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    Clinical Trial Results:
    A Phase 2, Open-label, Single-arm, Two-cohort Study of Nivolumab in Relapsed/Refractory Primary Central Nervous System Lymphoma (PCNSL) or Relapsed/Refractory Primary Testicular Lymphoma (PTL)

    Summary
    EudraCT number
    2016-000894-19
    Trial protocol
    HU   FR   DE   IT  
    Global end of trial date
    24 Nov 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    13 Dec 2021
    First version publication date
    13 Dec 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CA209-647
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Bristol-Myers Squibb
    Sponsor organisation address
    Chaussée de la Hulpe 185, Brussels, Belgium, 1170
    Public contact
    EU Study Start-Up Unit, Bristol-Myers Squibb International Corporation, Clinical.Trials@bms.com
    Scientific contact
    Bristol-Myers Squibb Study Director, Bristol-Myers Squibb, Clinical.Trials@bms.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    29 Jan 2021
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    24 Nov 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Investigate clinically meaningful efficacy treatment with Nivolumab in subjects with relapsed/refractory PCNSL or PTL
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and in compliance with all International Conference on Harmonization Good Clinical Practice Guidelines. All the local regulatory requirements pertinent to safety of trial participants were followed.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    21 Oct 2016
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Canada: 2
    Country: Number of subjects enrolled
    France: 7
    Country: Number of subjects enrolled
    Germany: 6
    Country: Number of subjects enrolled
    Hong Kong: 1
    Country: Number of subjects enrolled
    Hungary: 3
    Country: Number of subjects enrolled
    Israel: 2
    Country: Number of subjects enrolled
    Italy: 8
    Country: Number of subjects enrolled
    Japan: 9
    Country: Number of subjects enrolled
    Russian Federation: 1
    Country: Number of subjects enrolled
    Singapore: 1
    Country: Number of subjects enrolled
    United States: 26
    Worldwide total number of subjects
    66
    EEA total number of subjects
    24
    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)
    24
    From 65 to 84 years
    42
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    47 PCNSL participants treated. 19 PTL participants treated.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    PCNSL cohort
    Arm description
    Nivolumab dosed to participants with relapsed/refractory Primary Central Nervous System Lymphoma (PCNSL). Nivolumab 240 mg was given every 2 weeks for 8 cycles. Beginning with Cycle 9, nivolumab 480 mg was given every 4 weeks for a total therapy duration of 2 years, or until progressive disease, unacceptable toxicity, or withdrawal of consent. Nivolumab was administered as a 30-minute infusion.
    Arm type
    Experimental

    Investigational medicinal product name
    Nivolumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Nivolumab at a dose of 240 mg as a 30-minute infusion on Day 1 of each treatment cycle for 8 cycle. Beginning with Cycle 9, Nivolumab at a dose of 480 mg as a 30-minute infusion every 4 weeks

    Arm title
    PTL cohort
    Arm description
    Nivolumab dosed to participants with relapsed/refractory Primary Testicular Lymphoma (PTL). Nivolumab 240 mg was given every 2 weeks for 8 cycles. Beginning with Cycle 9, nivolumab 480 mg was given every 4 weeks for a total therapy duration of 2 years, or until progressive disease, unacceptable toxicity, or withdrawal of consent. Nivolumab was administered as a 30-minute infusion.
    Arm type
    Experimental

    Investigational medicinal product name
    Nivolumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Nivolumab at a dose of 240 mg as a 30-minute infusion on Day 1 of each treatment cycle for 8 cycle. Beginning with Cycle 9, Nivolumab at a dose of 480 mg as a 30-minute infusion every 4 weeks

    Number of subjects in period 1
    PCNSL cohort PTL cohort
    Started
    47
    19
    Completed
    0
    0
    Not completed
    47
    19
         Adverse event, serious fatal
    1
    -
         Completed treatment
    -
    2
         Disease progression
    34
    13
         Participant withdrew consent
    1
    1
         Study drug toxicity
    4
    1
         Maximum clinical benefit
    1
    -
         Adverse event unrelated to study drug
    6
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    PCNSL cohort
    Reporting group description
    Nivolumab dosed to participants with relapsed/refractory Primary Central Nervous System Lymphoma (PCNSL). Nivolumab 240 mg was given every 2 weeks for 8 cycles. Beginning with Cycle 9, nivolumab 480 mg was given every 4 weeks for a total therapy duration of 2 years, or until progressive disease, unacceptable toxicity, or withdrawal of consent. Nivolumab was administered as a 30-minute infusion.

