induction therapy idasanutlin and cytarabine for 5 days followed by 23 days of rest in Cycle 1 (treatment cycle length=28 days). Responding participants may continue with consolidation therapy for a maximum of 2 additional cycles including idasanutlin and cytarabine for 5 days followed by 23 days of rest in each cycle (treatment cycle length=28 days). After each cycle, for participants achieving CRp or complete remission with incomplete blood count recovery (CRi), up to 28 additional days are allowed for blood count recovery, if needed.
    Arm type
    Experimental

    Investigational medicinal product name
    Idasanutlin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Idasanutlin and cytarabine for 5 days followed by 23 days of rest in Cycle 1 (treatment cycle length=28 days). Responding participants may continue with consolidation therapy for a maximum of 2 additional cycles including idasanutlin and cytarabine for 5 days followed by 23 days of rest in each cycle (treatment cycle length=28 days).

    Number of subjects in period 1
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Started
    149
    298
    Completed
    0
    0
    Not completed
    149
    298
         Consent withdrawn by subject
    5
    9
         Study Terminated By Sponsor
    33
    71
         Death
    109
    211
         Lost to follow-up
    2
    4
         (Give reason)
    -
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Placebo plus Cytarabine
    Reporting group description
    Participants will receive induction therapy idasanutlin matching placebo and cytarabine for 5 days followed by 23 days of rest in Cycle 1 (treatment cycle length=28 days). Responding participants may continue with consolidation therapy for a maximum of 2 additional cycles including idasanutlin matching placebo and cytarabine for 5 days followed by 23 days of rest in each cycle (treatment cycle length=28 days). After each cycle, for participants achieving CRp or CRi, up to 28 additional days are allowed for blood count recovery, if needed.

    Reporting group title
    Idasanutlin plus Cytarabine
    Reporting group description
    Participants will receive induction therapy idasanutlin and cytarabine for 5 days followed by 23 days of rest in Cycle 1 (treatment cycle length=28 days). Responding participants may continue with consolidation therapy for a maximum of 2 additional cycles including idasanutlin and cytarabine for 5 days followed by 23 days of rest in each cycle (treatment cycle length=28 days). After each cycle, for participants achieving CRp or complete remission with incomplete blood count recovery (CRi), up to 28 additional days are allowed for blood count recovery, if needed.

    Reporting group values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine Total
    Number of subjects
    149 298 447
    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)
    83 169 252
        From 65-84 years
    66 129 195
        85 years and over
    0 0 0
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    59.9 ( 12.1 ) 59.4 ( 13.1 ) -
    Sex/Gender, Customized
    Units: Participants
        Male
    86 163 249
        Female
    63 135 198
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    8 11 19
        Not Hispanic or Latino
    112 231 343
        Not Stated
    18 36 54
        Unknown
    11 20 31
    Race
    Units: Subjects
        Asian
    11 20 31
        Black or African America
    2 4 6
        Native Hawaiian or other
    0 1 1
        White
    111 222 333
        Unknown
    25 51 76

    End points

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    End points reporting groups
    Reporting group title
    Placebo plus Cytarabine
    Reporting group description
    Participants will receive induction therapy idasanutlin matching placebo and cytarabine for 5 days followed by 23 days of rest in Cycle 1 (treatment cycle length=28 days). Responding participants may continue with consolidation therapy for a maximum of 2 additional cycles including idasanutlin matching placebo and cytarabine for 5 days followed by 23 days of rest in each cycle (treatment cycle length=28 days). After each cycle, for participants achieving CRp or CRi, up to 28 additional days are allowed for blood count recovery, if needed.

    Reporting group title
    Idasanutlin plus Cytarabine
    Reporting group description
    Participants will receive induction therapy idasanutlin and cytarabine for 5 days followed by 23 days of rest in Cycle 1 (treatment cycle length=28 days). Responding participants may continue with consolidation therapy for a maximum of 2 additional cycles including idasanutlin and cytarabine for 5 days followed by 23 days of rest in each cycle (treatment cycle length=28 days). After each cycle, for participants achieving CRp or complete remission with incomplete blood count recovery (CRi), up to 28 additional days are allowed for blood count recovery, if needed.

    Primary: Overall Survival in TP53 WT Population

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    End point title
    Overall Survival in TP53 WT Population
    End point description
    End point type
    Primary
    End point timeframe
    From randomization to death from any cause (up to approximately 5.5 years)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    123
    232
    Units: Months
        median (confidence interval 95%)
    9.13 (7.59 to 10.64)
    8.28 (6.67 to 10.87)
    Statistical analysis title
    Hazard Ratio Superiority Statistical Analysis
    Comparison groups
    Placebo plus Cytarabine v Idasanutlin plus Cytarabine
    Number of subjects included in analysis
    355
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.5752
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.81
         upper limit
    1.45

    Secondary: Percentage of Participants in Complete Response (CR) at the End of Induction According to Hematologic Malignancy Response Assessment (HMRA) in TP53 WT Population

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    End point title
    Percentage of Participants in Complete Response (CR) at the End of Induction According to Hematologic Malignancy Response Assessment (HMRA) in TP53 WT Population
    End point description
    End point type
    Secondary
    End point timeframe
    At the end of induction (up to Day 56)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    123
    232
    Units: Percentage of Participants
        number (not applicable)
    20.3
    17.1
    No statistical analyses for this end point

    Secondary: Event-Free Survival (EFS) According to HMRA in TP53 WT Population

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    End point title
    Event-Free Survival (EFS) According to HMRA in TP53 WT Population
    End point description
    Event Free Survival (EFS) is defined as the time from the date of randomization to whichever occurs first: treatment failure (failure to achieve CR, set as day of final response assessment), relapse from CR, or death from any cause.
    End point type
    Secondary
    End point timeframe
    From randomization up to treatment failure, relapse, or death from any cause (up to approximately 5.5 years)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    123
    232
    Units: Weeks
        median (confidence interval 95%)
    6.29 (5.86 to 8.00)
    4.36 (4.14 to 5.00)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Overall Remission (CR, CRp, and CRi) at the End of Induction According to HMRA in TP53 WT Population

