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    Clinical Trial Results:
    EFFICACY AND SAFETY OF LANREOTIDE AUTOGEL® 120 MG ADMINISTERED EVERY 14 DAYS IN WELL DIFFERENTIATED, METASTATIC OR LOCALLY ADVANCED, UNRESECTABLE PANCREATIC OR MIDGUT NEUROENDOCRINE TUMOURS HAVING PROGRESSED RADIOLOGICALLY WHILE PREVIOUSLY TREATED WITH LANREOTIDE AUTOGEL® 120 MG ADMINISTERED EVERY 28 DAYS

    Summary
    EudraCT number
    2014-005607-24
    Trial protocol
    DE   BE   NL   DK   ES   PL   IT  
    Global end of trial date
    24 Oct 2019

    Results information
    Results version number
    v1(current)
    This version publication date
    01 Nov 2020
    First version publication date
    01 Nov 2020
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    8-79-52030-326
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02651987
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Ipsen Innovation
    Sponsor organisation address
    5 Avenue du Canada, Les Ulis, France, 91940
    Public contact
    Medical Director, Ipsen Innovation, clinical.trials@ipsen.com
    Scientific contact
    Medical Director, Ipsen Innovation, clinical.trials@ipsen.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
    24 Oct 2019
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    24 Oct 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To assess progression free survival (PFS) in subjects with well differentiated, metastatic or locally advanced, unresectable, pancreatic or midgut neuroendocrine tumours (NETs) when treated with lanreotide Autogel® 120 milligrams (mg) administered subcutaneously (SC) every 14 days based on Response Evaluation Criteria in Solid Tumours (RECIST) v1.0, and according to central review.
    Protection of trial subjects
    The study was conducted under the provisions of the Declaration of Helsinki of World Medical Association, Independent Ethics Committee/Institutional Review Boards, informed consent regulations, and in accordance with the International Conference on Harmonisation (ICH) Good Clinical Practice [ICH E6], and also adhered to all applicable local regulatory requirements.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    19 Nov 2015
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 4
    Country: Number of subjects enrolled
    Poland: 22
    Country: Number of subjects enrolled
    Spain: 4
    Country: Number of subjects enrolled
    United Kingdom: 15
    Country: Number of subjects enrolled
    Belgium: 5
    Country: Number of subjects enrolled
    Denmark: 3
    Country: Number of subjects enrolled
    France: 25
    Country: Number of subjects enrolled
    Germany: 11
    Country: Number of subjects enrolled
    Ireland: 2
    Country: Number of subjects enrolled
    Italy: 8
    Worldwide total number of subjects
    99
    EEA total number of subjects
    99
    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)
    43
    From 65 to 84 years
    56
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects with well differentiated, metastatic or locally advanced, unresectable, pancreatic or midgut NETs and who had radiologically documented disease progression (as per RECIST v1.0) whilst receiving treatment with lanreotide Autogel® 120mg, every 28 days for at least 24 weeks were enrolled into this study in 25 centres across 10 countries.

    Pre-assignment
    Screening details
    Subjects who had radiologically documented disease progression within 24 months prior to enrolment and whilst receiving treatment with lanreotide Autogel® 120 mg, administered every 28 days for at least 24 weeks, were recruited into one of two cohorts based on the primary location of NET (i.e. pancreatic NET [panNET] or midgut NET cohort).

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    PanNET Cohort
    Arm description
    Subjects were treated with lanreotide Autogel® 120 mg, administered as deep SC injections, every 14 days starting from Day 1 (at a reduced dosing interval) for up to 48 weeks or until disease progression, death or unacceptable toxicity or tolerability. Subjects who had not progressed at Week 48 could continue study treatment with lanreotide Autogel® 120 mg every 14 days until 25 events (Progressive disease [PD] or death) in the panNET cohort had been observed. Additional visits were performed every 12 weeks until disease progression or death, or unacceptable toxicity or tolerability.
    Arm type
    Experimental

    Investigational medicinal product name
    Lanreotide Autogel®
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Subjects received lanreotide Autogel® 120 mg, administered as deep SC injections in the superior, external quadrant of the buttock, every 14 days.

    Arm title
    Midgut NET Cohort
    Arm description
    Subjects were treated with lanreotide Autogel® 120 mg, administered as deep SC injections, every 14 days starting from Day 1 (at a reduced dosing interval) for up to 96 weeks or until disease progression, death or unacceptable toxicity or tolerability. Subjects who had not progressed at Week 96 could continue study treatment with lanreotide Autogel® 120 mg every 14 days until 25 events (PD or death) in the midgut NET cohort had been observed. Additional visits were performed every 12 weeks until disease progression or death, or unacceptable toxicity or tolerability.
    Arm type
    Experimental

    Investigational medicinal product name
    Lanreotide Autogel®
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Subjects received lanreotide Autogel® 120 mg, administered as deep SC injections in the superior, external quadrant of the buttock, every 14 days.

    Number of subjects in period 1
    PanNET Cohort Midgut NET Cohort
    Started
    48
    51
    Completed
    43
    46
    Not completed
    5
    5
         Consent withdrawn by subject
    2
    -
         Adverse event, non-fatal
    2
    2
         Investigator Decision
    1
    1
         Local PD
    -
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    PanNET Cohort
    Reporting group description
    Subjects were treated with lanreotide Autogel® 120 mg, administered as deep SC injections, every 14 days starting from Day 1 (at a reduced dosing interval) for up to 48 weeks or until disease progression, death or unacceptable toxicity or tolerability. Subjects who had not progressed at Week 48 could continue study treatment with lanreotide Autogel® 120 mg every 14 days until 25 events (Progressive disease [PD] or death) in the panNET cohort had been observed. Additional visits were performed every 12 weeks until disease progression or death, or unacceptable toxicity or tolerability.

    Reporting group title
    Midgut NET Cohort
    Reporting group description
    Subjects were treated with lanreotide Autogel® 120 mg, administered as deep SC injections, every 14 days starting from Day 1 (at a reduced dosing interval) for up to 96 weeks or until disease progression, death or unacceptable toxicity or tolerability. Subjects who had not progressed at Week 96 could continue study treatment with lanreotide Autogel® 120 mg every 14 days until 25 events (PD or death) in the midgut NET cohort had been observed. Additional visits were performed every 12 weeks until disease progression or death, or unacceptable toxicity or tolerability.

