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    Clinical Trial Results:
    A Multi-Institutional, Single Arm, Two-Stage Phase II Trial of Nab-Paclitaxel and Gemcitabine for First-Line Treatment of Patients with Advanced or Metastatic Cholangiocarcinoma

    Summary
    EudraCT number
    2015-002066-24
    Trial protocol
    AT  
    Global end of trial date
    01 Oct 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    08 Mar 2025
    First version publication date
    08 Mar 2025
    Other versions
    Summary report(s)
    2015-002066-24 results posted 20Feb2025

    Trial information

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    Trial identification
    Sponsor protocol code
    PrE0204
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02181634
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Medizinische Universität Wien
    Sponsor organisation address
    Spitalgasse 23, Vienna, Austria, 1090
    Public contact
    Prof. Werner Scheithauer, Medizinische Universität Wien, werner.scheithauer@meduniwien.ac.at
    Scientific contact
    Prof. Werner Scheithauer, Medizinische Universität Wien, werner.scheithauer@meduniwien.ac.at
    Sponsor organisation name
    PrECOG, LLC
    Sponsor organisation address
    1818 Market Street, Suite 1100, Philadelphia, United States, PA 19103
    Public contact
    Project Manager, PrECOG LLC, candrews@precogllc.org
    Scientific contact
    Project Manager, PrECOG LLC, candrews@precogllc.org
    Sponsor organisation name
    Cancer Trials Ireland
    Sponsor organisation address
    RCSI House, 121 St. Stephen's Green, Dublin, Ireland, D02 H903
    Public contact
    Clinical Project Manager, Cancer Trials Ireland, info@cancertrials.ie
    Scientific contact
    Clinical Project Manager, Cancer Trials Ireland, info@cancertrials.ie
    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
    01 Oct 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    24 Sep 2016
    Global end of trial reached?
    Yes
    Global end of trial date
    01 Oct 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To determine the efficacy of gemcitabine and nab-paclitaxel in patients with advanced CCA as measured by improvement in 6-month Progression Free Survival .
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and in compliance with all International Council on Harmonization (ICH) Good Clinical Practice (GCP) Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were followed.
    Background therapy
    N/A
    Evidence for comparator
    N/A The purpose of this study is to evaluate the effectiveness and safety of the combination of nab-paclitaxel and gemcitabine.
    Actual start date of recruitment
    17 Sep 2014
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United States: 71
    Country: Number of subjects enrolled
    Austria: 3
    Worldwide total number of subjects
    74
    EEA total number of subjects
    3
    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)
    44
    From 65 to 84 years
    28
    85 years and over
    2

    Subject disposition

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    Recruitment
    Recruitment details
    Seventy-four patients were enrolled at 23 community and academic centers across the United States and Europe between September 2014 and March 2016

    Pre-assignment
    Screening details
    The tartget population are patients with advanced or metastatic cholangiocarcinoma (CCA) who are not eligible for curative surgery, transplantation, or ablative therapies. They must meet all of the inclusion criteria and none of the exclusion criteria.

    Pre-assignment period milestones
    Number of subjects started
    74
    Number of subjects completed
    73

    Pre-assignment subject non-completion reasons
    Reason: Number of subjects
    Inleigible: 1
    Period 1
    Period 1 title
    Overall Trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    N/A

    Arms
    Arm title
    Single arm (Overall Trial)
    Arm description
    Nab-Paclitaxel 125 mg/m² IV and Gemcitabine 1000 mg/m² on days 1, 8 and 15 every 28 days until progression or unacceptable toxicity. Nab-Paclitaxel and Gemcitabine: Nab-Paclitaxel will be administered first, at a dose of 125 mg/m² IV over a period of 30 minutes; gemcitabine will be administered second, at a dose of 1000 mg/m² over a period of 30 minutes.
    Arm type
    Experimental

    Investigational medicinal product name
    nab-Paclitaxel
    Investigational medicinal product code
    Other name
    Abraxane
    Pharmaceutical forms
    Injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Nab-Paclitaxel will be administered first, at a dose of 125 mg/m² IV over a period of 30 minutes.

    Investigational medicinal product name
    Gemcitabine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Gemcitabine will be administered second, at a dose of 1000 mg/m² over a period of 30 minutes.

