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    Clinical Trial Results:
    Phase II study evaluating the combination of cetuximab with afatinib as first-line treatment for patients with EGFR mutated Non Small Cell Lung Cancer

    Summary
    EudraCT number
    2015-003390-15
    Trial protocol
    FR  
    Global end of trial date
    30 May 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    03 Jun 2022
    First version publication date
    03 Jun 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    IFCT-1503
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02716311
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    IFCT
    Sponsor organisation address
    10 rue de la Grange-Batelière, PARIS, France, 75009
    Public contact
    Contact, IFCT, +33 156811045, contact@ifct.fr
    Scientific contact
    Contact, IFCT, +33 156811045, contact@ifct.fr
    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 Aug 2019
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    30 May 2020
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    Evaluating efficacy and toxicity of the combination of afatinib with cetuximab versus afatinib alone, in first-line treatment of patient with a EGFR mutated NSCLC
    Protection of trial subjects
    Algorithms for management of adverse events were provided in the protocol
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    16 Jun 2016
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 117
    Worldwide total number of subjects
    117
    EEA total number of subjects
    117
    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)
    55
    From 65 to 84 years
    61
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    A total of 117 of 172 (68%) patients initially planned had been included in the study between June 2016 and November 2018 and randomly assigned to group afatinib (59) or group afatinib + cetuximab (58). Only one patient (group afatinib + cetuximab) did not receive any study treatment due to the presence of intercurrent disease.

    Pre-assignment
    Screening details
    patients with stage III/IV EGFR-positive NSCLC

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    A - Afatinib
    Arm description
    Afatinib alone
    Arm type
    Active comparator

    Investigational medicinal product name
    Afatinib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Afatinib will be taken orally from D1 and until progression or dose-limiting toxicity, at the dose of 40 mg/d.

    Arm title
    B - Afatinib + cetuximab
    Arm description
    Afatinib in combinaison with cetuximab
    Arm type
    Experimental

    Investigational medicinal product name
    Afatinib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Afatinib will be taken orally from D1 and until progression or dose-limiting toxicity, at the dose of 40 mg/d.

    Investigational medicinal product name
    Cetuximab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Cetuximab will be administered by intravenous infusion from D15 of the 1st cycle (C1D15) at the dose of 250 mg/m² then every 2 weeks at the dose of 500 mg/m², for 6 months.

    Number of subjects in period 1
    A - Afatinib B - Afatinib + cetuximab
    Started
    59
    58
    Completed
    0
    0
    Not completed
    59
    58
         Patient's choice
    -
    1
         Treatment not started
    -
    1
         Adverse event, non-fatal
    6
    9
         Death
    1
    1
         Other
    7
    4
         Intercurrent disease
    -
    1
         2nd cancer
    1
    -
         Lack of efficacy
    44
    41

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    A - Afatinib
    Reporting group description
    Afatinib alone

    Reporting group title
    B - Afatinib + cetuximab
    Reporting group description
    Afatinib in combinaison with cetuximab

    Reporting group values
    A - Afatinib B - Afatinib + cetuximab Total
    Number of subjects
    59 58 117
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    22 33 55
        From 65-84 years
    36 25 61
        85 years and over
    1 0 1
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    65.63 ( 11.49 ) 63.61 ( 10.69 ) -
    Gender categorical
    Units: Subjects
        Female
    43 41 84
        Male
    16 17 33
    Smoking history
    Units: Subjects
        No
    35 32 67
        Yes
    24 26 50
    EGFR mutation type
    Units: Subjects
        Deletion exon 19
    33 32 65
        Mutation G719X exon 18
    2 0 2
        Mutation L858R exon 21
    23 24 47
        Mutation L861Q
    1 2 3
    ECOG performance status
    Units: Subjects
        PS = 0
    21 21 42
        PS = 1
    38 36 74
        PS = 2
    0 1 1
    TNM stage
    Units: Subjects
        IIIa
    1 0 1
        IIIb
    0 3 3
        IVa
    17 13 30
        IVb
    41 42 83
    Brain metastases
    Units: Subjects
        No
    44 46 90
        Yes
    15 12 27
    Histologic type
    Units: Subjects
        Adenocarcinoma (unspecified)
    57 56 113
        Non–small cell non-squamous cancer
    1 1 2
        Mixed carcinoma
    1 1 2
    Smoking history
    Units: Pack, years
        median (full range (min-max))
    20 (2 to 112) 16 (1 to 60) -

    End points

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    End points reporting groups
    Reporting group title
    A - Afatinib
    Reporting group description
    Afatinib alone

    Reporting group title
    B - Afatinib + cetuximab
    Reporting group description
    Afatinib in combinaison with cetuximab

    Subject analysis set title
    Efficacy population
    Subject analysis set type
    Per protocol
    Subject analysis set description
    Efficacy population is defined as all patient without major deviation on inclusion or exclusion criteria.

