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    Clinical Trial Results:
    A Randomized, Double-Blind, Phase III Study of Carboplatin-Paclitaxel/Nab-Paclitaxel Chemotherapy with or without Pembrolizumab (MK-3475) in First Line Metastatic Squamous Non-small Cell Lung Cancer Subjects (KEYNOTE-407)

    Summary
    EudraCT number
    2016-000229-38
    Trial protocol
    DE   IT   NL   ES   HU   FR   PL  
    Global end of trial date
    14 Sep 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    21 Sep 2024
    First version publication date
    21 Sep 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    3475-407
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02775435
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    MSD: KEYNOTE-407
    Sponsors
    Sponsor organisation name
    Merck Sharp & Dohme LLC
    Sponsor organisation address
    126 East Lincoln Avenue, P.O. Box 2000, Rahway, NJ, United States, 07065
    Public contact
    Clinical Trials Disclosure, Merck Sharp & Dohme LLC, ClinicalTrialsDisclosure@msd.com
    Scientific contact
    Clinical Trials Disclosure, Merck Sharp & Dohme LLC, ClinicalTrialsDisclosure@msd.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
    14 Sep 2023
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    14 Sep 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    This is a study of carboplatin and paclitaxel or nano particle albumin-bound paclitaxel (nab-paclitaxel) with or without pembrolizumab (MK-3475, KEYTRUDA®) in adults with first line metastatic squamous non-small cell lung cancer (NSCLC). The primary objective of this study was to evaluate if treatment with pembrolizumab prolongs: 1) Progression-free Survival (PFS) by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by a blinded central imaging vendor compared to placebo, and 2) Overall Survival (OS).
    Protection of trial subjects
    This study was conducted in conformance with Good Clinical Practice standards and applicable country and/or local statutes and regulations regarding ethical committee review, informed consent, and the protection of human subjects participating in biomedical research.
    Background therapy
    Background therapy consisted of appropriate supportive care measures as deemed necessary by the treating investigator. Supportive care measures included those for the management of AEs with potential immunologic etiology. Where appropriate, these included the use of oral or IV treatment with corticosteroids as well as additional anti-inflammatory agents if symptoms did not improve with administration of corticosteroids.
    Evidence for comparator
    -
    Actual start date of recruitment
    09 Jun 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: 19
    Country: Number of subjects enrolled
    Canada: 19
    Country: Number of subjects enrolled
    China: 15
    Country: Number of subjects enrolled
    France: 56
    Country: Number of subjects enrolled
    Germany: 18
    Country: Number of subjects enrolled
    Hungary: 41
    Country: Number of subjects enrolled
    Italy: 23
    Country: Number of subjects enrolled
    Japan: 50
    Country: Number of subjects enrolled
    Korea, Republic of: 37
    Country: Number of subjects enrolled
    Mexico: 21
    Country: Number of subjects enrolled
    Netherlands: 8
    Country: Number of subjects enrolled
    Poland: 36
    Country: Number of subjects enrolled
    Russian Federation: 50
    Country: Number of subjects enrolled
    Spain: 58
    Country: Number of subjects enrolled
    Thailand: 4
    Country: Number of subjects enrolled
    Türkiye: 69
    Country: Number of subjects enrolled
    United States: 35
    Worldwide total number of subjects
    559
    EEA total number of subjects
    240
    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)
    254
    From 65 to 84 years
    302
    85 years and over
    3

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Per protocol, response/progression, or adverse events during the second and switch-over pembrolizumab course were not counted towards efficacy outcome measures or safety outcome measures.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Pembrolizumab + Chemotherapy Combo
    Arm description
    Participants received pembrolizumab 200 mg by intravenous (IV) infusion prior to chemotherapy on Day 1 of each 21-day cycle (Q3W) for up to 35 cycles (~ 2 years) PLUS Investigator’s choice of paclitaxel (200 mg/m^2 by IV infusion on Day 1 of each 21-day cycle for 4 cycles) or nab-paclitaxel (100 mg/m^2 by IV infusion on Days 1, 8, 15 of each 21-day cycle for 4 cycles) PLUS carboplatin Area Under Curve (AUC) 6 by IV infusion on Day 1 of each 21-day cycle for 4 cycles. Participants who received pembrolizumab 200 mg IV Day 1 of 21-day cycle for up to 2 years, but experienced disease progression, were eligible to receive a second course of pembrolizumab 200 mg IV Day 1 of 21-day cycle, at the investigator's discretion, for 17 cycles (~ 1 year additional).
    Arm type
    Experimental

    Investigational medicinal product name
    Pembrolizumab + Paclitaxel/nab-Paclitaxel and carboplatin Area Under Curve (AUC)
    Investigational medicinal product code
    Other name
    MK-3475 KEYTRUDA®
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Participants received pembrolizumab 200 mg by intravenous (IV) infusion prior to chemotherapy on Day 1 of each 21-day cycle (Q3W) for up to 35 cycles (~ 2 years) PLUS Investigator’s choice of paclitaxel (200 mg/m^2 by IV infusion on Day 1 of each 21-day cycle for 4 cycles) or nab-paclitaxel (100 mg/m^2 by IV infusion on Days 1, 8, 15 of each 21-day cycle for 4 cycles) PLUS carboplatin Area Under Curve (AUC) 6 by IV infusion on Day 1 of each 21-day cycle for 4 cycles. Participants who received pembrolizumab 200 mg IV Day 1 of 21-day cycle for up to 2 years, but experienced disease progression, were eligible to receive a second course of pembrolizumab 200 mg IV Day 1 of 21-day cycle, at the investigator's discretion, for 17 cycles (~ 1 year additional).

