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    Clinical Trial Results:
    A Phase 3 Multicenter Open-label Study of Brigatinib (AP26113) versus Crizotinib in Participants with ALK-positive Advanced Lung Cancer

    Summary
    EudraCT number
    2015-003447-19
    Trial protocol
    GB   AT   DE   NL   FI   SE   NO   DK   ES   CZ   PT   FR   IT  
    Global end of trial date
    29 Jan 2021

    Results information
    Results version number
    v1(current)
    This version publication date
    12 Aug 2021
    First version publication date
    12 Aug 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    AP26113-13-301
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02737501
    WHO universal trial number (UTN)
    U1111-1210-4363
    Sponsors
    Sponsor organisation name
    ARIAD Pharmaceuticals
    Sponsor organisation address
    40 Lansdowne Street, Cambridge, MA, United States, 02139
    Public contact
    Study Director, Takeda, +1 877-825-3327, TrialDisclosures@takeda.com
    Scientific contact
    Study Director, Takeda, +1 877-825-3327, TrialDisclosures@takeda.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
    29 Jan 2021
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    29 Jan 2021
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of this trial is to compare the efficacy of brigatinib to that of crizotinib in anaplastic lymphoma kinase (ALK) plus locally advanced or metastatic non–small-cell lung cancer (NSCLC) participants naive to ALK inhibitors, as evidenced by PFS.
    Protection of trial subjects
    All study participants were required to read and sign an Informed Consent Form.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    26 May 2016
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 7
    Country: Number of subjects enrolled
    Hong Kong: 16
    Country: Number of subjects enrolled
    Singapore: 6
    Country: Number of subjects enrolled
    Korea, Republic of: 57
    Country: Number of subjects enrolled
    Taiwan: 21
    Country: Number of subjects enrolled
    Austria: 9
    Country: Number of subjects enrolled
    Denmark: 3
    Country: Number of subjects enrolled
    France: 11
    Country: Number of subjects enrolled
    Germany: 17
    Country: Number of subjects enrolled
    Italy: 38
    Country: Number of subjects enrolled
    Luxembourg: 1
    Country: Number of subjects enrolled
    Netherlands: 11
    Country: Number of subjects enrolled
    Norway: 2
    Country: Number of subjects enrolled
    Spain: 31
    Country: Number of subjects enrolled
    Sweden: 1
    Country: Number of subjects enrolled
    Switzerland: 1
    Country: Number of subjects enrolled
    United Kingdom: 18
    Country: Number of subjects enrolled
    Canada: 2
    Country: Number of subjects enrolled
    United States: 23
    Worldwide total number of subjects
    275
    EEA total number of subjects
    124
    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)
    188
    From 65 to 84 years
    84
    85 years and over
    3

    Subject disposition

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    Recruitment
    Recruitment details
    Participants took part in the study at 92 investigative sites in Australia, Hong Kong, Singapore, South Korea, Taiwan, Austria, Denmark, France, Germany, Italy, Luxembourg, Netherlands, Norway, Spain, Sweden, Switzerland, United Kingdom, Canada, and the United States of America from 26 May 2016 to 29 January 2021.

    Pre-assignment
    Screening details
    ALK+NSCLC participants who had not received ALK-targeted tyrosine kinase inhibitor(TKI)enrolled(1:1ratio) to receive brigatinib 90mg for 7 days followed by180mg or crizotinib250mg.Crizotinib arm participants with progressive disease(PD) or received radiotherapy to brain(Randomized Phase) were crossed over to brigatinib90mg/180mg(Crossover Phase).

    Period 1
    Period 1 title
    Randomized Phase
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Randomized Phase: Brigatinib 90 mg QD/180 QD
    Arm description
    Brigatinib 90 mg, tablets, orally, once daily (QD) for first 7 days followed by 180 mg, orally, QD, in each 28-day cycle until disease progression (PD), intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 34.86 months).
    Arm type
    Experimental

    Investigational medicinal product name
    Brigatinib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Brigatinib tablets

    Arm title
    Randomized Phase: Crizotinib 250 mg BID
    Arm description
    Crizotinib 250 mg, tablets, twice daily (BID) in each 28-day cycle until disease progression, intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 9.26 months).
    Arm type
    Active comparator

    Investigational medicinal product name
    Crizotinib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Crizotinib tablets

    Number of subjects in period 1
    Randomized Phase: Brigatinib 90 mg QD/180 QD Randomized Phase: Crizotinib 250 mg BID
    Started
    137
    138
    Safety Analysis Set
    136
    137
    Completed
    20
    84
    Not completed
    117
    54
         Consent withdrawn by subject
    16
    6
         Never Treated
    1
    1
         Site Terminated by Sponsor
    58
    16
         Died
    41
    29
         Lost to follow-up
    -
    1
         Reason not Specified
    1
    1
    Period 2
    Period 2 title
    Crossover Phase
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Crossover Phase: Brigatinib 90 mg QD/180 mg QD
    Arm description
    Participants who experienced PD as assessed by the blinded Independent Review Committee (BIRC) or received radiotherapy to the brain while on ‘Crizotinib 250 mg BID’ therapy in Randomized Phase were crossed over. Following 10-day washout period, crossover participants received brigatinib 90 mg, tablets, orally, QD for first 7 days followed by 180 mg, tablets, orally, QD in each 28-day cycle up to end of the study (The median duration of exposure was 17.25 months).
    Arm type
    Experimental

    Investigational medicinal product name
    Brigatinib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Brigatinib tablets

    Number of subjects in period 2 [1]
    Crossover Phase: Brigatinib 90 mg QD/180 mg QD
    Started
    65
    Completed
    10
    Not completed
    55
         Withdrew Consent
    9
         Physician decision
    1
         Site Terminated by Sponsor
    23
         Died
    22
    Notes
    [1] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: Participants from crizotinib arm who experienced progressive disease (PD) or received radiotherapy to the brain in Randomized Phase crossed over to brigatinib in the Crossover Phase.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Randomized Phase: Brigatinib 90 mg QD/180 QD
    Reporting group description
    Brigatinib 90 mg, tablets, orally, once daily (QD) for first 7 days followed by 180 mg, orally, QD, in each 28-day cycle until disease progression (PD), intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 34.86 months).

    Reporting group title
    Randomized Phase: Crizotinib 250 mg BID
    Reporting group description
    Crizotinib 250 mg, tablets, twice daily (BID) in each 28-day cycle until disease progression, intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 9.26 months).