    Primary: Treatment failure-free survival (TTF) at 9 months

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    End point title
    Treatment failure-free survival (TTF) at 9 months [1]
    End point description
    Treatment failure was defined as treatment discontinuation for any reason (including disease progression, death, or toxicity).
    End point type
    Primary
    End point timeframe
    9 months after randomization
    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: Non comparative study
    End point values
    A - Afatinib B - Afatinib + cetuximab
    Number of subjects analysed
    59
    57 [2]
    Units: percent
        number (confidence interval 95%)
    59.27 (45.66 to 70.55)
    64.91 (51.06 to 75.74)
    Notes
    [2] - Efficacy population analysis set
    No statistical analyses for this end point

    Secondary: Median TTF

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    End point title
    Median TTF
    End point description
    End point type
    Secondary
    End point timeframe
    Until the end of the study (median follow-up time of 21.7 months)
    End point values
    A - Afatinib B - Afatinib + cetuximab
    Number of subjects analysed
    59
    57 [3]
    Units: month
        median (confidence interval 95%)
    11.1 (8.48 to 14.13)
    12.94 (9.20 to 14.52)
    Notes
    [3] - Efficacy population
    No statistical analyses for this end point

    Secondary: Median Progression Free Survival

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    End point title
    Median Progression Free Survival
    End point description
    Progression-free survival is defined as the time between randomisation and tumour progression or death by any cause.
    End point type
    Secondary
    End point timeframe
    Until the end of the stuidy (median follow-up time of 21.7 months)
    End point values
    A - Afatinib B - Afatinib + cetuximab
    Number of subjects analysed
    59
    57 [4]
    Units: month
        median (confidence interval 95%)
    11.89 (9.10 to 15.01)
    13.44 (9.66 to 13.80)
    Notes
    [4] - Efficacy population
    No statistical analyses for this end point

    Secondary: Objective Response Rate

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    End point title
    Objective Response Rate
    End point description
    Patients are assessable for response after two cycles. The response will be assessed by planimetric measurement of unidimensional targets according to RECIST criteria (version 1.1 Eur J Cancer 2009;45:228-247) at each assessment.
    End point type
    Secondary
    End point timeframe
    Until the end of the study (median follow-up of 21.7 months)
    End point values
    A - Afatinib B - Afatinib + cetuximab
    Number of subjects analysed
    59
    57 [5]
    Units: percent
        number (not applicable)
    42
    37
    Notes
    [5] - Efficacy population
    No statistical analyses for this end point

    Secondary: 12-month survival rate

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    End point title
    12-month survival rate
    End point description
    Overall survival is defined as the time from date of enrolment and death by all causes.
    End point type
    Secondary
    End point timeframe
    12 months after randomization
    End point values
    A - Afatinib B - Afatinib + cetuximab
    Number of subjects analysed
    59
    57
    Units: percent
        number (confidence interval 95%)
    87.92 (76.31 to 94.05)
    89.4 (77.92 to 95.1)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Any adverse event occurring from the signature of consent up to 30 days after the end of administration.
    Adverse event reporting additional description
    The maximal grade of adverse events was collected by cycle of treatment.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21
    Reporting groups
    Reporting group title
    Safety Population - Arm A - Afatinib
    Reporting group description
    Safety population is defined as all patients who received a dose of treatment.

