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    Clinical Trial Results:
    A Randomized Double-blind Phase 3 Study of Avelumab in Combination With Standard of Care Chemoradiotherapy (Cisplatin Plus Definitive Radiation Therapy) Versus Standard of Care Chemoradiotherapy in the Front-line Treatment of Patients With Locally Advanced Squamous cell Carcinoma of The Head and Neck.

    Summary
    EudraCT number
    2016-001456-21
    Trial protocol
    GB   BE   DE   PL   AT   ES   IE   PT   HU   FR   GR   IT  
    Global end of trial date
    25 Aug 2020

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

    Trial information

    Close Top of page
    Trial identification
    Sponsor protocol code
    B9991016
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02952586
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Pfizer Inc.
    Sponsor organisation address
    235 E 42nd Street, New York, United States,
    Public contact
    Pfizer ClinicalTrials.gov Call Center, Pfizer Inc., +1 8007181021, ClinicalTrials.gov_Inquiries@pfizer.com
    Scientific contact
    Pfizer ClinicalTrials.gov Call Center, Pfizer Inc., +1 8007181021, ClinicalTrials.gov_Inquiries@pfizer.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
    19 Feb 2021
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    25 Aug 2020
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To demonstrate that treatment with avelumab in combination with Standard of Care Chemotherapy (SOC CRT) was superior to SOC CRT alone in prolonging Progression-free Survival (PFS) in front-line subjects with high risk, locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) who were candidates for definitive CRT with cisplatin.
    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 Council for Harmonisation (ICH) Good Clinical Practice (GCP) Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were followed.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    28 Nov 2016
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety
    Long term follow-up duration
    28 Months
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Canada: 1
    Country: Number of subjects enrolled
    United States: 173
    Country: Number of subjects enrolled
    China: 45
    Country: Number of subjects enrolled
    Japan: 51
    Country: Number of subjects enrolled
    Korea, Republic of: 19
    Country: Number of subjects enrolled
    Taiwan: 69
    Country: Number of subjects enrolled
    Australia: 10
    Country: Number of subjects enrolled
    Hungary: 43
    Country: Number of subjects enrolled
    Poland: 16
    Country: Number of subjects enrolled
    Russian Federation: 38
    Country: Number of subjects enrolled
    Israel: 13
    Country: Number of subjects enrolled
    Austria: 4
    Country: Number of subjects enrolled
    Belgium: 19
    Country: Number of subjects enrolled
    France: 53
    Country: Number of subjects enrolled
    Germany: 8
    Country: Number of subjects enrolled
    Greece: 23
    Country: Number of subjects enrolled
    Ireland: 3
    Country: Number of subjects enrolled
    Italy: 19
    Country: Number of subjects enrolled
    Portugal: 30
    Country: Number of subjects enrolled
    Spain: 31
    Country: Number of subjects enrolled
    Switzerland: 12
    Country: Number of subjects enrolled
    United Kingdom: 17
    Worldwide total number of subjects
    697
    EEA total number of subjects
    249
    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)
    495
    From 65 to 84 years
    201
    85 years and over
    1

    Subject disposition

    Close Top of page
    Recruitment
    Recruitment details
    Study had 3 sequential treatment phases: Lead-in,CRT and Maintenance. There were 3 treatments administered during CRT phase: Blinded therapy (Avelumab/placebo), Cisplatin and IMRT. Only blinded therapy (Avelumab/placebo) was administered during Lead-in and Maintenance phases. Reasons for discontinuation are summarized separately for each treatment.

    Pre-assignment
    Screening details
    If a subject discontinued all 3 treatments due to death, then death is included as reason for discontinuation in each treatment disposition summary. All deaths that are reported as reason for discontinuation at any phase are included in all-cause mortality summary.

    Period 1
    Period 1 title
    Lead-In Phase (7 Days)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Arm description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    Experimental

    Investigational medicinal product name
    Avelumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects were administered with avelumab 10 mg/kg IV injection on Day 1 of the Lead-in Phase.

    Arm title
    Placebo + SOC CRT
    Arm description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days).

    Number of subjects in period 1
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Started
    350
    347
    Safety Analysis Set
    348
    344
    Completed
    345
    343
    Not completed
    5
    4
         Adverse event, non-fatal
    3
    -
         Death
    -
    1
         No Longer Met Eligibility Criteria
    -
    1
         Withdrawal by subject
    2
    2
    Period 2
    Period 2 title
    CRT for Avelumab or Placebo (63 Days)
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Arm description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    Experimental

    Investigational medicinal product name
    Avelumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects were administered with avelumab 10 mg/kg IV injection on Days 8, 25 and 39 in CRT phase.

    Arm title
    Placebo + SOC CRT
    Arm description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects were administered with avelumab matching placebo 10 mg/kg IV injection on Days 8, 25 and 39 in CRT phase.

    Number of subjects in period 2 [1]
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Started
    345
    340
    Completed
    312
    313
    Not completed
    33
    27
         Physician decision
    2
    1
         Adverse event, non-fatal
    12
    12
         Death
    5
    8
         Unspecified
    2
    1
         Lost to follow-up
    1
    1
         Global Deterioration of Health Status
    1
    -
         Withdrawal by subject
    10
    4
    Notes
    [1] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: All subjects who did not withdraw from study after Lead-In phase, entered into CRT phase.
    Period 3
    Period 3 title
    CRT for Cisplatin (63 Days)
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Arm description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    Experimental

    Investigational medicinal product name
    Cisplastin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received Cisplatin 100 mg/m^2 IV injection on Days 1, 22 and 43 of CRT phase.

    Arm title
    Placebo + SOC CRT
    Arm description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    Placebo

    Investigational medicinal product name
    Cisplastin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received Cisplatin 100 mg/m^2 IV injection on Days 1, 22 and 43 of CRT phase.

    Number of subjects in period 3
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Started
    312
    313
    Completed
    234
    236
    Not completed
    111
    104
         Physician decision
    12
    10
         Adverse event, non-fatal
    82
    81
         Death
    3
    8
         Unspecified
    1
    1
         Lost to follow-up
    1
    1
         Global Deterioration of Health Status
    1
    -
         Withdrawal by subject
    11
    3
    Joined
    33
    27
         Continued in this period
    33
    27
    Period 4
    Period 4 title
    CRT for IMRT (63 Days)
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Arm description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Arm title
    Placebo + SOC CRT
    Arm description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 4
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Started
    234
    236
    Completed
    322
    320
    Not completed
    23
    20
         Adverse event, non-fatal
    5
    5
         Death
    5
    8
         Unspecified
    1
    -
         Lost to follow-up
    1
    1
         Global Deterioration of Health Status
    1
    -
         Withdrawal by subject
    10
    6
    Joined
    111
    104
         Continued in this period
    111
    104
    Period 5
    Period 5 title
    Maintenance Phase (MP) (12 Months)
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Arm description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    Experimental

    Investigational medicinal product name
    Avelumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received avelumab 10 mg/kg IV injection every 2 weeks for up to 12 months.

