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    Clinical Trial Results:
    RANDOMIZED, DOUBLE-BLIND, PHASE 3 STUDY EVALUATING TAS-102 PLUS BEST SUPPORTIVE CARE (BSC) VERSUS PLACEBO PLUS BSC IN PATIENTS WITH METASTATIC GASTRIC CANCER REFRACTORY TO STANDARD TREATMENTS

    Summary
    EudraCT number
    2015-002683-16
    Trial protocol
    GB   DE   BE   ES   IE   PT   CZ   PL   IT  
    Global end of trial date
    19 Dec 2019

    Results information
    Results version number
    v2(current)
    This version publication date
    12 Sep 2024
    First version publication date
    12 Apr 2020
    Other versions
    v1
    Version creation reason
    • Correction of full data set
    Updates are required to fix the data discrepancies.
    Summary report(s)
    TAS-120-302 CSR Synopsis

    Trial information

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    Trial identification
    Sponsor protocol code
    TO-TAS-102-302
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02500043
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Taiho Oncology, Inc
    Sponsor organisation address
    101 Carnegie Center, Suite 101, Princeton, New Jersey, United States, NJ 08540
    Public contact
    Taiho Oncology, Inc , Taiho Pharma Europe, Ltd, +1 844-878-2446, medicalinformation@taihooncology.com
    Scientific contact
    Taiho Oncology, Inc , Taiho Pharma Europe, Ltd, +1 844-878-2446, medicalinformation@taihooncology.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
    28 Sep 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    30 Apr 2018
    Global end of trial reached?
    Yes
    Global end of trial date
    19 Dec 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Overall survival (OS)
    Protection of trial subjects
    This study was designed and conducted in accordance with the Sponsor procedures, which comply with the ethical principles of Good Clinical Practice (GCP) as required by the major regulatory authorities and in accordance with the Declaration of Helsinki, ICH E6 Guideline for GCP, and local regulations. The protocol and amendments, Informed Consent Form (ICF), and the Investigator’s Brochure (IB) provided to the Investigators, and any other documents that pertained to patient information (eg, patient diaries), recruitment methods, and advertisements received Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approval before the first patient was enrolled at the investigational site. When necessary, all protocol amendments and changes to the ICF were submitted by the Investigator to the IRB/IEC for approval. The Investigators notified the IRB/IEC of deviations from the protocol or serious adverse events occurring at the site according to local policies and IRB/IEC requirements, as well as other adverse event reports, in accordance with local procedures. The Investigator or a designee under the Investigator’s responsibility (according to applicable regulatory requirements) fully informed patients of all pertinent aspects of the clinical study. All participants were informed to the fullest extent possible about the study in a language and in terms they were able to understand. Prior to participation in the trial, the written ICF was signed and personally dated by the patient or by the patient’s legal representative and by the person who conducted the informed consent discussion. A copy of the signed and dated ICF was provided to the patient.
    Background therapy
    Best Supportive Care according to local clinical practice i.e.: - regimens including fluoropyrimidines, platinum derivatives, and either a taxane- and/or irinotecan-containing regimen; - a anti-HER2+ therapy for patients whose tumors are HER2-neupositive (HER2+); - pre- or post-operative adjuvant chemotherapy or chemoradiotherapy,
    Evidence for comparator
    This present study was designed as a randomized, double-blind, Phase 3 study comparing TAS-102 plus best supportive care (BSC) to placebo plus BSC in patients with metastatic gastric cancer who have received at least 2 prior regimens for advanced disease and were refractory or unable to tolerate their last prior therapy. A placebo-controlled design was considered appropriate as there are currently no standard therapies for patients with metastatic gastric cancer who have failed first- and second-line therapies.
    Actual start date of recruitment
    11 Feb 2016
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety, Efficacy
    Long term follow-up duration
    2 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Italy: 66
    Country: Number of subjects enrolled
    United States: 26
    Country: Number of subjects enrolled
    Turkey: 43
    Country: Number of subjects enrolled
    France: 24
    Country: Number of subjects enrolled
    Japan: 73
    Country: Number of subjects enrolled
    Israel: 12
    Country: Number of subjects enrolled
    Russian Federation: 46
    Country: Number of subjects enrolled
    Belarus: 30
    Country: Number of subjects enrolled
    Poland: 14
    Country: Number of subjects enrolled
    Portugal: 39
    Country: Number of subjects enrolled
    Romania: 8
    Country: Number of subjects enrolled
    Spain: 40
    Country: Number of subjects enrolled
    United Kingdom: 45
    Country: Number of subjects enrolled
    Belgium: 13
    Country: Number of subjects enrolled
    Czech Republic: 9
    Country: Number of subjects enrolled
    Germany: 11
    Country: Number of subjects enrolled
    Ireland: 8
    Worldwide total number of subjects
    507
    EEA total number of subjects
    277
    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)
    279
    From 65 to 84 years
    226
    85 years and over
    2