    Reporting group title
    Safety Population - Arm B - Afatinib + cetuximab
    Reporting group description
    -

    Serious adverse events
    Safety Population - Arm A - Afatinib Safety Population - Arm B - Afatinib + cetuximab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    22 / 59 (37.29%)
    56 / 57 (98.25%)
         number of deaths (all causes)
    32
    31
         number of deaths resulting from adverse events
    2
    4
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Metastases to meninges
         subjects affected / exposed
    0 / 59 (0.00%)
    2 / 57 (3.51%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Neoplasm progression
         subjects affected / exposed
    2 / 59 (3.39%)
    2 / 57 (3.51%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Vascular disorders
    Lymphoedema
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Phlebitis
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    General disorders and administration site conditions
    General physical health deterioration
         subjects affected / exposed
    3 / 59 (5.08%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperthermia malignant
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mucosal inflammation
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malaise
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Immune system disorders
    Anaphylactic reaction
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary arterial hypertension
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Weight decreased
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Troponin increased
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pelvic fracture
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ankle fracture
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac tamponade
         subjects affected / exposed
    0 / 59 (0.00%)
    2 / 57 (3.51%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Pericarditis
         subjects affected / exposed
    1 / 59 (1.69%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Arrhythmia
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Nervous system disorder
         subjects affected / exposed
    0 / 59 (0.00%)
    2 / 57 (3.51%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Encephalopathy
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sciatica
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Retinal detachment
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    6 / 59 (10.17%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    4 / 6
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    7 / 59 (11.86%)
    2 / 57 (3.51%)
         occurrences causally related to treatment / all
    4 / 7
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Abdominal pain
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peptic ulcer haemorrhage
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal obstruction
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Faecaloma
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash papular
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    2 / 59 (3.39%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal colic
         subjects affected / exposed
    0 / 59 (0.00%)
    2 / 57 (3.51%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Bone pain
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rhabdomyolysis
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subcutaneous abscess
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ophthalmic herpes simplex
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyelonephritis acute
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Staphylococcal skin infection
         subjects affected / exposed
    0 / 59 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Folliculitis
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    0 / 59 (0.00%)
    2 / 57 (3.51%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    1 / 59 (1.69%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    1 / 59 (1.69%)
    0 / 57 (0.00%)
         occurrences causally related to treatment / all
    0 / 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
    Safety Population - Arm A - Afatinib Safety Population - Arm B - Afatinib + cetuximab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    59 / 59 (100.00%)
    57 / 57 (100.00%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    4 / 59 (6.78%)
    2 / 57 (3.51%)
         occurrences all number
    6
    8
    Pulmonary embolism
         subjects affected / exposed
    3 / 59 (5.08%)
    0 / 57 (0.00%)
         occurrences all number
    3
    0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    20 / 59 (33.90%)
    32 / 57 (56.14%)
         occurrences all number
    64
    111