    Reporting group values
    PanNET Cohort Midgut NET Cohort Total
    Number of subjects
    48 51 99
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    25 18 43
        From 65-84 years
    23 33 56
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    63.3 ± 10.6 67.1 ± 8.2 -
    Gender categorical
    Units: Subjects
        Female
    28 22 50
        Male
    20 29 49
    Race
    Units: Subjects
        Asian
    0 1 1
        White
    35 37 72
        Other
    1 0 1
        Not collected due to local regulations (France)
    12 13 25
    Categories of Proliferation index Ki67
    Units: Subjects
        ≥10%
    7 4 11
        <10%
    41 46 87
        Missing
    0 1 1
    Tumour grading (according to WHO 2010 classification)
    Units: Subjects
        Grade 1
    12 29 41
        Grade 2
    36 22 58
    Hepatic tumour load
    Units: Subjects
        >25%
    7 9 16
        ≤25%
    41 42 83

    End points

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    End points reporting groups
    Reporting group title
    PanNET Cohort
    Reporting group description
    Subjects were treated with lanreotide Autogel® 120 mg, administered as deep SC injections, every 14 days starting from Day 1 (at a reduced dosing interval) for up to 48 weeks or until disease progression, death or unacceptable toxicity or tolerability. Subjects who had not progressed at Week 48 could continue study treatment with lanreotide Autogel® 120 mg every 14 days until 25 events (Progressive disease [PD] or death) in the panNET cohort had been observed. Additional visits were performed every 12 weeks until disease progression or death, or unacceptable toxicity or tolerability.

    Reporting group title
    Midgut NET Cohort
    Reporting group description
    Subjects were treated with lanreotide Autogel® 120 mg, administered as deep SC injections, every 14 days starting from Day 1 (at a reduced dosing interval) for up to 96 weeks or until disease progression, death or unacceptable toxicity or tolerability. Subjects who had not progressed at Week 96 could continue study treatment with lanreotide Autogel® 120 mg every 14 days until 25 events (PD or death) in the midgut NET cohort had been observed. Additional visits were performed every 12 weeks until disease progression or death, or unacceptable toxicity or tolerability.

    Subject analysis set title
    Overall
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study.

    Primary: Median PFS

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    End point title
    Median PFS [1]
    End point description
    PFS was defined as the time from first injection of lanreotide Autogel® 120 mg every 14 days to progression or death. Disease progression was assessed by tumour response evaluation according to RECIST v1.0, every 12 weeks, measured by independent central review using the same imaging technique (computed tomography [CT] scan or magnetic resonance imaging [MRI]) for each subject throughout the study. The median PFS time was estimated using the Kaplan Meier method for each cohort. Analysis was performed on the Full Analysis Set (FAS) which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study.
    End point type
    Primary
    End point timeframe
    From Day 1 up to Week 60 for the panNET cohort and Week 103 for the midgut NET cohort
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive analyses were planned for the primary endpoint.
    End point values
    PanNET Cohort Midgut NET Cohort
    Number of subjects analysed
    48
    51
    Units: months
        median (confidence interval 95%)
    5.6 (5.5 to 8.3)
    8.3 (5.6 to 11.1)
    No statistical analyses for this end point

    Secondary: Median Time to Progression

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    End point title
    Median Time to Progression
    End point description
    Time to Progression was defined as time from first injection of lanreotide Autogel® 120 mg every 14 days to progression. Disease progression was assessed by tumour response evaluation according to RECIST v1.0, every 12 weeks, measured by independent central review using the same imaging technique (CT scan or MRI) for each subject throughout the study. Median time to progression was estimated using the Kaplan Meier method for each cohort. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study.
    End point type
    Secondary
    End point timeframe
    From Day 1 up to Week 60 for the panNET cohort and Week 103 for the midgut NET cohort
    End point values
    PanNET Cohort Midgut NET Cohort
    Number of subjects analysed
    48
    51
    Units: months
        median (confidence interval 95%)
    5.6 (5.5 to 8.3)
    8.7 (8.3 to 13.9)
    No statistical analyses for this end point

    Secondary: Percentage of Subjects Alive and Progression Free

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    End point title
    Percentage of Subjects Alive and Progression Free
    End point description
    The percentage of subjects alive and progression-free was assessed throughout the study up to Week 72 for the panNET cohort and Week 108 for the midgut cohort. Disease progression was assessed by tumour response evaluation according to RECIST v1.0, every 12 weeks measured by independent central review using the same imaging technique (CT scan or MRI) for each subject throughout the study. The percentage of subjects alive and progression free was estimated using the Kaplan Meier method for each cohort. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study.
    End point type
    Secondary
    End point timeframe
    Weeks 12, 24, 36, 48, 60 (for both cohorts) and Weeks 72, 84 and 96 (for midgut NET cohort)
    End point values
    PanNET Cohort Midgut NET Cohort
    Number of subjects analysed
    48 [2]
    51
    Units: percentage of subjects
    number (confidence interval 95%)
        Week 12
    93.3 (80.7 to 97.8)
    91.8 (79.7 to 96.9)
        Week 24
    64.4 (48.7 to 76.5)
    65.3 (50.3 to 76.8)
        Week 36
    37.8 (23.9 to 51.6)
    59.2 (44.2 to 71.4)
        Week 48
    28.5 (16.2 to 42.1)
    38.3 (24.8 to 51.6)
        Week 60
    20.7 (9.0 to 35.7)
    36.1 (22.9 to 49.5)
        Week 72
    99999 (99999 to 99999)
    29.8 (17.6 to 42.9)
        Week 84
    99999 (99999 to 99999)
    27.5 (15.7 to 40.5)
        Week 96
    99999 (99999 to 99999)
    25.2 (13.9 to 38.1)
    Notes
    [2] - 99999 = This cohort was not included after Week 72.
    No statistical analyses for this end point