    Reporting group title
    PTL cohort
    Reporting group description
    Nivolumab dosed to participants with relapsed/refractory Primary Testicular Lymphoma (PTL). Nivolumab 240 mg was given every 2 weeks for 8 cycles. Beginning with Cycle 9, nivolumab 480 mg was given every 4 weeks for a total therapy duration of 2 years, or until progressive disease, unacceptable toxicity, or withdrawal of consent. Nivolumab was administered as a 30-minute infusion.

    Reporting group values
    PCNSL cohort PTL cohort Total
    Number of subjects
    47 19 66
    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)
    18 6 24
        From 65-84 years
    29 13 42
        85 years and over
    0 0 0
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    65.9 ( 10.1 ) 66.7 ( 8.6 ) -
    Sex: Female, Male
    Units: Participants
        Female
    20 0 20
        Male
    27 19 46
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0 0
        Asian
    10 5 15
        Native Hawaiian or Other Pacific Islander
    0 0 0
        Black or African American
    0 0 0
        White
    37 12 49
        More than one race
    0 0 0
        Unknown or Not Reported
    0 2 2
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    1 0 1
        Not Hispanic or Latino
    33 11 44
        Unknown or Not Reported
    13 8 21

    End points

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    End points reporting groups
    Reporting group title
    PCNSL cohort
    Reporting group description
    Nivolumab dosed to participants with relapsed/refractory Primary Central Nervous System Lymphoma (PCNSL). Nivolumab 240 mg was given every 2 weeks for 8 cycles. Beginning with Cycle 9, nivolumab 480 mg was given every 4 weeks for a total therapy duration of 2 years, or until progressive disease, unacceptable toxicity, or withdrawal of consent. Nivolumab was administered as a 30-minute infusion.

    Reporting group title
    PTL cohort
    Reporting group description
    Nivolumab dosed to participants with relapsed/refractory Primary Testicular Lymphoma (PTL). Nivolumab 240 mg was given every 2 weeks for 8 cycles. Beginning with Cycle 9, nivolumab 480 mg was given every 4 weeks for a total therapy duration of 2 years, or until progressive disease, unacceptable toxicity, or withdrawal of consent. Nivolumab was administered as a 30-minute infusion.

    Primary: BICR-Assessed Objective Response Rate (ORR)

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    End point title
    BICR-Assessed Objective Response Rate (ORR) [1]
    End point description
    Percentage of participants with a confirmed objective response rate (ORR) by blinded independent central review (BICR) assessment was analyzed and reported for both PCNSL and PTL patient populations. This endpoint is further defined as the percentage of participants with a best overall response (BOR) of complete response (CR) or partial response (PR), based on the IPCG Criteria for PCNSL and Lugano 2014 response evaluation for PTL, divided by the number of treated participants within each cohort.
    End point type
    Primary
    End point timeframe
    Up to approximately 51 months
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only summary statistics planned for this endpoint since this is a single arm (by cohort) design.
    End point values
    PCNSL cohort PTL cohort
    Number of subjects analysed
    47
    19
    Units: Percentage of participants
        number (confidence interval 95%)
    6.4 (1.3 to 17.5)
    26.3 (9.1 to 51.2)
    No statistical analyses for this end point

    Secondary: BICR-Assessed Progression Free Survival (PFS)

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    End point title
    BICR-Assessed Progression Free Survival (PFS)
    End point description
    Progression-free survival (PFS) is defined as the time from first dosing date to the date of the first documented progression using the IPCG Criteria for PCNSL and Lugano 2014 response evaluation for PTL, as determined by BICR, or death due to any cause, whichever occurs first.
    End point type
    Secondary
    End point timeframe
    Up to approximately 51 months
    End point values
    PCNSL cohort PTL cohort
    Number of subjects analysed
    47
    19
    Units: Months
        median (confidence interval 95%)
    1.41 (1.08 to 1.74)
    1.72 (1.15 to 6.28)
    No statistical analyses for this end point

