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    Clinical Trial Results:
    A Single-Arm, Open-Label, Expanded Access Study of Vemurafenib in Patients With Metastatic Melanoma

    Summary
    EudraCT number
    2015-004211-20
    Trial protocol
    Outside EU/EEA  
    Global end of trial date
    24 Oct 2011

    Results information
    Results version number
    v1(current)
    This version publication date
    26 Jan 2017
    First version publication date
    26 Jan 2017
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    ML25597
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01248936
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    F. Hoffmann-La Roche AG
    Sponsor organisation address
    Grenzacherstrasse 124, Basel, Switzerland, CH-4070
    Public contact
    Roche Trial Information Hotline, F. Hoffmann-La Roche AG, +41 616878333, global.trial_information@roche.com
    Scientific contact
    Roche Trial Information Hotline, F. Hoffmann-La Roche AG, +41 616878333, global.trial_information@roche.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    24 Oct 2011
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    24 Oct 2011
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To provide vemurafenib to patients with metastatic melanoma who are otherwise without satisfactory treatment options
    Protection of trial subjects
    The conduct of this clinical study met all local legal and regulatory requirements. The study was conducted in accordance with the ethical principles that have their origin in the Declaration of Helsinki and the International Conference on Harmonization guideline E6: Good Clinical Practice. A Data Review committee (DRC) supervised the participants’ safety and performed the pre-specified interim analyses according to the protocol. Before entering the study, the informed consent form was read by and explained to all participants and/or their legally authorized representative. participants signed informed consent form and could withdraw from the study at any time without any disadvantage and without having to provide a reason for this decision. Only investigators qualified by training and experience were selected as appropriate experts to investigate the study drug.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    10 Dec 2010
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United States: 371
    Worldwide total number of subjects
    371
    EEA total number of subjects
    0
    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)
    1
    Adults (18-64 years)
    289
    From 65 to 84 years
    79
    85 years and over
    2

    Subject disposition

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    Recruitment
    Recruitment details
    The study was conducted in 29 study sites in the United States (US). In all 374 participants were enrolled in the study and 371 received the study medication.

    Pre-assignment
    Screening details
    Overall, 745 participants were screened during the study, of which 371 were randomized to receive study treatment; the main reason for screen failure was negative cobas test, consent withdrawal, BRAF test not performed, patient died or progressed.

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

    Arms
    Arm title
    Overall trial
    Arm description
    Participants received vemurafenib 960 milligram (mg) orally two times a day for up to one year. Participants were treated until disease progression, unmanageable toxicity most probably attributable to vemurafenib, withdrawal of consent, and study termination by the sponsor.
    Arm type
    Experimental

    Investigational medicinal product name
    Vemurafenib
    Investigational medicinal product code
    RO5185426
    Other name
    PLX4032, or RG7204
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Vemurafenib was administered 960 mg (four tablets of 240 mg each) orally two times a day for up to one year

    Number of subjects in period 1
    Overall trial
    Started
    371
    Completed
    0
    Not completed
    371
         Adverse event, not serious
    2
         Consent withdrawn by subject
    20
         Progression of Disease
    50
         Death
    26
         Refused Treatment
    1
         Adverse event, serious non-fatal
    6
         Lost to follow-up
    7
         Sponsor Decision (Switch to Commercial Drug)
    259

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    Participants received vemurafenib 960 milligram (mg) orally two times a day for up to one year. Participants were treated until disease progression, unmanageable toxicity most probably attributable to vemurafenib, withdrawal of consent, and study termination by the sponsor.

    Reporting group values
    Overall trial Total
    Number of subjects
    371 371
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    1 1
        Adults (18-64 years)
    289 289
        From 65-84 years
    79 79
        85 years and over
    2 2
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    53.5 ( 13.8 ) -
    Gender categorical
    Units: Subjects
        Female
    142 142
        Male
    229 229

    End points

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    End points reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    Participants received vemurafenib 960 milligram (mg) orally two times a day for up to one year. Participants were treated until disease progression, unmanageable toxicity most probably attributable to vemurafenib, withdrawal of consent, and study termination by the sponsor.