    Reporting group values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Randomized Phase: Crizotinib 250 mg BID Total
    Number of subjects
    137 138 275
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    93 95 188
        From 65-84 years
    42 42 84
        85 years and over
    2 1 3
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    57.9 ± 13.46 58.6 ± 11.42 -
    Sex: Female, Male
    Units: participants
        Female
    69 81 150
        Male
    68 57 125
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0 0
        Asian
    59 49 108
        Native Hawaiian or Other Pacific Islander
    0 0 0
        Black or African American
    0 2 2
        White
    76 86 162
        More than one race
    0 0 0
        Unknown or Not Reported
    2 1 3
    Race/Ethnicity, Customized
    Units: Subjects
        Hispanic, Latino or Spanish
    6 10 16
        Not Hispanic, Latino or Spanish
    131 128 259
    Region of Enrollment
    Units: Subjects
        Australia
    2 5 7
        Hong Kong
    10 6 16
        Singapore
    5 1 6
        Korea, Republic Of
    29 28 57
        Taiwan, Province Of China
    12 9 21
        Austria
    5 4 9
        Denmark
    2 1 3
        France
    7 4 11
        Germany
    6 11 17
        Italy
    19 19 38
        Luxembourg
    1 0 1
        Netherlands
    5 6 11
        Norway
    0 2 2
        Spain
    14 17 31
        Sweden
    0 1 1
        Switzerland
    0 1 1
        United Kingdom
    10 8 18
        Canada
    0 2 2
        United States
    10 13 23
    Global Health Status/Quality of Life (QoL)
    HRQoL:perceived quality of participant’s life, includes self-reported multidimensional measures of physical, mental health.EORTC-QLQ-C30 contains 30 items across 5 functional scales(physical,role,cognitive,emotional,social),9 symptom scales(fatigue,nausea and vomiting,pain,dyspnea,sleep disturbance,appetite loss,constipation,diarrhea,financial difficulties),a global health status/QOL scale on 4 response levels(not at all,a little,quite a bit,very much),with 2 questions relying on a 7-point numeric rating scale.Raw scores converted into overall score of 0-100,lower scores indicate better QOL.
    Units: score on a scale
        arithmetic mean (full range (min-max))
    -
    Subject analysis sets

    Subject analysis set title
    Randomized Phase: Brigatinib 90 mg QD/180 QD
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    Brigatinib 90 mg, tablets, orally, QD for first 7 days followed by 180 mg, orally, QD, in each 28-day cycle until PD, intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 34.86 months). Intent-to-treat (ITT) Population included all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to the assigned dose. Number analyzed is number of participants with data available for global health status/QoL at Baseline.

    Subject analysis set title
    Randomized Phase: Crizotinib 250 mg BID
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    Crizotinib 250 mg, tablets, BID in each 28-day cycle until disease progression, intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 9.26 months). Intent-to-treat (ITT) Population included all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to the assigned dose. Number analyzed is number of participants with data available for global health status/QoL at Baseline.

    Subject analysis sets values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Randomized Phase: Crizotinib 250 mg BID
    Number of subjects
    131
    131
    Age categorical
    Units: Subjects
        In utero
        Preterm newborn infants (gestational age < 37 wks)
        Newborns (0-27 days)
        Infants and toddlers (28 days-23 months)
        Children (2-11 years)
        Adolescents (12-17 years)
        Adults (18-64 years)
        From 65-84 years
        85 years and over
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    ±
    ±
    Sex: Female, Male
    Units: participants
        Female
        Male
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
        Asian
        Native Hawaiian or Other Pacific Islander
        Black or African American
        White
        More than one race
        Unknown or Not Reported
    Race/Ethnicity, Customized
    Units: Subjects
        Hispanic, Latino or Spanish
        Not Hispanic, Latino or Spanish
    Region of Enrollment
    Units: Subjects
        Australia
        Hong Kong
        Singapore
        Korea, Republic Of
        Taiwan, Province Of China
        Austria
        Denmark
        France
        Germany
        Italy
        Luxembourg
        Netherlands
        Norway
        Spain
        Sweden
        Switzerland
        United Kingdom
        Canada
        United States
    Global Health Status/Quality of Life (QoL)
    HRQoL:perceived quality of participant’s life, includes self-reported multidimensional measures of physical, mental health.EORTC-QLQ-C30 contains 30 items across 5 functional scales(physical,role,cognitive,emotional,social),9 symptom scales(fatigue,nausea and vomiting,pain,dyspnea,sleep disturbance,appetite loss,constipation,diarrhea,financial difficulties),a global health status/QOL scale on 4 response levels(not at all,a little,quite a bit,very much),with 2 questions relying on a 7-point numeric rating scale.Raw scores converted into overall score of 0-100,lower scores indicate better QOL.
    Units: score on a scale
        arithmetic mean (full range (min-max))
    60.432 (0.00 to 100.00)
    59.160 (0.00 to 100.00)

    End points

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    End points reporting groups
    Reporting group title
    Randomized Phase: Brigatinib 90 mg QD/180 QD
    Reporting group description
    Brigatinib 90 mg, tablets, orally, once daily (QD) for first 7 days followed by 180 mg, orally, QD, in each 28-day cycle until disease progression (PD), intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 34.86 months).

    Reporting group title
    Randomized Phase: Crizotinib 250 mg BID
    Reporting group description
    Crizotinib 250 mg, tablets, twice daily (BID) in each 28-day cycle until disease progression, intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 9.26 months).
    Reporting group title
    Crossover Phase: Brigatinib 90 mg QD/180 mg QD
    Reporting group description
    Participants who experienced PD as assessed by the blinded Independent Review Committee (BIRC) or received radiotherapy to the brain while on ‘Crizotinib 250 mg BID’ therapy in Randomized Phase were crossed over. Following 10-day washout period, crossover participants received brigatinib 90 mg, tablets, orally, QD for first 7 days followed by 180 mg, tablets, orally, QD in each 28-day cycle up to end of the study (The median duration of exposure was 17.25 months).

    Subject analysis set title
    Randomized Phase: Brigatinib 90 mg QD/180 QD
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    Brigatinib 90 mg, tablets, orally, QD for first 7 days followed by 180 mg, orally, QD, in each 28-day cycle until PD, intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 34.86 months). Intent-to-treat (ITT) Population included all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to the assigned dose. Number analyzed is number of participants with data available for global health status/QoL at Baseline.

    Subject analysis set title
    Randomized Phase: Crizotinib 250 mg BID
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    Crizotinib 250 mg, tablets, BID in each 28-day cycle until disease progression, intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 9.26 months). Intent-to-treat (ITT) Population included all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to the assigned dose. Number analyzed is number of participants with data available for global health status/QoL at Baseline.