    Arm title
    Placebo + SOC CRT
    Arm description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received avelumab 10 mg/kg matching placebo IV injection every 2 weeks for up to 12 months.

    Number of subjects in period 5 [2]
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Started
    291
    304
    Completed
    139
    177
    Not completed
    152
    127
         Physician decision
    1
    1
         Adverse event, non-fatal
    24
    21
         Non-compliance With Study Drug
    1
    1
         Death
    17
    11
         Unspecified
    2
    1
         Study Terminated by Sponsor
    1
    6
         Progressive disease
    60
    54
         Lost to follow-up
    1
    2
         Global Deterioration of Health Status
    14
    5
         Withdrawal by subject
    31
    25
    Notes
    [2] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: All subjects who did not withdraw from the CRT phase entered MP
    Period 6
    Period 6 title
    Follow-Up Phase (FUP) (90 Days)
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Arm description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Arm title
    Placebo + SOC CRT
    Arm description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 6
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Started
    139
    177
    Completed
    208
    216
    Not completed
    58
    68
         Death
    12
    10
         Unspecified
    7
    5
         Study Terminated by Sponsor
    32
    50
         Lost to follow-up
    1
    1
         Withdrawal by subject
    6
    2
    Joined
    127
    107
         Continued in this period
    127
    107
    Period 7
    Period 7 title
    LT Follow-up (up to 45 months)
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Arm description
    Ssubjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Arm title
    Placebo + SOC CRT
    Arm description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Arm type
    No intervention

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 7
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Started
    208
    216
    Completed
    0
    0
    Not completed
    247
    237
         Death
    51
    31
         Study Terminated by Sponsor
    187
    201
         Lost to follow-up
    2
    4
         Withdrawal by subject
    7
    1
    Joined
    39
    21
         Continued in this period
    39
    21

    Baseline characteristics

    Close Top of page
    Baseline characteristics reporting groups
    Reporting group title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Reporting group description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Reporting group title
    Placebo + SOC CRT
    Reporting group description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Reporting group values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT Total
    Number of subjects
    350 347 697
    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)
    248 247 495
        From 65-84 years
    102 99 201
        85 years and over
    0 1 1
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    59.36 ± 8.56 58.88 ± 9.09 -
    Sex: Female, Male
    Units: subjects
        Female
    60 62 122
        Male
    290 285 575
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    13 8 21
        Not Hispanic or Latino
    312 312 624
        Unknown or Not Reported
    25 27 52
    Race/Ethnicity, Customized
    Units: Subjects
        Black or African American
    9 10 19
        American Indian or Alaska Native
    1 0 1
        Asian
    102 86 188
        Native Hawaiian or Other Pacific Islander
    0 1 1
        White
    224 229 453
        Other
    14 21 35

    End points

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    End points reporting groups
    Reporting group title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Reporting group description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Reporting group title
    Placebo + SOC CRT
    Reporting group description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Reporting group title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Reporting group description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Reporting group title
    Placebo + SOC CRT
    Reporting group description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Reporting group title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Reporting group description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Reporting group title
    Placebo + SOC CRT
    Reporting group description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Reporting group title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Reporting group description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Reporting group title
    Placebo + SOC CRT
    Reporting group description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Reporting group title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Reporting group description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Reporting group title
    Placebo + SOC CRT
    Reporting group description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Reporting group title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Reporting group description
    Subjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Reporting group title
    Placebo + SOC CRT
    Reporting group description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.
    Reporting group title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Reporting group description
    Ssubjects with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received avelumab 10 mg/kg IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Reporting group title
    Placebo + SOC CRT
    Reporting group description
    Subjects with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase subjects also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which subjects received placebo IV injection every 2 weeks. All subjects were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose subjects were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Primary: Progression-free Survival (PFS) per Modified Response Evaluation Criteria in Solid Tumors v1.1 (RECIST v1.1) as Assessed by Investigator

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    End point title
    Progression-free Survival (PFS) per Modified Response Evaluation Criteria in Solid Tumors v1.1 (RECIST v1.1) as Assessed by Investigator
    End point description
    PFS= Time (in months) from date of randomization to first documented objective PD per modified RECIST v1.1 as assessed by Investigator or death (by any cause), whichever occurred first. Analysis was performed by Kaplan Meier method. PD=any of following: 1) Locoregional PD confirmed by pathology to verify radiographic changes represent true tumor progression and not radiation effects or non-malignant contrast enhancement. 2) Locoregional clinically detectable progression confirmed by pathology. 3) Salvage of primary tumor with tumor present on final pathology. 4) Salvage neck dissection >20 weeks after completion of CRT with tumor present on final pathology. 5) Metastatic PD. PFS data was censored on date of last adequate tumor assessment for subjects with no PFS event. FAS used. 99999=Median and upper limit of 95% CI were not reached at time of PCD. At time of pre-specified interim analysis for endpoint, futility boundaries for Avelumab +SOC CRT arm was crossed and study terminated.
    End point type
    Primary
    End point timeframe
    From randomization until documented PD or death, censored date, whichever occurred first (up to 37 months)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    350
    347
    Units: months
        median (confidence interval 95%)
    99999 (16.9 to 99999)
    99999 (23.0 to 99999)
    Statistical analysis title
    PFS analysis (Avelumab+SOC CRT Vs Placebo+SOC CRT)
    Comparison groups
    Placebo + SOC CRT v Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Number of subjects included in analysis
    697
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.9199 [1]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    1.21
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.928
         upper limit
    1.573
    Notes
    [1] - The treatment arms were compared using a stratified, 1-sided, log rank Test. The three stratification factors were tumor (T) stage (< T4 vs T4), Nodal (N) stage (N0 /N1/N2a/N2b vs N2c/N3), Human papillomavirus (HPV) status (Positive vs Negative).