    Arm title
    Placebo + Chemotherapy
    Arm description
    Participants received normal saline as placebo by IV infusion prior to chemotherapy on Day 1 of 21-day cycle for up to 35 cycles (~ 2 years) PLUS Investigator’s choice of paclitaxel (200 mg/m^2 by IV infusion on Day 1 of each 21-day cycle for 4 cycles) or nab-paclitaxel (100 mg/m^2 by IV infusion on Days 1, 8, 15 of each 21-day cycle for 4 cycles) PLUS carboplatin AUC 6 by IV infusion on Day 1 of each 21-day cycle for 4 cycles. Participants with documented disease progression following placebo chemotherapy combo could switch-over to receive pembrolizumab for up to 35 cycles (~ 2 years). Eligible cross over participants who stopped pembrolizumab and had stable disease but progressed after discontinuation, initiated a second course of pembrolizumab at the investigator's discretion for up to 17 cycles (~ 1 year additional).
    Arm type
    Placebo

    Investigational medicinal product name
    Normal saline + Paclitaxel/nab-Paclitaxel and carboplatin Area Under Curve (AUC)
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Participants received normal saline as placebo by IV infusion prior to chemotherapy on Day 1 of 21-day cycle for up to 35 cycles (~ 2 years) PLUS Investigator’s choice of paclitaxel (200 mg/m^2 by IV infusion on Day 1 of each 21-day cycle for 4 cycles) or nab-paclitaxel (100 mg/m^2 by IV infusion on Days 1, 8, 15 of each 21-day cycle for 4 cycles) PLUS carboplatin AUC 6 by IV infusion on Day 1 of each 21-day cycle for 4 cycles. Participants with documented disease progression following placebo chemotherapy combo could switch-over to receive pembrolizumab for up to 35 cycles (~ 2 years). Eligible cross over participants who stopped pembrolizumab and had stable disease but progressed after discontinuation, initiated a second course of pembrolizumab at the investigator's discretion for up to 17 cycles (~ 1 year additional).

    Number of subjects in period 1
    Pembrolizumab + Chemotherapy Combo Placebo + Chemotherapy
    Started
    278
    281
    Treated
    278
    280
    Received Second Course of Pembrolizumab
    12
    0
    Switch-over + 2nd course of Pembro
    0
    1
    Switched to Pembrolizumab+Chemotherapy
    0
    118
    Completed
    0
    0
    Not completed
    278
    281
         Consent withdrawn by subject
    4
    9
         Death
    196
    224
         Adverse event
    32
    27
         Sponsor Decision
    44
    19
         Lost to follow-up
    2
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Pembrolizumab + Chemotherapy Combo
    Reporting group description
    Participants received pembrolizumab 200 mg by intravenous (IV) infusion prior to chemotherapy on Day 1 of each 21-day cycle (Q3W) for up to 35 cycles (~ 2 years) PLUS Investigator’s choice of paclitaxel (200 mg/m^2 by IV infusion on Day 1 of each 21-day cycle for 4 cycles) or nab-paclitaxel (100 mg/m^2 by IV infusion on Days 1, 8, 15 of each 21-day cycle for 4 cycles) PLUS carboplatin Area Under Curve (AUC) 6 by IV infusion on Day 1 of each 21-day cycle for 4 cycles. Participants who received pembrolizumab 200 mg IV Day 1 of 21-day cycle for up to 2 years, but experienced disease progression, were eligible to receive a second course of pembrolizumab 200 mg IV Day 1 of 21-day cycle, at the investigator's discretion, for 17 cycles (~ 1 year additional).

    Reporting group title
    Placebo + Chemotherapy
    Reporting group description
    Participants received normal saline as placebo by IV infusion prior to chemotherapy on Day 1 of 21-day cycle for up to 35 cycles (~ 2 years) PLUS Investigator’s choice of paclitaxel (200 mg/m^2 by IV infusion on Day 1 of each 21-day cycle for 4 cycles) or nab-paclitaxel (100 mg/m^2 by IV infusion on Days 1, 8, 15 of each 21-day cycle for 4 cycles) PLUS carboplatin AUC 6 by IV infusion on Day 1 of each 21-day cycle for 4 cycles. Participants with documented disease progression following placebo chemotherapy combo could switch-over to receive pembrolizumab for up to 35 cycles (~ 2 years). Eligible cross over participants who stopped pembrolizumab and had stable disease but progressed after discontinuation, initiated a second course of pembrolizumab at the investigator's discretion for up to 17 cycles (~ 1 year additional).

    Reporting group values
    Pembrolizumab + Chemotherapy Combo Placebo + Chemotherapy Total
    Number of subjects
    278 281 559
    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)
    127 127 254
        From 65-84 years
    149 153 302
        85 years and over
    2 1 3
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    65.0 ( 8.8 ) 64.8 ( 8.7 ) -
    Sex: Female, Male
    Units: Participants
        Female
    58 46 104
        Male
    220 235 455
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 2 2
        Asian
    56 52 108
        Native Hawaiian or Other Pacific Islander
    1 0 1
        Black or African American
    3 4 7
        White
    216 214 430
        More than one race
    0 0 0
        Unknown or Not Reported
    2 9 11
    Programmed Cell Death-Ligand 1 (PD-L1) Tumor Expression Level: Tumor Proportion Score (TPS)
    Participants were assessed for their PD-L1 tumor expression level by immunohistochemistry assay using tumor tissue from a newly obtained biopsy. Participants with a TPS ≥1% were classified as PD-L1 positive and participants with a TPS <1% were classified as not PD-L1 positive.
    Units: Subjects
        TPS <1%
    95 99 194
        TPS ≥1%
    176 177 353
        Unknown
    7 5 12
    Taxane Chemotherapy
    Participants were classified according to their taxane chemotherapy regimen: paclitaxel or nab-paclitaxel.
    Units: Subjects
        +Paclitaxel
    169 167 336
        +Nab-paclitaxel
    109 114 223
    Geographic Region
    Participants were classified according to their geographic region: East Asia vs. non-East Asia.
    Units: Subjects
        East Asia
    54 52 106
        Non-East Asia
    224 229 453