    Primary: Progression-free Survival (PFS)

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    End point title
    Progression-free Survival (PFS)
    End point description
    PFS as assessed by Blinded Independent Review Committee (BIRC), per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, was defined as the time interval from the date of randomization until the date of the PFS event. The data was censored for participants without a PFS event. ITT Population included all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to the assigned dose.
    End point type
    Primary
    End point timeframe
    Up to end of study (Up to 56 months)
    End point values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Crossover Phase: Brigatinib 90 mg QD/180 mg QD Randomized Phase: Crizotinib 250 mg BID
    Number of subjects analysed
    137
    65
    138
    Units: months
        median (confidence interval 95%)
    24.016 (18.46 to 43.20)
    16.821 (10.12 to 23.85)
    11.072 (9.13 to 13.01)
    Statistical analysis title
    Statistical Analysis for PFS
    Comparison groups
    Randomized Phase: Brigatinib 90 mg QD/180 QD v Randomized Phase: Crizotinib 250 mg BID
    Number of subjects included in analysis
    275
    Analysis specification
    Pre-specified
    Analysis type
    superiority [1]
    P-value
    < 0.0001 [2]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.481
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.35
         upper limit
    0.66
    Notes
    [1] - The hazard ratio was obtained using a Cox proportional hazards model with randomization stratification factors (current) as covariates.
    [2] - P-values are from a log-rank test stratified by randomization stratification factors (current; presence of intracranial central nervous system (iCNS) metastases at baseline and prior chemotherapy for locally advanced or metastatic disease).

    Secondary: Confirmed Objective Response Rate (ORR)

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    End point title
    Confirmed Objective Response Rate (ORR)
    End point description
    ORR was defined as percentage of participants who achieved Complete response (CR) or Partial responses (PR) using Response Evaluation Criteria in Solid Tumors (RECIST) version (v). 1.1 criteria. CR is defined as disappearance of all extranodal target and non-target lesions. All pathological lymph nodes must have decreased to less than (<) 10 mm in short axis for target lesions and all lymph nodes must be non-pathological in size (<10 mm short axis), normalization of tumor marker level for non-target lesions. PR is at least a 30% decrease in SLD of target lesions, taking as reference baseline sum diameters. ITT Population included all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to the assigned dose.
    End point type
    Secondary
    End point timeframe
    Baseline up to end of treatment (Up to 36 months)
    End point values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Crossover Phase: Brigatinib 90 mg QD/180 mg QD Randomized Phase: Crizotinib 250 mg BID
    Number of subjects analysed
    137
    65
    138
    Units: percentage of participants
        number (confidence interval 95%)
    74.5 (66.30 to 81.52)
    56.9 (44.04 to 69.15)
    62.3 (53.68 to 70.42)
    Statistical analysis title
    Statistical Analysis for ORR
    Comparison groups
    Randomized Phase: Brigatinib 90 mg QD/180 QD v Randomized Phase: Crizotinib 250 mg BID
    Number of subjects included in analysis
    275
    Analysis specification
    Pre-specified
    Analysis type
    superiority [3]
    P-value
    = 0.033
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Odds ratio (OR)
    Point estimate
    1.74
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.04
         upper limit
    2.91
    Notes
    [3] - Odds ratios and p-values were from a Cochran-Mantel-Haenszel test stratified by presence of intracranial central nervous system (iCNS) metastases at Baseline, and prior chemotherapy for locally advanced or metastatic disease (current strata).

    Secondary: Confirmed Intracranial ORR (iORR)

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    End point title
    Confirmed Intracranial ORR (iORR)
    End point description
    ORR was defined as percentage of participants who achieved CR or PR in the central nervous system (CNS) in randomized participants with intracranial CNS metastasis at baseline. CR is defined as disappearance of all extranodal target and non-target lesions. All pathological lymph nodes must have decreased to <10 mm in short axis for target lesions and all lymph nodes must be non-pathological in size (<10 mm short axis), normalization of tumor marker level for non-target lesions. PR is at least a 30% decrease in the SLD of target lesions, taking as reference the baseline sum diameters. ITT Population included all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to the assigned dose. Overall number of participants analyzed are the participants with data available for analyses.
    End point type
    Secondary
    End point timeframe
    Baseline up to end of treatment (Up to 36 months)
    End point values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Crossover Phase: Brigatinib 90 mg QD/180 mg QD Randomized Phase: Crizotinib 250 mg BID
    Number of subjects analysed
    47
    42
    49
    Units: percentage of participants
        number (confidence interval 95%)
    66.0 (50.69 to 79.14)
    35.7 (21.55 to 51.97)
    14.3 (5.94 to 27.24)
    Statistical analysis title
    Statistical Analysis for iORR
    Comparison groups
    Randomized Phase: Brigatinib 90 mg QD/180 QD v Randomized Phase: Crizotinib 250 mg BID
    Number of subjects included in analysis
    96
    Analysis specification
    Pre-specified
    Analysis type
    superiority [4]
    P-value
    < 0.0001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Odds ratio (OR)
    Point estimate
    13.56
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    4.7
         upper limit
    39.11
    Notes
    [4] - Odds ratios and p-values were from a Cochran-Mantel-Haenszel test stratified by presence of prior chemotherapy for Locally advanced or metastatic disease at study entry (current strata).

    Secondary: Intracranial Progression Free Survival

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    End point title
    Intracranial Progression Free Survival
    End point description
    Intracranial PFS as assessed by BIRC, is defined as the time from randomization until first CNS PD is documented, or death due to any cause. PD is SLD increased by at least 20% from the smallest value on study (including baseline, if that is the smallest), the SLD must also demonstrate an absolute increase of at least 5 mm, and unequivocal progression of existing non-target lesions. ITT Population included all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to the assigned dose. Overall number of participants analyzed are the participants with data available for analyses. 99999 indicates upper limit of 95% confidence interval (CI) was not estimable due to low number of participants with events.
    End point type
    Secondary
    End point timeframe
    Baseline up to end of study (Up to 56 months)
    End point values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Crossover Phase: Brigatinib 90 mg QD/180 mg QD Randomized Phase: Crizotinib 250 mg BID
    Number of subjects analysed
    47
    42
    49
    Units: months
        median (confidence interval 95%)
    23.951 (12.91 to 30.78)
    24.542 (12.58 to 99999)
    5.520 (3.71 to 7.52)
    Statistical analysis title
    Statistical Analysis for Intracranial PFS
    Comparison groups
    Randomized Phase: Brigatinib 90 mg QD/180 QD v Randomized Phase: Crizotinib 250 mg BID
    Number of subjects included in analysis
    96
    Analysis specification
    Pre-specified
    Analysis type
    superiority [5]
    P-value
    < 0.0001 [6]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.293
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.17
         upper limit
    0.51
    Notes
    [5] - The hazard ratio was obtained using a Cox proportional hazards model with prior chemotherapy for locally advanced or metastatic disease (current strata) as covariate.
    [6] - P-values are from a log-rank test stratified by randomization stratification factors (current; presence of iCNS metastases at baseline and prior chemotherapy for locally advanced or metastatic disease).