    Subject disposition

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    Recruitment
    Recruitment details
    Patients were randomized at 110 centers in 17 countries. A total of 625 patients signed informed consent for participation in the study.

    Pre-assignment
    Screening details
    All patients had to complete the following study procedures prior to a confirmation of eligibility: -Medical History, -Histologic Confirmation, -Human Epidermal Growth Factor Receptor 2 (HER2) Status, -Physical Examination, -Baseline Signs and Symptoms, -Height, Vital Signs, Weight, -ECOG performance status and - Clinical Laboratory Evaluations

    Pre-assignment period milestones
    Number of subjects started
    625 [1]
    Intermediate milestone: Number of subjects
    Screening - Confirmation of Eligibility: 507
    Number of subjects completed
    507

    Pre-assignment subject non-completion reasons
    Reason: Number of subjects
    Screen failure: 111
    Reason: Number of subjects
    Consent withdrawn by subject: 1
    Reason: Number of subjects
    Other: 4
    Reason: Number of subjects
    Death: 1
    Reason: Number of subjects
    Protocol deviation: 1
    Notes
    [1] - The number of subjects reported to have started the pre-assignment period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: 625 subjects were screened and the same was showed as started in the pre-assignment period.
    Period 1
    Period 1 title
    Baseline Period
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Baseline
    Arm description
    Baseline period; screening for participation in the study
    Arm type
    Screening

    Investigational medicinal product name
    TAS-102
    Investigational medicinal product code
    FTD, F3TdR, F3dThd
    Other name
    5-TRIFLUOROTHYMIDINE
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    TAS-102 is formulated as an immediate-release film-coated tablet, which is supplied in 2 strengths: • The 15 mg white, round tablet • The 20 mg pale-red, round tablet The total dose is 70 mg/m2 milligram(s)/square meter, per day within 1 hour after completion of morning and evening meals, for 5 days a week with 2 days rest for 2 weeks, followed by a 14-day rest. This treatment cycle will be repeated every 4 weeks.

    Number of subjects in period 1
    Baseline
    Started
    507
    Sign ICF
    507
    Enrollment
    507
    Medical History
    507
    Histological Confirmation
    507
    HER2 status (if available)
    507
    Physical Examination
    507
    Baseline Signs & Symptoms
    507
    Height
    507
    Vital Signs & Weight
    507
    ECOG Performance Status
    507
    Hematology
    507
    Serum Chemistry
    507
    Urinalysis
    507
    Pregnancy Test
    507
    Tumor Measurements
    507
    Quality of Life Assessment
    507
    Concomitant Medications
    507
    Completed
    507
    Period 2
    Period 2 title
    Treatment Period
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Investigator, Subject
    Blinding implementation details
    Eligible patients who met all of the inclusion and none of the exclusion criteria were centrally randomized (2:1) to TAS-102 plus BSC (experimental arm) or placebo plus BSC (control arm) using a dynamic allocation method (biased coin) via an Interactive Voice/Web Response System (IXRS). Randomization was stratified by: region (Rest of World (ROW) vs Japan); ECOG performance status (0 vs 1); and prior treatment with ramucirumab (yes vs no).