    Number of subjects in period 1 [1]
    Single arm (Overall Trial)
    Started
    73
    Completed
    2
    Not completed
    71
         Physician decision
    8
         Consent withdrawn by subject
    5
         Adverse event, non-fatal
    17
         Max number of dose reduction
    1
         Death
    2
         Treatment delayed >4 weeks
    3
         Symptomatic progression
    1
         Patient opted to proceed to surgery
    1
         Lack of efficacy
    33
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: 74 Patients were enrolled but there was only 73 patients eligible and treated.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Single arm (Overall Trial)
    Reporting group description
    Nab-Paclitaxel 125 mg/m² IV and Gemcitabine 1000 mg/m² on days 1, 8 and 15 every 28 days until progression or unacceptable toxicity. Nab-Paclitaxel and Gemcitabine: Nab-Paclitaxel will be administered first, at a dose of 125 mg/m² IV over a period of 30 minutes; gemcitabine will be administered second, at a dose of 1000 mg/m² over a period of 30 minutes.

    Reporting group values
    Single arm (Overall Trial) Total
    Number of subjects
    73 73
    Age categorical
    Eligible and treated patients
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    44 44
        From 65-84 years
    28 28
        85 years and over
    1 1
    Age continuous
    Units: years
        median (full range (min-max))
    62 (36 to 87) -
    Gender categorical
    Units: Subjects
        Female
    43 43
        Male
    30 30
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    1 1
        Not Hispanic or Latino
    71 71
        Unknown or Not Reported
    1 1
    Race
    Units: Subjects
        American Indian or Alaska Native
    0 0
        Asian
    1 1
        Native Hawaiian or Other Pacific Islander
    0 0
        Black or African American
    3 3
        White
    67 67
        More than one race
    0 0
        Unknown or Not Reported
    2 2
    Subject analysis sets

    Subject analysis set title
    Overall Trial
    Subject analysis set type
    Full analysis
    Subject analysis set description
    This analysis set has been created as a workaround for reporting statistical analysis on a single arm study.

    Subject analysis sets values
    Overall Trial
    Number of subjects
    73
    Age categorical
    Eligible and treated patients
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    44
        From 65-84 years
    28
        85 years and over
    2
    Age continuous
    Units: years
        median (full range (min-max))
    62 (36 to 87)
    Gender categorical
    Units: Subjects
        Female
    43
        Male
    30
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    1
        Not Hispanic or Latino
    71
        Unknown or Not Reported
    1
    Race
    Units: Subjects
        American Indian or Alaska Native
    0
        Asian
    1
        Native Hawaiian or Other Pacific Islander
    0
        Black or African American
    3
        White
    67
        More than one race
    0
        Unknown or Not Reported
    2

    End points

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    End points reporting groups
    Reporting group title
    Single arm (Overall Trial)
    Reporting group description
    Nab-Paclitaxel 125 mg/m² IV and Gemcitabine 1000 mg/m² on days 1, 8 and 15 every 28 days until progression or unacceptable toxicity. Nab-Paclitaxel and Gemcitabine: Nab-Paclitaxel will be administered first, at a dose of 125 mg/m² IV over a period of 30 minutes; gemcitabine will be administered second, at a dose of 1000 mg/m² over a period of 30 minutes.

    Subject analysis set title
    Overall Trial
    Subject analysis set type
    Full analysis
    Subject analysis set description
    This analysis set has been created as a workaround for reporting statistical analysis on a single arm study.

    Primary: Progression-Free Survival (PFS) Rate at 6 Months (Proportion of Participants Alive and Progression-Free at 6 Months)

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    End point title
    Progression-Free Survival (PFS) Rate at 6 Months (Proportion of Participants Alive and Progression-Free at 6 Months) [1]
    End point description
    Progression-free survival is defined as the time from the date of first study treatment to either the date of documented disease progression or death from any cause, whichever occurred first. Progression-free survival rate at 6 months is defined as the proportion of patients who were disease progression-free and alive at 6 months. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1), as a 20% increase in the sum of the diameter/axes of target lesions, taking as reference the smallest sum on study, or unequivocal progression of existing non-target lesions, or the appearance of new lesions.
    End point type
    Primary
    End point timeframe
    Assessed at 6 months
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: This is a single arm study with no comparison groups therefore statistical analyses(comparison analysis) were not conducted.
    End point values
    Single arm (Overall Trial)
    Number of subjects analysed
    73 [2]
    Units: Proportion of participants
        number (confidence interval 95%)
    0.605 (0.482 to 0.729)
    Notes
    [2] - Eligible and treated patients
    No statistical analyses for this end point