    Secondary: Investigator-Assessed Objective Response Rate (ORR)

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    End point title
    Investigator-Assessed Objective Response Rate (ORR)
    End point description
    Percentage of participants with a confirmed objective response rate (ORR) by investigator assessment was analyzed and reported for both PCNSL and PTL patient populations. This endpoint is further defined as the percentage of participants with a best overall response (BOR) of complete response (CR) or partial response (PR), based on the IPCG Criteria for PCNSL and Lugano 2014 response evaluation for PTL, divided by the number of treated participants within each cohort.
    End point type
    Secondary
    End point timeframe
    Up to approximately 51 months
    End point values
    PCNSL cohort PTL cohort
    Number of subjects analysed
    47
    19
    Units: Percentage of participants
        number (confidence interval 95%)
    10.6 (3.5 to 23.1)
    26.3 (9.1 to 51.2)
    No statistical analyses for this end point

    Secondary: Investigator-Assessed Duration of Response (DOR)

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    End point title
    Investigator-Assessed Duration of Response (DOR)
    End point description
    Duration of response (DOR) by investigator assessment was analyzed and reported for both PCNSL and PTL patient populations. This endpoint is further defined as the time from first response (CR or PR) to the date of initial objectively documented progression as determined using the IPCG Criteria for PCNSL and Lugano 2014 response evaluation for PTL, as determined by BICR, or death due to any cause, whichever occurs first.
    End point type
    Secondary
    End point timeframe
    Up to approximately 51 months
    End point values
    PCNSL cohort PTL cohort
    Number of subjects analysed
    5
    5
    Units: Months
        median (confidence interval 95%)
    1.71 (0.72 to 7.10)
    20.63 (0.03 to 99999)
    No statistical analyses for this end point

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    Overall survival (OS) was analyzed and reported for both PCNSL and PTL patient populations. OS is defined as the time from first dosing date to the date of death. For participants without documentation of death, OS will be censored on the last date the participant was known to be alive.
    End point type
    Secondary
    End point timeframe
    Up to approximately 51 months
    End point values
    PCNSL cohort PTL cohort
    Number of subjects analysed
    47
    19
    Units: Months
        median (confidence interval 95%)
    6.77 (3.68 to 11.99)
    11.17 (2.60 to 24.41)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    AEs collected were reported between first dose of the study treatment upto 100 days after last dose of study treatment
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    23.1
    Reporting groups
    Reporting group title
    Primary central nervous system lymphoma (PCNSL) Cohort
    Reporting group description
    Subjects with pathologically confirmed PCNSL were administered 240 milligram (mg) of Nivolumab as a 30-minute intravenous (IV) infusion every 2 weeks (Q2W) for a total of 8 cycles followed by 480 mg of Nivolumab every 4 weeks (Q4W) for a maximum of 2 years or until progressive disease, unacceptable toxicity, or withdrawal of consent.

    Reporting group title
    Primary Testicular Lymphoma (PTL) Cohort
    Reporting group description
    Subjects with pathologically confirmed PTL were administered 240 mg of Nivolumab as a 30-minute IV infusion Q2W for a total of 8 cycles followed by 480 mg of Nivolumab Q4W for a maximum of 2 years or until progressive disease, unacceptable toxicity, or withdrawal of consent.