    End points

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    End points reporting groups
    Reporting group title
    Pembrolizumab + Chemotherapy Combo
    Reporting group description
    Participants received pembrolizumab 200 mg by intravenous (IV) infusion prior to chemotherapy on Day 1 of each 21-day cycle (Q3W) for up to 35 cycles (~ 2 years) PLUS Investigator’s choice of paclitaxel (200 mg/m^2 by IV infusion on Day 1 of each 21-day cycle for 4 cycles) or nab-paclitaxel (100 mg/m^2 by IV infusion on Days 1, 8, 15 of each 21-day cycle for 4 cycles) PLUS carboplatin Area Under Curve (AUC) 6 by IV infusion on Day 1 of each 21-day cycle for 4 cycles. Participants who received pembrolizumab 200 mg IV Day 1 of 21-day cycle for up to 2 years, but experienced disease progression, were eligible to receive a second course of pembrolizumab 200 mg IV Day 1 of 21-day cycle, at the investigator's discretion, for 17 cycles (~ 1 year additional).

    Reporting group title
    Placebo + Chemotherapy
    Reporting group description
    Participants received normal saline as placebo by IV infusion prior to chemotherapy on Day 1 of 21-day cycle for up to 35 cycles (~ 2 years) PLUS Investigator’s choice of paclitaxel (200 mg/m^2 by IV infusion on Day 1 of each 21-day cycle for 4 cycles) or nab-paclitaxel (100 mg/m^2 by IV infusion on Days 1, 8, 15 of each 21-day cycle for 4 cycles) PLUS carboplatin AUC 6 by IV infusion on Day 1 of each 21-day cycle for 4 cycles. Participants with documented disease progression following placebo chemotherapy combo could switch-over to receive pembrolizumab for up to 35 cycles (~ 2 years). Eligible cross over participants who stopped pembrolizumab and had stable disease but progressed after discontinuation, initiated a second course of pembrolizumab at the investigator's discretion for up to 17 cycles (~ 1 year additional).

    Primary: Progression-free Survival (PFS) as Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)

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    End point title
    Progression-free Survival (PFS) as Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)
    End point description
    PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first. Per Response Criteria in Solid Tumors version 1.1 (RECIST 1.1), PD was defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also have demonstrated an absolute increase of ≥5 mm. Note: The appearance of ≥1 new lesions was also considered PD. PFS as assessed by blinded independent central review per RECIST 1.1 is presented.
    End point type
    Primary
    End point timeframe
    Up to approximately 19 months
    End point values
    Pembrolizumab + Chemotherapy Combo Placebo + Chemotherapy
    Number of subjects analysed
    278
    281
    Units: Months
        median (confidence interval 95%)
    6.4 (6.2 to 8.3)
    4.8 (4.3 to 5.7)
    Statistical analysis title
    PFS Hazard Ratio
    Comparison groups
    Pembrolizumab + Chemotherapy Combo v Placebo + Chemotherapy
    Number of subjects included in analysis
    559
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001 [1]
    Method
    Regression, Cox
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.56
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.45
         upper limit
    0.7
    Notes
    [1] - Treatment comparison stratified by programmed cell death-ligand 1 (PD-L1) status (Tumor Proportion Score [TPS] ≥1% vs. <1%), taxane chemotherapy (paclitaxel vs. nab-paclitaxel) & geographic region (East Asia vs. non-East Asia)

    Primary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    OS was defined as the time from randomization to death due to any cause. OS is presented.
    End point type
    Primary
    End point timeframe
    Up to approximately 19 months
    End point values
    Pembrolizumab + Chemotherapy Combo Placebo + Chemotherapy
    Number of subjects analysed
    278
    281
    Units: Months
        median (confidence interval 95%)
    15.9 (13.2 to 9999)
    11.3 (9.5 to 14.8)
    Statistical analysis title
    OS Hazard ratio
    Comparison groups
    Pembrolizumab + Chemotherapy Combo v Placebo + Chemotherapy
    Number of subjects included in analysis
    559
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0008 [2]
    Method
    Regression, Cox
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.64
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.49
         upper limit
    0.85
    Notes
    [2] - Treatment comparison stratified by programmed cell death-ligand 1 (PD-L1) status (Tumor Proportion Score [TPS] ≥1% vs. <1%), taxane chemotherapy (paclitaxel vs. nab-paclitaxel) & geographic region (East Asia vs. non-East Asia)

    Secondary: Objective Response Rate (ORR) as Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)

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    End point title
    Objective Response Rate (ORR) as Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)
    End point description
    ORR was defined as the percentage of participants who had a Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) as assessed by RECIST 1.1. ORR as assessed by blinded independent central review per RECIST 1.1 is presented.
    End point type
    Secondary
    End point timeframe
    Up to approximately 19 months
    End point values
    Pembrolizumab + Chemotherapy Combo Placebo + Chemotherapy
    Number of subjects analysed
    278
    281
    Units: Percentage of Participants
        number (confidence interval 95%)
    57.9 (51.9 to 63.8)
    38.4 (32.7 to 44.4)
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR) as Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)