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    Overall survival was defined as the time (in months) from the date of randomization to the date of death due to any cause. Subjects last known to be alive were censored at date of last contact. Analysis was performed using Kaplan Meier method. FAS included all randomized subjects. 99999=Median and 95% CI were not reached at the time of primary completion date. At the time of pre-specified interim analysis for the endpoint, the futility boundaries for the Avelumab +SOC CRT arm was crossed and the study was terminated.
    End point type
    Secondary
    End point timeframe
    From randomization to the date of death or censored date, whichever occurred first (up to 37 months)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    350
    347
    Units: months
        median (confidence interval 95%)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    Statistical analysis title
    OS analysis (Avelumab+SOC CRT Vs Placebo+SOC CRT)
    Comparison groups
    Avelumab + Standard of Care Chemotherapy (SOC CRT) v Placebo + SOC CRT
    Number of subjects included in analysis
    697
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.9372 [2]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    1.31
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.927
         upper limit
    1.849
    Notes
    [2] - The treatment arms were compared using a stratified, 1-sided, log rank Test. The three stratification factors were tumor (T) stage (< T4 vs T4), Nodal (N) stage (N0 /N1/N2a/N2b vs N2c/N3), Human papillomavirus (HPV) status (Positive vs Negative).

    Secondary: Pathologic Complete Response (pCR) Rate in Subjects With Salvage Surgery at the Primary Site

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    End point title
    Pathologic Complete Response (pCR) Rate in Subjects With Salvage Surgery at the Primary Site
    End point description
    pCR was defined as the absence of histologically identifiable residual cancer in any resected specimen. The pCR rate at primary site was estimated by dividing the number of subjects with pCR recorded at any visit from randomization until PD per modified RECIST v1.1 or death due to any cause by the number of subjects randomised who had salvage surgery at the primary site. All randomized subjects who had salvage surgery at the primary site.
    End point type
    Secondary
    End point timeframe
    From randomization until PD or death (up to 37 months)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    6
    7
    Units: percentage of subjects
        number (confidence interval 95%)
    0 (0.0 to 45.9)
    14.3 (0.4 to 57.9)
    No statistical analyses for this end point

    Secondary: Time to Locoregional Failure per Modified RECIST v1.1 as Assessed by Investigator

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    End point title
    Time to Locoregional Failure per Modified RECIST v1.1 as Assessed by Investigator
    End point description
    Locoregional failure was defined as the time from the date of randomization to the date of the first documentation of locoregional recurrence per modified RECIST v1.1 as assessed by Investigator or death due to any cause , whichever occurred first. Analysis was performed using Kaplan Meier method. Here, "99999" indicated median and upper limit of 95% CI were not reached. FAS included all randomized subjects.
    End point type
    Secondary
    End point timeframe
    From the date of randomization to the date of the first documentation of locoregional recurrence or death, whichever occurred first (up to 37 months)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    350
    347
    Units: months
        median (confidence interval 95%)
    99999 (22.4 to 99999)
    99999 (25.0 to 99999)
    Statistical analysis title
    Avelumab + SOC CRT Vs Placebo + SOC CRT
    Comparison groups
    Avelumab + Standard of Care Chemotherapy (SOC CRT) v Placebo + SOC CRT
    Number of subjects included in analysis
    697
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.9316 [3]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    1.25
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.93
         upper limit
    1.694
    Notes
    [3] - The treatment arms were compared using a stratified, 1-sided, log rank Test. The three stratification factors were tumor (T) stage (< T4 vs T4), Nodal (N) stage (N0 /N1/N2a/N2b vs N2c/N3), Human papillomavirus (HPV) status (Positive vs Negative).

    Secondary: Objective Response Rate (ORR) per Modified RECIST v1.1 as Assessed by Investigator

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    End point title
    Objective Response Rate (ORR) per Modified RECIST v1.1 as Assessed by Investigator
    End point description
    Objective response (OR) was defined as a complete response (CR) or partial response (PR) per RECIST v1.1 recorded from randomization until disease progression per modified RECIST v1.1 or death due to any cause. A subject was considered to have achieved an OR if the subject had a CR or PR which did not need to be confirmed at a subsequent assessment. CR for target disease: complete disappearance of all target lesions with the exception of nodal disease. All target nodes must decrease to normal size (short axis less than [<] 10 millimeter [mm]). CR for non-target disease: disappearance of all non-target lesions and normalization of tumor marker levels. All lymph nodes must be ‘normal’ in size (<10 mm short axis). PR: Greater than or equal to (>=) 30% decrease under baseline of the sum of diameters of all target measurable lesions. The ORR was estimated by dividing the number of subjects with OR (CR or PR) by the number of subjects randomized. FAS included all randomized subjects.
    End point type
    Secondary
    End point timeframe
    From randomization until disease progression or death, whichever occurred first (up to 37 months)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    350
    347
    Units: percentage of subjects
        number (confidence interval 95%)
    74.0 (69.1 to 78.5)
    74.9 (70.0 to 79.4)
    Statistical analysis title
    ORR analysis (Avelumab+SOC CRT Vs Placebo+SOC CRT)
    Comparison groups
    Avelumab + Standard of Care Chemotherapy (SOC CRT) v Placebo + SOC CRT
    Number of subjects included in analysis
    697
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.6229 [4]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Odds ratio (OR)
    Point estimate
    0.947
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.663
         upper limit
    1.352
    Notes
    [4] - The treatment arms were compared using a stratified, 1-sided, Cochran-Mantel-Haenszel Test. The 3 stratification factors were tumor stage (< T4 vs T4), Nodal stage (N0 /N1/N2a/N2b vs N2c/N3), HPV status (Positive vs Negative).

    Secondary: Time to Distant Metastatic Failure per Modified RECIST v1.1 as Assessed by Investigator

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    End point title
    Time to Distant Metastatic Failure per Modified RECIST v1.1 as Assessed by Investigator
    End point description
    Time to distant metastatic failure or distant metastasis (DM) was defined as the time from the date of randomization to the date of the first documentation of distant metastasis or death due to any cause, whichever occurred first. Distant metastatic disease was defined as new tumor identified at a site distant from the head and neck anatomic region or draining lymph nodes. Analysis was performed using Kaplan Meier method. FAS included all randomized subjects. 99999=Median and upper limit of 95% CI were not reached at the time of primary completion date. At the time of pre-specified interim analysis for the outcome measure, the futility boundaries for the Avelumab +SOC CRT arm was crossed and the study was terminated.
    End point type
    Secondary
    End point timeframe
    From the date of randomization to the date of the first documentation of distant metastatic or death (up to 37 months)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    350
    347
    Units: months
        median (confidence interval 95%)
    99999 (22.8 to 99999)
    99999 (99999 to 99999)
    Statistical analysis title
    Avelumab + SOC CRT Vs Placebo + SOC CRT
    Comparison groups
    Avelumab + Standard of Care Chemotherapy (SOC CRT) v Placebo + SOC CRT
    Number of subjects included in analysis
    697
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.9061 [5]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    1.21
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.909
         upper limit
    1.624
    Notes
    [5] - The treatment arms were compared using a stratified, 1-sided, log rank Test. The three stratification factors were tumor stage (< T4 vs T4), Nodal stage (N0 /N1/N2a/N2b vs N2c/N3), HPV status (Positive vs Negative).