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    OS is defined as the time from enrollment until death or last patient contact.
    End point type
    Secondary
    End point timeframe
    Every 3-6 months for up to 3 years
    End point values
    Single arm (Overall Trial)
    Number of subjects analysed
    73 [3]
    Units: Months
        median (confidence interval 95%)
    11.2 (9.6 to 14.7)
    Notes
    [3] - Eligible and treated patients
    No statistical analyses for this end point

    Secondary: Progression-free Survival (PFS)

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    End point title
    Progression-free Survival (PFS)
    End point description
    Progression-free survival is defined as the time from the date of first study treatment to either the date of documented disease progression or death from any cause, whichever occurred first.
    End point type
    Secondary
    End point timeframe
    Every 3-6 months for up to 3 years
    End point values
    Single arm (Overall Trial)
    Number of subjects analysed
    73 [4]
    Units: Months
        median (confidence interval 95%)
    7.7 (5.9 to 13.1)
    Notes
    [4] - Eligible and treated patients
    No statistical analyses for this end point

    Secondary: Time To Progression (TTP)

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    End point title
    Time To Progression (TTP)
    End point description
    TTP was defined as the time from date of first dose of study therapy to date of removal from study for progression. Patients who have not experienced progression were censored at the date of last disease evaluation. Progression is evaluated using Solid Tumor Response Criteria (RECIST) Version 1.1. Progression is defined as at least a 20% increase in the sum of the diameters/axes of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5mm over the nadir. The appearance of new lesions or unequivocal progression of existing non-target lesions also constitutes disease progression.
    End point type
    Secondary
    End point timeframe
    Every 3-6 months for up to 3 years
    End point values
    Single arm (Overall Trial)
    Number of subjects analysed
    73 [5]
    Units: Months
        median (confidence interval 95%)
    7.7 (6.5 to 13.1)
    Notes
    [5] - Eligible and treated
    No statistical analyses for this end point

    Secondary: Overall Response Rate (ORR)

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    End point title
    Overall Response Rate (ORR)
    End point description
    Overall response rate is defined as the proportion of patients with complete response or partial response per RECIST version 1.1. Complete response is defined as disappearance of all lesions. Partial response is defined as at least a 30% decrease in the sum of the diameters/axes of target lesions and the persistence of one or more non-target lesion(s) and/or the maintenance of tumor marker levels above the normal limits. A confirmation assessment performed >=4 weeks after the criteria for response is met is required.
    End point type
    Secondary
    End point timeframe
    Every 3-6 months for up to 3 years
    End point values
    Single arm (Overall Trial)
    Number of subjects analysed
    73 [6]
    Units: Proportion of participants
        number (confidence interval 95%)
    0.301 (0.199 to 0.420)
    Notes
    [6] - Eligible and treated
    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
    Disease control rate is the proportion of patients achieved complete response, partial response or stable disease per RECIST version 1.1. Complete response is defined as disappearance of all lesions. Partial response is defined as at least a 30% decrease in the sum of the diameters/axes of target lesions and the persistence of one or more non-target lesion(s) and/or the maintenance of tumor marker levels above the normal limits. Stable disease is defined as neither sufficient shrinkage to qualify for complete or partial response nor sufficient increase to qualify for progression. A confirmation assessment performed >=4 weeks after the criteria for response is met is required.
    End point type
    Secondary
    End point timeframe
    Every 3-6 months for up to 3 years
    End point values
    Single arm (Overall Trial)
    Number of subjects analysed
    73 [7]
    Units: Proportion of participants
        number (confidence interval 95%)
    0.658 (0.537 to 0.765)
    Notes
    [7] - Eligible and treated patients
    No statistical analyses for this end point

    Secondary: Association Between PFS and Maximum Change in Carbohydrate Antigen (CA) 19-9 From Baseline

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    End point title
    Association Between PFS and Maximum Change in Carbohydrate Antigen (CA) 19-9 From Baseline
    End point description
    Patients were dichotomized into maximum CA 19-9 decline >=50% and maximum CA 19-9 decline <50%. Cox proportional hazards model was used to evaluate the association between PFS and maximum change in CA 19-9.
    End point type
    Secondary
    End point timeframe
    CA 19-9 was evaluated every 8 weeks until progression or for up to 3 years and off-treatment
    End point values
    Single arm (Overall Trial) Overall Trial
    Number of subjects analysed
    35 [8]
    35 [9]
    Units: Months
    number (confidence interval 95%)
        CA 19-9 decline >=50% (26 Participants)
    7.7 (6.6 to 13.1)
    7.7 (6.6 to 13.1)
        CA 19-9 decline <50% (9 Participants)
    1.9 (1.6 to 18.2)
    1.9 (1.6 to 18.2)
    Notes
    [8] - Eligible and treated patients with CA 19-9 data available
    [9] - Eligible and treated patients with CA 19-9 data available
    Statistical analysis title
    Nab-Paclitaxel and Gemcitabine
    Comparison groups
    Single arm (Overall Trial) v Overall Trial
    Number of subjects included in analysis
    70
    Analysis specification
    Post-hoc
    Analysis type
    superiority
    P-value
    = 0.099
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    2.02
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.86
         upper limit
    4.75