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    End point title
    Duration of Response (DOR) as Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)
    End point description
    For participants who demonstrated a confirmed response (Complete Response [CR]: Disappearance of all target lesions or Partial Response [PR]: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, DOR was defined as the time from first documented evidence of CR or PR until disease progression as assessed by RECIST 1.1 or death. DOR as assessed by blinded independent central review per RECIST 1.1 is presented.
    End point type
    Secondary
    End point timeframe
    Up to approximately 19 months
    End point values
    Pembrolizumab + Chemotherapy Combo Placebo + Chemotherapy
    Number of subjects analysed
    161
    108
    Units: Months
        median (full range (min-max))
    7.7 (1.1 to 14.7)
    4.8 (1.3 to 15.8)
    No statistical analyses for this end point

    Secondary: Number of Participants Who Experienced an Adverse Event (AE)

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    End point title
    Number of Participants Who Experienced an Adverse Event (AE)
    End point description
    An AE was defined as any untoward medical occurrence in a participant administered study treatment and which did not necessarily have to have a causal relationship with this treatment. The number of participants who experienced an AE is presented.
    End point type
    Secondary
    End point timeframe
    Up to approximately 83 months
    End point values
    Pembrolizumab + Chemotherapy Combo Placebo + Chemotherapy
    Number of subjects analysed
    278
    280
    Units: Participants
    274
    275
    No statistical analyses for this end point

    Secondary: Number of Participants Who Discontinued Study Treatment Due to an Adverse Event (AE)

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    End point title
    Number of Participants Who Discontinued Study Treatment Due to an Adverse Event (AE)
    End point description
    The number of participants who discontinued study treatment due to an AE is presented.
    End point type
    Secondary
    End point timeframe
    Up to approximately 29 months
    End point values
    Pembrolizumab + Chemotherapy Combo Placebo + Chemotherapy
    Number of subjects analysed
    278
    280
    Units: Participants
    80
    37
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to approximately 83 months
    Adverse event reporting additional description
    All-Cause Mortality (ACM): all randomized participants. AEs: all participants who got ≥1 dose of study drug. Per protocol disease progression of cancer was not considered an AE unless related to study drug; participants receiving switch-over, second course, and switch-over plus second course treatment were monitored for ACM and AEs separately.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    26.0
    Reporting groups
    Reporting group title
    Placebo + Chemotherapy
    Reporting group description
    Participants received normal saline as placebo by IV infusion prior to chemotherapy on Day 1 of each 21-day cycle for up to 35 cycles (~ 2 years) PLUS Investigator’s choice of paclitaxel (200 mg/m^2 by IV infusion on Day 1 of each 21-day cycle for 4 cycles) or nab-paclitaxel (100 mg/m^2 by IV infusion on Days 1, 8, 15 of each 21-day cycle for 4 cycles) PLUS carboplatin AUC 6 by IV infusion on Day 1 of each 21-day cycle for 4 cycles.

    Reporting group title
    Pembrolizumab + Chemotherapy Combo
    Reporting group description
    Participants received pembrolizumab 200 mg by intravenous (IV) infusion prior to chemotherapy on Day 1 of 21-day cycle for up to 35 cycles PLUS Investigator’s choice of paclitaxel (200 mg/m^2 by IV infusion on Day 1 of each 21-day cycle for 4 cycles) or nab paclitaxel (100 mg/m^2 by IV infusion on Days 1, 8, 15 of each 21-day cycle for 4 cycles) PLUS carboplatin Area Under Curve (AUC) 6 by IV infusion on Day 1 of each 21-day cycle for 4 cycles.

    Reporting group title
    Pembrolizumab Combo (Second Course)
    Reporting group description
    Participants who completed the first course of up to 35 administrations of pembrolizumab (~2 years) and were deemed to be benefitting clinically despite progression, received a second course of pembrolizumab at the investigator's discretion. Pembrolizumab was administered at 200 mg IV on Day 1 of each 21-day cycle for up to 17 cycles (up to ~1 year additional).

    Reporting group title
    Placebo Switched Over to Pembrolizumab (Second Course)
    Reporting group description
    Participants who switched from saline placebo to complete the first course of up to 35 administrations of pembrolizumab (~2 years), initiated a second course of pembrolizumab at investigator’s discretion. Pembrolizumab was administered 200 mg IV on Day 1 of each 21-day cycle for up to 17 cycles (up to ~1 year).

    Reporting group title
    Placebo Switched Over to Pembrolizumab
    Reporting group description
    Participants who received saline placebo with chemotherapy and who experienced disease progression, switched over to receive pembrolizumab monotherapy at investigator's discretion. Pembrolizumab was administered at 200 mg IV on Day 1 of each 21-day cycle for 35 cycles (~ 2 years).