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    TAS-102 plus BSC
    Arm description
    Experimental arm, evaluating the efficacy and safety of TAS-102 (Investigational Medicinal Product) plus Best Supportive Care (BSC)
    Arm type
    Experimental

    Investigational medicinal product name
    TAS-102
    Investigational medicinal product code
    FTD, F3TdR, F3dThd
    Other name
    5-TRIFLUOROTHYMIDINE
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    TAS-102 is formulated as an immediate-release film-coated tablet, which is supplied in 2 strengths: • The 15 mg white, round tablet • The 20 mg pale-red, round tablet The total dose is 70 mg/m2 milligram(s)/square meter, per day within 1 hour after completion of morning and evening meals, for 5 days a week with 2 days rest for 2 weeks, followed by a 14-day rest. This treatment cycle will be repeated every 4 weeks.

    Arm title
    Placebo plus BSC
    Arm description
    Experimental arm, evaluating the efficacy and safety of placebo plus Best Supportive Care (BSC)
    Arm type
    Placebo

    Investigational medicinal product name
    TAS-102
    Investigational medicinal product code
    FTD, F3TdR, F3dThd
    Other name
    5-TRIFLUOROTHYMIDINE
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    TAS-102 is formulated as an immediate-release film-coated tablet, which is supplied in 2 strengths: • The 15 mg white, round tablet • The 20 mg pale-red, round tablet The total dose is 70 mg/m2 milligram(s)/square meter, per day within 1 hour after completion of morning and evening meals, for 5 days a week with 2 days rest for 2 weeks, followed by a 14-day rest. This treatment cycle will be repeated every 4 weeks.

    Number of subjects in period 2
    TAS-102 plus BSC Placebo plus BSC
    Started
    337
    170
    Randomization
    337
    170
    Physical Examination
    337
    170
    Vital Signs & Weight
    337
    170
    ECOG Performance Status
    337
    170
    Hematology
    337
    170
    Serum Chemistry
    337
    170
    Tumor Measurements
    337
    170
    Quality of Life Assessment
    337
    170
    Concomitant Medications
    337
    170
    AE/SAE Assessment
    337
    170
    TAS-102 or Placebo treatment
    337
    170
    Survival Status
    337
    170
    Completed
    335
    168
    Not completed
    2
    2
         Adverse event, serious fatal
    1
    -
         Consent withdrawn by subject
    -
    2
         Protocol deviation
    1
    -
    Period 3
    Period 3 title
    End of Treatment Period
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    End of Study
    Arm description
    End of Treatment
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 3
    End of Study
    Started
    503
    Physical Examination
    22
    Vital Signs & Weight
    22
    ECOG Performance Status
    22
    Hematology
    22
    Serum Chemistry
    22
    Pregnancy Test
    22
    Tumor Measurements
    22
    Quality of Life Assessment
    22
    Concomitant Medications
    22
    AE/SAE Assessment
    22
    Survival Status
    22
    Completed
    22
    Not completed
    481
         Clinical progression
    89
         Consent withdrawn by subject
    18
         Physician decision
    14
         Radiological progression
    302
         Adverse event, non-fatal
    44
         Death
    13
         Protocol deviation
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Baseline Period
    Reporting group description
    -

    Reporting group values
    Baseline Period Total
    Number of subjects
    507 507
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    279 279
        From 65-84 years
    226 226
        85 years and over
    2 2
    Age continuous
    Units: years
        arithmetic mean (full range (min-max))
    62.5 (24 to 89) -
    Gender categorical
    Units: Subjects
        Female
    138 138
        Male
    369 369
    Race
    Units: Subjects
        White
    357 357
        Black/African American
    3 3
        Asian
    80 80
        Not collectable
    62 62
        Other
    5 5
    Region
    Units: Subjects
        Japan
    73 73
        United States
    26 26
        European Union
    408 408
    Baseline renal function
    Units: Subjects
        Normal (CrCl ≥ 90 mL/min)
    202 202
        Mild impairment (CrCl 60-89 mL/min)
    212 212
        Moderate impairment (CrCl 30-59 mL/min)
    86 86
        Severe impairment (CrCl < 30 mL/min)
    3 3
        Not recorded
    4 4
    Body Surface Area
    Units: m2
        arithmetic mean (full range (min-max))
    1.749 (1.20 to 2.52) -
    Subject analysis sets