    Secondary: Association Between OS and Maximum Change in Carbohydrate Antigen (CA) 19-9 From Baseline

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    End point title
    Association Between OS and Maximum Change in Carbohydrate Antigen (CA) 19-9 From Baseline
    End point description
    Patients were dichotomized into maximum CA 19-9 decline >=50% and maximum CA 19-9 decline <50%. Cox proportional hazards model was used to evaluate the association between OS and maximum change in CA 19-9. The upper limit of the 95% confidence interval was not calculable because an insufficient number of participants reached the event at the final time point for assessment.
    End point type
    Secondary
    End point timeframe
    CA 19-9 was evaluated every 8 weeks until progression or for up to 3 years and off-treatment
    End point values
    Single arm (Overall Trial) Overall Trial
    Number of subjects analysed
    35 [10]
    35
    Units: Months
        number (not applicable)
    35
    35
    Notes
    [10] - Eligible and treated patients with CA 19-9 data available
    No statistical analyses for this end point

    Secondary: Change in Circulating Tumor Cells (CTCs)

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    End point title
    Change in Circulating Tumor Cells (CTCs)
    End point description
    Correlate change in CTCs to median PFS, OS, TTP, ORR and DCR.
    End point type
    Secondary
    End point timeframe
    Prior to Cycle 1, Day 1; Cycle 1 Day 8; Cycle 3, Day 1 and at Off Treatment
    End point values
    Single arm (Overall Trial) Overall Trial
    Number of subjects analysed
    0 [11]
    0 [12]
    Units: Outcome Measure Data Not Reported
        number (not applicable)
    Notes
    [11] - Outcome Measure Data Not Reported
    [12] - Outcome Measure Data Not Reported
    No statistical analyses for this end point

    Secondary: Stromal SPARC Expression

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    End point title
    Stromal SPARC Expression
    End point description
    Correlate stromal SPARC (high versus low) expression by immunohistochemistry (IHC) with median PFS, OS, TTP, ORR and DCR.
    End point type
    Secondary
    End point timeframe
    Baseline
    End point values
    Single arm (Overall Trial) Overall Trial
    Number of subjects analysed
    0 [13]
    0 [14]
    Units: Outcome Measure Data Not Reported
        number (not applicable)
    Notes
    [13] - Outcome Measure Data Not Reported
    [14] - Outcome Measure Data Not Reported
    No statistical analyses for this end point

    Secondary: Fibrosis Expression

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    End point title
    Fibrosis Expression
    End point description
    Correlate fibrosis (low, intermediate and high) by trichrome staining with median PFS, OS, TTP, ORR and DCR.
    End point type
    Secondary
    End point timeframe
    Baseline
    End point values
    Single arm (Overall Trial) Overall Trial
    Number of subjects analysed
    0 [15]
    0 [16]
    Units: Outcome Measure Data Not Reported
        number (not applicable)
    Notes
    [15] - Outcome Measure Data Not Reported
    [16] - Outcome Measure Data Not Reported
    No statistical analyses for this end point

    Secondary: CDA Expression

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    End point title
    CDA Expression
    End point description
    Correlate CDA (high versus low) expression by IHC with median PFS, OS, TTP, ORR and DCR.
    End point type
    Secondary
    End point timeframe
    Baseline
    End point values
    Single arm (Overall Trial) Overall Trial
    Number of subjects analysed
    0 [17]
    0 [18]
    Units: Outcome Measure Data Not Reported
        number (not applicable)
    Notes
    [17] - Outcome Measure Data Not Reported
    [18] - Outcome Measure Data Not Reported
    No statistical analyses for this end point