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    End point title
    Percentage of Participants with Overall Remission (CR, CRp, and CRi) at the End of Induction According to HMRA in TP53 WT Population
    End point description
    End point type
    Secondary
    End point timeframe
    At the end of induction (up to Day 56)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    123
    232
    Units: Percentage of Participants
        number (not applicable)
    38.8
    22.0
    No statistical analyses for this end point

    Secondary: Duration of Remission Following CR (DOR) in TP53 WT Population

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    End point title
    Duration of Remission Following CR (DOR) in TP53 WT Population
    End point description
    Duration of Remission Following CR (DOR) in TP53 WT Population is based on any patients with CR observed after study treatment or HSCT or further salvage therapy.
    End point type
    Secondary
    End point timeframe
    From achieving CR until relapse or death from any cause (up to approximately 5.5 years)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    25
    59
    Units: Months
        median (confidence interval 95%)
    18.73 (5.26 to 999)
    16.76 (7.82 to 999)
    No statistical analyses for this end point

    Secondary: Percentage of Participants Undergoing HSCT Following Complete Response (CR), in TP53 WT Population

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    End point title
    Percentage of Participants Undergoing HSCT Following Complete Response (CR), in TP53 WT Population
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline up to approximately 5.5 years
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    123
    232
    Units: Percentage of Participants
        number (not applicable)
    10.6
    11.6
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Complete Response (CR) in Clinically Actionable Mutation-Defined Subpopulation (FLT3, IDH1 and IDH2) in TP53 WT Population

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    End point title
    Percentage of Participants with Complete Response (CR) in Clinically Actionable Mutation-Defined Subpopulation (FLT3, IDH1 and IDH2) in TP53 WT Population
    End point description
    End point type
    Secondary
    End point timeframe
    At the end of induction (up to Day 56)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    123
    232
    Units: Percentage of Participants
    number (not applicable)
        IDH2
    23.1
    29.5
        IDH1
    11.1
    34.8
        FLT3
    12.5
    15.3
    No statistical analyses for this end point

    Secondary: Overall Survival in Clinically Actionable Mutation-Defined Subpopulation (FLT3, IDH1 and IDH2) in TP53 WT Population

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    End point title
    Overall Survival in Clinically Actionable Mutation-Defined Subpopulation (FLT3, IDH1 and IDH2) in TP53 WT Population
    End point description
    End point type
    Secondary
    End point timeframe
    From randomization to death from any cause (up to approximately 5.5 years)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    123
    232
    Units: Months
    median (confidence interval 95%)
        IDH2
    11.37 (8.02 to 999)
    11.01 (6.87 to 999)
        IDH1
    9.13 (2.50 to 16.69)
    8.25 (4.27 to 37.29)
        FLT3
    4.76 (1.97 to 13.04)
    5.55 (4.50 to 8.25)
    No statistical analyses for this end point

    Secondary: Number of Participants who Experienced at Least One Adverse Event by Severity, According to National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.03 (NCI-CTCAE v4.03)

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    End point title
    Number of Participants who Experienced at Least One Adverse Event by Severity, According to National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.03 (NCI-CTCAE v4.03)
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline up to approximately 5.5 years
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    232
    Units: Participants
    149
    232
    No statistical analyses for this end point

    Secondary: Number of Participants with Adverse Events Leading to Discontinuation

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    End point title
    Number of Participants with Adverse Events Leading to Discontinuation
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline up to approximately 5.5 years
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Participants
    0
    0
    No statistical analyses for this end point

    Secondary: Number of Participants with Adverse Events Leading to Death up to Day 30

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    End point title
    Number of Participants with Adverse Events Leading to Death up to Day 30
    End point description
    End point type
    Secondary
    End point timeframe
    Up to Day 30
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Participants
    9
    23
    No statistical analyses for this end point

    Secondary: Number of Participants with Adverse Events Leading to Death up to Day 60

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    End point title
    Number of Participants with Adverse Events Leading to Death up to Day 60
    End point description
    End point type
    Secondary
    End point timeframe
    Up to Day 60
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Participants
    60
    24
    No statistical analyses for this end point

    Secondary: Number of Participants with Clinical Laboratory Abnormalities in Biochemistry Tests at the Greatest Severity, According to NCI-CTCAE v4.03

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    End point title
    Number of Participants with Clinical Laboratory Abnormalities in Biochemistry Tests at the Greatest Severity, According to NCI-CTCAE v4.03
    End point description
    Laboratory parameters for blood biochemistry will be measured and compared with a standard reference range. Values outside the standard reference range are considered abnormalities. Not every laboratory abnormality qualifies as an adverse event. A laboratory test result will be reported as an adverse event if it meets any of the following criteria: is accompanied by clinical symptoms; results in a change in study treatment or a medical intervention; or is clinically significant in the investigator's judgment.
    End point type
    Secondary
    End point timeframe
    Baseline; Cycles 1-3 Days 1, 2, 8, 15, 22, and 28 (1 cycle is 28 days); and, if incomplete blood count recovery, Cycle 1 Days 29-42, Days 43-56, Cycles 2 and 3 Days 29-56 (max delay between cycles is 56 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Participants
    0
    0
    No statistical analyses for this end point

    Secondary: Number of Participants with Clinical Laboratory Abnormalities in Hematology Tests at the Greatest Severity, According to NCI-CTCAE v4.03

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    End point title
    Number of Participants with Clinical Laboratory Abnormalities in Hematology Tests at the Greatest Severity, According to NCI-CTCAE v4.03
    End point description
    Laboratory parameters for hematology will be measured and compared with a standard reference range. Values outside the standard reference range are considered abnormalities. Not every laboratory abnormality qualifies as an adverse event. A laboratory test result will be reported as an adverse event if it meets any of the following criteria: is accompanied by clinical symptoms; results in a change in study treatment or a medical intervention; or is clinically significant in the investigator's judgment.
    End point type
    Secondary
    End point timeframe
    Baseline; Cycles 1-3 Days 1, 2, 8, 15, 22, and 28 (1 cycle is 28 days); and, 30 Days after CR or CRp in Cycle 1, or if incomplete blood count recovery, Cycle 1 Days 29-42, Days 43-56, Cycles 2 and 3 Days 29-56 (max delay between cycles is 56 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    232
    Units: Participants
    0
    0
    No statistical analyses for this end point