    Secondary: Overall Survival

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    End point title
    Overall Survival
    End point description
    Overall survival was defined as the time in months from the first injection of lanreotide Autogel® 120 mg every 14 days to death due to any cause. Median overall survival was estimated using the Kaplan Meier method for each cohort. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study.
    End point type
    Secondary
    End point timeframe
    From Day 1 up to Week 60 for the panNET cohort and Week 103 for the midgut NET cohort
    End point values
    PanNET Cohort Midgut NET Cohort
    Number of subjects analysed
    48 [3]
    51 [4]
    Units: months
        median (confidence interval 95%)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    Notes
    [3] - 99999 = The median overall survival from the Kaplan Meier model was not reached for this cohort.
    [4] - 99999 = The median overall survival from the Kaplan Meier model was not reached for this cohort.
    No statistical analyses for this end point

    Secondary: Objective Response Rate (ORR)

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    End point title
    Objective Response Rate (ORR)
    End point description
    The ORR was defined as the percentage of subjects who achieve either complete response (CR) or partial response (PR) according to RECIST v1.0 criteria. ORR was evaluated every 12 weeks and results are presented for each cohort. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study.
    End point type
    Secondary
    End point timeframe
    Weeks 12, 24, 36, 48, 60 (for both cohorts) and Weeks 72, 84, and 96 (for midgut cohort)
    End point values
    PanNET Cohort Midgut NET Cohort
    Number of subjects analysed
    48 [5]
    51
    Units: percentage of subjects
    number (confidence interval 95%)
        Week 12
    0.0 (0.0 to 7.4)
    0.0 (0.0 to 7.0)
        Week 24
    0.0 (0.0 to 7.4)
    0.0 (0.0 to 7.0)
        Week 36
    0.0 (0.0 to 7.4)
    0.0 (0.0 to 7.0)
        Week 48
    0.0 (0.0 to 7.4)
    0.0 (0.0 to 7.0)
        Week 60
    0.0 (0.0 to 7.4)
    2.0 (0.0 to 10.4)
        Week 72
    99999 (99999 to 99999)
    3.9 (0.5 to 13.5)
        Week 84
    99999 (99999 to 99999)
    2.0 (0.0 to 10.4)
        Week 96
    99999 (99999 to 99999)
    2.0 (0.0 to 10.4)
    Notes
    [5] - 99999 = This cohort was not included after Week 72.
    No statistical analyses for this end point

    Secondary: Disease Control Rate (DCR)

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    End point title
    Disease Control Rate (DCR)
    End point description
    The DCR was defined as the percentage of subjects who achieved CR plus PR plus Stable Disease (SD), evaluated according to RECIST v1.0 criteria. The DCR at Weeks 24 and 48 is presented for each cohort. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study.
    End point type
    Secondary
    End point timeframe
    Weeks 24 and 48
    End point values
    PanNET Cohort Midgut NET Cohort
    Number of subjects analysed
    48
    51
    Units: percentage of subjects
    number (confidence interval 95%)
        Week 24
    43.8 (29.5 to 58.8)
    58.8 (44.2 to 72.4)
        Week 48
    22.9 (12.0 to 37.3)
    33.3 (20.8 to 47.9)
    No statistical analyses for this end point

    Secondary: Best Overall Response Rate

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    End point title
    Best Overall Response Rate
    End point description
    Best overall response was defined as the best response recorded from the initiation of treatment until disease progression, according to RECIST v1.0 evaluation. The percentage of subjects in each response category and those who were non-evaluable (i.e. with no tumour assessment after the start of study treatment) throughout the study are presented for each cohort. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study.
    End point type
    Secondary
    End point timeframe
    From Day 1 up to Week 60 for the panNET cohort and Week 103 for the midgut NET cohort
    End point values
    PanNET Cohort Midgut NET Cohort
    Number of subjects analysed
    48
    51
    Units: percentage of subjects
    number (confidence interval 95%)
        CR
    0.0 (0.0 to 7.4)
    0.0 (0.0 to 7.0)
        PR
    0.0 (0.0 to 7.4)
    3.9 (0.5 to 13.5)
        SD
    66.7 (51.6 to 79.6)
    68.6 (54.1 to 80.9)
        PD
    31.3 (18.7 to 46.3)
    23.5 (12.8 to 37.5)
        Not evaluable
    0.0 (0.0 to 7.4)
    2.0 (0.0 to 10.4)
    No statistical analyses for this end point

    Secondary: Median Duration of Stable Disease

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    End point title
    Median Duration of Stable Disease
    End point description
    Median duration of SD was the time from first injection of lanreotide Autogel® 120 mg every 14 days until the first occurrence of PD by central assessment. Disease progression was assessed by tumour response evaluation according to RECIST v1.0, every 12 weeks, measured using the same imaging technique (CT scan or MRI) for each subject throughout the study. Median duration of SD was estimated using the Kaplan Meier method for each cohort. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study.
    End point type
    Secondary
    End point timeframe
    From Day 1 up to Week 60 for the panNET cohort and Week 103 for the midgut NET cohort
    End point values
    PanNET Cohort Midgut NET Cohort
    Number of subjects analysed
    48
    51 [6]
    Units: months
        median (confidence interval 95%)
    8.3 (8.0 to 13.8)
    13.8 (8.6 to 99999)
    Notes
    [6] - 99999 = could not be calculated as an insufficient number of events were observed.
    No statistical analyses for this end point