    Serious adverse events
    Primary central nervous system lymphoma (PCNSL) Cohort Primary Testicular Lymphoma (PTL) Cohort
    Total subjects affected by serious adverse events
         subjects affected / exposed
    33 / 47 (70.21%)
    15 / 19 (78.95%)
         number of deaths (all causes)
    32
    13
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Adenocarcinoma of colon
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung adenocarcinoma
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malignant neoplasm progression
         subjects affected / exposed
    13 / 47 (27.66%)
    8 / 19 (42.11%)
         occurrences causally related to treatment / all
    0 / 13
    0 / 9
         deaths causally related to treatment / all
    0 / 9
    0 / 6
    Tumour flare
         subjects affected / exposed
    2 / 47 (4.26%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour pseudoprogression
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fatigue
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gait disturbance
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    2 / 47 (4.26%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Mucosal inflammation
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sudden death
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary embolism
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    2 / 47 (4.26%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mental status changes
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Lymphocyte count decreased
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Cervical vertebral fracture
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    2 / 47 (4.26%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hip fracture
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infusion related reaction
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Brain oedema
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cognitive disorder
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Depressed level of consciousness
         subjects affected / exposed
    2 / 47 (4.26%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Encephalopathy
         subjects affected / exposed
    2 / 47 (4.26%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Epilepsy
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemorrhage intracranial
         subjects affected / exposed
    3 / 47 (6.38%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Headache
         subjects affected / exposed
    2 / 47 (4.26%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hemianopia homonymous
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hemiparesis
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hemiplegia
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mental impairment
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorder
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neurological decompensation
         subjects affected / exposed
    2 / 47 (4.26%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Optic neuritis
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    4 / 47 (8.51%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    1 / 5
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Leukopenia
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancytopenia
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Dysphagia
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Hepatitis
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatitis acute
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Erythema multiforme
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 47 (2.13%)
    2 / 19 (10.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Muscular weakness
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Cystitis
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Influenza
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Meningitis viral
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary sepsis
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Sepsis
         subjects affected / exposed
    3 / 47 (6.38%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular device infection
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    2 / 47 (4.26%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Failure to thrive
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Primary central nervous system lymphoma (PCNSL) Cohort Primary Testicular Lymphoma (PTL) Cohort
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    40 / 47 (85.11%)
    16 / 19 (84.21%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Malignant neoplasm progression
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Vascular disorders
    Hypotension
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    2 / 47 (4.26%)
    2 / 19 (10.53%)
         occurrences all number
    2
    2
    Fatigue
         subjects affected / exposed
    12 / 47 (25.53%)
    2 / 19 (10.53%)
         occurrences all number
    18
    2
    Gait disturbance
         subjects affected / exposed
    6 / 47 (12.77%)
    1 / 19 (5.26%)
         occurrences all number
    6
    1
    Mucosal inflammation
         subjects affected / exposed
    2 / 47 (4.26%)
    1 / 19 (5.26%)
         occurrences all number
    2
    1
    Non-cardiac chest pain
         subjects affected / exposed
    3 / 47 (6.38%)
    1 / 19 (5.26%)
         occurrences all number
    3
    1
    Oedema peripheral
         subjects affected / exposed
    3 / 47 (6.38%)
    2 / 19 (10.53%)
         occurrences all number
    3
    2
    Pyrexia