    Subject analysis set title
    Intention to treat (ITT)
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    ITT population - patients who were randomized

    Subject analysis set title
    TAS-102 + BSC
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Subjects randomised to TAS-102 + BSC group

    Subject analysis set title
    Placebo + BSC
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Subjects randomised to Placebo + BSC group

    Subject analysis sets values
    Intention to treat (ITT) TAS-102 + BSC Placebo + BSC
    Number of subjects
    507
    337
    170
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    279
    183
    96
        From 65-84 years
    226
    152
    74
        85 years and over
    2
    2
    0
    Age continuous
    Units: years
        arithmetic mean (full range (min-max))
    62.5 (24 to 89)
    62.8 (24 to 89)
    62.0 (32 to 82)
    Gender categorical
    Units: Subjects
        Female
    138
    85
    53
        Male
    369
    252
    117
    Race
    Units: Subjects
        White
    357
    244
    113
        Black/African American
    3
    1
    2
        Asian
    80
    51
    29
        Not collectable
    62
    38
    24
        Other
    5
    3
    2
    Region
    Units: Subjects
        Japan
    73
    46
    27
        United States
    26
    21
    5
        European Union
    408
    270
    138
    Baseline renal function
    Units: Subjects
        Normal (CrCl ≥ 90 mL/min)
    202
    134
    68
        Mild impairment (CrCl 60-89 mL/min)
    212
    141
    71
        Moderate impairment (CrCl 30-59 mL/min)
    86
    58
    28
        Severe impairment (CrCl < 30 mL/min)
    3
    2
    1
        Not recorded
    4
    2
    2
    Body Surface Area
    Units: m2
        arithmetic mean (full range (min-max))
    1.749 (1.20 to 2.52)
    1.747 (1.20 to 2.37)
    1.754 (1.29 to 2.52)

    End points

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    End points reporting groups
    Reporting group title
    Baseline
    Reporting group description
    Baseline period; screening for participation in the study
    Reporting group title
    TAS-102 plus BSC
    Reporting group description
    Experimental arm, evaluating the efficacy and safety of TAS-102 (Investigational Medicinal Product) plus Best Supportive Care (BSC)

    Reporting group title
    Placebo plus BSC
    Reporting group description
    Experimental arm, evaluating the efficacy and safety of placebo plus Best Supportive Care (BSC)
    Reporting group title
    End of Study
    Reporting group description
    End of Treatment

    Subject analysis set title
    Intention to treat (ITT)
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    ITT population - patients who were randomized

    Subject analysis set title
    TAS-102 + BSC
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Subjects randomised to TAS-102 + BSC group

    Subject analysis set title
    Placebo + BSC
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Subjects randomised to Placebo + BSC group

    Primary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    Overall Survival (OS) was the primary endpoint of this study and was defined as the time from the date of randomization to the death date. In the absence of death confirmation or for patients alive on the survival cut-off date, survival was censored at the date of last study follow-up or the cut-off date, whichever was earlier.
    End point type
    Primary
    End point timeframe
    The overall survival (OS) cut-off date used for the primary analysis was based on the survival data obtained through the date of the 384th death observed in the study (27 Mar 2018).
    End point values
    TAS-102 plus BSC Placebo plus BSC
    Number of subjects analysed
    337
    170
    Units: Subjects
        Total patients
    337
    170
        Not censored (dead)
    244
    140
        Censored
    93
    30
        Overall Survival by Region: Japan
    46
    27
        Overall Survival by Region: Rest of World
    291
    143
        Overall Survival by ECOG status at baseline: 0
    123
    68
        Overall Survival by ECOG status at baseline: 1
    214
    102
        OS by Prior treatment with ramucirumab: Yes
    114
    55
        OS by Prior treatment with ramucirumab: No
    223
    115
    Statistical analysis title
    Overall Survival (months)
    Statistical analysis description
    Overall Survival (OS) in the Intent to Treat (ITT) population will be compared between the 2 treatment groups using the stratified log-rank test.
    Comparison groups
    TAS-102 plus BSC v Placebo plus BSC
    Number of subjects included in analysis
    507
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.0006
    Method
    t-test, 2-sided
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.6917
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.5597
         upper limit
    0.8548
    Variability estimate
    Standard deviation