    Secondary: hENT Expression

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    End point title
    hENT Expression
    End point description
    Correlate hENT1 (high versus low) expression by IHC with median PFS, OS, TTP, ORR and DCR.
    End point type
    Secondary
    End point timeframe
    Baseline
    End point values
    Single arm (Overall Trial) Overall Trial
    Number of subjects analysed
    0 [19]
    0 [20]
    Units: Outcome Measure Data Not Reported
        number (not applicable)
    Notes
    [19] - Outcome Measure Data Not Reported
    [20] - Outcome Measure Data Not Reported
    No statistical analyses for this end point

    Secondary: Banking Biospecimens for Future Assessment

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    End point title
    Banking Biospecimens for Future Assessment
    End point description
    Optional specimen banking of patient blood specimens (including serum, plasma and buffy coat) as well as fixed left-over tissue specimens when available from all enrolled patients in this trial for possible future molecular, pharmacogenomic, and/or proteomic testing.
    End point type
    Secondary
    End point timeframe
    Prior to Cycle 1, Day 1; Cycle 1, Day 8; Cycle 3, Day 1 and at Off Treatment
    End point values
    Single arm (Overall Trial) Overall Trial
    Number of subjects analysed
    0 [21]
    0 [22]
    Units: Outcome Measure Data Not Reported
        number (not applicable)
    Notes
    [21] - Outcome Measure Data Not Reported
    [22] - Outcome Measure Data Not Reported
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Assessed every week for the first 2 cycles, then every two cycles (every 8 weeks) and 30 days after the last dose of therapy
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE
    Dictionary version
    4.0
    Reporting groups
    Reporting group title
    Single arm (Overall Trial)
    Reporting group description
    Nab-Paclitaxel 125 mg/m² IV and Gemcitabine 1000 mg/m² on days 1, 8 and 15 every 28 days until progression or unacceptable toxicity. Nab-Paclitaxel and Gemcitabine: Nab-Paclitaxel will be administered first, at a dose of 125 mg/m² IV over a period of 30 minutes; gemcitabine will be administered second, at a dose of 1000 mg/m² over a period of 30 minutes.