    Primary: Number of Participants With Any Adverse Event, Adverse Events With Severity, Adverse Events Leading to Discontinuation

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    End point title
    Number of Participants With Any Adverse Event, Adverse Events With Severity, Adverse Events Leading to Discontinuation [1]
    End point description
    An Adverse Event (AE) is defined as any untoward medical occurrence in a participant or clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. AEs will be graded according to the ‘National Cancer Institute Common Terminology Criteria for Adverse Events’ (NCI CTCAE, v4.0). However Laboratory data will be summarized by grade using the NCI CTCAE, v4.0 toxicity grade.
    End point type
    Primary
    End point timeframe
    Up to 1 year
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Study data were analyzed by descriptive summaries. No formal hypothesis testing was planned.
    End point values
    Overall trial
    Number of subjects analysed
    371
    Units: Number of Participants
        Any AE
    346
        Grade 3 AEs
    115
        Grade 4 AEs
    15
        Grade 5 AEs
    7
        AEs leading to discontinuation
    9
    No statistical analyses for this end point

    Primary: Number of Participants With Any Serious Adverse Event, Death and Cause of Death

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    End point title
    Number of Participants With Any Serious Adverse Event, Death and Cause of Death [2]
    End point description
    Serious Adverse Event (SAEs) is defined as those events that were fatal or immediately life-threatening, and those events that resulted in hospitalization; prolonged an existing hospitalization; resulted in disability; or was a congenital anomaly. Number of participants who died and the cause of death are also recorded.
    End point type
    Primary
    End point timeframe
    Up to 1 year
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Study data were analyzed by descriptive summaries. No formal hypothesis testing was planned.
    End point values
    Overall trial
    Number of subjects analysed
    371
    Units: Number of Participants
        Any SAEs
    83
        All Deaths
    43
        Death due to progression of disease
    22
        Death due to adverse event
    8
        Deaths which are not related to study drug
    6
        Deaths which are related to study drug
    2
    No statistical analyses for this end point

    Secondary: Number of Participants With Best Overall Response (Unconfirmed)

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    End point title
    Number of Participants With Best Overall Response (Unconfirmed)
    End point description
    The best overall response (unconfirmed) is the best response recorded from the start of the treatment until disease progression/recurrence which was unconfirmed. Participants were assessed for best overall response by investigator as per ‘Response Evaluation Criteria in Solid Tumors’ (RECIST v1.1).
    End point type
    Secondary
    End point timeframe
    Up to 1 year
    End point values
    Overall trial
    Number of subjects analysed
    241
    Units: Number of Participants
        Unconfirmed objective response
    129
    No statistical analyses for this end point

    Secondary: Number of Participants With Best Overall Response (Unconfirmed) by ECOG Performance

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    End point title
    Number of Participants With Best Overall Response (Unconfirmed) by ECOG Performance
    End point description
    The best overall response recorded from the start of the treatment until disease progression/recurrence which was unconfirmed in patients with Eastern Cooperative Oncology Group (ECOG) performance status 2 or 3/0 or 1. This endpoint was tumor response category according to investigator assessment per RECIST v1.1 for efficacy assessment. The ‘n’ is number of participants with ECOG performance status in each criteria.
    End point type
    Secondary
    End point timeframe
    Up to 1 year
    End point values
    Overall trial
    Number of subjects analysed
    241
    Units: Number of Participants
        ECOG performance status 2 or 3, n=31
    13
        ECOG performance status 0 or 1, n=210
    116
    No statistical analyses for this end point

    Secondary: Number of Participants With Best Overall Response (Confirmed)

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    End point title
    Number of Participants With Best Overall Response (Confirmed)
    End point description
    The best overall response (confirmed) is the best response recorded from the start of the treatment until disease progression/recurrence which was confirmed. Participants were assessed for best overall response by investigator as per RECIST v1.1.
    End point type
    Secondary
    End point timeframe
    Up to 1 year
    End point values
    Overall trial
    Number of subjects analysed
    241
    Units: Number of Participants
        Confirmed objective response
    26
    No statistical analyses for this end point

    Secondary: Number of Participants With Best Overall Response (Confirmed) by ECOG Performance