    Secondary: Body Temperature Over Time

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    End point title
    Body Temperature Over Time
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline; Cycles 1-3 Days 1, 8, 15, 22, and 28 (1 cycle is 28 days); and, if incomplete blood count recovery, Cycle 1 Days 29-42, Days 43-56, Cycles 2 and 3 Days 29-56 (max delay between cycles is 56 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: C, Celsius degree
    arithmetic mean (standard deviation)
        Baseline
    36.49 ( 0.59 )
    36.52 ( 0.51 )
        Cycle 1 Day 8
    0.07 ( 0.82 )
    0.32 ( 0.72 )
        Cycle 1 Day 15
    0.30 ( 0.91 )
    0.46 ( 0.92 )
        Cycle 1 Day 22
    0.22 ( 0.74 )
    0.36 ( 0.86 )
        Cycle 1 Day 28
    0.06 ( 0.65 )
    0.23 ( 0.87 )
        Cycle 1 Day 29-42
    0.08 ( 0.69 )
    0.00 ( 0.71 )
        Cycle 1 Day 43-56
    -0.02 ( 0.53 )
    0.07 ( 0.80 )
        Cycle 2 Day 1
    0.11 ( 0.60 )
    -0.10 ( 0.47 )
        Cycle 2 Day 8
    -0.08 ( 0.51 )
    0.07 ( 0.56 )
        Cycle 2 Day 15
    0.17 ( 0.76 )
    0.34 ( 0.83 )
        Cycle 2 Day 22
    0.04 ( 0.72 )
    0.10 ( 0.59 )
        Cycle 2 Day 28
    -0.22 ( 0.65 )
    0.04 ( 0.62 )
        Cycle 2 Day 29-56
    -0.06 ( 0.36 )
    -0.09 ( 0.55 )
        Cycle 3 Day 1
    -0.25 ( 0.54 )
    -0.19 ( 0.51 )
        Cycle 3 Day 8
    0.10 ( 0.60 )
    -0.04 ( 0.59 )
        Cycle 3 Day 15
    -0.09 ( 0.76 )
    0.29 ( 0.65 )
        Cycle 3 Day 22
    -0.07 ( 0.64 )
    0.04 ( 0.49 )
        Cycle 3 Day 28
    -0.26 ( 0.63 )
    -0.15 ( 0.52 )
        Cycle 3 Day 29-56
    0.27 ( 0.47 )
    -0.25 ( 0.52 )
    No statistical analyses for this end point

    Secondary: Systolic Blood Pressure Over Time

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    End point title
    Systolic Blood Pressure Over Time
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline; Cycles 1-3 Days 1, 8, 15, 22, and 28 (1 cycle is 28 days); and, if incomplete blood count recovery, Cycle 1 Days 29-42, Days 43-56, Cycles 2 and 3 Days 29-56 (max delay between cycles is 56 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Millimeters of mercury (mmHg)
    arithmetic mean (standard deviation)
        Baseline
    120.6 ( 17.2 )
    122.1 ( 16.2 )
        Cycle 1 Day 8
    -3.7 ( 20.0 )
    -6.9 ( 18.6 )
        Cycle 1 Day 15
    -2.8 ( 19.2 )
    -0.1 ( 18.7 )
        Cycle 1 Day 22
    0.7 ( 20.3 )
    -1.5 ( 19.6 )
        Cycle 1 Day 28
    1.2 ( 21.7 )
    -0.5 ( 17.6 )
        Cycle 1 Day 29-42
    4.4 ( 17.8 )
    3.4 ( 17.7 )
        Cycle 1 Day 43-56
    9.8 ( 17.4 )
    3.8 ( 20.9 )
        Cycle 2 Day 1
    6.9 ( 15.6 )
    0.6 ( 15.2 )
        Cycle 2 Day 8
    5.3 ( 18.6 )
    -5.1 ( 16.2 )
        Cycle 2 Day 15
    -1.7 ( 17.7 )
    -0.2 ( 19.6 )
        Cycle 2 Day 22
    5.5 ( 19.8 )
    2.5 ( 17.0 )
        Cycle 2 Day 28
    5.8 ( 22.2 )
    5.0 ( 17.9 )
        Cycle 2 Day 29-56
    -1.0 ( 18.2 )
    6.6 ( 16.3 )
        Cycle 3 Day 1
    11.2 ( 18.9 )
    2.3 ( 18.2 )
        Cycle 3 Day 8
    6.0 ( 23.5 )
    -1.7 ( 13.4 )
        Cycle 3 Day 15
    3.3 ( 22.5 )
    0.2 ( 21.7 )
        Cycle 3 Day 22
    13.9 ( 22.8 )
    -1.1 ( 17.7 )
        Cycle 3 Day 28
    5.3 ( 23.0 )
    7.1 ( 18.0 )
        Cycle 3 Day 29-56
    27.7 ( 28.3 )
    5.1 ( 18.4 )
    No statistical analyses for this end point