    Secondary: Factors Associated With PFS

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    End point title
    Factors Associated With PFS
    End point description
    A univariate cox proportional hazards model was used to assess whether the following factors were associated with PFS: • Hepatic tumour load: >25% versus reference ≤25% • Tumour Grade: Grade 2 versus reference Grade 1, • Previous surgery of the primary tumour: No versus reference Yes, • Proliferation index Ki67: ≥10% versus reference <10% • Duration of treatment with lanreotide Autogel® 120 mg every 28 days by category: ≥median value versus reference <median value, • Age by category: ≥65 years versus reference <65 years, • Time from diagnosis to study entry by category: ≥3 years versus reference <3 years, • Time interval between the two CT scans (pre-screening/screening): ≥12 months versus reference <12 months and • Symptoms (diarrhoea or flushing at baseline): No versus reference Yes. Each factor was assessed for its importance in the Cox model for PFS in a univariate fashion.
    End point type
    Secondary
    End point timeframe
    Screening/Baseline (Day 1)
    End point values
    PanNET Cohort Midgut NET Cohort
    Number of subjects analysed
    48 [7]
    51 [8]
    Units: Hazard ratio
    number (confidence interval 95%)
        Hepatic tumour load: >25% Vs ≤25%
    0.96 (0.40 to 2.32)
    1.54 (0.70 to 3.40)
        Tumour grade: Grade 2 Vs Grade 1
    0.68 (0.32 to 1.45)
    0.90 (0.46 to 1.77)
        Previous surgery: No Vs Yes
    1.04 (0.53 to 2.04)
    2.14 (0.83 to 5.52)
        Ki67: ≥10% Vs <10%
    3.60 (1.39 to 9.32)
    2.26 (0.67 to 7.60)
        Duration of treatment*: ≥median Vs <median
    0.68 (0.34 to 1.34)
    0.76 (0.40 to 1.47)
        Age: ≥65 years Vs <65 years
    1.55 (0.79 to 3.06)
    1.15 (0.58 to 2.31)
        Time from diagnosis: ≥3 years Vs <3 years
    0.49 (0.25 to 0.96)
    0.94 (0.49 to 1.82)
        Time between CT scans: ≥12 months Vs <12 months
    0.47 (0.24 to 0.94)
    0.72 (0.37 to 1.39)
        Symptoms: No Vs Yes
    2.55 (0.89 to 7.28)
    1.32 (0.68 to 2.56)
    Notes
    [7] - *Duration of treatment with lanreotide Autogel® 120 mg every 28 days
    [8] - Except: Ki67 + symptoms, n=50 *Duration of treatment with lanreotide Autogel® 120 mg every 28 days
    No statistical analyses for this end point

    Secondary: Mean Change from Baseline in Number of Stools and Flushing Episodes

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    End point title
    Mean Change from Baseline in Number of Stools and Flushing Episodes
    End point description
    Symptom control was measured by the total number of stools (diarrhoea) and flushing episodes during the 7 days prior to the visit, reported orally by the subject to the investigator. The mean change from baseline in the number of stools and flushing episodes reported at each visit is presented for each cohort. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study. Numbers analysed at each time point correspond to the number of subjects reporting episodes in the 7 days prior to the visit.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1), Weeks 8, 12, 48 and EoS
    End point values
    PanNET Cohort Midgut NET Cohort
    Number of subjects analysed
    5 [9]
    13 [10]
    Units: episodes
    arithmetic mean (standard deviation)
        Stools - Week 8
    1.0 ± 5.5
    -1.0 ± 8.2
        Stools - Week 12
    -1.2 ± 7.9
    0.7 ± 2.5
        Stools - Week 48
    -1.0 ± 0.0
    3.4 ± 4.8
        Stools - EoS
    0.5 ± 5.4
    -1.2 ± 12.2
        Flushing - Week 8
    0.7 ± 2.1
    -3.3 ± 8.3
        Flushing - Week 12
    -1.0 ± 0.0
    1.5 ± 10.0
        Flushing - Week 48
    -1.0 ± 0.0
    -1.5 ± 2.1
        Flushing - EoS
    0.0 ± 1.4
    -0.5 ± 6.2
    Notes
    [9] - Except Stools - Week 48=2, EoS=4 Flushing- Week 8=3, Weeks 12, 48 and EOS=2
    [10] - Except Stools -Week 48 & EoS=5, Flushing-Week 8=9, Week 12=6, Week 24=5, Week 48=2, Eos=4
    No statistical analyses for this end point

    Secondary: Mean Change From Baseline in QoL Measured Using European Organisation Into the Research and Treatment of Cancer (EORTC), Quality of Life (QoL) Questionnaire Core 30 (QLQ-C30 v3.0) (Global Health Status Sub-score)

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    End point title
    Mean Change From Baseline in QoL Measured Using European Organisation Into the Research and Treatment of Cancer (EORTC), Quality of Life (QoL) Questionnaire Core 30 (QLQ-C30 v3.0) (Global Health Status Sub-score)
    End point description
    Subjects were instructed to complete the 30 questions in the EORTC-QLQ-C30 v3.0 questionnaire at baseline and every 12 weeks throughout the study. The global health status sub-score was assessed using the last 2 questions which represented subject's assessment of overall health & QoL. Each question was coded on a 7-point scale (1=very poor to 7=excellent). The sub-score was transformed to range from 0-100, with a high score for global health status representing a high QoL. The mean change from baseline in the transformed global health status are presented for the EoS visit, with a positive change indicating an improvement in QoL. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study. Only subjects with data available for analysis are presented.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1), EoS
    End point values
    PanNET Cohort Midgut NET Cohort Overall
    Number of subjects analysed
    22
    25
    47
    Units: score on a scale
        arithmetic mean (standard deviation)
    -0.38 ± 15.32
    -1.33 ± 17.13
    -0.89 ± 16.4
    No statistical analyses for this end point

    Secondary: Mean Change From Baseline EuroQoL 5 Dimensions, 5 Levels (EQ-5D-5L) v 1.0 Questionnaire (Descriptive System)

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    End point title
    Mean Change From Baseline EuroQoL 5 Dimensions, 5 Levels (EQ-5D-5L) v 1.0 Questionnaire (Descriptive System)
    End point description
    Subjects were instructed to complete the EQ-5D-5L descriptive system at baseline and every 12 weeks throughout the study. The EQ-5D-5L descriptive system comprised the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension had 5 levels: no problems, slight problems, moderate problems, severe problems, extreme problems. The EQ-5D-5L health states, defined by the EQ-5D-5L descriptive system, was converted into a single index value with scores ranging from 0 (no problems) to 1 (extreme problems). The mean change from baseline at the EoS visit is presented with a positive change from baseline in the index values indicating a worsening of symptoms. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study. Only subjects with data available for analysis are presented.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1), EoS
    End point values
    PanNET Cohort Midgut NET Cohort Overall
    Number of subjects analysed
    22
    21
    43
    Units: Index value
        arithmetic mean (standard deviation)
    -0.04 ± 0.12
    0.00 ± 0.11
    -0.02 ± 0.12
    No statistical analyses for this end point