    Secondary: Duration of Response (DOR) per modified RECIST v1.1 as Assessed by Investigator

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    End point title
    Duration of Response (DOR) per modified RECIST v1.1 as Assessed by Investigator
    End point description
    DOR:time from 1st documentation of objective tumor response (CR/PR) to first documentation of PD/death (any cause),whichever occurred first.PR:>=30% decrease under baseline of sum of diameters of all target measurable lesions. CR(Target disease):Complete disappearance of all target lesions with exception of nodal disease.CR(non-target disease):disappearance of all non-target lesions and normalization of tumor marker levels PD is anyone:1)Locoregional PD confirmed by pathology to verify radiographic changes denote true tumor progression and not radiation effects or non-malignant contrast boost.2)Locoregional clinically detectable progression confirmed by pathology.3)Surgical removal of primary tumor with tumor present on final pathology.4)Salvage neck dissection >20 weeks after completion of CRT with tumor present on final pathology.5)Metastatic PD.DOR data censored on date of last adequate tumor assessment for subject with no overall response.All randomized with unconfirmed CR or PR.
    End point type
    Secondary
    End point timeframe
    From the first documentation of objective tumor response to the first documentation of PD or death or censored date, whichever occurred first (up to 37 months)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    259
    260
    Units: months
        median (confidence interval 95%)
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    No statistical analyses for this end point

    Secondary: Number of Subjects With Treatment-Emergent Adverse Events (TEAEs) as Graded by National Cancer Institute Common Terminology Criteria (NCI-CTCAE), Version 4.03

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    End point title
    Number of Subjects With Treatment-Emergent Adverse Events (TEAEs) as Graded by National Cancer Institute Common Terminology Criteria (NCI-CTCAE), Version 4.03
    End point description
    Adverse event (AE) was any untoward medical occurrence in a subject who received study drug without regard to possibility of causal relationship. As per NCI-CTCAE version 4.03, severity was graded as Grade 1: asymptomatic/mild symptoms, clinical/diagnostic observations only, intervention not indicated; Grade 2: moderate, minimal, local/noninvasive intervention indicated, limiting age-appropriate instrumental activities of daily life (ADL); Grade 3: severe/medically significant but not immediately life-threatening, hospitalization/prolongation of existing hospitalization indicated, disabling, limiting self-care ADL; Grade 4: life-threatening consequence, urgent intervention indicated; Grade 5: death related to AE. TEAE was defined as event with onset dates occurring during the on-treatment period. Safety analysis set included all subjects who received at least one dose of study drug.
    End point type
    Secondary
    End point timeframe
    Baseline up to 44 months
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    348
    344
    Units: subjects
        Grade 1
    10
    8
        Grade 2
    30
    53
        Grade 3
    224
    215
        Grade 4
    59
    49
        Grade 5
    22
    17
    No statistical analyses for this end point

    Secondary: Number of Subjects with Shift From Baseline in Clinical Laboratory Parameters

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    End point title
    Number of Subjects with Shift From Baseline in Clinical Laboratory Parameters
    End point description
    Grade 1 and 3 ranges: Anemia:Hb:<LLN-10.0,<8.0 g/dL;LC decreased (dec):<LLN-800/mm^3,500-200/mm^3;LC increased (inc):grade 3:>20,000/mm^3:NC dec:<LLN-1500/mm^3;<1000-500/mm^3;PC dec:<LLN-75,000/mm^3;<50,000-25,000/mm^3;WBC dec:<LLN-3000/mm^3;<2000-1000/mm^3;ALT inc:>ULN-3.0*ULN;>5.0-20.0*ULN;ALP & GGT inc:>ULN-2.5*ULN;>5.0-20.0*ULN;AST inc:>ULN-3.0*ULN;>5.0-20.0*ULN;BB inc:>ULN-1.5*ULN;>3.0-10.0*ULN;CH high:>ULN-300 mg/dL;>400-500 mg/dL;Hypercalcemia:>ULN-11.5;>12.5-13.5mg/dL;Hyperglycemia:>ULN-160; >250-500mg/dL;Hyperkalemia:>ULN-5.5;>6.0-7.0mmol/L;Hypermagnesemia:>ULN-3.0;>3.0-8.0 mg/dL;Hypernatremia:>ULN-150; >155-160 mmol/L;Hypertriglyceridemia;150-300;>500-1000 mg/dL;Hypoalbuminemia:<LLN-3;<2g/dL;Hypocalcemia:<LLN-8.0;<8.0-7.0mg/dL;Hypokalemia:<LLN-3.0;<3.0-2.5mmol/L;Hypomagnesemia;<LLN-1.2;<0.9-0.7 mg/dL;Hyponatremia:<LLN-130;<130-120mmol/L;Hypophosphatemia:<LLN-2.5;<2.0-1.0mg/dL. Safety. N=subjects evaluable for this endpoint, n=subjects evaluable for each specified category.