    Serious adverse events
    Placebo + Chemotherapy Pembrolizumab + Chemotherapy Combo Pembrolizumab Combo (Second Course) Placebo Switched Over to Pembrolizumab (Second Course) Placebo Switched Over to Pembrolizumab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    114 / 280 (40.71%)
    128 / 278 (46.04%)
    2 / 12 (16.67%)
    0 / 1 (0.00%)
    35 / 118 (29.66%)
         number of deaths (all causes)
    143
    225
    6
    0
    111
         number of deaths resulting from adverse events
    20
    32
    0
    0
    7
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Cancer pain
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Colon cancer
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tumour necrosis
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Transitional cell carcinoma
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Prostate cancer
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Paraneoplastic syndrome
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Arterial disorder
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Arterial haemorrhage
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Embolism
         subjects affected / exposed
    1 / 280 (0.36%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    2 / 280 (0.71%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Orthostatic hypotension
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Circulatory collapse
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Thrombophlebitis migrans
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Superficial vein thrombosis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Superior vena cava syndrome
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Vasculitis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    2 / 280 (0.71%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Asthenia
         subjects affected / exposed
    5 / 280 (1.79%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    4 / 5
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Death
         subjects affected / exposed
    3 / 280 (1.07%)
    6 / 278 (2.16%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 3
    2 / 6
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 3
    2 / 6
    0 / 0
    0 / 0
    0 / 1
    Fatigue
         subjects affected / exposed
    2 / 280 (0.71%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Malaise
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    5 / 280 (1.79%)
    5 / 278 (1.80%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    3 / 6
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Amyloidosis
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Drug hypersensitivity
         subjects affected / exposed
    0 / 280 (0.00%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Atelectasis
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    2 / 280 (0.71%)
    3 / 278 (1.08%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    2 / 118 (1.69%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Bronchitis chronic
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bronchial haemorrhage
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    2 / 280 (0.71%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    4 / 280 (1.43%)
    6 / 278 (2.16%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    2 / 118 (1.69%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 6
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonitis aspiration
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    2 / 280 (0.71%)
    9 / 278 (3.24%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    5 / 118 (4.24%)
         occurrences causally related to treatment / all
    1 / 2
    7 / 9
    0 / 0
    0 / 0
    5 / 5
         deaths causally related to treatment / all
    0 / 1
    1 / 1
    0 / 0
    0 / 0
    2 / 2
    Pleural effusion
         subjects affected / exposed
    2 / 280 (0.71%)
    4 / 278 (1.44%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 5
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Obstructive airways disorder
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Interstitial lung disease
         subjects affected / exposed
    2 / 280 (0.71%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    2 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Haemothorax
         subjects affected / exposed
    1 / 280 (0.36%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    3 / 280 (1.07%)
    3 / 278 (1.08%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    1 / 280 (0.36%)
    3 / 278 (1.08%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary haemorrhage
         subjects affected / exposed
    2 / 280 (0.71%)
    3 / 278 (1.08%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 3
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    1 / 2
    0 / 0
    0 / 0
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    1 / 280 (0.36%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    0 / 280 (0.00%)
    4 / 278 (1.44%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 4
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 4
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Delirium
         subjects affected / exposed
    2 / 280 (0.71%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    1 / 280 (0.36%)
    5 / 278 (1.80%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    6 / 6
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Acute coronary syndrome
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    2 / 280 (0.71%)
    0 / 278 (0.00%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Atrial flutter
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Atrioventricular block
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    2 / 280 (0.71%)
    4 / 278 (1.44%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 4
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    1 / 4
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 280 (0.36%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    1 / 2
    0 / 0
    0 / 0
    0 / 0
    Cardio-respiratory arrest
         subjects affected / exposed
    2 / 280 (0.71%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Prinzmetal angina
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pericardial effusion
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Balance disorder
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cerebral infarction
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cerebral ischaemia
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    0 / 280 (0.00%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Dysarthria
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Epilepsy
         subjects affected / exposed
    1 / 280 (0.36%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Carotid artery occlusion
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Carotid artery stenosis
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    1 / 280 (0.36%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    Intercostal neuralgia
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Facial paralysis
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Neuropathy peripheral
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Sciatica
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    0 / 280 (0.00%)
    3 / 278 (1.08%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Uraemic encephalopathy
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 280 (0.36%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    2 / 280 (0.71%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Spinal cord compression
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    7 / 280 (2.50%)
    5 / 278 (1.80%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    5 / 7
    5 / 5
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Autoimmune haemolytic anaemia
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    8 / 280 (2.86%)
    7 / 278 (2.52%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    9 / 9
    8 / 8
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Splenic haematoma
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    3 / 280 (1.07%)
    6 / 278 (2.16%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    4 / 4
    7 / 7
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    10 / 280 (3.57%)
    15 / 278 (5.40%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    11 / 12
    14 / 15
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Eosinophilia
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Leukopenia
         subjects affected / exposed
    0 / 280 (0.00%)
    4 / 278 (1.44%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    4 / 4
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Eye disorders
    Cataract
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Autoimmune colitis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Duodenal ulcer
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    6 / 280 (2.14%)
    8 / 278 (2.88%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    4 / 6
    6 / 9
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 280 (0.36%)
    6 / 278 (2.16%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    6 / 6
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Duodenitis
         subjects affected / exposed
    0 / 280 (0.00%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    3 / 3
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastric ulcer haemorrhage
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Enterocolitis
         subjects affected / exposed
    1 / 280 (0.36%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Dysphagia
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ileus
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumatosis intestinalis
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Oesophageal stenosis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Intestinal perforation
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    3 / 280 (1.07%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Autoimmune hepatitis
         subjects affected / exposed
    0 / 280 (0.00%)
    3 / 278 (1.08%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    3 / 3
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bile duct stone
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis acute
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cholangitis
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatic failure
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    Hepatitis