    Secondary: Progression-Free Survival (PFS)

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    End point title
    Progression-Free Survival (PFS)
    End point description
    Progression free survival was defined as the time from the date of randomization until the date of the investigator-assessed radiological disease progression or death due to any cause. Patients who were alive with no disease progression as of the analysis cut-off date were censored at the date of the last tumor assessment. Patients who received non-study cancer treatment before disease progression, or patients with clinical but not radiological evidence of progression was censored at the date of the last evaluable tumor assessment before the non-study cancer treatment was initiated.
    End point type
    Secondary
    End point timeframe
    PFS was defined as the time from the date of randomization until the date of the investigator-assessed radiological disease progression or death due to any cause as of the pre-specified cut-off date of 31 Mar 2018 for non-survival data.
    End point values
    TAS-102 plus BSC Placebo plus BSC
    Number of subjects analysed
    337
    170
    Units: Subjects
        Total patients
    337
    170
        PFS Events
    287
    156
        Progressed
    209
    113
        Death
    78
    43
        Censored
    50
    14
        Discontinued follow-up
    12
    1
        Initiated anti-tumor therapy
    8
    6
        Missed visit (> 91 days since last response)
    10
    3
        Follow-up ongoing at the time of analysis
    20
    4
        PFS by Region: Japan
    46
    27
        PFS by Region: Rest of World
    291
    143
        PFS by ECOG Performance Status at Baseline: 0
    123
    68
        PFS by ECOG Performance Status at Baseline: 1
    214
    102
        PFS by Prior Treatment with Ramucirumab: Yes
    114
    55
        PFS by Prior Treatment with Ramucirumab: No
    223
    115
    Statistical analysis title
    Progression-Free Survival
    Statistical analysis description
    Progression-free survival (PFS) was defined as the time from the date of randomization until the date of the investigator-assessed radiological disease progression or death due to any cause as of the pre-specified cut-off date of 31 Mar 2018 for non-survival data.
    Comparison groups
    TAS-102 plus BSC v Placebo plus BSC
    Number of subjects included in analysis
    507
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    < 0.0001
    Method
    t-test, 2-sided
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.5723
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.4674
         upper limit
    0.7008
    Variability estimate
    Standard deviation

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse Events (AE) were reported from the first dose of study medication through the period of patient follow-up (30 days after the last dose of study medication or until the start of new anti-tumor therapy, whichever was earlier).
    Adverse event reporting additional description
    All adverse event reporting were performed using the as-treated (AT) analysis population. The Common Terminology Criteria for Adverse Events (CTCAE Version 4.03) terms was used to assess severity/provide the grade for each adverse event (AE) that was reported.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE
    Dictionary version
    4.03
    Reporting groups
    Reporting group title
    Placebo plus BSC
    Reporting group description
    Adverse Events occurring in subjects within the placebo group

    Reporting group title
    TAS-102 plus BSC
    Reporting group description
    Adverse Events occurring in subjects within the treatment (TAS-102) group