    Mucosal inflammation
         subjects affected / exposed
    13 / 59 (22.03%)
    19 / 57 (33.33%)
         occurrences all number
    45
    42
    Chest pain
         subjects affected / exposed
    9 / 59 (15.25%)
    14 / 57 (24.56%)
         occurrences all number
    19
    37
    Fatigue
         subjects affected / exposed
    6 / 59 (10.17%)
    12 / 57 (21.05%)
         occurrences all number
    19
    23
    Oedema peripheral
         subjects affected / exposed
    5 / 59 (8.47%)
    6 / 57 (10.53%)
         occurrences all number
    6
    10
    Xerosis
         subjects affected / exposed
    4 / 59 (6.78%)
    6 / 57 (10.53%)
         occurrences all number
    7
    8
    Pain
         subjects affected / exposed
    3 / 59 (5.08%)
    5 / 57 (8.77%)
         occurrences all number
    3
    9
    Pyrexia
         subjects affected / exposed
    6 / 59 (10.17%)
    2 / 57 (3.51%)
         occurrences all number
    6
    2
    General physical health deterioration
         subjects affected / exposed
    5 / 59 (8.47%)
    1 / 57 (1.75%)
         occurrences all number
    6
    2
    Chest discomfort
         subjects affected / exposed
    0 / 59 (0.00%)
    3 / 57 (5.26%)
         occurrences all number
    0
    3
    Reproductive system and breast disorders
    Vulvovaginal dryness
         subjects affected / exposed
    3 / 59 (5.08%)
    2 / 57 (3.51%)
         occurrences all number
    3
    2
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    15 / 59 (25.42%)
    24 / 57 (42.11%)
         occurrences all number
    47
    49
    Epistaxis
         subjects affected / exposed
    11 / 59 (18.64%)
    14 / 57 (24.56%)
         occurrences all number
    23
    38
    Dyspnoea exertional
         subjects affected / exposed
    3 / 59 (5.08%)
    9 / 57 (15.79%)
         occurrences all number
    3
    15
    Lung disorder
         subjects affected / exposed
    2 / 59 (3.39%)
    3 / 57 (5.26%)
         occurrences all number
    6
    8
    Rhinorrhoea
         subjects affected / exposed
    5 / 59 (8.47%)
    4 / 57 (7.02%)
         occurrences all number
    7
    6
    Productive cough
         subjects affected / exposed
    3 / 59 (5.08%)
    3 / 57 (5.26%)
         occurrences all number
    5
    5
    Dysphonia
         subjects affected / exposed
    2 / 59 (3.39%)
    3 / 57 (5.26%)
         occurrences all number
    3
    4
    Haemoptysis
         subjects affected / exposed
    1 / 59 (1.69%)
    3 / 57 (5.26%)
         occurrences all number
    3
    4
    Nasal dryness
         subjects affected / exposed
    3 / 59 (5.08%)
    1 / 57 (1.75%)
         occurrences all number
    4
    2
    Pleural effusion
         subjects affected / exposed
    0 / 59 (0.00%)
    3 / 57 (5.26%)
         occurrences all number
    0
    3
    Psychiatric disorders
    Depression
         subjects affected / exposed
    1 / 59 (1.69%)
    4 / 57 (7.02%)
         occurrences all number
    2
    16
    Anxiety
         subjects affected / exposed
    2 / 59 (3.39%)
    5 / 57 (8.77%)
         occurrences all number
    2
    5
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    8 / 59 (13.56%)
    13 / 57 (22.81%)
         occurrences all number
    29
    21
    Aspartate aminotransferase increased
         subjects affected / exposed
    7 / 59 (11.86%)
    8 / 57 (14.04%)
         occurrences all number
    14
    16
    Blood alkaline phosphatase increased
         subjects affected / exposed
    4 / 59 (6.78%)
    7 / 57 (12.28%)
         occurrences all number
    12
    16
    Blood bilirubin increased
         subjects affected / exposed
    3 / 59 (5.08%)
    2 / 57 (3.51%)
         occurrences all number
    9
    16
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    3 / 59 (5.08%)
    6 / 57 (10.53%)
         occurrences all number
    4
    19
    Weight decreased
         subjects affected / exposed
    9 / 59 (15.25%)
    9 / 57 (15.79%)
         occurrences all number
    14
    9
    Blood magnesium decreased
         subjects affected / exposed
    3 / 59 (5.08%)
    4 / 57 (7.02%)
         occurrences all number
    5
    16
    Blood lactate dehydrogenase increased
         subjects affected / exposed
    3 / 59 (5.08%)
    4 / 57 (7.02%)
         occurrences all number
    6
    7
    Neutrophil count decreased
         subjects affected / exposed
    1 / 59 (1.69%)
    5 / 57 (8.77%)
         occurrences all number
    1
    8
    Transaminases increased
         subjects affected / exposed
    3 / 59 (5.08%)
    0 / 57 (0.00%)
         occurrences all number
    3
    0
    Nervous system disorders
    Headache
         subjects affected / exposed
    5 / 59 (8.47%)
    11 / 57 (19.30%)
         occurrences all number
    19
    17
    Neuralgia
         subjects affected / exposed