    Secondary: Diastolic Blood Pressure Over Time

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    End point title
    Diastolic Blood Pressure Over Time
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline; Cycles 1-3 Days 1, 8, 15, 22, and 28 (1 cycle is 28 days); and, if incomplete blood count recovery, Cycle 1 Days 29-42, Days 43-56, Cycles 2 and 3 Days 29-56 (max delay between cycles is 56 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Millimeters of mercury (mmHg)
    arithmetic mean (standard deviation)
        Baseline
    70.2 ( 9.9 )
    71.5 ( 10.6 )
        Cycle 1 Day 8
    -1.5 ( 12.6 )
    -3.1 ( 12.7 )
        Cycle 1 Day 15
    -1.3 ( 11.3 )
    -1.3 ( 12.3 )
        Cycle 1 Day 22
    -0.5 ( 11.1 )
    -1.4 ( 12.9 )
        Cycle 1 Day 28
    1.0 ( 13.2 )
    -0.7 ( 12.6 )
        Cycle 1 Day 29-42
    3.8 ( 10.5 )
    0.6 ( 12.4 )
        Cycle 1 Day 43-56
    1.7 ( 11.8 )
    0.9 ( 13.5 )
        Cycle 2 Day 1
    1.1 ( 13.5 )
    0.9 ( 12.9 )
        Cycle 2 Day 8
    0.4 ( 13.5 )
    -2.2 ( 13.2 )
        Cycle 2 Day 15
    -0.6 ( 14.8 )
    -1.5 ( 15.4 )
        Cycle 2 Day 22
    3.1 ( 11.6 )
    1.7 ( 11.3 )
        Cycle 2 Day 28
    4.6 ( 13.9 )
    3.9 ( 12.7 )
        Cycle 2 Day 29-56
    -2.9 ( 12.4 )
    3.2 ( 15.8 )
        Cycle 3 Day 1
    5.0 ( 8.4 )
    0.3 ( 10.7 )
        Cycle 3 Day 8
    2.0 ( 15.5 )
    -3.3 ( 11.8 )
        Cycle 3 Day 15
    0.7 ( 11.1 )
    -1.8 ( 11.1 )
        Cycle 3 Day 22
    10.1 ( 14.3 )
    -2.1 ( 9.3 )
        Cycle 3 Day 28
    2.3 ( 14.7 )
    1.3 ( 10.1 )
        Cycle 3 Day 29-56
    5.0 ( 21.8 )
    2.6 ( 13.6 )
    No statistical analyses for this end point

    Secondary: Pulse Rate Over Time

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    End point title
    Pulse Rate Over Time
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline; Cycles 1-3 Days 1, 8, 15, 22, and 28 (1 cycle is 28 days); and, if incomplete blood count recovery, Cycle 1 Days 29-42, Days 43-56, Cycles 2 and 3 Days 29-56 (max delay between cycles is 56 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Beats per Minute
    arithmetic mean (standard deviation)
        Baseline
    78.4 ( 14.4 )
    79.2 ( 12.9 )
        Cycle 1 Day 8
    -4.3 ( 15.9 )
    3.4 ( 15.6 )
        Cycle 1 Day 15
    1.5 ( 16.0 )
    1.1 ( 17.2 )
        Cycle 1 Day 22
    0.2 ( 16.2 )
    4.1 ( 15.8 )
        Cycle 1 Day 28
    4.8 ( 15.8 )
    4.0 ( 16.8 )
        Cycle 1 Day 29-42
    2.0 ( 13.5 )
    5.1 ( 16.4 )
        Cycle 1 Day 43-56
    5.5 ( 18.6 )
    6.8 ( 14.0 )
        Cycle 2 Day 1
    2.0 ( 16.6 )
    -0.9 ( 12.0 )
        Cycle 2 Day 8
    -3.3 ( 18.6 )
    2.4 ( 14.9 )
        Cycle 2 Day 15
    -0.4 ( 12.7 )
    1.7 ( 18.4 )
        Cycle 2 Day 22
    2.3 ( 15.5 )
    0.3 ( 15.4 )
        Cycle 2 Day 28
    -2.3 ( 14.6 )
    1.2 ( 12.2 )
        Cycle 2 Day 29-56
    1.8 ( 11.8 )
    4.0 ( 14.8 )
        Cycle 3 Day 1
    0.4 ( 18.4 )
    1.0 ( 9.8 )
        Cycle 3 Day 8
    1.3 ( 21.5 )
    2.4 ( 16.2 )
        Cycle 3 Day 15
    2.5 ( 16.9 )
    1.9 ( 11.9 )
        Cycle 3 Day 22
    4.8 ( 19.7 )
    3.4 ( 13.6 )
        Cycle 3 Day 28
    0.4 ( 16.1 )
    0.9 ( 13.7 )
        Cycle 3 Day 29-56
    -5.0 ( 1.7 )
    5.2 ( 11.5 )
    No statistical analyses for this end point

    Secondary: Respiratory Rate Over Time

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    End point title
    Respiratory Rate Over Time
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline; Cycles 1-3 Days 1, 8, 15, 22, and 28 (1 cycle is 28 days); and, if incomplete blood count recovery, Cycle 1 Days 29-42, Days 43-56, Cycles 2 and 3 Days 29-56 (max delay between cycles is 56 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Breaths per Minute
    arithmetic mean (standard deviation)
        Baseline
    16.3 ( 2.7 )
    16.6 ( 2.7 )
        Cycle 1 Day 8
    -0.1 ( 2.7 )
    0.0 ( 2.8 )
        Cycle 1 Day 15
    0.7 ( 2.9 )
    0.4 ( 2.8 )
        Cycle 1 Day 22
    0.6 ( 3.2 )
    0.7 ( 4.1 )
        Cycle 1 Day 28
    0.4 ( 2.9 )
    0.6 ( 2.9 )
        Cycle 1 Day 29-42
    0.7 ( 2.1 )
    0.5 ( 2.7 )
        Cycle 1 Day 43-56
    0.3 ( 1.0 )
    0.0 ( 2.9 )
        Cycle 2 Day 1
    -0.3 ( 2.8 )
    -0.2 ( 3.2 )
        Cycle 2 Day 8
    -0.2 ( 2.9 )
    0.1 ( 3.3 )
        Cycle 2 Day 15
    0.5 ( 2.4 )
    0.0 ( 2.5 )
        Cycle 2 Day 22
    0.8 ( 2.3 )
    0.4 ( 1.4 )
        Cycle 2 Day 28
    -0.3 ( 2.3 )
    0.5 ( 3.5 )
        Cycle 2 Day 29-56
    0.2 ( 1.8 )
    0.3 ( 2.5 )
        Cycle 3 Day 1
    1.1 ( 2.5 )
    0.2 ( 2.1 )
        Cycle 3 Day 8
    0.2 ( 2.5 )
    -1.0 ( 3.1 )
        Cycle 3 Day 15
    1.5 ( 3.6 )
    0.9 ( 2.2 )
        Cycle 3 Day 22
    1.1 ( 2.7 )
    0.8 ( 1.6 )
        Cycle 3 Day 28
    0.3 ( 1.2 )
    0.8 ( 1.8 )
        Cycle 3 Day 29-56
    0.7 ( 4.6 )
    0.1 ( 2.4 )
    No statistical analyses for this end point