    Secondary: Mean Change From Baseline in EQ-5D-5L v1.0 Questionnaire (Visual Analogue Scale [VAS])

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    End point title
    Mean Change From Baseline in EQ-5D-5L v1.0 Questionnaire (Visual Analogue Scale [VAS])
    End point description
    Subjects were instructed to complete the EQ-5D-5L VAS at baseline and every 12 weeks throughout the study. The EQ-5D-5L VAS recorded the subject's self-rated health on a vertical VAS which is numbered from 0 (worst health state) to 100 (best health state). The mean change from baseline at the EoS visit is presented with a positive change in the VAS indicating an improvement in symptoms. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study. Only subjects with data available for analysis are presented.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1), EoS
    End point values
    PanNET Cohort Midgut NET Cohort Overall
    Number of subjects analysed
    21
    21
    42
    Units: score on a scale
        arithmetic mean (standard deviation)
    -1.90 ± 14.80
    -1.76 ± 9.34
    -1.83 ± 12.22
    No statistical analyses for this end point

    Secondary: Mean Change From Baseline in QoL Questionnaire Gastrointestinal Neuroendocrine Tumour 21 (QLQ-GI.NET21; 2006)

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    End point title
    Mean Change From Baseline in QoL Questionnaire Gastrointestinal Neuroendocrine Tumour 21 (QLQ-GI.NET21; 2006)
    End point description
    Subjects were asked to complete the EORTC QLQ-GI.NET21 module which comprised 21 questions that used a 4-point scale (1 = Not at all, 2 = A little, 3 = Quite a bit, 4 = Very much) to evaluate 3 defined multi-item symptom scales (endocrine, gastrointestinal and treatment related side effects), 2 single item symptoms (bone/muscle pain and concern about weight loss), 2 psychosocial scales (social function and disease-related worries) and 2 other single items (sexuality and communication). Answers were converted into grading scale, with values between 0 and 100. Each individual sub-score was transformed to range from 0 to 100. The mean change from baseline at the EoS visit is presented with a higher score representing more or worse problems. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study. Only subjects with data available for analysis are presented.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1), EoS
    End point values
    PanNET Cohort Midgut NET Cohort Overall
    Number of subjects analysed
    21 [11]
    24 [12]
    45 [13]
    Units: score on a scale
    arithmetic mean (standard deviation)
        Endocrine Symptoms
    -0.53 ± 11.37
    -5.09 ± 17.33
    -2.96 ± 14.87
        Gastrointestinal Symptoms
    -3.49 ± 14.24
    -2.78 ± 15.96
    -3.11 ± 15.02
        Treatment Related Symptoms (TRS)
    5.93 ± 15.64
    -3.47 ± 14.47
    1.08 ± 15.54
        Social Function
    -0.79 ± 13.41
    -9.49 ± 18.20
    -5.43 ± 16.56
        Disease Related Worries
    3.17 ± 15.47
    -0.93 ± 27.40
    0.99 ± 22.48
        Muscle/Bone Pain (MBP)
    -1.67 ± 33.29
    0.00 ± 36.78
    -0.76 ± 34.84
        Sexual Function (SF)
    2.38 ± 15.82
    -2.78 ± 26.43
    0.00 ± 21.08
        Information/Communication Function (ICF)
    7.94 ± 29.64
    -2.90 ± 9.60
    2.27 ± 22.04
        Body Image (BI)
    0.00 ± 15.29
    -7.58 ± 28.97
    -3.97 ± 23.52
    Notes
    [11] - Except TRS=15, MBP=20, SF=14, BI=20
    [12] - Except TRS=16, SF=12, ICF=23, BI=22
    [13] - Except TRS=31, MBP=44, SF=26, ICF=44, BI=42
    No statistical analyses for this end point

    Secondary: Mean Change From Baseline in Nonspecific Tumour Biomarkers

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    End point title
    Mean Change From Baseline in Nonspecific Tumour Biomarkers
    End point description
    Nonspecific tumour peptide biomarkers (chromogranin A [CgA], neuron specific enolase [NSE] and plasma/urinary 5-hydroxyindoleacetic acid [5-HIAA]) were evaluated in both pancreas and midgut subjects at baseline and Week 12 and every 12 weeks thereafter. At all scheduled visits, except baseline, plasma/urinary 5-HIAA was only performed in subjects with symptoms of carcinoid syndrome (diarrhoea and/or flushing) or if urinary 5-HIAA was elevated (above upper limit of normal [ULN]) at baseline. Mean change from baseline values were normalised by the ULN (xULN) and are presented for each cohort. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study. Only subjects with data available for analysis are presented.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1) and EoS
    End point values
    PanNET Cohort Midgut NET Cohort
    Number of subjects analysed
    22 [14]
    24 [15]
    Units: xULN
    arithmetic mean (standard deviation)
        CgA
    0.205 ± 1.258
    0.370 ± 1.843
        NSE
    0.03 ± 1.00
    -0.49 ± 1.86
        Plasma 5-HIAA
    -0.42 ± 1.44
    3.90 ± 7.39
    Notes
    [14] - Except NSE=15, Plasma5-HIAA=20
    [15] - Except NSE=10, Plasma5-HIAA=17
    No statistical analyses for this end point

    Secondary: Mean Change From Baseline in PanNet Specific Tumour Biomarkers: Pancreatic Polypeptide, Gastrin