    End point type
    Secondary
    End point timeframe
    Baseline up to 15 months
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    346
    340
    Units: subjects
        Anemia: New/worsened (N/W) grade >=1 (n =346,340)
    314
    311
        Anemia: N/W to grade >=3 (n =346, 340)
    42
    49
        LC Dec: N/W to grade >=1(n =346, 340)
    336
    330
        LC Decreased: N/W to grade >=3(n =346, 340)
    279
    284
        LC Increased: N/W to grade >=1(n =346, 340)
    7
    7
        LC increased: N/W to grade >=3 (n =346, 340)
    0
    0
        NC Decreased: N/W to grade >=1 (n =346, 340)
    257
    237
        NC Decreased N/W to grade >=3 (n =346, 340)
    120
    101
        PC Decreased : N/W to grade >=1 (n =346, 340)
    157
    154
        PC Decreased: N/W to grade >=3 (n =346, 340)
    20
    7
        WBC Decreased: N/W to grade >=1 (n =346, 340)
    309
    307
        WBC Decreased: N/W to grade >=3 (n =346, 340)
    121
    129
        ALT increased: N/W to grade >=1 (n =346, 340)
    152
    135
        ALT increased: N/W to grade >=3 (n =346, 340)
    13
    2
        ALP: N/W to grade >=1 (n =346, 340)
    72
    49
        ALP increased: N/W to grade >=3 (n =346, 340)
    1
    1
        AST increased: N/W to grade >=1 (n= 345, 340)
    146
    111
        AST increased: N/W to grade >=3 (n =345, 340)
    11
    4
        Bilurubin increased: N/W to grade >=1(n =346,340)
    58
    54
        Bilirubin increased: N/W to grade >=3 (n=346, 340)
    9
    4
        Cholesterol (CH) high:N/W to grade >=1(n=161,164)
    25
    21
        CH high: N/W to grade >=3 (n=161,164)
    0
    0
        CPK increased: N/W grade >=1 (n=160,156)
    7
    7
        CPK increased: N/W to grade >=3 (n=160,156)
    0
    1
        Creatinine increased: N/W to grade >=1 (n=346,340)
    334
    325
        Creatinine increased: N/W to grade >=3 (n=346,340)
    36
    37
        GGT increased: N/W to grade >=1 (n=191,193)
    37
    23
        GGT increased: N/W to grade >=3 (n=191,193)
    10
    5
        Hypercalcemia: N/W to grade >=1 (n=346,340)
    67
    59
        Hypercalcemia: N/W to grade >=3 (n=346,340)
    1
    5
        Hyperglycemia: N/W to grade >=1 (n=345,340)
    144
    137
        Hyperglycemia: N/W to grade >=3 (n=345,340)
    28
    29
        Hyperkalemia: N/W to grade >=1 (n=346,340)
    106
    113
        Hyperkalemia: N/W to grade >=3 (n=346,340)
    9
    17
        Hypermagnesemia: N/W to grade >=1 (n=346,339)
    39
    40
        Hypermagnesemia: N/W to grade >=3 (n=346,339)
    10
    10
        Hypernatremia: N/W to grade >=1 (n=346,340)
    22
    20
        Hypernatremia: N/W to grade >=3 (n=346,340)
    1
    0
        Hypertriglyceridemia: N/W to grade >=1 (n=162,161)
    35
    26
        Hypertriglyceridemia: N/W to grade >=3 (n=162,161)
    1
    2
        Hypoalbuminemia: N/W to grade >=1 (n=346,340)
    195
    170
        Hypoalbuminemia: N/W to grade >=3 (n=346,340)
    7
    5
        Hypocalcemia: N/W to grade >=1 (n=346,340)
    82
    88
        Hypocalcemia: N/W to grade >=3(n=346,340)
    8
    14
        Hypoglycemia: N/W to grade >=1 (n=345,340)
    56
    44
        Hypoglycemia: N/W to grade >=3 (n=345,340)
    2
    2
        Hypokalemia: N/W to grade >=1 (n=346,340)
    140
    122
        Hypokalemia: N/W to grade >=3 (n=346,340)
    55
    49
        Hypomagnesemia: N/W to grade >=1(n=346,339)
    180
    158
        Hypomagnesemia: N/W to grade >=3(n=346,339)
    8
    12
        Hyponatremia: N/W to grade >=1 (n=346,340)
    232
    212
        Hyponatremia: N/W to grade >=3 (n=346,340)
    74
    70
        Hypophosphatemia: N/W to grade >=1 (n=340,339)
    108
    100
        Hypophosphatemia: N/W to grade >=3 (n=340,339)
    21
    19
        Lipase increased: N/W to grade >=1 (n=161,154)
    19
    13
        Lipase increased: N/W to grade >=3 (n=161,154)
    11
    3
        Serum amylase increased: N/W Grade >=1 (n=159,152)
    13
    10
        Serum amylase increased: N/W grade >=3 (n=159,152)
    9
    5
    No statistical analyses for this end point