    Secondary: Change from Baseline in Heart Rate, as Measured by Electrocardiogram

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    End point title
    Change from Baseline in Heart Rate, as Measured by Electrocardiogram
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline, Days 1, 2, and 5 of Cycle 1, Days 1, 2 of Cycles 2 and 3 (1 cycle is 28 days), Treatment Discontinuation Visit (28 days after last dose of study drug)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Beats per Minute
        arithmetic mean (standard deviation)
    0 ( 0 )
    0 ( 0 )
    No statistical analyses for this end point

    Secondary: Change from Baseline in Electrocardiogram Parameters: PQ, PR, RR, QRS, QT and QTcF Intervals

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    End point title
    Change from Baseline in Electrocardiogram Parameters: PQ, PR, RR, QRS, QT and QTcF Intervals
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline, Days 1, 2, and 5 of Cycle 1, Days 1, 2 of Cycles 2 and 3 (1 cycle is 28 days), Treatment Discontinuation Visit (28 days after last dose of study drug)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Millisecond (msec)
        arithmetic mean (standard deviation)
    0 ( 0 )
    0 ( 0 )
    No statistical analyses for this end point

    Secondary: Total Duration of Study Treatment

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    End point title
    Total Duration of Study Treatment
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 3 cycles (1 cycle is 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Days
        arithmetic mean (standard deviation)
    17.6 ( 28.25 )
    16.5 ( 28.29 )
    No statistical analyses for this end point

    Secondary: Number of Treatment Cycles Started

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    End point title
    Number of Treatment Cycles Started
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 3 cycles (1 cycle is 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Numbers
        arithmetic mean (standard deviation)
    1.3 ( 0.63 )
    1.2 ( 0.54 )
    No statistical analyses for this end point

    Secondary: Cumulative Dose of Idasanutlin and Cytarabine

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    End point title
    Cumulative Dose of Idasanutlin and Cytarabine
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 3 cycles (1 cycle is 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Milligram (mg) and Gram (g)
    arithmetic mean (standard deviation)
        Idasanutlin/Placebo cumulative dose (mg)
    0 ( 0 )
    3340.1 ( 896.35 )
        Cytarabine cumulative dose (g)
    11.5 ( 5.85 )
    11.2 ( 5.19 )
    No statistical analyses for this end point

    Secondary: Apparent Clearance (CL/F) of Idasanutlin

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    End point title
    Apparent Clearance (CL/F) of Idasanutlin
    End point description
    End point type
    Secondary
    End point timeframe
    Cycle 1: Predose (0 hour [Hr]), end of 1-3 Hr cytarabine infusion, 6 Hr postdose on Days 1, 5; Predose (0 Hr) on Day 2; at Days 8, 10; Cycle 2, 3: predose (0 Hr) on Days 2, 5 (predose/postdose: relative to idasanutlin morning dose; cycle length= 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Number
    0
    0
    No statistical analyses for this end point

    Secondary: Apparent Volume of Distribution (Vd/F) of Idasanutlin

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    End point title
    Apparent Volume of Distribution (Vd/F) of Idasanutlin
    End point description
    End point type
    Secondary
    End point timeframe
    Cycle 1: Predose (0 Hr), end of 1-3 Hr cytarabine infusion, 6 Hr postdose on Days 1, 5; Predose (0 Hr) on Day 2; at Days 8, 10; Cycle 2, 3: predose (0 Hr) on Days 2, 5 (predose/postdose: relative to idasanutlin morning dose; cycle length= 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Number
    0
    0
    No statistical analyses for this end point

    Secondary: Maximum Concentration Observed (Cmax) of Idasanutlin

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    End point title
    Maximum Concentration Observed (Cmax) of Idasanutlin
    End point description
    End point type
    Secondary
    End point timeframe
    Cycle 1: Predose (0 Hr), end of 1-3 Hr cytarabine infusion, 6 Hr postdose on Days 1, 5; Predose (0 Hr) on Day 2; at Days 8, 10; Cycle 2, 3: predose (0 Hr) on Days 2, 5 (predose/postdose: relative to idasanutlin morning dose; cycle length= 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Number
    0
    0
    No statistical analyses for this end point

    Secondary: Steady-State Concentration (Ctrough) of Idasanutlin

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    End point title
    Steady-State Concentration (Ctrough) of Idasanutlin
    End point description
    End point type
    Secondary
    End point timeframe
    Cycle 1: Predose (0 Hr), end of 1-3 Hr cytarabine infusion, 6 Hr postdose on Days 1, 5; Predose (0 Hr) on Day 2; at Days 8, 10; Cycle 2, 3: predose (0 Hr) on Days 2, 5 (predose/postdose: relative to idasanutlin morning dose; cycle length= 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Number
    0
    0
    No statistical analyses for this end point

    Secondary: Area Under the Concentration-Time Curve (AUC) During One Dosing Interval (AUCtau) of Idasanutlin

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    End point title
    Area Under the Concentration-Time Curve (AUC) During One Dosing Interval (AUCtau) of Idasanutlin
    End point description
    End point type
    Secondary
    End point timeframe
    Cycle 1: Predose (0 Hr), end of 1-3 Hr cytarabine infusion, 6 Hr postdose on Days 1, 5; Predose (0 Hr) on Day 2; at Days 8, 10; Cycle 2, 3: predose (0 Hr) on Days 2, 5 (predose/postdose: relative to idasanutlin morning dose; cycle length= 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Number
    0
    0
    No statistical analyses for this end point

    Secondary: AUC from Time Zero to 24 Hours Post Dose (AUC0-24) of Idasanutlin

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    End point title
    AUC from Time Zero to 24 Hours Post Dose (AUC0-24) of Idasanutlin
    End point description
    End point type
    Secondary
    End point timeframe
    Cycle 1: Predose (0 Hr), end of 1-3 Hr cytarabine infusion, 6 Hr postdose on Days 1, 5; Predose (0 Hr) on Day 2; at Days 8, 10; Cycle 2, 3: predose (0 Hr) on Days 2, 5 (predose/postdose: relative to idasanutlin morning dose; cycle length= 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Number
    0
    0
    No statistical analyses for this end point