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    End point title
    Mean Change From Baseline in PanNet Specific Tumour Biomarkers: Pancreatic Polypeptide, Gastrin [16]
    End point description
    PanNET specific tumour peptide biomarkers were evaluated in pancreas subjects at baseline. Only the tumour biomarkers that were above normal range at baseline were evaluated every 12 weeks thereafter and at the EoS visit. The mean change from baseline values in picomole/liter (pmol/L) are presented for the EoS visit. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study. Only subjects with data available for analysis are presented.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1) and EoS
    Notes
    [16] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Specific tumour biomarkers were only evaluated in pancreas NET subjects in the panNET cohort. Subjects in the midgut NET cohort were not evaluated.
    End point values
    PanNET Cohort
    Number of subjects analysed
    4 [17]
    Units: pmol/L
    arithmetic mean (standard deviation)
        Pancreatic Polypeptide
    82.7 ± 146.7
        Gastrin
    -9.8 ± 70.7
    Notes
    [17] - Except pancreatic polypeptide=3
    No statistical analyses for this end point

    Secondary: Mean Change From Baseline in PanNet Specific Tumour Biomarkers: Glucagon

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    End point title
    Mean Change From Baseline in PanNet Specific Tumour Biomarkers: Glucagon [18]
    End point description
    PanNET specific tumour peptide biomarkers were evaluated in pancreas subjects at baseline. Only the tumour biomarkers that were above normal range at baseline were evaluated every 12 weeks thereafter and at the EoS visit. The mean change from baseline values in nanograms (ng)/L are presented for the EoS visit. Analysis was performed on the FAS which included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study. Only subjects with data available for analysis are presented.
    End point type
    Secondary
    End point timeframe
    Baseline (Day 1) and EoS
    Notes
    [18] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Specific tumour biomarkers were only evaluated in pancreas NET subjects in the panNET cohort. Subjects in the midgut NET cohort were not evaluated.
    End point values
    PanNET Cohort
    Number of subjects analysed
    4
    Units: ng/L
        arithmetic mean (standard deviation)
    5.5 ± 36.4
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Treatment emergent adverse events were recorded from the first dose of lanreotide Autogel® 120 mg on Day 1 until 28 days after the last treatment. Up to Week 64 for panNet cohort and Week 108 for midgut NET (and overall) cohort.
    Adverse event reporting additional description
    The FAS included all subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.0
    Reporting groups
    Reporting group title
    PanNET Cohort
    Reporting group description
    Subjects were treated with lanreotide Autogel® 120 mg, administered as deep SC injections, every 14 days starting from Day 1 (at a reduced dosing interval) for up to 48 weeks or until disease progression, death or unacceptable toxicity or tolerability. Subjects who had not progressed at Week 48 could continue study treatment with lanreotide Autogel® 120 mg every 14 days until 25 events (PD or death) in the panNET cohort had been observed. Additional visits were performed every 12 weeks until disease progression or death, or unacceptable toxicity or tolerability.

    Reporting group title
    Midgut NET Cohort
    Reporting group description
    Subjects were treated with lanreotide Autogel® 120 mg, administered as deep SC injections, every 14... more days starting from Day 1 (at a reduced dosing interval) for up to 96 weeks or until disease progression, death or unacceptable toxicity or tolerability. Subjects who had not progressed at Week 96 could continue study treatment with lanreotide Autogel® 120 mg every 14 days until 25 events (PD or death) in the midgut NET cohort had been observed. Additional visits were performed every 12 weeks until disease progression or death, or unacceptable toxicity or tolerability.

    Reporting group title
    Overall Subjects
    Reporting group description
    All subjects who received at least one dose of lanreotide Autogel® 120 mg every 14 days during the study.