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    Overall survival is defined as the time from randomization until death due to any cause.ITT Population included all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to the assigned dose. 99999 indicates that median and 95% CI was not estimable due to fewer number of participants with events. 999999 indicates upper limit of 95% CI was not estimable due to fewer number of participants with events.
    End point type
    Secondary
    End point timeframe
    Baseline up to end of study (Up to 56 months)
    End point values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Crossover Phase: Brigatinib 90 mg QD/180 mg QD Randomized Phase: Crizotinib 250 mg BID
    Number of subjects analysed
    137
    65
    138
    Units: months
        median (confidence interval 95%)
    99999 (99999 to 99999)
    35.023 (30.42 to 999999)
    99999 (99999 to 99999)
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR)

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    End point title
    Duration of Response (DOR)
    End point description
    DOR as assessed by BIRC:time interval from date that criteria are first met for CR/PR(whichever is first recorded)until first date that progressive disease(PD)is objectively documented.CR:disappearance of all extranodal target and non-target lesions.All pathological lymph nodes must have decreased to<10mm in short axis for target lesions,all lymph nodes must be non-pathological in size(<10mm short axis),normalization of tumor marker level for non-target lesions.PR:>=30%decrease in SLD of target lesions,taking as reference baseline sum diameters.PD:SLD increased by>=20%from smallest value on study(including baseline,if that is smallest),SLD must also demonstrate absolute increase of>=5mm,for non-target lesions,unequivocal progression of existing non-target lesions.ITT Population:all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to assigned dose.Only responders were reported for this outcome measure.
    End point type
    Secondary
    End point timeframe
    Baseline up to end of study (Up to 56 months)
    End point values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Crossover Phase: Brigatinib 90 mg QD/180 mg QD Randomized Phase: Crizotinib 250 mg BID
    Number of subjects analysed
    102
    37
    86
    Units: months
        median (full range (min-max))
    33.150 (1.84 to 50.60)
    19.154 (1.97 to 33.15)
    13.832 (1.45 to 49.81)
    No statistical analyses for this end point

    Secondary: Time to Response (TTR)

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    End point title
    Time to Response (TTR)
    End point description
    Time to response as assessed by BIRC, assessment and is defined as the time interval from the date of randomization until the initial observation of CR or PR. CR is defined as disappearance of all extranodal target and non-target lesions. All pathological lymph nodes must have decreased to <10 mm in short axis for target lesions and all lymph nodes must be non-pathological in size (<10 mm short axis), normalization of tumor marker level for non-target lesions. PR is at least a 30% decrease in the SLD of target lesions, taking as reference the baseline sum diameters. ITT Population included all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to the assigned dose. Only responders were reported for this outcome measure.
    End point type
    Secondary
    End point timeframe
    Baseline up to end of treatment (Up to 36 months)
    End point values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Crossover Phase: Brigatinib 90 mg QD/180 mg QD Randomized Phase: Crizotinib 250 mg BID
    Number of subjects analysed
    137
    65
    138
    Units: months
        median (full range (min-max))
    1.840 (1.02 to 29.47)
    1.873 (0.20 to 18.33)
    1.873 (0.79 to 7.43)
    No statistical analyses for this end point

    Secondary: Disease Control Rate (DCR)

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    End point title
    Disease Control Rate (DCR)
    End point description
    Disease control as assessed by BIRC:percentage of randomized participants who have achieved CR,PR,or stable disease(SD)after randomization.CR:disappearance of all extranodal target and non-target lesions. All pathological lymph nodes must have decreased to <10 mm in short axis for target lesions and all lymph nodes must be non-pathological in size (<10 mm short axis), normalization of tumor marker level for non-target lesions. PR: >=30% decrease in SLD of target lesions, taking as reference baseline sum diameters. SD: neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD. PD:SLD increased by >=20% from the smallest value on study, SLD must also demonstrate an absolute increase of >=5 mm, and unequivocal progression of existing non-target lesions. ITT Population:all participants randomized to each regimen regardless of whether they tested ALK+, or whether they received study drug or adhered to assigned dose.
    End point type
    Secondary
    End point timeframe
    Baseline up to end of treatment (Up to 36 months)
    End point values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Crossover Phase: Brigatinib 90 mg QD/180 mg QD Randomized Phase: Crizotinib 250 mg BID
    Number of subjects analysed
    137
    65
    138
    Units: percentage of participants
        number (confidence interval 95%)
    85.4 (78.36 to 90.85)
    73.8 (61.46 to 83.97)
    86.2 (79.34 to 91.50)
    Statistical analysis title
    Statistical Analysis for DCR
    Comparison groups
    Randomized Phase: Brigatinib 90 mg QD/180 QD v Randomized Phase: Crizotinib 250 mg BID
    Number of subjects included in analysis
    275
    Analysis specification
    Pre-specified
    Analysis type
    superiority [7]
    P-value
    = 0.822
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Odds ratio (OR)
    Point estimate
    0.93
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.47
         upper limit
    1.82
    Notes
    [7] - Odds ratios and p-values were from a Cochran-Mantel-Haenszel test stratified by presence of iCNS metastases at Baseline, and prior chemotherapy for locally advanced or metastatic disease (current strata).

    Secondary: Percentage of Participants with Treatment-emergent Adverse Events (TEAEs)

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    End point title
    Percentage of Participants with Treatment-emergent Adverse Events (TEAEs)
    End point description
    An AE is any untoward medical occurrence in a participant. An AE can be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product whether or not considered related to the medicinal product. Any worsening of a preexisting condition which is temporally associated with the use of the study drug (i.e., occurs after the first dose of study drug) is also an AE. TEAEs are defined as AEs starting/worsening on or after the first dose of study treatment and no later than the earliest of 30 days after the last dose of the treatment to which the participant was assigned, or the day before start of brigatinib therapy in crossover participant. Treated Population included all participant who received ≥at least 1 dose of study drug and served as basis of safety analysis.
    End point type
    Secondary
    End point timeframe
    From first dose up to 30 days after last dose of study drug (Up to approximately 37 months)
    End point values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Crossover Phase: Brigatinib 90 mg QD/180 mg QD Randomized Phase: Crizotinib 250 mg BID
    Number of subjects analysed
    136
    65
    137
    Units: percentage of participants
        number (not applicable)
    100
    98.5
    100
    No statistical analyses for this end point

    Secondary: Change from Baseline in Global Health Status/Quality of Life as Assessed by EORTC QLQ-C30 (Version 3.0)