         subjects affected / exposed
    9 / 47 (19.15%)
    5 / 19 (26.32%)
         occurrences all number
    14
    6
    Reproductive system and breast disorders
    Testicular pain
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Testicular swelling
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    3 / 47 (6.38%)
    1 / 19 (5.26%)
         occurrences all number
    3
    1
    Cough
         subjects affected / exposed
    3 / 47 (6.38%)
    2 / 19 (10.53%)
         occurrences all number
    3
    2
    Pleural effusion
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Pneumonitis
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Psychiatric disorders
    Agitation
         subjects affected / exposed
    3 / 47 (6.38%)
    0 / 19 (0.00%)
         occurrences all number
    4
    0
    Anxiety
         subjects affected / exposed
    4 / 47 (8.51%)
    0 / 19 (0.00%)
         occurrences all number
    4
    0
    Confusional state
         subjects affected / exposed
    4 / 47 (8.51%)
    1 / 19 (5.26%)
         occurrences all number
    7
    1
    Depression
         subjects affected / exposed
    3 / 47 (6.38%)
    0 / 19 (0.00%)
         occurrences all number
    3
    0
    Insomnia
         subjects affected / exposed
    5 / 47 (10.64%)
    1 / 19 (5.26%)
         occurrences all number
    8
    1
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    10 / 47 (21.28%)
    1 / 19 (5.26%)
         occurrences all number
    19
    1
    Aspartate aminotransferase increased
         subjects affected / exposed
    7 / 47 (14.89%)
    1 / 19 (5.26%)
         occurrences all number
    9
    1
    Blood creatinine increased
         subjects affected / exposed
    3 / 47 (6.38%)
    1 / 19 (5.26%)
         occurrences all number
    3
    1
    Human rhinovirus test positive
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Lipase increased
         subjects affected / exposed
    3 / 47 (6.38%)
    1 / 19 (5.26%)
         occurrences all number
    3
    1
    Lymphocyte count decreased
         subjects affected / exposed
    6 / 47 (12.77%)
    0 / 19 (0.00%)
         occurrences all number
    12
    0
    Neutrophil count decreased
         subjects affected / exposed
    5 / 47 (10.64%)
    1 / 19 (5.26%)
         occurrences all number
    8
    2
    Weight decreased
         subjects affected / exposed
    4 / 47 (8.51%)
    0 / 19 (0.00%)
         occurrences all number
    4
    0
    Platelet count decreased
         subjects affected / exposed
    5 / 47 (10.64%)
    1 / 19 (5.26%)
         occurrences all number
    24
    3
    White blood cell count decreased
         subjects affected / exposed
    3 / 47 (6.38%)
    1 / 19 (5.26%)
         occurrences all number
    11
    1
    Injury, poisoning and procedural complications
    Clavicle fracture
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Ankle fracture
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Fall
         subjects affected / exposed
    9 / 47 (19.15%)
    3 / 19 (15.79%)
         occurrences all number
    12
    4
    Procedural pain
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Infusion related reaction
         subjects affected / exposed
    2 / 47 (4.26%)
    1 / 19 (5.26%)
         occurrences all number
    2
    1
    Recall phenomenon
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Upper limb fracture
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Cardiac disorders
    Bradycardia
         subjects affected / exposed
    2 / 47 (4.26%)
    1 / 19 (5.26%)
         occurrences all number
    2
    1
    Tachycardia
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Nervous system disorders
    Aphasia
         subjects affected / exposed
    5 / 47 (10.64%)
    0 / 19 (0.00%)
         occurrences all number
    6
    0
    Ataxia
         subjects affected / exposed
    4 / 47 (8.51%)
    0 / 19 (0.00%)
         occurrences all number
    4
    0
    Dizziness
         subjects affected / exposed
    4 / 47 (8.51%)
    0 / 19 (0.00%)
         occurrences all number
    4
    0
    Dysaesthesia
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Facial paresis
         subjects affected / exposed
    3 / 47 (6.38%)
    0 / 19 (0.00%)
         occurrences all number
    3
    0
    Headache
         subjects affected / exposed
    12 / 47 (25.53%)
    1 / 19 (5.26%)
         occurrences all number
    19
    1
    Paraesthesia
         subjects affected / exposed
    3 / 47 (6.38%)
    0 / 19 (0.00%)
         occurrences all number
    4
    0
    Hemiparesis
         subjects affected / exposed
    5 / 47 (10.64%)
    0 / 19 (0.00%)
         occurrences all number
    5
    0
    Seizure
         subjects affected / exposed
    6 / 47 (12.77%)
    0 / 19 (0.00%)
         occurrences all number
    6
    0
    Somnolence
         subjects affected / exposed
    3 / 47 (6.38%)
    0 / 19 (0.00%)
         occurrences all number
    4
    0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    13 / 47 (27.66%)
    1 / 19 (5.26%)
         occurrences all number
    42
    1
    Thrombocytopenia
         subjects affected / exposed
    4 / 47 (8.51%)
    1 / 19 (5.26%)
         occurrences all number
    23
    1
    Ear and labyrinth disorders
    Tinnitus
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Vertigo
         subjects affected / exposed
    3 / 47 (6.38%)
    0 / 19 (0.00%)
         occurrences all number
    4
    0
    Eye disorders
    Conjunctival hyperaemia
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Dry eye