    Serious adverse events
    PanNET Cohort Midgut NET Cohort Overall Subjects
    Total subjects affected by serious adverse events
         subjects affected / exposed
    5 / 48 (10.42%)
    13 / 51 (25.49%)
    18 / 99 (18.18%)
         number of deaths (all causes)
    1
    3
    4
         number of deaths resulting from adverse events
    0
    1
    1
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Bone neoplasm
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Breast cancer
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Craniocerebral injury
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal fracture
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Hypotension
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac failure
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulseless electrical activity
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    Nervous system disorders
    Spinal cord compression
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Anaphylactic reaction
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary embolism
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Peritonitis
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Viral infection
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    PanNET Cohort Midgut NET Cohort Overall Subjects
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    41 / 48 (85.42%)
    47 / 51 (92.16%)
    88 / 99 (88.89%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Metastases to liver
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Flushing
         subjects affected / exposed
    2 / 48 (4.17%)
    9 / 51 (17.65%)
    11 / 99 (11.11%)
         occurrences all number
    2
    14
    16
    Haematoma
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Hot flush
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    14
    14
    Hypertension
         subjects affected / exposed
    2 / 48 (4.17%)
    9 / 51 (17.65%)
    11 / 99 (11.11%)
         occurrences all number
    2
    9
    11
    Venous thrombosis limb
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Peripheral venous disease
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Surgical and medical procedures
    Injection
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    4 / 48 (8.33%)
    4 / 51 (7.84%)
    8 / 99 (8.08%)
         occurrences all number
    24
    5
    29
    Chest pain
         subjects affected / exposed
    0 / 48 (0.00%)
    3 / 51 (5.88%)
    3 / 99 (3.03%)
         occurrences all number
    0
    3
    3
    Fatigue
         subjects affected / exposed
    7 / 48 (14.58%)
    8 / 51 (15.69%)
    15 / 99 (15.15%)
         occurrences all number
    8
    11
    19
    Gait disturbance
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Hunger
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Influenza like illness
         subjects affected / exposed
    1 / 48 (2.08%)
    3 / 51 (5.88%)
    4 / 99 (4.04%)
         occurrences all number
    1
    3
    4
    Injection site bruising
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Injection site pain
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Malaise
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    2
    3
    Medical device site pain
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Oedema peripheral
         subjects affected / exposed
    2 / 48 (4.17%)
    2 / 51 (3.92%)
    4 / 99 (4.04%)
         occurrences all number
    2
    2
    4
    Pain
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Peripheral swelling
         subjects affected / exposed
    0 / 48 (0.00%)
    3 / 51 (5.88%)
    3 / 99 (3.03%)
         occurrences all number
    0
    3
    3
    Polyp
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Pyrexia
         subjects affected / exposed
    2 / 48 (4.17%)
    2 / 51 (3.92%)
    4 / 99 (4.04%)
         occurrences all number
    2
    5
    7
    Immune system disorders
    Drug hypersensitivity
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Reproductive system and breast disorders
    Gynaecomastia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Respiratory, thoracic and mediastinal disorders
    Asthma
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Cough
         subjects affected / exposed
    3 / 48 (6.25%)
    3 / 51 (5.88%)
    6 / 99 (6.06%)
         occurrences all number
    3
    3
    6
    Dysphonia
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Dyspnoea
         subjects affected / exposed
    0 / 48 (0.00%)
    4 / 51 (7.84%)
    4 / 99 (4.04%)
         occurrences all number
    0
    5
    5
    Dyspnoea exertional
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    2
    3
    Increased upper airway secretion
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Oropharyngeal pain
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Orthopnoea
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Productive cough
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Sputum discoloured
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Psychiatric disorders
    Acrophobia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Confusional state
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Insomnia
         subjects affected / exposed
    2 / 48 (4.17%)
    0 / 51 (0.00%)
    2 / 99 (2.02%)
         occurrences all number
    2
    0
    2
    Mood altered
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Panic attack
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Sleep disorder
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    2
    3
    Aspartate aminotransferase abnormal
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Bacterial test positive
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Blood alkaline phosphatase increased
         subjects affected / exposed
    3 / 48 (6.25%)
    1 / 51 (1.96%)
    4 / 99 (4.04%)
         occurrences all number
    3
    1
    4
    Blood bilirubin increased
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Blood chromogranin A increased
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Blood creatinine increased
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Blood glucose decreased
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Blood glucose increased
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Blood potassium increased
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Blood triglycerides increased
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Blood urea increased
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Blood urine present
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    C-reactive protein increased
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Gamma-glutamyltransferase abnormal
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Gamma-glutamyltransferase decreased
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    2
    3
    Glycosylated haemoglobin increased
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Lymphocyte count decreased
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Neutrophil count decreased
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Platelet count decreased
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Specific gravity urine increased
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Urine ketone body present
         subjects affected / exposed
    2 / 48 (4.17%)
    0 / 51 (0.00%)
    2 / 99 (2.02%)
         occurrences all number
    2
    0
    2
    Weight decreased
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    2
    3
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Incision site pain
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Incisional hernia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Ligament sprain
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Muscle strain
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Post procedural complication
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Radiation skin injury
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Skin abrasion
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Cardiac disorders
    Arrhythmia
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Cardiac failure
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    2
    2
    Heart valve incompetence
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Palpitations
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Right ventricular failure
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Tachycardia
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Tricuspid valve disease
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Nervous system disorders
    Ageusia
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Aphasia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    2
    2
    Balance disorder
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Dizziness
         subjects affected / exposed
    3 / 48 (6.25%)
    5 / 51 (9.80%)
    8 / 99 (8.08%)
         occurrences all number
    3
    7
    10
    Dizziness postural
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Head discomfort
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Headache
         subjects affected / exposed
    3 / 48 (6.25%)
    4 / 51 (7.84%)
    7 / 99 (7.07%)
         occurrences all number
    3
    5
    8
    Lethargy
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Poor quality sleep
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Presyncope
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Sciatica
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Syncope
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Taste disorder
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Tremor
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    2
    3
    Blood and lymphatic system disorders
    Lymphopenia
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Monocytopenia
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Ear and labyrinth disorders
    Deafness
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Deafness unilateral
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Ear pain
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Hypoacusis
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Vertigo
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    2
    2
    Vertigo positional
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Eye disorders
    Diplopia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Dry eye
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Eye pain
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Eye pruritus
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Glaucoma
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Ocular hyperaemia
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Gastrointestinal disorders
    Abdominal discomfort
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Abdominal distension
         subjects affected / exposed
    0 / 48 (0.00%)
    6 / 51 (11.76%)
    6 / 99 (6.06%)
         occurrences all number
    0
    7
    7