    Secondary: Half-Life (t 1/2) of Idasanutlin

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    End point title
    Half-Life (t 1/2) of Idasanutlin
    End point description
    End point type
    Secondary
    End point timeframe
    Cycle 1: Predose (0 Hr), end of 1-3 Hr cytarabine infusion, 6 Hr postdose on Days 1, 5; Predose (0 Hr) on Day 2; at Days 8, 10; Cycle 2, 3: predose (0 Hr) on Days 2, 5 (predose/postdose: relative to idasanutlin morning dose; cycle length= 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Number
    0
    0
    No statistical analyses for this end point

    Secondary: Total Clearance (CL) of Cytarabine

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    End point title
    Total Clearance (CL) of Cytarabine
    End point description
    End point type
    Secondary
    End point timeframe
    Cycle 1: Within 2 Hr pre-cytarabine dose, end of 1-3 Hr cytarabine infusion, 6 Hr post idasanutlin morning dose on Days 1, 5; Within 2 Hr pre-cytarabine dose on Day 2; Cycle 2, 3: Within 2 Hr pre-cytarabine dose on Day 2 (Cycle length= 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Number
    0
    0
    No statistical analyses for this end point

    Secondary: Volume of Distribution (Vd) of Cytarabine

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    End point title
    Volume of Distribution (Vd) of Cytarabine
    End point description
    End point type
    Secondary
    End point timeframe
    Cycle 1: Within 2 Hr pre-cytarabine dose, end of 1-3 Hr cytarabine infusion, 6 Hr post idasanutlin morning dose on Days 1, 5; Within 2 Hr pre-cytarabine dose on Day 2; Cycle 2, 3: Within 2 Hr pre-cytarabine dose on Day 2 (Cycle length= 28 days)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    149
    292
    Units: Milliliter
        arithmetic mean (standard deviation)
    0 ( 0 )
    0 ( 0 )
    No statistical analyses for this end point

    Secondary: Change from Baseline in European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Score

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    End point title
    Change from Baseline in European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Score
    End point description
    Due to the study termination, no data derived
    End point type
    Secondary
    End point timeframe
    Cycle 1 Day 1 (Baseline), Days 8, 15, 28 of Cycle 1, Days 1, 8, 15, 28 of Cycles 2, 3, 28 days after last dose (last dose on Cycle 3 Day 5), thereafter every 3 months until relapse (maximum up to 3.5 years)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    123
    232
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    0 ( 0 )
    0 ( 0 )
    No statistical analyses for this end point

    Secondary: Change from Baseline in EuroQol 5 Dimension 5-Level (EQ-5D-5L) Questionnaire Score

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    End point title
    Change from Baseline in EuroQol 5 Dimension 5-Level (EQ-5D-5L) Questionnaire Score
    End point description
    Due to the study termination, no result data derived.
    End point type
    Secondary
    End point timeframe
    Cycle 1 Day 1 (Baseline), Days 8, 15, 28 of Cycle 1, Days 1, 8, 15, 28 of Cycles 2, 3, 28 days after last dose (last dose on Cycle 3 Day 5), thereafter every 3 months until relapse (maximum up to 3.5 years)
    End point values
    Placebo plus Cytarabine Idasanutlin plus Cytarabine
    Number of subjects analysed
    123
    232
    Units: Score on a Scale
        arithmetic mean (standard deviation)
    0 ( 0 )
    0 ( 0 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline up to approximately 5.5 years. The study was pre-maturely terminated, therefore did not reach the planned end of study.
    Adverse event reporting additional description
    Reported: Safety Population. During the Safety Follow-up Period, non-Serious Adverse Events occurred at the 5% frequency threshold.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    23.0
    Reporting groups
    Reporting group title
    Placebo-Cytarabine
    Reporting group description
    Participants will receive induction therapy idasanutlin matching placebo and cytarabine for 5 days followed by 23 days of rest in Cycle 1 (treatment cycle length=28 days). Responding participants may continue with consolidation therapy for a maximum of 2 additional cycles including idasanutlin matching placebo and cytarabine for 5 days followed by 23 days of rest in each cycle (treatment cycle length=28 days). After each cycle, for participants achieving CRp or CRi, up to 28 additional days are allowed for blood count recovery, if needed.

    Reporting group title
    Idasanutlin-Cytarabine
    Reporting group description
    Participants will receive induction therapy idasanutlin and cytarabine for 5 days followed by 23 days of rest in Cycle 1 (treatment cycle length=28 days). Responding participants may continue with consolidation therapy for a maximum of 2 additional cycles including idasanutlin and cytarabine for 5 days followed by 23 days of rest in each cycle (treatment cycle length=28 days). After each cycle, for participants achieving CRp or complete remission with incomplete blood count recovery (CRi), up to 28 additional days are allowed for blood count recovery, if needed