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyperbilirubinaemia
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Diabetic foot
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psoriasis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Rash maculo-papular
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Haematuria
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Glomerulonephritis membranous
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Acute kidney injury
         subjects affected / exposed
    4 / 280 (1.43%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    3 / 4
    2 / 3
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nephritis
         subjects affected / exposed
    1 / 280 (0.36%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tubulointerstitial nephritis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Urinary retention
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Endocrine disorders
    Autoimmune thyroiditis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyperthyroidism
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Inappropriate antidiuretic hormone secretion
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypothyroidism
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypopituitarism
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypophysitis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Myalgia
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Haematoma muscle
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Back pain
         subjects affected / exposed
    1 / 280 (0.36%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    2 / 118 (1.69%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Arthralgia
         subjects affected / exposed
    0 / 280 (0.00%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pathological fracture
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Appendiceal abscess
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Biliary tract infection
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Blister infected
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    COVID-19 pneumonia
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Campylobacter colitis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Candida infection
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    2 / 280 (0.71%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatitis B
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatitis E
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Necrotising fasciitis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Kidney infection
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Klebsiella infection
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Large intestine infection
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 280 (0.36%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Lung abscess
         subjects affected / exposed
    1 / 280 (0.36%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 3
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    Meningitis pneumococcal
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary sepsis
         subjects affected / exposed
    1 / 280 (0.36%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
    Prostatic abscess
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia legionella
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia klebsiella
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia fungal
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia bacterial
         subjects affected / exposed
    1 / 280 (0.36%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 2
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    21 / 280 (7.50%)
    22 / 278 (7.91%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    7 / 118 (5.93%)
         occurrences causally related to treatment / all
    5 / 23
    8 / 23
    0 / 0
    0 / 0
    0 / 9
         deaths causally related to treatment / all
    1 / 1
    0 / 2
    0 / 0
    0 / 0
    0 / 0
    Pyelonephritis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Oral candidiasis
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 280 (0.36%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 280 (0.00%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tracheobronchitis
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Stoma site infection
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    3 / 280 (1.07%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    2 / 3
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    2 / 280 (0.71%)
    6 / 278 (2.16%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    4 / 6
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    3 / 4
    0 / 0
    0 / 0
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular device infection
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 280 (0.36%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    1 / 280 (0.36%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Diabetes mellitus
         subjects affected / exposed
    1 / 280 (0.36%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    2 / 280 (0.71%)
    1 / 278 (0.36%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypercalcaemia
         subjects affected / exposed
    5 / 280 (1.79%)
    0 / 278 (0.00%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    3 / 280 (1.07%)
    2 / 278 (0.72%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    3 / 4
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo + Chemotherapy Pembrolizumab + Chemotherapy Combo Pembrolizumab Combo (Second Course) Placebo Switched Over to Pembrolizumab (Second Course) Placebo Switched Over to Pembrolizumab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    272 / 280 (97.14%)
    270 / 278 (97.12%)
    9 / 12 (75.00%)
    0 / 1 (0.00%)
    90 / 118 (76.27%)
    Vascular disorders
    Hypotension
         subjects affected / exposed
    16 / 280 (5.71%)
    12 / 278 (4.32%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    4 / 118 (3.39%)
         occurrences all number
    19
    13
    1
    0
    4
    Hypertension
         subjects affected / exposed
    14 / 280 (5.00%)
    18 / 278 (6.47%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    3 / 118 (2.54%)
         occurrences all number
    15
    22
    0
    0
    3
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    60 / 280 (21.43%)
    62 / 278 (22.30%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    8 / 118 (6.78%)
         occurrences all number
    72
    83
    0
    0
    16
    Chest pain
         subjects affected / exposed
    24 / 280 (8.57%)
    20 / 278 (7.19%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    9 / 118 (7.63%)
         occurrences all number
    24
    21
    0
    0
    10
    Fatigue
         subjects affected / exposed
    72 / 280 (25.71%)
    67 / 278 (24.10%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    15 / 118 (12.71%)
         occurrences all number
    102
    92
    2
    0
    15
    Oedema peripheral
         subjects affected / exposed
    22 / 280 (7.86%)
    26 / 278 (9.35%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    3 / 118 (2.54%)
         occurrences all number
    30
    27
    0
    0
    4
    Pyrexia
         subjects affected / exposed
    35 / 280 (12.50%)
    39 / 278 (14.03%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    5 / 118 (4.24%)
         occurrences all number
    41
    45
    0
    0
    7
    Respiratory, thoracic and mediastinal disorders
    Haemoptysis
         subjects affected / exposed
    25 / 280 (8.93%)
    23 / 278 (8.27%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    12 / 118 (10.17%)
         occurrences all number
    36
    24
    1
    0
    14
    Epistaxis
         subjects affected / exposed
    19 / 280 (6.79%)
    27 / 278 (9.71%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    21
    32
    0
    0
    0
    Dyspnoea
         subjects affected / exposed
    45 / 280 (16.07%)
    41 / 278 (14.75%)
    2 / 12 (16.67%)
    0 / 1 (0.00%)
    15 / 118 (12.71%)
         occurrences all number
    49
    46
    2
    0
    15
    Cough
         subjects affected / exposed
    56 / 280 (20.00%)
    49 / 278 (17.63%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    12 / 118 (10.17%)
         occurrences all number
    66
    55
    0
    0
    13
    Lung infiltration
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    Hiccups
         subjects affected / exposed
    6 / 280 (2.14%)
    14 / 278 (5.04%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    6
    21
    0
    0
    0
    Productive cough
         subjects affected / exposed
    13 / 280 (4.64%)
    18 / 278 (6.47%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    8 / 118 (6.78%)
         occurrences all number
    15
    21
    0
    0
    8
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    23 / 280 (8.21%)
    31 / 278 (11.15%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    5 / 118 (4.24%)
         occurrences all number
    24
    32
    0
    0
    5
    Anxiety
         subjects affected / exposed
    8 / 280 (2.86%)
    15 / 278 (5.40%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    9
    17
    0
    0
    0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    12 / 280 (4.29%)
    23 / 278 (8.27%)
    2 / 12 (16.67%)
    0 / 1 (0.00%)
    5 / 118 (4.24%)
         occurrences all number
    12
    39
    3
    0
    9
    White blood cell count decreased
         subjects affected / exposed
    32 / 280 (11.43%)
    32 / 278 (11.51%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    61
    78
    4
    0
    0
    Blood alkaline phosphatase increased
         subjects affected / exposed
    12 / 280 (4.29%)
    12 / 278 (4.32%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    4 / 118 (3.39%)
         occurrences all number
    12
    19
    2
    0
    5
    Blood bilirubin increased
         subjects affected / exposed
    3 / 280 (1.07%)
    5 / 278 (1.80%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    3 / 118 (2.54%)
         occurrences all number
    6
    13
    2
    0
    6
    Blood creatinine increased
         subjects affected / exposed
    15 / 280 (5.36%)
    26 / 278 (9.35%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    11 / 118 (9.32%)
         occurrences all number
    24
    37
    4
    0
    20
    Weight decreased
         subjects affected / exposed
    24 / 280 (8.57%)
    31 / 278 (11.15%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    11 / 118 (9.32%)