    Abdominal pain
         subjects affected / exposed
    7 / 48 (14.58%)
    12 / 51 (23.53%)
    19 / 99 (19.19%)
         occurrences all number
    13
    16
    29
    Abdominal pain lower
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Abdominal pain upper
         subjects affected / exposed
    2 / 48 (4.17%)
    6 / 51 (11.76%)
    8 / 99 (8.08%)
         occurrences all number
    2
    7
    9
    Anal incontinence
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Anorectal discomfort
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Ascites
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Constipation
         subjects affected / exposed
    2 / 48 (4.17%)
    2 / 51 (3.92%)
    4 / 99 (4.04%)
         occurrences all number
    3
    3
    6
    Diarrhoea
         subjects affected / exposed
    14 / 48 (29.17%)
    27 / 51 (52.94%)
    41 / 99 (41.41%)
         occurrences all number
    20
    35
    55
    Dry mouth
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Dyspepsia
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    3
    3
    Faeces discoloured
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Flatulence
         subjects affected / exposed
    1 / 48 (2.08%)
    6 / 51 (11.76%)
    7 / 99 (7.07%)
         occurrences all number
    1
    8
    9
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    2
    3
    Gingival bleeding
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Glossodynia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Haematochezia
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Haemorrhoids
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Hernial eventration
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Inguinal hernia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Nausea
         subjects affected / exposed
    5 / 48 (10.42%)
    6 / 51 (11.76%)
    11 / 99 (11.11%)
         occurrences all number
    5
    9
    14
    Oral pain
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Pancreatic failure
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Proctalgia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Steatorrhoea
         subjects affected / exposed
    2 / 48 (4.17%)
    3 / 51 (5.88%)
    5 / 99 (5.05%)
         occurrences all number
    2
    3
    5
    Stomatitis
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Toothache
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Vomiting
         subjects affected / exposed
    6 / 48 (12.50%)
    4 / 51 (7.84%)
    10 / 99 (10.10%)
         occurrences all number
    9
    4
    13
    Gingival pain
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Hepatobiliary disorders
    Bile duct stone
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Cholelithiasis
         subjects affected / exposed
    0 / 48 (0.00%)
    3 / 51 (5.88%)
    3 / 99 (3.03%)
         occurrences all number
    0
    3
    3
    Hepatic failure
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Liver injury
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Skin and subcutaneous tissue disorders
    Erythema
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Hyperhidrosis
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Photosensitivity reaction
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Pruritus
         subjects affected / exposed
    1 / 48 (2.08%)
    3 / 51 (5.88%)
    4 / 99 (4.04%)
         occurrences all number
    1
    4
    5
    Pruritus generalised
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Rash
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Skin fissures
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Skin irritation
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Urticaria
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Night sweats
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Renal and urinary disorders
    Chronic kidney disease
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Dysuria
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Haematuria
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    2
    3
    Urethral stenosis
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    0 / 48 (0.00%)
    5 / 51 (9.80%)
    5 / 99 (5.05%)
         occurrences all number
    0
    7
    7
    Back pain
         subjects affected / exposed
    2 / 48 (4.17%)
    2 / 51 (3.92%)
    4 / 99 (4.04%)
         occurrences all number
    2
    2
    4
    Exostosis
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Flank pain
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Intervertebral disc degeneration
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Intervertebral disc protrusion
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Joint swelling
         subjects affected / exposed
    0 / 48 (0.00%)
    3 / 51 (5.88%)
    3 / 99 (3.03%)
         occurrences all number
    0
    5
    5
    Mobility decreased
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Muscle spasms
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    3
    4
    Musculoskeletal chest pain
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Musculoskeletal discomfort
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Musculoskeletal pain
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    2
    3
    Myalgia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    2
    2
    Neck pain
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Osteoarthritis
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Osteoporosis
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Pain in extremity
         subjects affected / exposed
    2 / 48 (4.17%)
    1 / 51 (1.96%)
    3 / 99 (3.03%)
         occurrences all number
    2
    2
    4
    Periarthritis
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Rheumatoid arthritis
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    2
    2
    Spinal pain
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    2
    3
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Carbuncle
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Cystitis
         subjects affected / exposed
    2 / 48 (4.17%)
    1 / 51 (1.96%)
    3 / 99 (3.03%)
         occurrences all number
    2
    1
    3
    Cystitis bacterial
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Diverticulitis
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Folliculitis
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Herpes zoster
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Influenza
         subjects affected / exposed
    2 / 48 (4.17%)
    3 / 51 (5.88%)
    5 / 99 (5.05%)
         occurrences all number
    2
    6
    8
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 48 (2.08%)
    3 / 51 (5.88%)
    4 / 99 (4.04%)
         occurrences all number
    2
    3
    5
    Nasopharyngitis
         subjects affected / exposed
    7 / 48 (14.58%)
    5 / 51 (9.80%)
    12 / 99 (12.12%)
         occurrences all number
    7
    6
    13
    Respiratory tract infection
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Tonsillitis
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Urinary tract infection
         subjects affected / exposed
    4 / 48 (8.33%)
    1 / 51 (1.96%)
    5 / 99 (5.05%)
         occurrences all number
    6
    1
    7
    Metabolism and nutrition disorders
    Carbohydrate intolerance
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Decreased appetite
         subjects affected / exposed
    5 / 48 (10.42%)
    2 / 51 (3.92%)
    7 / 99 (7.07%)
         occurrences all number
    5
    2
    7
    Hypercholesterolaemia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Hyperglycaemia
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2
    Hyperkalaemia
         subjects affected / exposed
    0 / 48 (0.00%)
    2 / 51 (3.92%)
    2 / 99 (2.02%)
         occurrences all number
    0
    2
    2
    Hypernatraemia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Hypertriglyceridaemia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Hyperuricaemia
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Hypoalbuminaemia
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Hypocalcaemia
         subjects affected / exposed
    1 / 48 (2.08%)
    2 / 51 (3.92%)
    3 / 99 (3.03%)
         occurrences all number
    1
    2
    3
    Hypoglycaemia
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    3
    1
    4
    Hypokalaemia
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Hyponatraemia
         subjects affected / exposed
    1 / 48 (2.08%)
    0 / 51 (0.00%)
    1 / 99 (1.01%)
         occurrences all number
    1
    0
    1
    Malnutrition
         subjects affected / exposed
    0 / 48 (0.00%)
    1 / 51 (1.96%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Vitamin D deficiency
         subjects affected / exposed
    1 / 48 (2.08%)
    1 / 51 (1.96%)
    2 / 99 (2.02%)
         occurrences all number
    1
    1
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    07 Oct 2015
    • The criteria of treatment terminations was added to the protocol on request of German Regulatory authorities.
    16 Dec 2015
    • Clarification that specific tumour biomarkers were only applicable to the panNET cohort and not the midgut NET cohort • Clarification of which subjects in the panNET cohort were to have 5-HIAA repeated during the study treatment period • Removal of the following assessments at Visit 3 (Week 2): electrocardiogram (ECG), clinical laboratory tests, nonspecific biomarkers, specific tumour biomarkers and biobanking; and addition of ECG at Week 4 (Visit 4) • Clarification of radiology imaging assessments • Addition of tertiary objective and endpoint to include the use of MRI as a method of texture analysis • Addition and clarification of exclusion criteria • Recalculation of blood volumes
    09 Jan 2017
    • Redefined some exclusion criteria to allow more subjects to enter the study without impacting their safety, physical, or mental integrity, or the scientific value of the trial • Exclusion criterion modified to authorise inclusion of subjects treated by long acting formulation of octreotide and who stopped this treatment for other reason than disease progression • Exclusion criterion modified to exclude subjects with symptomatic gallbladder lithiasis/sludge at screening or history of symptomatic cholelithiasis • Exclusion criterion modified to allow re-screening of subjects who screen failed following central reviewers eligibility assessment (ie non PD). • Clarifications for exclusion criterion where subject has had previous cancer (except basocellular carcinoma of the skin and/or in situ carcinoma of the cervix/uterus if subjects were treated with curative intent and free from disease for more than 5 years) • Clarifications for the technique of imaging of the tertiary endpoints • The removal of United States as a country for study conduct.

    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.
    Please note that 99999 (or any variants thereof) is used when data is not available.
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