    2 / 59 (3.39%)
    3 / 57 (5.26%)
         occurrences all number
    14
    4
    Dysgeusia
         subjects affected / exposed
    3 / 59 (5.08%)
    3 / 57 (5.26%)
         occurrences all number
    9
    3
    Sciatica
         subjects affected / exposed
    2 / 59 (3.39%)
    3 / 57 (5.26%)
         occurrences all number
    2
    8
    Paraesthesia
         subjects affected / exposed
    2 / 59 (3.39%)
    3 / 57 (5.26%)
         occurrences all number
    3
    5
    Hypoaesthesia
         subjects affected / exposed
    1 / 59 (1.69%)
    3 / 57 (5.26%)
         occurrences all number
    1
    5
    Neuropathy peripheral
         subjects affected / exposed
    1 / 59 (1.69%)
    3 / 57 (5.26%)
         occurrences all number
    1
    3
    Presyncope
         subjects affected / exposed
    3 / 59 (5.08%)
    0 / 57 (0.00%)
         occurrences all number
    3
    0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    13 / 59 (22.03%)
    7 / 57 (12.28%)
         occurrences all number
    38
    25
    Lymphopenia
         subjects affected / exposed
    4 / 59 (6.78%)
    9 / 57 (15.79%)
         occurrences all number
    8
    31
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    1 / 59 (1.69%)
    6 / 57 (10.53%)
         occurrences all number
    2
    10
    Eye disorders
    Conjunctivitis
         subjects affected / exposed
    7 / 59 (11.86%)
    10 / 57 (17.54%)
         occurrences all number
    14
    20
    Dry eye
         subjects affected / exposed
    5 / 59 (8.47%)
    9 / 57 (15.79%)
         occurrences all number
    12
    16
    Keratitis
         subjects affected / exposed
    3 / 59 (5.08%)
    2 / 57 (3.51%)
         occurrences all number
    13
    4
    Trichomegaly
         subjects affected / exposed
    0 / 59 (0.00%)
    3 / 57 (5.26%)
         occurrences all number
    0
    8
    Eye pain
         subjects affected / exposed
    1 / 59 (1.69%)
    3 / 57 (5.26%)
         occurrences all number
    1
    5
    Visual impairment
         subjects affected / exposed
    3 / 59 (5.08%)
    0 / 57 (0.00%)
         occurrences all number
    6
    0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    56 / 59 (94.92%)
    52 / 57 (91.23%)
         occurrences all number
    338
    271
    Stomatitis
         subjects affected / exposed
    18 / 59 (30.51%)
    17 / 57 (29.82%)
         occurrences all number
    46
    36
    Nausea
         subjects affected / exposed
    20 / 59 (33.90%)
    17 / 57 (29.82%)
         occurrences all number
    41
    32
    Constipation
         subjects affected / exposed
    4 / 59 (6.78%)
    15 / 57 (26.32%)
         occurrences all number
    15
    25
    Vomiting
         subjects affected / exposed
    12 / 59 (20.34%)
    13 / 57 (22.81%)
         occurrences all number
    19
    20
    Abdominal pain
         subjects affected / exposed
    8 / 59 (13.56%)
    9 / 57 (15.79%)
         occurrences all number
    16
    14
    Abdominal pain upper
         subjects affected / exposed
    5 / 59 (8.47%)
    7 / 57 (12.28%)
         occurrences all number
    5
    15
    Gastrooesophageal reflux disease
         subjects affected / exposed
    6 / 59 (10.17%)
    5 / 57 (8.77%)
         occurrences all number
    10
    10
    Dry mouth
         subjects affected / exposed
    4 / 59 (6.78%)
    5 / 57 (8.77%)
         occurrences all number
    9
    9
    Dysphagia
         subjects affected / exposed
    3 / 59 (5.08%)
    3 / 57 (5.26%)
         occurrences all number
    15
    3
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    47 / 59 (79.66%)
    54 / 57 (94.74%)
         occurrences all number
    288
    437
    Nail disorder
         subjects affected / exposed
    31 / 59 (52.54%)
    35 / 57 (61.40%)
         occurrences all number
    172
    224
    Skin fissures
         subjects affected / exposed
    23 / 59 (38.98%)
    32 / 57 (56.14%)
         occurrences all number
    76
    185
    Hypertrichosis
         subjects affected / exposed
    4 / 59 (6.78%)
    14 / 57 (24.56%)
         occurrences all number
    12
    44
    Pruritus
         subjects affected / exposed
    6 / 59 (10.17%)
    15 / 57 (26.32%)
         occurrences all number
    14
    37
    Alopecia
         subjects affected / exposed
    11 / 59 (18.64%)
    4 / 57 (7.02%)
         occurrences all number
    34
    7
    Skin toxicity
         subjects affected / exposed
    6 / 59 (10.17%)
    7 / 57 (12.28%)
         occurrences all number
    7
    10
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    2 / 59 (3.39%)
    5 / 57 (8.77%)
         occurrences all number
    2
    6
    Hair texture abnormal
         subjects affected / exposed
    1 / 59 (1.69%)
    3 / 57 (5.26%)
         occurrences all number