    Serious adverse events
    Placebo plus BSC TAS-102 plus BSC
    Total subjects affected by serious adverse events
         subjects affected / exposed
    70 / 168 (41.67%)
    143 / 335 (42.69%)
         number of deaths (all causes)
    142
    253
         number of deaths resulting from adverse events
    19
    45
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Metastases to central nervous system
         subjects affected / exposed
    0 / 168 (0.00%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Tumour haemorrhage
         subjects affected / exposed
    1 / 168 (0.60%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Brain neoplasm
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lymphangiosis carcinomatosa
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Malignant ascites
         subjects affected / exposed
    2 / 168 (1.19%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neoplasm malignant
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Cancer pain
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ureteric cancer metastatic
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Shock haemorrhagic
         subjects affected / exposed
    0 / 168 (0.00%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    2 / 2
    Lymphoedema
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Venous thrombosis
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    General disorders and administration site conditions
    General physical health deterioration
         subjects affected / exposed
    15 / 168 (8.93%)
    21 / 335 (6.27%)
         occurrences causally related to treatment / all
    15 / 15
    21 / 21
         deaths causally related to treatment / all
    11 / 11
    17 / 17
    Fatigue
         subjects affected / exposed
    0 / 168 (0.00%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    0 / 168 (0.00%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Asthenia
         subjects affected / exposed
    3 / 168 (1.79%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    3 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Disease progression
         subjects affected / exposed
    1 / 168 (0.60%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Pain
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malaise
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Performance status decreased
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Breast pain
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endometrial hyperplasia
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pleural effusion
         subjects affected / exposed
    1 / 168 (0.60%)
    5 / 335 (1.49%)
         occurrences causally related to treatment / all
    1 / 1
    5 / 5
         deaths causally related to treatment / all
    1 / 1
    2 / 2
    Pulmonary embolism
         subjects affected / exposed
    2 / 168 (1.19%)
    5 / 335 (1.49%)
         occurrences causally related to treatment / all
    2 / 2
    5 / 5
         deaths causally related to treatment / all
    0 / 0
    3 / 3
    Dyspnoea
         subjects affected / exposed
    2 / 168 (1.19%)
    4 / 335 (1.19%)
         occurrences causally related to treatment / all
    2 / 2
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia aspiration
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Investigations
    Neutrophil count decreased
         subjects affected / exposed
    0 / 168 (0.00%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood bilirubin increased
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    White blood cell count decreased
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bilirubin conjugated increased
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Accidental overdose
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clavicle fracture
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thoracic vertebral fracture
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Acute coronary syndrome
         subjects affected / exposed
    1 / 168 (0.60%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    2 / 2
    Atrial fibrillation
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Altered state of consciousness
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Cerebral haemorrhage
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Hemiparesis
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Presyncope
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebral infarction
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Depressed level of consciousness
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    4 / 168 (2.38%)
    13 / 335 (3.88%)
         occurrences causally related to treatment / all
    4 / 4
    13 / 13
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancytopenia
         subjects affected / exposed
    0 / 168 (0.00%)
    7 / 335 (2.09%)
         occurrences causally related to treatment / all
    0 / 0
    7 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    0 / 168 (0.00%)
    4 / 335 (1.19%)
         occurrences causally related to treatment / all
    0 / 0
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    0 / 168 (0.00%)
    4 / 335 (1.19%)
         occurrences causally related to treatment / all
    0 / 0
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Disseminated intravascular coagulation
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 168 (0.00%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardio-respiratory arrest
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    1 / 168 (0.60%)
    9 / 335 (2.69%)
         occurrences causally related to treatment / all
    1 / 1
    9 / 9
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain
         subjects affected / exposed
    6 / 168 (3.57%)
    8 / 335 (2.39%)
         occurrences causally related to treatment / all
    6 / 6
    8 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    0 / 168 (0.00%)
    6 / 335 (1.79%)
         occurrences causally related to treatment / all
    0 / 0
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dysphagia
         subjects affected / exposed
    2 / 168 (1.19%)
    6 / 335 (1.79%)
         occurrences causally related to treatment / all
    2 / 2
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 168 (0.60%)
    4 / 335 (1.19%)
         occurrences causally related to treatment / all
    1 / 1
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Intestinal obstruction
         subjects affected / exposed
    3 / 168 (1.79%)
    4 / 335 (1.19%)
         occurrences causally related to treatment / all
    3 / 3
    4 / 4
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Ascites
         subjects affected / exposed
    7 / 168 (4.17%)
    3 / 335 (0.90%)
         occurrences causally related to treatment / all
    7 / 7
    3 / 3
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Gastric haemorrhage
         subjects affected / exposed
    3 / 168 (1.79%)
    3 / 335 (0.90%)
         occurrences causally related to treatment / all
    3 / 3
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematemesis
         subjects affected / exposed
    0 / 168 (0.00%)
    3 / 335 (0.90%)
         occurrences causally related to treatment / all
    0 / 0
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    2 / 168 (1.19%)
    3 / 335 (0.90%)
         occurrences causally related to treatment / all
    2 / 2
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ileus
         subjects affected / exposed
    1 / 168 (0.60%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Obstruction gastric
         subjects affected / exposed
    0 / 168 (0.00%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    2 / 168 (1.19%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    2 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Nausea
         subjects affected / exposed
    0 / 168 (0.00%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric ulcer haemorrhage
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Large intestinal obstruction
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal obstruction
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal distension
         subjects affected / exposed
    1 / 168 (0.60%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric stenosis
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain lower
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal obstruction
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Melaena
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal pain
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophagitis
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatitis
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stomatitis
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subileus
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ulcerative gastritis
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Hepatic failure
         subjects affected / exposed
    0 / 168 (0.00%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    2 / 2
    Jaundice
         subjects affected / exposed
    0 / 168 (0.00%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholangitis
         subjects affected / exposed
    1 / 168 (0.60%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholestasis
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Jaundice cholestatic
         subjects affected / exposed
    1 / 168 (0.60%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatitis toxic
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 168 (0.60%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hydronephrosis
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Joint swelling
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Back pain
         subjects affected / exposed
    3 / 168 (1.79%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Neutropenic sepsis
         subjects affected / exposed
    0 / 168 (0.00%)
    4 / 335 (1.19%)
         occurrences causally related to treatment / all
    0 / 0
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    2 / 168 (1.19%)
    4 / 335 (1.19%)
         occurrences causally related to treatment / all
    2 / 2
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Septic shock
         subjects affected / exposed
    0 / 168 (0.00%)
    3 / 335 (0.90%)
         occurrences causally related to treatment / all
    0 / 0
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    3 / 3
    Infection
         subjects affected / exposed
    1 / 168 (0.60%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Escherichia sepsis
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Influenza
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Salmonellosis
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 168 (0.60%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    1 / 168 (0.60%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Typhoid fever
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Biliary sepsis
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peritonitis bacterial
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    4 / 168 (2.38%)
    11 / 335 (3.28%)
         occurrences causally related to treatment / all
    4 / 4
    11 / 11
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Failure to thrive
         subjects affected / exposed
    1 / 168 (0.60%)
    2 / 335 (0.60%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 2