    Serious adverse events
    Single arm (Overall Trial)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    42 / 74 (56.76%)
         number of deaths (all causes)
    2
         number of deaths resulting from adverse events
    0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Embolism
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Hypertension
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombosis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pregnancy, puerperium and perinatal conditions
    Headache
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Disease progression
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Fatigue
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Generalised oedema
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Multi-organ failure
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences causally related to treatment / all
    2 / 6
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Dyspnoea
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory failure
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Neutrophil count decreased
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Humerus fracture
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Post procedural haemorrhage
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pericardial effusion
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Tachycardia
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Encephalopathy
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Facial nerve disorder
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemorrhage intracranial
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatic encephalopathy
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Haemolytic uraemic syndromeemaly
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Neutropenia
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Ascites
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Bile duct obstruction
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bile duct stenosis
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Biliary fistula
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Cholangitis
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Cholecystitis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholestasis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperbilirubinaemia
         subjects affected / exposed
    3 / 74 (4.05%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash macular
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Rash maculo-papular
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Abscess
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Biliary tract infection
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Device related infection
         subjects affected / exposed
    2 / 74 (2.70%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Diverticulitis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Emphysematous cholecystitis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infection
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neutropenic sepsis
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Hyponatraemia
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypovolaemia
         subjects affected / exposed
    1 / 74 (1.35%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Single arm (Overall Trial)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    72 / 74 (97.30%)
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Embolism
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    44
    Hot flashes
         subjects affected / exposed
    6 / 74 (8.11%)
         occurrences all number
    6
    Hypertension
         subjects affected / exposed
    10 / 74 (13.51%)
         occurrences all number
    10
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Chills
         subjects affected / exposed
    11 / 74 (14.86%)
         occurrences all number
    11
    Fatigue
         subjects affected / exposed
    53 / 74 (71.62%)
         occurrences all number
    53
    Influenza like illness
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Oedema peripheral
         subjects affected / exposed
    31 / 74 (41.89%)
         occurrences all number
    31
    Pain
         subjects affected / exposed
    7 / 74 (9.46%)
         occurrences all number
    7
    Pyrexia
         subjects affected / exposed
    18 / 74 (24.32%)
         occurrences all number
    18
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    11 / 74 (14.86%)
         occurrences all number
    11
    Dyspnoea
         subjects affected / exposed
    22 / 74 (29.73%)
         occurrences all number
    22
    Epistaxis
         subjects affected / exposed
    11 / 74 (14.86%)
         occurrences all number
    11
    Pleural effusion
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    12 / 74 (16.22%)
         occurrences all number
    12
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    18 / 74 (24.32%)
         occurrences all number
    18
    Aspartate aminotransferase increased
         subjects affected / exposed
    18 / 74 (24.32%)
         occurrences all number
    18
    Blood alkaline phosphatase increased
         subjects affected / exposed
    17 / 74 (22.97%)
         occurrences all number
    17
    Blood bilirubin increased
         subjects affected / exposed
    7 / 74 (9.46%)
         occurrences all number
    7
    Hyperbilirubinaemia
         subjects affected / exposed
    7 / 74 (9.46%)
         occurrences all number
    7
    Hypoalbuminaemia
         subjects affected / exposed
    9 / 74 (12.16%)
         occurrences all number
    9
    Hypocalcaemia
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Leukopenia
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Neutrophil count decreased
         subjects affected / exposed
    14 / 74 (18.92%)
         occurrences all number
    14
    Platelet count decreased
         subjects affected / exposed
    11 / 74 (14.86%)
         occurrences all number
    11
    Thrombocytopenia
         subjects affected / exposed
    16 / 74 (21.62%)
         occurrences all number
    16
    Weight decreased
         subjects affected / exposed
    22 / 74 (29.73%)
         occurrences all number
    22
    Weight increased
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    White blood cell count decreased
         subjects affected / exposed
    10 / 74 (13.51%)
         occurrences all number
    10
    Hyponatraemia
         subjects affected / exposed
    8 / 74 (10.81%)
         occurrences all number
    8
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    11 / 74 (14.86%)
         occurrences all number
    11
    Dysgeusia
         subjects affected / exposed
    17 / 74 (22.97%)
         occurrences all number
    17
    Headache
         subjects affected / exposed
    6 / 74 (8.11%)
         occurrences all number
    6
    Neuropathy peripheral
         subjects affected / exposed
    28 / 74 (37.84%)
         occurrences all number
    28
    Peripheral sensory neuropathy
         subjects affected / exposed
    9 / 74 (12.16%)
         occurrences all number
    9
    Tremor
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    31 / 74 (41.89%)
         occurrences all number
    31
    Neutropenia
         subjects affected / exposed
    26 / 74 (35.14%)
         occurrences all number
    26
    Eye disorders
    Vision blurred
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Ascites
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Constipation
         subjects affected / exposed
    34 / 74 (45.95%)
         occurrences all number
    34
    Decreased appetite
         subjects affected / exposed
    28 / 74 (37.84%)
         occurrences all number
    28
    Diarrhoea
         subjects affected / exposed
    35 / 74 (47.30%)
         occurrences all number
    35
    Dry mouth
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Nausea
         subjects affected / exposed
    34 / 74 (45.95%)
         occurrences all number
    34
    Stomatitis
         subjects affected / exposed
    8 / 74 (10.81%)
         occurrences all number
    8
    Vomiting
         subjects affected / exposed
    18 / 74 (24.32%)
         occurrences all number
    18
    Abdominal pain
         subjects affected / exposed
    12 / 74 (16.22%)
         occurrences all number
    12
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    39 / 74 (52.70%)
         occurrences all number
    39
    Nail discolouration
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Pruritus
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Rash
         subjects affected / exposed
    9 / 74 (12.16%)
         occurrences all number
    9
    Rash maculo-papular
         subjects affected / exposed
    7 / 74 (9.46%)
         occurrences all number
    7
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    13 / 74 (17.57%)
         occurrences all number
    13
    Back pain
         subjects affected / exposed
    6 / 74 (8.11%)
         occurrences all number
    6
    Bone pain
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Muscular weakness
         subjects affected / exposed
    14 / 74 (18.92%)
         occurrences all number
    14
    Musculoskeletal pain
         subjects affected / exposed
    5 / 74 (6.76%)
         occurrences all number
    5
    Myalgia
         subjects affected / exposed
    8 / 74 (10.81%)
         occurrences all number
    8
    Pain in extremity
         subjects affected / exposed
    9 / 74 (12.16%)
         occurrences all number
    9
    Infections and infestations
    Mucosal inflammation
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Sepsis
         subjects affected / exposed
    4 / 74 (5.41%)
         occurrences all number
    4
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    7 / 74 (9.46%)
         occurrences all number
    7
    Hypokalaemia
         subjects affected / exposed
    7 / 74 (9.46%)
         occurrences all number
    7

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

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

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/30178032
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