    Secondary: Change From Baseline in Vital Sign - Systolic and Diastolic Blood Pressure

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    End point title
    Change From Baseline in Vital Sign - Systolic and Diastolic Blood Pressure
    End point description
    Change from baseline in systolic blood pressure (SBP) and diastolic blood pressure (DBP) measured in sitting position were reported. Safety analysis set included all subjects who received at least one dose of study drug. Here, "Overall Number of Subjects Analysed" signifies number of subjects evaluable for this endpoint and "n" signifies subjects evaluable for each specified category at each specified time point. Maintenance Phase =MP
    End point type
    Secondary
    End point timeframe
    Baseline, Lead-in phase: Day1; CRT Phase: Days 1, 8, 22, 25, 39, and 43; Maintenance phase: on Days 1 and 15 in Cycles 1 to 13 and EOT (3 days after the last dose of study drug)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    342
    336
    Units: millimeter of mercury
    arithmetic mean (standard deviation)
        DBP: Baseline (n=342, 336)
    77.8 ± 10.13
    78.1 ± 10.91
        Lead in Phase: DBP: Change at Day 1 (n=2,2)
    -3.0 ± 4.24
    -8.0 ± 11.31
        CRT Phase: DBP: Change at Day 1 (n=332,322)
    -1.5 ± 9.52
    -2.2 ± 9.91
        CRT Phase: DBP: Change at Day 8 (n=323,315)
    -3.8 ± 10.46
    -3.9 ± 10.99
        CRT Phase: DBP: Change at Day 22 (n-313,309)
    -4.2 ± 11.77
    -5.0 ± 10.95
        CRT Phase: DBP: Change at Day 25 (n=310,306)
    -3.4 ± 11.91
    -3.3 ± 11.44
        CRT Phase: DBP: Change at Day 39 (n=309,302)
    -5.7 ± 11.83
    -5.1 ± 12.14
        CRT Phase: DBP: Change at Day 43 (n=293,283)
    -5.0 ± 11.49
    -4.7 ± 11.76
        Maintenance Phase: DBP: Change at C1D1 (n=282,290)
    -4.8 ± 11.43
    -4.3 ± 11.67
        MP: DBP: Change at C1D15 (n=265,279)
    -3.7 ± 11.78
    -4.0 ± 10.96
        MP: DBP: Change at C2D1(n=266,277)
    -3.3 ± 11.74
    -3.3 ± 12.31
        MP:DBP:Change at C2D15 (n=255,272)
    -2.7 ± 11.05
    -2.3 ± 11.82
        MP:DBP: Change at C3D1(n=249,262)
    -2.7 ± 11.37
    -3.6 ± 11.42
        MP: DBP: Change at C3D15 (n=234,255)
    -2.7 ± 11.09
    -3.4 ± 11.10
        MP: DBP: Change at C4D1 (n=222,247)
    -2.2 ± 12.07
    -3.4 ± 11.42
        MP: DBP: Change at C4D15(n=216,240)
    -2.4 ± 11.38
    -3.3 ± 11.54
        MP: DBP: Change at C5D1(n=210,241)
    -2.8 ± 11.61
    -3.2 ± 10.88
        MP: DBP: Change at C5D15(n=204,232)
    -2.5 ± 11.89
    -3.5 ± 10.69
        MP: DBP: Change at C6D1(n=201,226)
    -3.1 ± 11.21
    -3.8 ± 11.28
        MP: DBP: Change at C6D15(n=198,230)
    -3.8 ± 12.20
    -4.6 ± 11.43
        MP: DBP: Change at C7D1(n=190,220)
    -4.1 ± 11.48
    -4.2 ± 11.52
        MP: DBP: Change at C7D15 (n=185,214)
    -3.8 ± 12.05
    -3.8 ± 10.88
        MP: DBP: Change at C8D1(n=173,209)
    -2.9 ± 11.29
    -4.1 ± 10.95
        MP: DBP: Change at C8D15 (n=167,194)
    -3.4 ± 11.48
    -4.0 ± 12.29
        MP: DBP: Change at C9D1(n=169,198)
    -3.1 ± 11.78
    -4.2 ± 10.98
        MP: DBP: Change at C9D15(n=162,194)
    -2.1 ± 11.52
    -3.7 ± 12.07
        MP: DBP: Change at C10D1 (n=161,192)
    -2.2 ± 11.58
    -3.5 ± 11.54
        MP: DBP: Change at C10D15 (n=159,191)
    -2.5 ± 10.90
    -4.4 ± 11.69
        MP: DBP: Change at C11D1(n=146,179)
    -2.7 ± 11.01
    -4.6 ± 11.23
        MP: DBP: Change at C11D15(n=139,162)
    -2.9 ± 10.37
    -3.9 ± 10.22
        MP: DBP: Change at C12D1(n=125,156)
    -2.1 ± 9.51
    -3.5 ± 11.40
        MP: DBP: Change at C12D15(n=115,146)
    -3.3 ± 11.78
    -4.6 ± 11.19
        MP: DBP: Change at C13D1(n=105,132)
    -2.0 ± 9.60
    -3.3 ± 11.49
        MP: DBP: Change at C13D15(n=92,118)
    -1.1 ± 10.22
    -3.8 ± 11.44
        DBP: EOT(n=225,210)
    -2.4 ± 11.96
    -3.2 ± 11.17
        SBP: Baseline (n=342,336)
    129.8 ± 16.42
    130.5 ± 17.44
        Lead in Phase:SBP: Change at Day 1(n=2,2)
    -5.5 ± 2.12
    12.5 ± 6.36
        CRT Phase: SBP: Change at Day 1(n=332,322)
    -2.5 ± 15.32
    -3.5 ± 14.82
        CRT Phase: SBP: Change at Day 8(n=323,315)
    -8.3 ± 17.78
    -8.0 ± 17.58
        CRT Phase: SBP: Change at Day 22(n=313,309)
    -8.9 ± 18.54
    -8.4 ± 17.55
        CRT Phase: SBP: Change at Day 25(n=310,306)
    -7.9 ± 19.06
    -5.8 ± 19.51
        CRT Phase: SBP: Change at Day 39(n=309,302)
    -10.6 ± 20.51
    -10.3 ± 19.05
        CRT Phase: SBP: Change at Day 43(n=293,283)
    -9.6 ± 18.53
    -9.2 ± 19.52
        MP: SBP: Change at C1D1 (n=282,290)
    -9.4 ± 17.97
    -9.4 ± 20.19
        MP: SBP: Change at C1D15(n=265, 279)
    -9.5 ± 17.73
    -8.2 ± 19.58
        MP: SBP: Change at C2D1(n=266,277)
    -7.0 ± 18.03
    -7.8 ± 20.09
        MP: SBP: Change at C2D15(n=255,272)
    -7.9 ± 18.55
    -6.6 ± 19.73
        MP: SBP: Change at C3D1(n=249,262)
    -7.3 ± 18.93
    -8.5 ± 18.04
        MP: SBP: Change at C3D15(n=234,255)
    -8.3 ± 17.79
    -7.1 ± 19.90
        Maintenance Phase: SBP: Change at C4D1(n=222,247)
    -8.4 ± 18.01
    -8.9 ± 18.41
        Maintenance Phase: SBP: Change at C4D15(n=216,240)
    -6.2 ± 18.20
    -8.2 ± 19.62
        MP: SBP: Change at C5D1(n=210,241)
    -7.6 ± 17.57
    -7.7 ± 18.69
        MP: SBP: Change at C5D15(n=204,232)
    -8.4 ± 18.69
    -7.5 ± 18.49
        MP: SBP: Change at C6D1(n=201,206)
    -7.6 ± 17.67
    -8.3 ± 18.96
        MP: SBP: Change at C6D15(n=198,230)
    -7.1 ± 19.35
    -9.4 ± 19.56
        MP: SBP: Change at C7D1(n=190,220)
    -9.0 ± 18.30
    -8.9 ± 18.96
        MP: SBP: Change at C7D15(n=185,214)
    -8.7 ± 18.10
    -6.8 ± 18.73
        MP: SBP: Change at C8D1(n=173,209)
    -6.5 ± 17.00
    -9.4 ± 18.65
        MP: SBP: Change at C8D15(n=167,194)
    -6.8 ± 16.69
    -7.9 ± 18.21
        MP: SBP: Change at C9D1(n=169,198)
    -6.1 ± 18.49
    -8.1 ± 18.41
        MP: SBP: Change at C9D15(n=162,194)
    -6.3 ± 19.00
    -6.7 ± 20.28
        MP: SBP: Change at C10D1(n=161,192)
    -6.1 ± 19.24
    -7.2 ± 18.63
        MP: SBP: Change at C10D15(n=159,191)
    -5.6 ± 17.07
    -7.7 ± 18.76
        MP: SBP: Change at C11D1(n=146,179)
    -6.3 ± 19.44
    -7.7 ± 18.86
        MP: SBP: Change at C11D15(n=139,162)
    -6.3 ± 18.99
    -7.4 ± 18.65
        MP: SBP: Change at C12D1(n=125,156)
    -6.8 ± 18.25
    -6.1 ± 20.21
        MP: SBP: Change at C12D15(n=115,146)
    -7.1 ± 19.34
    -7.8 ± 19.12
        MP: SBP: Change at C13D1(n=105,132)
    -5.8 ± 20.04
    -6.2 ± 18.54
        MP: SBP: Change at C13D15(n=92,118)
    -4.9 ± 18.82
    -5.6 ± 19.00
        MP: SBP: EOT(n=225,210)
    -7.0 ± 19.83
    -4.9 ± 17.97
    No statistical analyses for this end point