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    End point title
    Change from Baseline in Global Health Status/Quality of Life as Assessed by EORTC QLQ-C30 (Version 3.0)
    End point description
    HRQoL:perceived quality of participant’s life,includes self-reported multidimensional measures of physical,mental health.Patient-reported symptoms(PROs)and HRQoL-collected by administering european organisation for research and treatment of cancer(EORTC)quality of life(QLQ)-C30questionnaire,which contains 30 items across 5 functional scales(physical,role,cognitive,emotional,social),9 symptom scales(fatigue,nausea and vomiting,pain,dyspnea,sleep disturbance,appetite loss,constipation,diarrhea,financial difficulties),global health status/QOL scale.30 items have 4 response levels(not at all,a little,quite a bit,very much),2 questions rely on7-point numeric rating scale.Raw scores converted into overall score of 0-100,where lower scores=better QOL.A negative change from Baseline=improvement.ITT Population:all participants randomized regardless of ALK+ status/received study drug/adhered to assigned dose.Overall number of participants analyzed:participants with data available for analyses.
    End point type
    Secondary
    End point timeframe
    Baseline and Month 36
    End point values
    Randomized Phase: Brigatinib 90 mg QD/180 QD Randomized Phase: Crizotinib 250 mg BID
    Number of subjects analysed
    104
    53
    Units: score on a scale
        arithmetic mean (standard deviation)
    4.007 ± 25.7563
    -4.088 ± 27.4748
    Statistical analysis title
    Statistical Analysis for HRQoL
    Comparison groups
    Randomized Phase: Brigatinib 90 mg QD/180 QD v Randomized Phase: Crizotinib 250 mg BID
    Number of subjects included in analysis
    157
    Analysis specification
    Pre-specified
    Analysis type
    superiority [8]
    P-value
    = 0.0295 [9]
    Method
    Mixed models analysis
    Parameter type
    Least Square Mean Difference
    Point estimate
    5.79
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.58
         upper limit
    11
    Notes
    [8] - A mixed effect model is used with an unstructured covariance matrix.
    [9] - p-values were obtained using mixed effects models stratified by presence of iCNS metastases at study entry, prior chemotherapy at Baseline.

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All-Cause Mortality - Up to 56 months; Serious and other adverse events - From first dose up to 30 days after last dose of study drug (Up to approximately 37 months)
    Adverse event reporting additional description
    All Cause-mortality:ITT Population[participants randomized regardless of-ALK+status/received study drug/took assigned dose:N=137,138,65].Serious+other(Nonserious):Treated Population(participants who had≥1dose,included in safety analysis).Crossover Population:‘Crizotinib 250mgBID’participants who crossed over to brigatinib after BIRC-assessed PD.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    23.0
    Reporting groups
    Reporting group title
    Randomized Phase: Brigatinib 90 mg QD/180 QD
    Reporting group description
    Brigatinib 90 mg, tablets, orally, QD for first 7 days followed by 180 mg, orally, QD, in each 28-day cycle until PD, intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 34.86 months).

    Reporting group title
    Crossover Phase: Brigatinib 90 mg QD/180 mg QD
    Reporting group description
    Participants who experienced PD as assessed by the BIRC or received radiotherapy to the brain while on ‘Crizotinib 250 mg BID’ therapy in Randomized Phase were crossed over. Following 10-day washout period, crossover participants received brigatinib 90 mg, tablets, orally, QD for first 7 days followed by 180 mg, tablets, orally, QD in each 28-day cycle up to end of the study (The median duration of exposure was 17.25 months).

    Reporting group title
    Randomized Phase: Crizotinib 250 mg BID
    Reporting group description
    Crizotinib 250 mg, tablets, BID in each 28-day cycle until disease progression, intolerable toxicity, consent withdrawal, or death (The median duration of exposure was 9.26 months).