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    End point title
    Number of Participants With Best Overall Response (Confirmed) by ECOG Performance
    End point description
    ] The best overall response recorded from the start of the treatment until disease progression/recurrence which was confirmed in patients with Eastern Cooperative Oncology Group (ECOG) performance status 2 or 3/0 or 1. Participants were assessed for best overall response by investigator as per RECIST v1.1. The ‘n’ is number of participants with ECOG performance status in each criteria.
    End point type
    Secondary
    End point timeframe
    Up to 1 year
    End point values
    Overall trial
    Number of subjects analysed
    241
    Units: Number of Participants
        ECOG performance status 2 or 3; n=31
    1
        ECOG performance status 0 or 1; n=210
    25
    No statistical analyses for this end point

    Secondary: Mean Time to Complete Response/Partial Response

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    End point title
    Mean Time to Complete Response/Partial Response
    End point description
    Mean time to Complete Response (CR)/Partial Response(PR) (confirmed or unconfirmed was assessed). Participants were assessed for best overall response by investigator as per RECIST v1.1.
    End point type
    Secondary
    End point timeframe
    Up to 1 year
    End point values
    Overall trial
    Number of subjects analysed
    241
    Units: Months
    arithmetic mean (standard deviation)
        Mean time to confirmed CR or PR
    1.8 ( 0.3 )
        Mean time to unconfirmed CR or PR
    2 ( 0.7 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to 1 Year
    Adverse event reporting additional description
    Serious adverse events and non-serious adverse events are reported in safety analysis set, which consists of all participants who received at least one dose of study medication and had a safety assessment performed post baseline.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    15.0
    Reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    Participants received vemurafenib 960 milligram (mg) orally two times a day for up to one year. Participants were treated until disease progression, unmanageable toxicity most probably attributable to vemurafenib, withdrawal of consent, and study termination by the sponsor.