    Secondary: Change From Baseline in Vital Sign - Pulse Rate

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    End point title
    Change From Baseline in Vital Sign - Pulse Rate
    End point description
    Change from baseline in pulse rate in sitting position in beats per minute was reported. Here, "Overall Number of Subjects Analysed" signifies number of subjects evaluable for this endpoint and "n" signifies subjects evaluable for each specified category at each specified time point.
    End point type
    Secondary
    End point timeframe
    Baseline, Lead-in phase: Day1; CRT Phase: Days 1, 8, 22, 25, 39, and 43; Maintenance phase: on Days 1 and 15 in Cycles 1 to 13 and EOT (3 days after the last dose of study drug)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    342
    336
    Units: beats per minute
    arithmetic mean (standard deviation)
        Baseline (n=342,336)
    79.9 ± 13.72
    86.0 ± 43.0
        Lead in Phase: Change at Day 1 ((n=2,2)
    -3.5 ± 0.71
    -8.5 ± 19.09
        CRT Phase: Change at Day 1 (n=331,322)
    0.7 ± 11.70
    1.3 ± 10.92
        CRT Phase: Change at Day 8 (n=323,315)
    1.5 ± 13.15
    2.2 ± 12.42
        CRT Phase: Change at Day 22(n=314,309)
    0.5 ± 13.86
    2.6 ± 12.24
        CRT Phase: Change at Day 25(n=310,306)
    -1.6 ± 14.87
    -1.2 ± 13.90
        CRT Phase: Change at Day 29(n=10,8)
    -11.0 ± 20.47
    3.6 ± 21.29
        CRT Phase: Change at Day 39(n=310,301)
    4.0 ± 15.46
    4.3 ± 14.71
        CRT Phase: Change at Day 43(n=293,283)
    4.7 ± 16.82
    6.1 ± 14.78
        Maintenance Phase: Change at C1D1 1(n=282,291)
    5.1 ± 16.23
    7.5 ± 14.43
        Maintenance Phase: Change at C1D15(n=265,279)
    3.8 ± 15.04
    6.3 ± 13.65
        Maintenance Phase: Change at C2D1(n=266,277)
    3.5 ± 15.30
    5.9 ± 14.74
        Maintenance Phase: Change at C2D15(n=254,272)
    4.1 ± 15.32
    4.9 ± 13.94
        Maintenance Phase: Change at C3D1(n=249,262)
    3.5 ± 14.49
    3.9 ± 14.37
        Maintenance Phase: Change at C3D15(n=234,255)
    2.8 ± 14.73
    2.8 ± 14.14
        Maintenance Phase: Change at C4D1(n=222,247)
    1.8 ± 14.79
    3.8 ± 14.95
        MP: Change at C4D15(n=216,240)
    1.6 ± 14.80
    3.8 ± 15.02
        MP: Change at C5D1(n=210,241)
    2.6 ± 13.88
    2.9 ± 14.82
        MP: Change at C5D15(n=204,232)
    1.6 ± 15.11
    3.3 ± 13.74
        MP: Change at C6D1(n=201,226)
    1.6 ± 15.42
    2.7 ± 15.72
        MP: Change at C6D15(n=198,230)
    0.4 ± 14.04
    1.4 ± 13.66
        MP: Change at C7D1(n=190,220)
    -0.1 ± 14.47
    2.5 ± 14.18
        MP: Change at C7D15(n=185,214)
    -0.1 ± 14.24
    1.4 ± 14.33
        MP: Change at C8D1(n=173,209)
    -0.2 ± 13.84
    1.0 ± 13.67
        MP: Change at C8D15(n=167,194)
    -1.5 ± 14.52
    1.5 ± 14.86
        MP: Change at C9D1(n=169,198)
    -1.0 ± 14.29
    -0.1 ± 14.06
        MP: Change at C9D15(n=162,194)
    -1.0 ± 14.20
    0.2 ± 14.44
        MP: Change at C10D1(n=161,192)
    -0.9 ± 13.40
    0.7 ± 14.52
        MP: Change at C10D15(n=159,191)
    -0.5 ± 15.33
    0.7 ± 14.66
        MP: Change at C11D1(n=145,178)
    -1.6 ± 14.57
    0.2 ± 14.01
        MP: Change at C11D15(n=139,162)
    -0.2 ± 13.23
    0.3 ± 12.93
        MP: Change at C12D1(n=125,156)
    -0.3 ± 13.92
    0.4 ± 13.67
        MP: Change at C12D15(n=115,146)
    -1.4 ± 14.92
    -0.5 ± 12.47
        MP: Change at C13D1(n=105,132)
    -1.4 ± 14.09
    -0.1 ± 12.22
        MP: Change at C13D15(n=92,118)
    -1.3 ± 15.57
    0.4 ± 13.24
        EOT(n=223,210)
    0.2 ± 14.73
    1.9 ± 14.09
    No statistical analyses for this end point

    Secondary: Change from Baseline in the European Quality of Life- 5 Dimension-5 Levels (EQ-5D-5L) Index Score at CRT Phase and Maintenance Phase

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    End point title
    Change from Baseline in the European Quality of Life- 5 Dimension-5 Levels (EQ-5D-5L) Index Score at CRT Phase and Maintenance Phase
    End point description
    EQ-5D-5L is a standardized subject completed questionnaire that measures health status in terms of a single index value or utility score. EQ-5D-5L consisted of two components: a health state profile (descriptive system) and a visual analogue scale (VAS) in which subjects rate their overall health status from 0 (worst imaginable) to 100 (best imaginable), where higher scores indicated better health status. EQ-5D health state profile is comprised of 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 response levels: 1=no problems, 2=slight problems, 3=moderate problems, 4=severe problems and 5=extreme problems. EQ-5D-5L health status index score range between 0 to 1. Higher score indicated better health status. FAS included all randomized subjects. Overall Number of Subjects Analysed=subjects evaluable for this endpoint and "n" signifies subjects evaluable for each specified category at each specified time point.
    End point type
    Secondary
    End point timeframe
    Baseline, CRT Phase: Days 1 and 29; Maintenance phase: Cycle 1/Day 1, Cycle 3/Day 1, Cycle 7/Day 1, Cycle 7/Day 15, Cycle 11/Day 1, Cycle 11/Day 15, EOT (3 days after the last dose of study drug)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    334
    333
    Units: units on a scale
    arithmetic mean (standard deviation)
        Baseline: (n=334, 333)
    0.7718 ± 0.17822
    0.7615 ± 0.18517
        CRT Phase: Change at Day 1: (n=321, 318)
    -0.0078 ± 0.13269
    0.0176 ± 0.14066
        CRT Phase: Change at Day 2 (n=293, 276)
    -0.0915 ± 0.22053
    -0.0487 ± 0.19175
        MP: Change at C1D1 (n=272, 279)
    -0.0749 ± 0.22126
    -0.0519 ± 0.17253
        MP: Change at C3D1 (n=239, 243)
    -0.0203 ± 0.21340
    -0.0160 ± 0.18179
        MP: Change at C7D1 (n=95,113)
    0.0088 ± 0.16690
    0.0140 ± 0.16240
        MP: Change at C7D15 (n=59, 79)
    0.0552 ± 0.18544
    0.0472 ± 0.17990
        MP: Change at C11D1 (n=90,111)
    0.0376 ± 0.21078
    0.0792 ± 0.19287
        MP: Change at C11D15 (n=36, 40)
    0.0673 ± 0.17227
    0.0389 ± 0.18732
        MP: Change at EOT (n=184,187)
    -0.0051 ± 0.24528
    0.0074 ± 0.24874
    No statistical analyses for this end point