         occurrences all number
    24
    33
    1
    0
    12
    Platelet count decreased
         subjects affected / exposed
    23 / 280 (8.21%)
    25 / 278 (8.99%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences all number
    42
    52
    2
    0
    1
    Neutrophil count decreased
         subjects affected / exposed
    28 / 280 (10.00%)
    24 / 278 (8.63%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    60
    59
    0
    0
    0
    Aspartate aminotransferase increased
         subjects affected / exposed
    16 / 280 (5.71%)
    26 / 278 (9.35%)
    2 / 12 (16.67%)
    0 / 1 (0.00%)
    6 / 118 (5.08%)
         occurrences all number
    17
    40
    2
    0
    8
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    20 / 280 (7.14%)
    21 / 278 (7.55%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    4 / 118 (3.39%)
         occurrences all number
    23
    25
    0
    0
    5
    Peripheral sensory neuropathy
         subjects affected / exposed
    37 / 280 (13.21%)
    33 / 278 (11.87%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    39
    34
    0
    0
    0
    Paraesthesia
         subjects affected / exposed
    16 / 280 (5.71%)
    21 / 278 (7.55%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    17
    22
    0
    0
    0
    Neuropathy peripheral
         subjects affected / exposed
    48 / 280 (17.14%)
    60 / 278 (21.58%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    56
    69
    0
    0
    0
    Dysgeusia
         subjects affected / exposed
    11 / 280 (3.93%)
    24 / 278 (8.63%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    2 / 118 (1.69%)
         occurrences all number
    11
    27
    0
    0
    2
    Headache
         subjects affected / exposed
    23 / 280 (8.21%)
    25 / 278 (8.99%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    4 / 118 (3.39%)
         occurrences all number
    27
    28
    0
    0
    9
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    85 / 280 (30.36%)
    99 / 278 (35.61%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    166
    201
    0
    0
    0
    Leukopenia
         subjects affected / exposed
    20 / 280 (7.14%)
    20 / 278 (7.19%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences all number
    40
    46
    0
    0
    1
    Anaemia
         subjects affected / exposed
    139 / 280 (49.64%)
    148 / 278 (53.24%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    17 / 118 (14.41%)
         occurrences all number
    186
    200
    1
    0
    26
    Thrombocytopenia
         subjects affected / exposed
    64 / 280 (22.86%)
    81 / 278 (29.14%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    4 / 118 (3.39%)
         occurrences all number
    95
    131
    1
    0
    6
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    17 / 280 (6.07%)
    22 / 278 (7.91%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    3 / 118 (2.54%)
         occurrences all number
    17
    24
    0
    0
    4
    Vomiting
         subjects affected / exposed
    30 / 280 (10.71%)
    51 / 278 (18.35%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    6 / 118 (5.08%)
         occurrences all number
    47
    71
    0
    0
    8
    Stomatitis
         subjects affected / exposed
    15 / 280 (5.36%)
    14 / 278 (5.04%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    2 / 118 (1.69%)
         occurrences all number
    16
    17
    0
    0
    2
    Nausea
         subjects affected / exposed
    90 / 280 (32.14%)
    101 / 278 (36.33%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    12 / 118 (10.17%)
         occurrences all number
    136
    151
    0
    0
    13
    Dysphagia
         subjects affected / exposed
    6 / 280 (2.14%)
    5 / 278 (1.80%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    3 / 118 (2.54%)
         occurrences all number
    7
    5
    1
    0
    3
    Dry mouth
         subjects affected / exposed
    3 / 280 (1.07%)
    10 / 278 (3.60%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    6 / 118 (5.08%)
         occurrences all number
    3
    12
    0
    0
    7
    Diarrhoea
         subjects affected / exposed
    65 / 280 (23.21%)
    88 / 278 (31.65%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    16 / 118 (13.56%)
         occurrences all number
    86
    141
    0
    0
    22
    Constipation
         subjects affected / exposed
    62 / 280 (22.14%)
    70 / 278 (25.18%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    12 / 118 (10.17%)
         occurrences all number
    74
    93
    0
    0
    14
    Hepatobiliary disorders
    Cholestasis
         subjects affected / exposed
    0 / 280 (0.00%)
    1 / 278 (0.36%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences all number
    0
    1
    1
    0
    1
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    32 / 280 (11.43%)
    52 / 278 (18.71%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    7 / 118 (5.93%)
         occurrences all number
    37
    62
    1
    0
    7
    Pruritus
         subjects affected / exposed
    25 / 280 (8.93%)
    51 / 278 (18.35%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    15 / 118 (12.71%)
         occurrences all number
    29
    61
    0
    0
    18
    Dry skin
         subjects affected / exposed
    8 / 280 (2.86%)
    12 / 278 (4.32%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    1 / 118 (0.85%)
         occurrences all number
    8
    12
    1
    0
    1
    Alopecia
         subjects affected / exposed
    105 / 280 (37.50%)
    128 / 278 (46.04%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    106
    129
    0
    0
    0
    Skin necrosis
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    6 / 280 (2.14%)
    33 / 278 (11.87%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    5 / 118 (4.24%)
         occurrences all number
    7
    36
    0
    0
    6
    Hyperthyroidism
         subjects affected / exposed
    2 / 280 (0.71%)
    20 / 278 (7.19%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    5 / 118 (4.24%)
         occurrences all number
    2
    22
    0
    0
    5
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    48 / 280 (17.14%)
    70 / 278 (25.18%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    10 / 118 (8.47%)
         occurrences all number
    61
    103
    0
    0
    13
    Back pain
         subjects affected / exposed
    37 / 280 (13.21%)
    24 / 278 (8.63%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    7 / 118 (5.93%)
         occurrences all number
    38
    24
    0
    0
    7
    Myalgia
         subjects affected / exposed
    34 / 280 (12.14%)
    37 / 278 (13.31%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    3 / 118 (2.54%)
         occurrences all number
    41
    47
    0
    0
    3
    Pain in extremity
         subjects affected / exposed
    27 / 280 (9.64%)
    23 / 278 (8.27%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    4 / 118 (3.39%)
         occurrences all number
    36
    31
    0
    0
    4
    Polyarthritis
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    11 / 280 (3.93%)
    22 / 278 (7.91%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    5 / 118 (4.24%)
         occurrences all number
    12
    25
    0
    0
    5
    Nasopharyngitis
         subjects affected / exposed
    7 / 280 (2.50%)
    20 / 278 (7.19%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    2 / 118 (1.69%)
         occurrences all number
    7
    27
    0
    0
    2
    Pneumonia
         subjects affected / exposed
    16 / 280 (5.71%)
    14 / 278 (5.04%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    5 / 118 (4.24%)
         occurrences all number
    16
    16
    0
    0
    6
    Stoma site infection
         subjects affected / exposed
    0 / 280 (0.00%)
    0 / 278 (0.00%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    0 / 118 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    Upper respiratory tract infection
         subjects affected / exposed
    10 / 280 (3.57%)
    20 / 278 (7.19%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    4 / 118 (3.39%)
         occurrences all number
    13
    30
    0
    0
    7
    Urinary tract infection
         subjects affected / exposed
    8 / 280 (2.86%)
    16 / 278 (5.76%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    7 / 118 (5.93%)
         occurrences all number
    9
    17
    2
    0
    7
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    82 / 280 (29.29%)
    77 / 278 (27.70%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    9 / 118 (7.63%)
         occurrences all number
    101
    120
    0
    0
    11
    Hypercalcaemia
         subjects affected / exposed
    7 / 280 (2.50%)
    8 / 278 (2.88%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    8 / 118 (6.78%)
         occurrences all number
    8
    9
    0
    0
    10
    Hyperglycaemia
         subjects affected / exposed
    12 / 280 (4.29%)
    11 / 278 (3.96%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    5 / 118 (4.24%)
         occurrences all number
    13
    14
    1
    0
    7
    Hypoalbuminaemia
         subjects affected / exposed
    12 / 280 (4.29%)
    15 / 278 (5.40%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    7 / 118 (5.93%)
         occurrences all number
    19
    21
    0
    0
    8
    Hypocalcaemia
         subjects affected / exposed
    18 / 280 (6.43%)
    7 / 278 (2.52%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    4 / 118 (3.39%)
         occurrences all number
    27
    13
    0
    0
    5
    Hypokalaemia
         subjects affected / exposed
    19 / 280 (6.79%)
    18 / 278 (6.47%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    8 / 118 (6.78%)
         occurrences all number
    28
    31
    0
    0
    13
    Hypomagnesaemia
         subjects affected / exposed
    21 / 280 (7.50%)
    24 / 278 (8.63%)
    1 / 12 (8.33%)
    0 / 1 (0.00%)
    4 / 118 (3.39%)
         occurrences all number
    27
    36
    1
    0
    4
    Hyponatraemia
         subjects affected / exposed
    13 / 280 (4.64%)
    20 / 278 (7.19%)
    2 / 12 (16.67%)
    0 / 1 (0.00%)
    7 / 118 (5.93%)
         occurrences all number
    14
    28
    2
    0
    8
    Hypophosphataemia
         subjects affected / exposed
    11 / 280 (3.93%)
    7 / 278 (2.52%)
    0 / 12 (0.00%)
    0 / 1 (0.00%)
    7 / 118 (5.93%)
         occurrences all number
    17
    9
    0
    0
    9