    1
    4
    Skin burning sensation
         subjects affected / exposed
    0 / 59 (0.00%)
    3 / 57 (5.26%)
         occurrences all number
    0
    5
    Eczema
         subjects affected / exposed
    0 / 59 (0.00%)
    3 / 57 (5.26%)
         occurrences all number
    0
    3
    Dry skin
         subjects affected / exposed
    21 / 59 (35.59%)
    35 / 57 (61.40%)
         occurrences all number
    70
    141
    Renal and urinary disorders
    Cough
         subjects affected / exposed
    22 / 59 (37.29%)
    26 / 57 (45.61%)
         occurrences all number
    37
    57
    Renal failure
         subjects affected / exposed
    6 / 59 (10.17%)
    3 / 57 (5.26%)
         occurrences all number
    14
    25
    Haematuria
         subjects affected / exposed
    0 / 59 (0.00%)
    3 / 57 (5.26%)
         occurrences all number
    0
    5
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    10 / 59 (16.95%)
    14 / 57 (24.56%)
         occurrences all number
    21
    31
    Arthralgia
         subjects affected / exposed
    12 / 59 (20.34%)
    7 / 57 (12.28%)
         occurrences all number
    28
    16
    Bone pain
         subjects affected / exposed
    6 / 59 (10.17%)
    6 / 57 (10.53%)
         occurrences all number
    11
    15
    Neck pain
         subjects affected / exposed
    4 / 59 (6.78%)
    4 / 57 (7.02%)
         occurrences all number
    20
    6
    Muscle spasms
         subjects affected / exposed
    8 / 59 (13.56%)
    4 / 57 (7.02%)
         occurrences all number
    16
    5
    Pain in extremity
         subjects affected / exposed
    3 / 59 (5.08%)
    5 / 57 (8.77%)
         occurrences all number
    7
    10
    Musculoskeletal chest pain
         subjects affected / exposed
    4 / 59 (6.78%)
    3 / 57 (5.26%)
         occurrences all number
    11
    5
    Myalgia
         subjects affected / exposed
    4 / 59 (6.78%)
    2 / 57 (3.51%)
         occurrences all number
    11
    5
    Musculoskeletal pain
         subjects affected / exposed
    3 / 59 (5.08%)
    3 / 57 (5.26%)
         occurrences all number
    7
    3
    Infections and infestations
    Cystitis
         subjects affected / exposed
    4 / 59 (6.78%)
    3 / 57 (5.26%)
         occurrences all number
    7
    4
    Nasopharyngitis
         subjects affected / exposed
    5 / 59 (8.47%)
    5 / 57 (8.77%)
         occurrences all number
    5
    6
    Rhinitis
         subjects affected / exposed
    4 / 59 (6.78%)
    3 / 57 (5.26%)
         occurrences all number
    5
    5
    Urinary tract infection
         subjects affected / exposed
    4 / 59 (6.78%)
    4 / 57 (7.02%)
         occurrences all number
    4
    5
    Angular cheilitis
         subjects affected / exposed
    3 / 59 (5.08%)
    2 / 57 (3.51%)
         occurrences all number
    10
    6
    Oral herpes
         subjects affected / exposed
    3 / 59 (5.08%)
    0 / 57 (0.00%)
         occurrences all number
    3
    0
    Bronchitis
         subjects affected / exposed
    2 / 59 (3.39%)
    3 / 57 (5.26%)
         occurrences all number
    3
    3
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    13 / 59 (22.03%)
    16 / 57 (28.07%)
         occurrences all number
    19
    25
    Hypokalaemia
         subjects affected / exposed
    10 / 59 (16.95%)
    4 / 57 (7.02%)
         occurrences all number
    16
    6
    Hypoalbuminaemia
         subjects affected / exposed
    4 / 59 (6.78%)
    3 / 57 (5.26%)
         occurrences all number
    4
    7
    Hypocalcaemia
         subjects affected / exposed
    2 / 59 (3.39%)
    3 / 57 (5.26%)
         occurrences all number
    3
    8
    Hyponatraemia
         subjects affected / exposed
    3 / 59 (5.08%)
    1 / 57 (1.75%)
         occurrences all number
    4
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    13 May 2016
    The1st amendment aimed to clarify the assessments to be made during the study, the dose reductions, to add an additional blood tube for a total volume of 20 mL and to modify the patient information letter following the review of the patient committee of the Ligue contre le Cancer.
    29 Aug 2018
    The 3rd amendment aimed to Add an interim analysis Make various corrections to the protocol and synopsis Declare the new version of the afatinib Smpc. This modification did not have an impact on patient safety but have an impact on the expected or unexpected nature of serious adverse events. To modify the patient information consent letter following the update of the afatinib Smpc and in order to bring it into compliance with the European Data Protection Regulation. Translated with www.DeepL.com/Translator (free version)

    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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