    Serious adverse events
    Overall trial
    Total subjects affected by serious adverse events
         subjects affected / exposed
    83 / 371 (22.37%)
         number of deaths (all causes)
    43
         number of deaths resulting from adverse events
    2
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Metastases to central nervous system
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    5 / 371 (1.35%)
         occurrences causally related to treatment / all
    2 / 6
         deaths causally related to treatment / all
    0 / 0
    Death
         subjects affected / exposed
    2 / 371 (0.54%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Asthenia
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Drug withdrawal syndrome
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fatigue
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Multi-organ failure
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Pain
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Female genital tract fistula
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    3 / 371 (0.81%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Respiratory failure
         subjects affected / exposed
    3 / 371 (0.81%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 1
    Pulmonary embolism
         subjects affected / exposed
    2 / 371 (0.54%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Pulmonary haemorrhage
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    3 / 371 (0.81%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Mental status changes
         subjects affected / exposed
    2 / 371 (0.54%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Paranoia
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Electrocardiogram QT prolonged
         subjects affected / exposed
    3 / 371 (0.81%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Blood bilirubin increased
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood creatine phosphokinase increased
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood uric acid increased
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Procedural pain
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Toxicity to various agents
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Atrial flutter
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pericardial effusion
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Convulsion
         subjects affected / exposed
    5 / 371 (1.35%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Headache
         subjects affected / exposed
    2 / 371 (0.54%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Cerebral haemorrhage
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Hydrocephalus
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Lethargy
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lumbar radiculopathy
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Paraesthesia
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Spinal cord compression
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    3 / 371 (0.81%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Lymphopenia
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 10
         deaths causally related to treatment / all
    0 / 0
    Neutropenia
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Pupils unequal
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Uveitis
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    5 / 371 (1.35%)
         occurrences causally related to treatment / all
    2 / 5
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    3 / 371 (0.81%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    2 / 371 (0.54%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Ascites
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diverticular perforation
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric ulcer
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Hyperbilirubinaemia
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Angioedema
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Dermatitis
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Photosensitivity reaction
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Rash
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Rash maculo-papular
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal colic
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal failure acute
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    2 / 371 (0.54%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Neck pain
         subjects affected / exposed
    2 / 371 (0.54%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Back pain
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal pain
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Cellulitis
         subjects affected / exposed
    4 / 371 (1.08%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    4 / 371 (1.08%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    3 / 371 (0.81%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Bacterial infection
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Clostridial infection
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    5 / 371 (1.35%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    2 / 371 (0.54%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Failure to thrive
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    1 / 371 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Overall trial
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    308 / 371 (83.02%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Squamous cell carcinoma of skin
         subjects affected / exposed
    25 / 371 (6.74%)
         occurrences all number
    48
    Skin papilloma
         subjects affected / exposed
    23 / 371 (6.20%)
         occurrences all number
    27
    Investigations
    Weight decreased
         subjects affected / exposed
    27 / 371 (7.28%)
         occurrences all number
    28
    Injury, poisoning and procedural complications
    Sunburn
         subjects affected / exposed
    48 / 371 (12.94%)
         occurrences all number
    51
    Nervous system disorders
    Headache
         subjects affected / exposed
    37 / 371 (9.97%)
         occurrences all number
    39
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    102 / 371 (27.49%)
         occurrences all number
    108
    Oedema peripheral
         subjects affected / exposed
    41 / 371 (11.05%)
         occurrences all number
    46
    Pyrexia
         subjects affected / exposed
    37 / 371 (9.97%)
         occurrences all number
    43
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    69 / 371 (18.60%)
         occurrences all number
    75
    Diarrhoea
         subjects affected / exposed
    42 / 371 (11.32%)
         occurrences all number
    43
    Vomiting
         subjects affected / exposed
    30 / 371 (8.09%)
         occurrences all number
    32
    Constipation
         subjects affected / exposed
    20 / 371 (5.39%)
         occurrences all number
    20
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    102 / 371 (27.49%)
         occurrences all number
    115
    Photosensitivity reaction
         subjects affected / exposed
    62 / 371 (16.71%)
         occurrences all number
    65
    Alopecia
         subjects affected / exposed
    41 / 371 (11.05%)
         occurrences all number
    41
    Hyperkeratosis
         subjects affected / exposed
    29 / 371 (7.82%)
         occurrences all number
    29
    Dry skin
         subjects affected / exposed
    26 / 371 (7.01%)
         occurrences all number
    26
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    23 / 371 (6.20%)
         occurrences all number
    24
    Pruritus
         subjects affected / exposed
    36 / 371 (9.70%)
         occurrences all number
    40
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    136 / 371 (36.66%)
         occurrences all number
    147
    Myalgia
         subjects affected / exposed
    30 / 371 (8.09%)
         occurrences all number
    33
    Pain in extremity
         subjects affected / exposed
    20 / 371 (5.39%)
         occurrences all number
    26
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    42 / 371 (11.32%)
         occurrences all number
    45

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    05 Nov 2010
    In this protocol amendment, the eligible patient population was limited to patients who had received prior systemic therapy for metastatic melanoma, since broader evidence for efficacy and safety of vemurafenib in patients with metastatic melanoma. In addition to head and neck, dermatological, and chest CT examinations, further assessments (examination of anus and for woman in addition pelvic examination)were introduced at baseline and at the end of study to more closely monitor the risk for SCC.
    07 Feb 2011
    In this protocol amendment, new information has been added to Sections 3.4 (Safety Plan) and 4.3.2 (Dosage and Administration) that describes how dosing of vemurafenib should be modified according to QTc interval. Related to this, in Section 4.5.3 (Assessments during treatment) and Appendix A of the protocol (Study Flowchart), 12-lead ECGs became mandatory and occurred >= 4 weeks after study drug initiation, monthly for the next 3 months, and every 3 months thereafter. The earliest age at which patients were eligible was reduced from 18 years to 16 years.
    05 May 2011
    In this protocol amendment, the patients with melanoma brain metastases, with unresectable Stage IIIc metastatic melanoma, and with concurrent malignancies for which therapeutic intervention was not warranted became eligible. Performance status for eligibility was broadened from a performance status of 0–2 to a performance status of 0–3. The dosage of vemurafenib was no longer allowed to be reduced to 480 mg b.i.d. if an increase in QTc > 500 msec or a change from baseline > 60 msec was observed after a prior dose reduction from 960 mg b.i.d. to 720 mg b.i.d. Patients with a history of long QT syndrome were explicitly excluded.

    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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