         deaths causally related to treatment / all
    1 / 1
    2 / 2
    Dehydration
         subjects affected / exposed
    1 / 168 (0.60%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoalbuminaemia
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Alkalosis hypochloraemic
         subjects affected / exposed
    0 / 168 (0.00%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cachexia
         subjects affected / exposed
    1 / 168 (0.60%)
    1 / 335 (0.30%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    1 / 168 (0.60%)
    0 / 335 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo plus BSC TAS-102 plus BSC
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    151 / 168 (89.88%)
    319 / 335 (95.22%)
    Investigations
    Neutrophil count decreased
         subjects affected / exposed
    1 / 168 (0.60%)
    50 / 335 (14.93%)
         occurrences all number
    1
    139
    Blood alkaline phosphatase increased
         subjects affected / exposed
    14 / 168 (8.33%)
    30 / 335 (8.96%)
         occurrences all number
    15
    35
    Platelet count decreased
         subjects affected / exposed
    6 / 168 (3.57%)
    28 / 335 (8.36%)
         occurrences all number
    11
    43
    White blood cell count decreased
         subjects affected / exposed
    0 / 168 (0.00%)
    23 / 335 (6.87%)
         occurrences all number
    0
    59
    Aspartate aminotransferase increased
         subjects affected / exposed
    13 / 168 (7.74%)
    21 / 335 (6.27%)
         occurrences all number
    15
    26
    Weight decreased
         subjects affected / exposed
    12 / 168 (7.14%)
    20 / 335 (5.97%)
         occurrences all number
    13
    21
    Blood bilirubin increased
         subjects affected / exposed
    7 / 168 (4.17%)
    17 / 335 (5.07%)
         occurrences all number
    9
    28
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    30 / 168 (17.86%)
    142 / 335 (42.39%)
         occurrences all number
    52
    250
    Neutropenia
         subjects affected / exposed
    6 / 168 (3.57%)
    128 / 335 (38.21%)
         occurrences all number
    9
    314
    Leukopenia
         subjects affected / exposed
    3 / 168 (1.79%)
    57 / 335 (17.01%)
         occurrences all number
    14
    116
    Thrombocytopenia
         subjects affected / exposed
    2 / 168 (1.19%)
    32 / 335 (9.55%)
         occurrences all number
    2
    45
    Lymphopenia
         subjects affected / exposed
    8 / 168 (4.76%)
    20 / 335 (5.97%)
         occurrences all number
    21
    42
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    35 / 168 (20.83%)
    87 / 335 (25.97%)
         occurrences all number
    41
    136
    Asthenia
         subjects affected / exposed
    37 / 168 (22.02%)
    65 / 335 (19.40%)
         occurrences all number
    45
    97
    Pyrexia
         subjects affected / exposed
    8 / 168 (4.76%)
    23 / 335 (6.87%)
         occurrences all number
    9
    37
    Oedema peripheral
         subjects affected / exposed
    12 / 168 (7.14%)
    17 / 335 (5.07%)
         occurrences all number
    12
    17
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    53 / 168 (31.55%)
    123 / 335 (36.72%)
         occurrences all number
    64
    201
    Vomiting
         subjects affected / exposed
    34 / 168 (20.24%)
    80 / 335 (23.88%)
         occurrences all number
    48
    104
    Diarrhoea
         subjects affected / exposed
    24 / 168 (14.29%)
    73 / 335 (21.79%)
         occurrences all number
    28
    118
    Abdominal pain
         subjects affected / exposed
    27 / 168 (16.07%)
    50 / 335 (14.93%)
         occurrences all number
    34
    75
    Constipation
         subjects affected / exposed
    25 / 168 (14.88%)
    44 / 335 (13.13%)
         occurrences all number
    31
    54
    Abdominal pain upper
         subjects affected / exposed
    14 / 168 (8.33%)
    22 / 335 (6.57%)
         occurrences all number
    15
    27
    Ascites
         subjects affected / exposed
    10 / 168 (5.95%)
    16 / 335 (4.78%)
         occurrences all number
    18
    24
    Abdominal distension
         subjects affected / exposed
    9 / 168 (5.36%)
    13 / 335 (3.88%)
         occurrences all number
    9
    15
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    16 / 168 (9.52%)
    21 / 335 (6.27%)
         occurrences all number
    16
    24
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    10 / 168 (5.95%)
    11 / 335 (3.28%)
         occurrences all number
    10
    12
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    9 / 168 (5.36%)
    25 / 335 (7.46%)
         occurrences all number
    10
    31
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    49 / 168 (29.17%)
    109 / 335 (32.54%)
         occurrences all number
    54
    165
    Hypoalbuminaemia
         subjects affected / exposed
    10 / 168 (5.95%)
    21 / 335 (6.27%)
         occurrences all number
    11
    28

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    19 Feb 2016
    Various sections of the protocol was amended (namely Inclusion/Exclusion criteria etc) in response to Health Authority requests and in order to make changes for consistency and/or clarification.
    05 May 2016
    The following sections of the study protocol were updated in response to Health Authority requests, and in order to make changes for consistency and/or clarification: - Section 8.8.1, Prohibited Medications and Therapies - Section 9.2.4.3, Dose Modification in Response to Hematologic Toxicities - Section 9.5, Study Drug Accountability - Section 12.1.1, Adverse Events

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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