    Serious adverse events
    Placebo-Cytarabine Idasanutlin-Cytarabine
    Total subjects affected by serious adverse events
         subjects affected / exposed
    72 / 149 (48.32%)
    173 / 292 (59.25%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Adenocarcinoma gastric
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metastatic malignant melanoma
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Embolism
         subjects affected / exposed
    1 / 149 (0.67%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    0 / 149 (0.00%)
    5 / 292 (1.71%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peripheral artery thrombosis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Venoocclusive disease
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         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
    Death
         subjects affected / exposed
    1 / 149 (0.67%)
    6 / 292 (2.05%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injection site extravasation
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    2 / 149 (1.34%)
    6 / 292 (2.05%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 149 (0.67%)
    6 / 292 (2.05%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Immune system disorders
    Acute graft versus host disease
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute graft versus host disease in intestine
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anaphylactic shock
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic graft versus host disease
         subjects affected / exposed
    1 / 149 (0.67%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Graft versus host disease
         subjects affected / exposed
    1 / 149 (0.67%)
    4 / 292 (1.37%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Graft versus host disease in gastrointestinal tract
         subjects affected / exposed
    1 / 149 (0.67%)
    3 / 292 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemophagocytic lymphohistiocytosis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aspiration
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 149 (0.67%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 149 (0.67%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary haemorrhage
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory distress
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    2 / 149 (1.34%)
    4 / 292 (1.37%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atypical mycobacterium test positive
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood creatinine increased
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transaminases increased
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Anaphylactic transfusion reaction
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower limb fracture
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subdural haematoma
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subdural haemorrhage
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Traumatic intracranial haemorrhage
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Wrist fracture
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Acute coronary syndrome
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bundle branch block right
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac tamponade
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    1 / 149 (0.67%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocarditis
         subjects affected / exposed
    2 / 149 (1.34%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pericardial effusion
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pericarditis
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sinus bradycardia
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sinus tachycardia
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Ataxia
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Central nervous system haemorrhage
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         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
    2 / 149 (1.34%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Coma
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Encephalopathy
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epilepsy
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemorrhagic stroke
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (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
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intracranial mass
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neuropathy peripheral
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subarachnoid haemorrhage
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 149 (0.67%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Cytopenia
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile bone marrow aplasia
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    13 / 149 (8.72%)
    28 / 292 (9.59%)
         occurrences causally related to treatment / all
    0 / 16
    0 / 37
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Leukopenia
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    0 / 149 (0.00%)
    3 / 292 (1.03%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancytopenia
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    2 / 149 (1.34%)
    4 / 292 (1.37%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Colitis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colitis ischaemic
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 149 (0.67%)
    8 / 292 (2.74%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric haemorrhage
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ileus paralytic
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal haemorrhage
         subjects affected / exposed
    1 / 149 (0.67%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Large intestinal obstruction
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Melaena
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatitis
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tongue haematoma
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystitis acute
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic failure
         subjects affected / exposed
    1 / 149 (0.67%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatitis acute
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatocellular injury
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatotoxicity
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperbilirubinaemia
         subjects affected / exposed
    1 / 149 (0.67%)
    6 / 292 (2.05%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ocular icterus
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Venoocclusive liver disease
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Erythema
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pruritus
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rash maculo-papular
         subjects affected / exposed
    1 / 149 (0.67%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 149 (0.67%)
    3 / 292 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    0 / 149 (0.00%)
    3 / 292 (1.03%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal tubular acidosis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bone pain
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Soft tissue necrosis
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Anal abscess
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anal infection
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Appendicitis
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aspergillus infection
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacteraemia
         subjects affected / exposed
    1 / 149 (0.67%)
    4 / 292 (1.37%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacterial infection
         subjects affected / exposed
    1 / 149 (0.67%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacterial sepsis
         subjects affected / exposed
    1 / 149 (0.67%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchopulmonary aspergillosis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    1 / 149 (0.67%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related sepsis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Encephalitis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endocarditis
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterobacter sepsis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterococcal sepsis
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterocolitis infectious
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Escherichia bacteraemia
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Escherichia sepsis
         subjects affected / exposed
    1 / 149 (0.67%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fusobacterium infection
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gingivitis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes simplex
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Klebsiella infection
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Klebsiella sepsis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenic infection
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenic sepsis
         subjects affected / exposed
    2 / 149 (1.34%)
    5 / 292 (1.71%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Periorbital cellulitis
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    13 / 149 (8.72%)
    21 / 292 (7.19%)
         occurrences causally related to treatment / all
    0 / 13
    0 / 21
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pseudomonas infection
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary sepsis