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Eye irritation
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Pupils unequal
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Glaucoma
         subjects affected / exposed
    0 / 47 (0.00%)
    2 / 19 (10.53%)
         occurrences all number
    0
    2
    Vision blurred
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    8 / 47 (17.02%)
    4 / 19 (21.05%)
         occurrences all number
    9
    4
    Diarrhoea
         subjects affected / exposed
    5 / 47 (10.64%)
    2 / 19 (10.53%)
         occurrences all number
    7
    2
    Dry mouth
         subjects affected / exposed
    0 / 47 (0.00%)
    2 / 19 (10.53%)
         occurrences all number
    0
    2
    Dysphagia
         subjects affected / exposed
    3 / 47 (6.38%)
    0 / 19 (0.00%)
         occurrences all number
    4
    0
    Haematochezia
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Nausea
         subjects affected / exposed
    6 / 47 (12.77%)
    2 / 19 (10.53%)
         occurrences all number
    6
    2
    Stomatitis
         subjects affected / exposed
    3 / 47 (6.38%)
    0 / 19 (0.00%)
         occurrences all number
    4
    0
    Vomiting
         subjects affected / exposed
    7 / 47 (14.89%)
    0 / 19 (0.00%)
         occurrences all number
    13
    0
    Hepatobiliary disorders
    Hepatic steatosis
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Hepatitis
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Hepatotoxicity
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Skin and subcutaneous tissue disorders
    Dermal cyst
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Eczema asteatotic
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Hyperhidrosis
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Pruritus
         subjects affected / exposed
    7 / 47 (14.89%)
    1 / 19 (5.26%)
         occurrences all number
    10
    1
    Rash
         subjects affected / exposed
    4 / 47 (8.51%)
    2 / 19 (10.53%)
         occurrences all number
    4
    2
    Rash maculo-papular
         subjects affected / exposed
    1 / 47 (2.13%)
    3 / 19 (15.79%)
         occurrences all number
    8
    3
    Skin ulcer
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Urinary incontinence
         subjects affected / exposed
    5 / 47 (10.64%)
    0 / 19 (0.00%)
         occurrences all number
    5
    0
    Chronic kidney disease
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    2 / 47 (4.26%)
    4 / 19 (21.05%)
         occurrences all number
    5
    7
    Arthritis
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Bursitis
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Back pain
         subjects affected / exposed
    4 / 47 (8.51%)
    0 / 19 (0.00%)
         occurrences all number
    7
    0
    Muscular weakness
         subjects affected / exposed
    4 / 47 (8.51%)
    2 / 19 (10.53%)
         occurrences all number
    4
    2
    Myalgia
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Musculoskeletal chest pain
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Pain in extremity
         subjects affected / exposed
    3 / 47 (6.38%)
    1 / 19 (5.26%)
         occurrences all number
    3
    1
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Cellulitis
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    2
    1
    Clostridium difficile infection
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Gastroenteritis
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    2
    Herpes simplex
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Influenza
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Oral candidiasis
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Pneumonia
         subjects affected / exposed
    2 / 47 (4.26%)
    1 / 19 (5.26%)
         occurrences all number
    2
    1
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Urinary tract infection
         subjects affected / exposed
    5 / 47 (10.64%)
    0 / 19 (0.00%)
         occurrences all number
    6
    0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    3 / 47 (6.38%)
    0 / 19 (0.00%)
         occurrences all number
    3
    0
    Decreased appetite
         subjects affected / exposed
    5 / 47 (10.64%)
    0 / 19 (0.00%)
         occurrences all number
    6
    0
    Hyperglycaemia
         subjects affected / exposed
    6 / 47 (12.77%)
    1 / 19 (5.26%)
         occurrences all number
    16
    1
    Hypernatraemia
         subjects affected / exposed
    3 / 47 (6.38%)
    1 / 19 (5.26%)
         occurrences all number
    3
    1
    Hypoalbuminaemia
         subjects affected / exposed
    5 / 47 (10.64%)
    0 / 19 (0.00%)
         occurrences all number
    7
    0
    Hypocalcaemia
         subjects affected / exposed
    5 / 47 (10.64%)
    0 / 19 (0.00%)
         occurrences all number
    15
    0
    Hypokalaemia
         subjects affected / exposed
    5 / 47 (10.64%)
    1 / 19 (5.26%)
         occurrences all number
    17
    1
    Hyponatraemia
         subjects affected / exposed
    7 / 47 (14.89%)
    0 / 19 (0.00%)
         occurrences all number
    10
    0
    Hypophosphataemia
         subjects affected / exposed
    4 / 47 (8.51%)
    0 / 19 (0.00%)
         occurrences all number
    6
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    22 Jun 2016
    Inclusion Criteria Update
    07 Apr 2017
    Eligibility Criteria Update

    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
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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