    Serious adverse events
    Randomized Phase: Brigatinib 90 mg QD/180 QD Crossover Phase: Brigatinib 90 mg QD/180 mg QD Randomized Phase: Crizotinib 250 mg BID
    Total subjects affected by serious adverse events
         subjects affected / exposed
    56 / 136 (41.18%)
    24 / 65 (36.92%)
    53 / 137 (38.69%)
         number of deaths (all causes)
    41
    22
    29
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasm Progression
         subjects affected / exposed
    5 / 136 (3.68%)
    3 / 65 (4.62%)
    4 / 137 (2.92%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 3
    0 / 4
         deaths causally related to treatment / all
    0 / 2
    0 / 2
    0 / 2
    Metastases To Meninges
         subjects affected / exposed
    2 / 136 (1.47%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Malignant Pleural Effusion
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Metastases To Central Nervous System
         subjects affected / exposed
    1 / 136 (0.74%)
    1 / 65 (1.54%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cancer Pain
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diffuse Large B-Cell Lymphoma
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Invasive Breast Carcinoma
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lung Adenocarcinoma
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Lung Neoplasm Malignant
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Ovarian Cancer Stage I
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Squamous Cell Carcinoma Of Skin
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hodgkins Disease
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Tumour Haemorrhage
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Intracranial Tumour Haemorrhage
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Prostate Cancer
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    4 / 136 (2.94%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    1 / 7
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Asthenia
         subjects affected / exposed
    2 / 136 (1.47%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fatigue
         subjects affected / exposed
    1 / 136 (0.74%)
    1 / 65 (1.54%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Mucosal Inflammation
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Multiple Organ Dysfunction Syndrome
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Sudden Death
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Non-Cardiac Chest Pain
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    3 / 137 (2.19%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General Physical Health Deterioration
         subjects affected / exposed
    0 / 136 (0.00%)
    2 / 65 (3.08%)
    2 / 137 (1.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    Performance Status Decreased
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Menorrhagia
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    3 / 136 (2.21%)
    1 / 65 (1.54%)
    6 / 137 (4.38%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 1
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Pulmonary Embolism
         subjects affected / exposed
    3 / 136 (2.21%)
    0 / 65 (0.00%)
    5 / 137 (3.65%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Pleural Effusion
         subjects affected / exposed
    3 / 136 (2.21%)
    1 / 65 (1.54%)
    3 / 137 (2.19%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 3
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Interstitial Lung Disease
         subjects affected / exposed
    3 / 136 (2.21%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    2 / 136 (1.47%)
    2 / 65 (3.08%)
    2 / 137 (1.46%)
         occurrences causally related to treatment / all
    3 / 3
    2 / 2
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonia Aspiration
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    1 / 136 (0.74%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary Oedema
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory Distress
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Acute Respiratory Failure
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory Failure
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Respiratory Arrest
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusional State
         subjects affected / exposed
    2 / 136 (1.47%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    1 / 5
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Delirium
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Disorientation
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Alanine Aminotransferase Increased
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Aspartate Aminotransferase Increased
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    C-Reactive Protein Increased
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lipase Increased
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Transaminases Abnormal
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Neutrophil Count Decreased
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Platelet Count Decreased
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Femoral Neck Fracture
         subjects affected / exposed
    2 / 136 (1.47%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    1 / 136 (0.74%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ligament Rupture
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Brain Herniation
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal Fracture
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Tibia Fracture
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Toxicity To Various Agents
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Atrial Fibrillation
         subjects affected / exposed
    2 / 136 (1.47%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pericardial Effusion
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    2 / 137 (1.46%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac Tamponade
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Acute Myocardial Infarction
         subjects affected / exposed
    1 / 136 (0.74%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Angina Pectoris
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arrhythmia
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bradycardia
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myocardial Infarction
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Palpitations
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac Failure
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Headache
         subjects affected / exposed
    2 / 136 (1.47%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    2 / 136 (1.47%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dizziness
         subjects affected / exposed
    1 / 136 (0.74%)
    1 / 65 (1.54%)
    2 / 137 (1.46%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    1 / 136 (0.74%)
    2 / 65 (3.08%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Balance Disorder
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cerebrovascular Accident
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Cognitive Disorder
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dysarthria
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Encephalopathy
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Memory Impairment
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Paraesthesia
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Partial Seizures
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral Sensory Neuropathy
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vocal Cord Paralysis
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ischaemic Stroke
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    2 / 137 (1.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Central Nervous System Lesion
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Aphasia
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Depressed Level Of Consciousness
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Generalised Tonic-Clonic Seizure
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hemiparesis
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intraventricular Haemorrhage
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Disseminated Intravascular Coagulation
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Anaemia Macrocytic
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Vertigo Positional
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    2 / 136 (1.47%)
    0 / 65 (0.00%)
    2 / 137 (1.46%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    2 / 136 (1.47%)
    2 / 65 (3.08%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    1 / 2
    6 / 9
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    2 / 136 (1.47%)
    1 / 65 (1.54%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    1 / 2
    2 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 136 (0.74%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dysphagia
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastric Haemorrhage
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Inguinal Hernia
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Neutropenic Colitis
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Oesophageal Obstruction
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal Pain Lower
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal Pain Upper
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ascites
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Large Intestine Perforation
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Oesophagitis Ulcerative
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intestinal Obstruction
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal Pain