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    13 Oct 2017
    Amendment 1 (AM1):To attain the necessary number of Chinese participants and events for investigating efficacy and safety in Chinese NSCLC participants, it was proposed to extend the enrollment period beyond the global study.
    26 Oct 2017
    AM2: The statistical design was updated to optimize the study for the identification of long-term treatment effect in overall survival (OS) and progression free survival (PFS).
    05 Dec 2017
    AM3: The statistical design was updated to optimize the study for the identification of long-term treatment effect in OS and PFS.
    29 Jun 2018
    AM4: The statistical design had an update specific to China, aiming to optimize the identification of long-term treatment effects in OS and PFS.
    30 Jul 2018
    AM5: Following positive interim results from the global study, participants were provided with the option to discontinue placebo treatment.
    30 Oct 2019
    AM6: Due to positive interim results obtained from the China amendment, participants had the opportunity to choose discontinuation of placebo treatment.
    22 Feb 2022
    AM7: Incorporating the global amendment, which includes China, language was included regarding the enrollment of participants in a pembrolizumab extension study upon completion of the main study.
    06 Sep 2022
    AM8: Including China, the global amendment introduced additional language permitting participants in the crossover phase of the study to be eligible for second-course treatment with pembrolizumab. Furthermore, it allowed participants in the first-course follow-up to be eligible for second-course treatment for a duration longer than 2 years.

    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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