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory syncytial virus infection
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    8 / 149 (5.37%)
    34 / 292 (11.64%)
         occurrences causally related to treatment / all
    0 / 8
    0 / 34
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    8 / 149 (5.37%)
    11 / 292 (3.77%)
         occurrences causally related to treatment / all
    0 / 8
    0 / 11
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Soft tissue infection
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Staphylococcal sepsis
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Streptococcal bacteraemia
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Systemic candida
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 149 (0.67%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular device infection
         subjects affected / exposed
    1 / 149 (0.67%)
    0 / 292 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral infection
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vulvovaginitis
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Electrolyte imbalance
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypernatraemia
         subjects affected / exposed
    0 / 149 (0.00%)
    1 / 292 (0.34%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    0 / 149 (0.00%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour lysis syndrome
         subjects affected / exposed
    1 / 149 (0.67%)
    2 / 292 (0.68%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo-Cytarabine Idasanutlin-Cytarabine
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    147 / 149 (98.66%)
    290 / 292 (99.32%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    12 / 149 (8.05%)
    26 / 292 (8.90%)
         occurrences all number
    12
    34
    Hypotension
         subjects affected / exposed
    16 / 149 (10.74%)
    44 / 292 (15.07%)
         occurrences all number
    16
    53
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    19 / 149 (12.75%)
    56 / 292 (19.18%)
         occurrences all number
    24
    70
    Chest pain
         subjects affected / exposed
    9 / 149 (6.04%)
    19 / 292 (6.51%)
         occurrences all number
    9
    25
    Fatigue
         subjects affected / exposed
    13 / 149 (8.72%)
    28 / 292 (9.59%)
         occurrences all number
    15
    30
    Mucosal inflammation
         subjects affected / exposed
    10 / 149 (6.71%)
    46 / 292 (15.75%)
         occurrences all number
    11
    50
    Oedema
         subjects affected / exposed
    5 / 149 (3.36%)
    22 / 292 (7.53%)
         occurrences all number
    6
    24
    Oedema peripheral
         subjects affected / exposed
    26 / 149 (17.45%)
    65 / 292 (22.26%)
         occurrences all number
    34
    88
    Pyrexia
         subjects affected / exposed
    49 / 149 (32.89%)
    108 / 292 (36.99%)
         occurrences all number
    67
    174
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    12 / 149 (8.05%)
    40 / 292 (13.70%)
         occurrences all number
    13
    45
    Dyspnoea
         subjects affected / exposed
    7 / 149 (4.70%)
    28 / 292 (9.59%)
         occurrences all number
    8
    34
    Epistaxis
         subjects affected / exposed
    26 / 149 (17.45%)
    29 / 292 (9.93%)
         occurrences all number
    37
    39
    Hiccups
         subjects affected / exposed
    6 / 149 (4.03%)
    15 / 292 (5.14%)
         occurrences all number
    6
    17
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    24 / 149 (16.11%)
    24 / 292 (8.22%)
         occurrences all number
    26
    24
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    12 / 149 (8.05%)
    15 / 292 (5.14%)
         occurrences all number
    12
    20
    Blood creatinine increased
         subjects affected / exposed
    9 / 149 (6.04%)
    10 / 292 (3.42%)
         occurrences all number
    10
    12
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    9 / 149 (6.04%)
    15 / 292 (5.14%)
         occurrences all number
    9
    16
    Weight increased
         subjects affected / exposed
    6 / 149 (4.03%)
    16 / 292 (5.48%)
         occurrences all number
    7
    16
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    10 / 149 (6.71%)
    14 / 292 (4.79%)
         occurrences all number
    11
    21
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    6 / 149 (4.03%)
    15 / 292 (5.14%)
         occurrences all number
    8
    20
    Tachycardia
         subjects affected / exposed
    3 / 149 (2.01%)
    16 / 292 (5.48%)
         occurrences all number
    3
    17
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    5 / 149 (3.36%)
    17 / 292 (5.82%)
         occurrences all number
    6
    19
    Headache
         subjects affected / exposed
    33 / 149 (22.15%)
    49 / 292 (16.78%)
         occurrences all number
    39
    67
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    49 / 149 (32.89%)
    79 / 292 (27.05%)
         occurrences all number
    71
    131
    Febrile neutropenia
         subjects affected / exposed
    63 / 149 (42.28%)
    136 / 292 (46.58%)
         occurrences all number
    79
    178
    Neutropenia
         subjects affected / exposed
    13 / 149 (8.72%)
    35 / 292 (11.99%)
         occurrences all number
    19
    36
    Thrombocytopenia
         subjects affected / exposed
    69 / 149 (46.31%)
    120 / 292 (41.10%)
         occurrences all number
    104
    175
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    18 / 149 (12.08%)
    54 / 292 (18.49%)
         occurrences all number
    19
    68
    Abdominal pain upper
         subjects affected / exposed
    6 / 149 (4.03%)
    24 / 292 (8.22%)
         occurrences all number
    6
    28
    Constipation
         subjects affected / exposed
    76 / 149 (51.01%)
    53 / 292 (18.15%)
         occurrences all number
    99
    76
    Diarrhoea
         subjects affected / exposed
    49 / 149 (32.89%)
    251 / 292 (85.96%)
         occurrences all number
    65
    404
    Dry mouth
         subjects affected / exposed
    3 / 149 (2.01%)
    15 / 292 (5.14%)
         occurrences all number
    3
    15
    Dyspepsia
         subjects affected / exposed
    10 / 149 (6.71%)
    15 / 292 (5.14%)
         occurrences all number
    12
    19
    Haemorrhoids
         subjects affected / exposed
    8 / 149 (5.37%)
    18 / 292 (6.16%)
         occurrences all number
    8
    22
    Nausea
         subjects affected / exposed
    47 / 149 (31.54%)
    153 / 292 (52.40%)
         occurrences all number
    56
    227
    Stomatitis
         subjects affected / exposed
    6 / 149 (4.03%)
    24 / 292 (8.22%)
         occurrences all number
    8
    24
    Vomiting
         subjects affected / exposed
    27 / 149 (18.12%)
    89 / 292 (30.48%)
         occurrences all number
    30
    145
    Hepatobiliary disorders
    Hyperbilirubinaemia
         subjects affected / exposed
    12 / 149 (8.05%)
    52 / 292 (17.81%)
         occurrences all number
    15
    56
    Skin and subcutaneous tissue disorders
    Erythema
         subjects affected / exposed
    8 / 149 (5.37%)
    38 / 292 (13.01%)
         occurrences all number
    9
    44
    Petechiae
         subjects affected / exposed
    7 / 149 (4.70%)
    17 / 292 (5.82%)
         occurrences all number
    8
    21
    Rash
         subjects affected / exposed
    24 / 149 (16.11%)
    55 / 292 (18.84%)
         occurrences all number
    32
    62
    Rash maculo-papular
         subjects affected / exposed
    8 / 149 (5.37%)
    14 / 292 (4.79%)
         occurrences all number
    9
    15
    Renal and urinary disorders
    Haematuria
         subjects affected / exposed
    2 / 149 (1.34%)
    17 / 292 (5.82%)
         occurrences all number
    2
    26
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    13 / 149 (8.72%)
    27 / 292 (9.25%)
         occurrences all number
    15
    28
    Bone pain
         subjects affected / exposed
    9 / 149 (6.04%)
    3 / 292 (1.03%)
         occurrences all number
    10
    3
    Infections and infestations
    Bacteraemia
         subjects affected / exposed
    2 / 149 (1.34%)
    15 / 292 (5.14%)
         occurrences all number
    2
    15
    Device related infection
         subjects affected / exposed
    8 / 149 (5.37%)
    16 / 292 (5.48%)
         occurrences all number
    8
    16
    Oral herpes
         subjects affected / exposed
    11 / 149 (7.38%)
    22 / 292 (7.53%)
         occurrences all number
    11
    23
    Pneumonia
         subjects affected / exposed
    7 / 149 (4.70%)
    18 / 292 (6.16%)
         occurrences all number
    7
    18
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    14 / 149 (9.40%)
    54 / 292 (18.49%)
         occurrences all number
    14
    58
    Hyperglycaemia
         subjects affected / exposed
    9 / 149 (6.04%)
    17 / 292 (5.82%)
         occurrences all number
    9
    23
    Hypoalbuminaemia
         subjects affected / exposed
    4 / 149 (2.68%)
    20 / 292 (6.85%)
         occurrences all number
    4
    23
    Hypocalcaemia
         subjects affected / exposed
    7 / 149 (4.70%)
    35 / 292 (11.99%)
         occurrences all number
    9
    42
    Hypokalaemia
         subjects affected / exposed
    48 / 149 (32.21%)
    129 / 292 (44.18%)
         occurrences all number
    65
    207
    Hypomagnesaemia
         subjects affected / exposed
    12 / 149 (8.05%)
    51 / 292 (17.47%)
         occurrences all number
    12
    72
    Hypophosphataemia
         subjects affected / exposed
    11 / 149 (7.38%)
    30 / 292 (10.27%)
         occurrences all number
    15
    43

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

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