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis
         subjects affected / exposed
    2 / 136 (1.47%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bile Duct Stone
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholestasis
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatocellular Injury
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Drug-Induced Liver Injury
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute Kidney Injury
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary Retention
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haematuria
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back Pain
         subjects affected / exposed
    1 / 136 (0.74%)
    1 / 65 (1.54%)
    2 / 137 (1.46%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 6
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Muscular Weakness
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arthritis
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bone Pain
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rotator Cuff Syndrome
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    6 / 136 (4.41%)
    4 / 65 (6.15%)
    5 / 137 (3.65%)
         occurrences causally related to treatment / all
    1 / 8
    0 / 4
    0 / 5
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    0 / 2
    Urinary Tract Infection
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    3 / 137 (2.19%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lower Respiratory Tract Infection
         subjects affected / exposed
    2 / 136 (1.47%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Appendicitis
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Upper Respiratory Tract Infection
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 136 (0.74%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Viral Infection
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory Tract Infection
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    3 / 137 (2.19%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    2 / 137 (1.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cytomegalovirus Oesophagitis
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Herpes Zoster
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Listeriosis
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pleural Infection
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Septic Shock
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sinusitis Fungal
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atypical Pneumonia
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis Viral
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyelonephritis Acute
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Covid-19
         subjects affected / exposed
    0 / 136 (0.00%)
    2 / 65 (3.08%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Salmonella Sepsis
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hyperkalaemia
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gout
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    0 / 136 (0.00%)
    1 / 65 (1.54%)
    0 / 137 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Randomized Phase: Brigatinib 90 mg QD/180 QD Crossover Phase: Brigatinib 90 mg QD/180 mg QD Randomized Phase: Crizotinib 250 mg BID
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    132 / 136 (97.06%)
    63 / 65 (96.92%)
    135 / 137 (98.54%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    44 / 136 (32.35%)
    15 / 65 (23.08%)
    12 / 137 (8.76%)
         occurrences all number
    61
    17
    13
    Hypotension
         subjects affected / exposed
    3 / 136 (2.21%)
    0 / 65 (0.00%)
    10 / 137 (7.30%)
         occurrences all number
    3
    0
    10
    Deep Vein Thrombosis
         subjects affected / exposed
    0 / 136 (0.00%)
    0 / 65 (0.00%)
    9 / 137 (6.57%)
         occurrences all number
    0
    0
    9
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    28 / 136 (20.59%)
    9 / 65 (13.85%)
    31 / 137 (22.63%)
         occurrences all number
    37
    9
    43
    Pyrexia
         subjects affected / exposed
    20 / 136 (14.71%)
    9 / 65 (13.85%)
    22 / 137 (16.06%)
         occurrences all number
    27
    11
    29
    Asthenia
         subjects affected / exposed
    18 / 136 (13.24%)
    8 / 65 (12.31%)
    26 / 137 (18.98%)
         occurrences all number
    24
    15
    30
    Oedema Peripheral
         subjects affected / exposed
    13 / 136 (9.56%)
    6 / 65 (9.23%)
    63 / 137 (45.99%)
         occurrences all number
    15
    6
    76
    Non-Cardiac Chest Pain
         subjects affected / exposed
    11 / 136 (8.09%)
    0 / 65 (0.00%)
    10 / 137 (7.30%)
         occurrences all number
    11
    0
    10
    Malaise
         subjects affected / exposed
    7 / 136 (5.15%)
    0 / 65 (0.00%)
    3 / 137 (2.19%)
         occurrences all number
    7
    0
    3
    Influenza Like Illness
         subjects affected / exposed
    6 / 136 (4.41%)
    10 / 65 (15.38%)
    11 / 137 (8.03%)
         occurrences all number
    7
    10
    11
    Peripheral Swelling
         subjects affected / exposed
    5 / 136 (3.68%)
    0 / 65 (0.00%)
    8 / 137 (5.84%)
         occurrences all number
    6
    0
    9
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    49 / 136 (36.03%)
    16 / 65 (24.62%)
    29 / 137 (21.17%)
         occurrences all number
    78
    19
    37
    Dyspnoea
         subjects affected / exposed
    31 / 136 (22.79%)
    8 / 65 (12.31%)
    26 / 137 (18.98%)
         occurrences all number
    36
    10
    33
    Oropharyngeal Pain
         subjects affected / exposed
    13 / 136 (9.56%)
    8 / 65 (12.31%)
    7 / 137 (5.11%)
         occurrences all number
    17
    13
    8
    Productive Cough
         subjects affected / exposed
    12 / 136 (8.82%)
    8 / 65 (12.31%)
    10 / 137 (7.30%)
         occurrences all number
    14
    9
    15
    Epistaxis
         subjects affected / exposed
    9 / 136 (6.62%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences all number
    11
    0
    0
    Dysphonia
         subjects affected / exposed
    8 / 136 (5.88%)
    0 / 65 (0.00%)
    6 / 137 (4.38%)
         occurrences all number
    10
    0
    9
    Rhinorrhoea
         subjects affected / exposed
    7 / 136 (5.15%)
    0 / 65 (0.00%)
    5 / 137 (3.65%)
         occurrences all number
    12
    0
    6
    Pleural Effusion
         subjects affected / exposed
    2 / 136 (1.47%)
    0 / 65 (0.00%)
    9 / 137 (6.57%)
         occurrences all number
    2
    0
    9
    Haemoptysis
         subjects affected / exposed
    0 / 136 (0.00%)
    4 / 65 (6.15%)
    0 / 137 (0.00%)
         occurrences all number
    0
    4
    0
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    14 / 136 (10.29%)
    7 / 65 (10.77%)
    12 / 137 (8.76%)
         occurrences all number
    15
    7
    16
    Depression
         subjects affected / exposed
    5 / 136 (3.68%)
    0 / 65 (0.00%)
    8 / 137 (5.84%)
         occurrences all number
    5
    0
    9
    Anxiety
         subjects affected / exposed
    0 / 136 (0.00%)
    4 / 65 (6.15%)
    0 / 137 (0.00%)
         occurrences all number
    0
    4
    0
    Investigations
    Blood Creatine Phosphokinase Increased
         subjects affected / exposed
    68 / 136 (50.00%)
    31 / 65 (47.69%)
    23 / 137 (16.79%)
         occurrences all number
    198
    59
    65
    Aspartate Aminotransferase Increased
         subjects affected / exposed
    35 / 136 (25.74%)
    17 / 65 (26.15%)
    36 / 137 (26.28%)
         occurrences all number
    105
    31
    62
    Alanine Aminotransferase Increased
         subjects affected / exposed
    31 / 136 (22.79%)
    11 / 65 (16.92%)
    49 / 137 (35.77%)
         occurrences all number
    71
    24
    92
    Lipase Increased
         subjects affected / exposed
    31 / 136 (22.79%)
    18 / 65 (27.69%)
    23 / 137 (16.79%)
         occurrences all number
    77
    36
    42
    Amylase Increased
         subjects affected / exposed
    25 / 136 (18.38%)
    14 / 65 (21.54%)
    13 / 137 (9.49%)
         occurrences all number
    84
    23
    20
    Blood Alkaline Phosphatase Increased
         subjects affected / exposed
    17 / 136 (12.50%)
    4 / 65 (6.15%)
    18 / 137 (13.14%)
         occurrences all number
    35
    6
    23
    Blood Cholesterol Increased
         subjects affected / exposed
    13 / 136 (9.56%)
    5 / 65 (7.69%)
    1 / 137 (0.73%)
         occurrences all number
    30
    8
    1
    Blood Creatinine Increased
         subjects affected / exposed
    8 / 136 (5.88%)
    0 / 65 (0.00%)
    20 / 137 (14.60%)
         occurrences all number
    19
    0
    38
    Electrocardiogram Qt Prolonged
         subjects affected / exposed
    8 / 136 (5.88%)
    5 / 65 (7.69%)
    8 / 137 (5.84%)
         occurrences all number
    18
    8
    13
    Blood Lactate Dehydrogenase Increased
         subjects affected / exposed
    7 / 136 (5.15%)
    0 / 65 (0.00%)
    5 / 137 (3.65%)
         occurrences all number
    11
    0
    5
    Gamma-Glutamyltransferase Increased
         subjects affected / exposed
    5 / 136 (3.68%)
    0 / 65 (0.00%)
    8 / 137 (5.84%)
         occurrences all number
    7
    0
    9
    Neutrophil Count Decreased
         subjects affected / exposed
    3 / 136 (2.21%)
    0 / 65 (0.00%)
    14 / 137 (10.22%)
         occurrences all number
    4
    0
    60
    Blood Insulin Increased
         subjects affected / exposed
    0 / 136 (0.00%)
    4 / 65 (6.15%)
    0 / 137 (0.00%)
         occurrences all number
    0
    4
    0
    Cardiac disorders
    Bradycardia
         subjects affected / exposed
    10 / 136 (7.35%)
    0 / 65 (0.00%)
    22 / 137 (16.06%)
         occurrences all number
    14
    0
    26
    Sinus Bradycardia
         subjects affected / exposed
    7 / 136 (5.15%)
    0 / 65 (0.00%)
    11 / 137 (8.03%)
         occurrences all number
    14
    0
    14
    Nervous system disorders
    Headache
         subjects affected / exposed
    31 / 136 (22.79%)
    16 / 65 (24.62%)
    25 / 137 (18.25%)
         occurrences all number
    52
    19
    37
    Dizziness
         subjects affected / exposed
    23 / 136 (16.91%)
    12 / 65 (18.46%)
    29 / 137 (21.17%)
         occurrences all number
    28
    15
    37
    Paraesthesia
         subjects affected / exposed
    12 / 136 (8.82%)
    5 / 65 (7.69%)
    9 / 137 (6.57%)
         occurrences all number
    12
    7
    14
    Dysgeusia
         subjects affected / exposed
    5 / 136 (3.68%)
    0 / 65 (0.00%)
    20 / 137 (14.60%)
         occurrences all number
    6
    0
    23
    Hypoaesthesia
         subjects affected / exposed
    3 / 136 (2.21%)
    0 / 65 (0.00%)
    9 / 137 (6.57%)
         occurrences all number
    3
    0
    14
    Taste Disorder
         subjects affected / exposed
    3 / 136 (2.21%)
    0 / 65 (0.00%)
    8 / 137 (5.84%)
         occurrences all number
    3
    0
    8
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    12 / 136 (8.82%)
    5 / 65 (7.69%)
    8 / 137 (5.84%)
         occurrences all number
    18
    5
    8
    Eye disorders
    Vision Blurred
         subjects affected / exposed
    7 / 136 (5.15%)
    0 / 65 (0.00%)
    14 / 137 (10.22%)
         occurrences all number
    8
    0
    15
    Photopsia
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    29 / 137 (21.17%)
         occurrences all number
    1
    0
    32
    Visual Impairment
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    23 / 137 (16.79%)
         occurrences all number
    1
    0
    27
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    78 / 136 (57.35%)
    17 / 65 (26.15%)
    77 / 137 (56.20%)
         occurrences all number
    213
    31
    206
    Nausea
         subjects affected / exposed
    44 / 136 (32.35%)
    11 / 65 (16.92%)
    81 / 137 (59.12%)
         occurrences all number
    97
    18
    135
    Vomiting
         subjects affected / exposed
    30 / 136 (22.06%)
    9 / 65 (13.85%)
    59 / 137 (43.07%)
         occurrences all number
    47
    9
    129
    Constipation
         subjects affected / exposed
    26 / 136 (19.12%)
    10 / 65 (15.38%)
    57 / 137 (41.61%)
         occurrences all number
    33
    13
    77
    Abdominal Pain
         subjects affected / exposed
    18 / 136 (13.24%)
    0 / 65 (0.00%)
    20 / 137 (14.60%)
         occurrences all number
    25
    0
    24
    Dyspepsia
         subjects affected / exposed
    15 / 136 (11.03%)
    0 / 65 (0.00%)
    23 / 137 (16.79%)
         occurrences all number
    18
    0
    36
    Stomatitis
         subjects affected / exposed
    12 / 136 (8.82%)
    5 / 65 (7.69%)
    9 / 137 (6.57%)
         occurrences all number
    33
    5
    9
    Abdominal Pain Upper
         subjects affected / exposed
    11 / 136 (8.09%)
    0 / 65 (0.00%)
    26 / 137 (18.98%)
         occurrences all number
    15
    0
    37
    Dry Mouth
         subjects affected / exposed
    8 / 136 (5.88%)
    0 / 65 (0.00%)
    6 / 137 (4.38%)
         occurrences all number
    8
    0
    10
    Dysphagia
         subjects affected / exposed
    2 / 136 (1.47%)
    0 / 65 (0.00%)
    12 / 137 (8.76%)
         occurrences all number
    2
    0
    14
    Gastrooesophageal Reflux Disease
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    16 / 137 (11.68%)
         occurrences all number
    1
    0
    23
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    28 / 136 (20.59%)
    6 / 65 (9.23%)
    8 / 137 (5.84%)
         occurrences all number
    34
    6
    11
    Rash
         subjects affected / exposed
    25 / 136 (18.38%)
    6 / 65 (9.23%)
    4 / 137 (2.92%)
         occurrences all number
    34
    9
    4
    Dermatitis Acneiform
         subjects affected / exposed
    13 / 136 (9.56%)
    5 / 65 (7.69%)
    3 / 137 (2.19%)
         occurrences all number
    16
    6
    3
    Rash Erythematous
         subjects affected / exposed
    9 / 136 (6.62%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences all number
    12
    0
    1
    Dry Skin
         subjects affected / exposed
    8 / 136 (5.88%)
    0 / 65 (0.00%)
    6 / 137 (4.38%)
         occurrences all number
    8
    0
    7
    Rash Maculo-Papular
         subjects affected / exposed
    8 / 136 (5.88%)
    9 / 65 (13.85%)
    5 / 137 (3.65%)
         occurrences all number
    11
    13
    5
    Eczema
         subjects affected / exposed
    8 / 136 (5.88%)
    6 / 65 (9.23%)
    3 / 137 (2.19%)
         occurrences all number
    10
    6
    4
    Musculoskeletal and connective tissue disorders
    Back Pain
         subjects affected / exposed
    35 / 136 (25.74%)
    11 / 65 (16.92%)
    22 / 137 (16.06%)
         occurrences all number
    43
    12
    22
    Arthralgia
         subjects affected / exposed
    27 / 136 (19.85%)
    9 / 65 (13.85%)
    17 / 137 (12.41%)
         occurrences all number
    33
    10
    19
    Muscle Spasms
         subjects affected / exposed
    20 / 136 (14.71%)
    17 / 65 (26.15%)
    15 / 137 (10.95%)
         occurrences all number
    27
    27
    18
    Musculoskeletal Pain
         subjects affected / exposed
    15 / 136 (11.03%)
    10 / 65 (15.38%)
    11 / 137 (8.03%)
         occurrences all number
    19
    10
    12
    Myalgia
         subjects affected / exposed
    14 / 136 (10.29%)
    11 / 65 (16.92%)
    11 / 137 (8.03%)
         occurrences all number
    17
    16
    12
    Musculoskeletal Chest Pain
         subjects affected / exposed
    12 / 136 (8.82%)
    0 / 65 (0.00%)
    10 / 137 (7.30%)
         occurrences all number
    13
    0
    13
    Pain In Extremity
         subjects affected / exposed
    9 / 136 (6.62%)
    5 / 65 (7.69%)
    19 / 137 (13.87%)
         occurrences all number
    9
    5
    24
    Muscular Weakness
         subjects affected / exposed
    0 / 136 (0.00%)
    5 / 65 (7.69%)
    0 / 137 (0.00%)
         occurrences all number
    0
    5
    0
    Infections and infestations
    Upper Respiratory Tract Infection
         subjects affected / exposed
    18 / 136 (13.24%)
    6 / 65 (9.23%)
    12 / 137 (8.76%)
         occurrences all number
    24
    7
    21
    Nasopharyngitis
         subjects affected / exposed
    12 / 136 (8.82%)
    5 / 65 (7.69%)
    15 / 137 (10.95%)
         occurrences all number
    16
    5
    28
    Urinary Tract Infection
         subjects affected / exposed
    10 / 136 (7.35%)
    5 / 65 (7.69%)
    11 / 137 (8.03%)
         occurrences all number
    14
    6
    11
    Pneumonia
         subjects affected / exposed
    10 / 136 (7.35%)
    6 / 65 (9.23%)
    5 / 137 (3.65%)
         occurrences all number
    13
    7
    5
    Respiratory Tract Infection
         subjects affected / exposed
    7 / 136 (5.15%)
    0 / 65 (0.00%)
    3 / 137 (2.19%)
         occurrences all number
    8
    0
    3
    Metabolism and nutrition disorders
    Decreased Appetite
         subjects affected / exposed
    16 / 136 (11.76%)
    7 / 65 (10.77%)
    28 / 137 (20.44%)
         occurrences all number
    20
    7
    36
    Hyperglycaemia
         subjects affected / exposed
    7 / 136 (5.15%)
    0 / 65 (0.00%)
    6 / 137 (4.38%)
         occurrences all number
    12
    0
    6
    Hypophosphataemia
         subjects affected / exposed
    7 / 136 (5.15%)
    0 / 65 (0.00%)
    5 / 137 (3.65%)
         occurrences all number
    9
    0
    6
    Hypokalaemia
         subjects affected / exposed
    7 / 136 (5.15%)
    0 / 65 (0.00%)
    1 / 137 (0.73%)
         occurrences all number
    7
    0
    1
    Hypercholesterolaemia
         subjects affected / exposed
    7 / 136 (5.15%)
    0 / 65 (0.00%)
    0 / 137 (0.00%)
         occurrences all number
    14
    0
    0
    Hypocalcaemia
         subjects affected / exposed
    3 / 136 (2.21%)
    0 / 65 (0.00%)
    11 / 137 (8.03%)
         occurrences all number
    3
    0
    11
    Hypoalbuminaemia
         subjects affected / exposed
    1 / 136 (0.74%)
    0 / 65 (0.00%)
    11 / 137 (8.03%)
         occurrences all number
    1
    0
    13

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    17 Mar 2018
    Amendment 2.0: The primary purpose of this amendment was to make following changes: The primary reason for this amendment was to remove hormonal contraception methods from permitted treatment/therapy and from the definition of highly effective contraceptive methods. The rationale for this change was based on in vitro Cytochrome P450 (CYP3A) induction observed with brigatinib, which may decrease concentrations of CYP3A substrates, including hormonal contraceptives. Coadministration of brigatinib with hormonal contraceptives can result in decreased concentrations and loss of efficacy of hormonal contraceptives. Additional protocol deviation language was added per the sponsor’s updated template.
    12 May 2020
    Amendment 3.0: The primary purpose of this amendment was to make following changes: The primary reasons for this amendment are to update the “final statistical analysis” and “End-of Study” due to achievement of the primary efficacy endpoint at the pre-planned interim analysis. The approximate duration of patient participation is 4 years which was added. Also that the primary analysis of the primary endpoint will be performed at the End-of-Study if the study ended before 198 events progression-free survival (PFS) events were observed. The analysis of the final assessment of overall survival (OS) was added and will also be performed at the end of the study.

    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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