    Secondary: Change From Baseline in the European Quality of Life- 5 Dimension-5 Levels (EQ-5D-5L) VAS Score at CRT Phase and Maintenance Phase

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    End point title
    Change From Baseline in the European Quality of Life- 5 Dimension-5 Levels (EQ-5D-5L) VAS Score at CRT Phase and Maintenance Phase
    End point description
    EQ-5D-5L is a standardized subject completed questionnaire that measures health status in terms of a single index value or utility score. EQ-5D-5L consisted of two components: a health state profile (descriptive system) and a visual analogue scale (VAS). EQ-5D health state profile is comprised of 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 response levels: 1=no problems, 2=slight problems, 3=moderate problems, 4=severe problems and 5=extreme problems. EQ-5D-5L health status index score range between 0 to 1. Higher score indicated worse health status. In VAS subjects rate their overall health status from 0 (worst imaginable) to 100 (best imaginable), where higher scores indicated better health status. FAS included all randomized subjects. "Overall Number of subjects Analysed" signifies subjects evaluable for this endpoint and "n" signifies subjects evaluable at each specified time point.
    End point type
    Secondary
    End point timeframe
    Baseline, CRT Phase: Days 1 and 29; Maintenance phase: Cycle 1/Day 1, Cycle 3/Day 1, Cycle 7/Day 1, Cycle 7/Day 15, Cycle 11/Day 1, Cycle 11/Day 15, EOT (3 days after the last dose of study drug)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    333
    330
    Units: units on a scale
    arithmetic mean (standard deviation)
        Baseline: (n=333, 330)
    75.8 ± 18.20
    74.9 ± 18.24
        CRT Phase: Change at Day 1 (n=317, 314)
    -1.1 ± 13.49
    -1.4 ± 11.39
        CRT Phase: Change at Day 29 (n=291, 271)
    -10.9 ± 19.94
    -9.2 ± 18.70
        MP: Change at C1D1 (n=272, 277)
    -7.7 ± 19.05
    -6.2 ± 18.67
        MP: Change at C3D1 (n=240, 236)
    -1.8 ± 18.00
    -0.7 ± 16.14
        MP: Change at C7D1 (n=95,113)
    -0.6 ± 14.91
    8.6 ± 81.42
        MP: Change at C7D15 (n=59, 78)
    4.8 ± 18.52
    3.1 ± 19.28
        MP: Change at C11D1 (n=89,108)
    0.3 ± 17.60
    4.3 ± 16.10
        MP: Change at C11D15 (n=37, 40)
    10.1 ± 24.69
    2.4 ± 18.20
        MP: Change at EOT (n=183, 184)
    -1.9 ± 22.55
    0.7 ± 19.28
    No statistical analyses for this end point

    Secondary: Change From Baseline in National Cancer Comprehensive Network Head and Neck Symptom Index-22 Item Scores (NCCN FHNSI-22) at CRT Phase and Maintenance Phase

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    End point title
    Change From Baseline in National Cancer Comprehensive Network Head and Neck Symptom Index-22 Item Scores (NCCN FHNSI-22) at CRT Phase and Maintenance Phase
    End point description
    The NCCN FHNSI-22 questionnaire measured disease symptoms, treatment side effects and overall quality of life in participants with head and neck cancer. The questionnaire contained 22 items with 5-point Likert scales ranging from 0 to 4 as follows: ‘not at all = 0’, a little bit = 1, somewhat = 2, quite a bit = 3 and very much = 4. Total score ranged from 0 to 88 where, higher scores represented better symptomatology, quality of life or functioning. FAS included all randomized subjects. Here, "Overall Number of Subjects Analysed" signifies number of subjects evaluable for this endpoint and "n" signifies subjects evaluable for each specified category at each specified time point.
    End point type
    Secondary
    End point timeframe
    Baseline, CRT Phase: Days 1 and 29; Maintenance phase: Cycle 1/Day 1, Cycle 3/Day 1, Cycle 7/Day 1, Cycle 7/Day 15, Cycle 11/Day 1, Cycle 11/Day 15, EOT (3 days after the last dose of study drug)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    333
    331
    Units: units on a scale
    arithmetic mean (standard deviation)
        Baseline: (n=333, 331)
    60.56 ± 13.731
    61.05 ± 13.155
        CRT Phase: Change at Day 1: (n=318, 317)
    -0.59 ± 8.719
    -0.14 ± 9.136
        CRT Phase: Change at Day 29 (n=294, 275)
    -14.34 ± 16.847
    -14.56 ± 15.470
        MP: Change at C1D1 (n=272, 281)
    -11.33 ± 16.054
    -12.08 ± 14.950
        MP: Change at C3D1 (n=241, 241)
    -3.81 ± 14.017
    -2.26 ± 13.625
        MP: Change at C7D1 (n=96,113)
    -0.86 ± 12.503
    -0.51 ± 14.585
        MP: Change at C7D15 (n=61, 78)
    3.96 ± 14.035
    0.92 ± 14.454
        MP: Change at C11D1 (n=88,110)
    2.68 ± 13.367
    4.90 ± 14.207
        MP: Change at C11D15 (n=37, 40)
    3.96 ± 14.322
    3.37 ± 12.689
        MP: Change at EOT (n=184, 187)
    -2.35 ± 17.428
    0.79 ± 16.509
    No statistical analyses for this end point

    Secondary: Programmed Death Receptor-1 Ligand-1 (PD-L1) Biomarker Expression in Tumor Tissue as Assessed by Immunohistochemistry (IHC)

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    End point title
    Programmed Death Receptor-1 Ligand-1 (PD-L1) Biomarker Expression in Tumor Tissue as Assessed by Immunohistochemistry (IHC)
    End point description
    PD-L1 biomarker expression in tumor tissue as assessed by IHC in the form of positive immune cells and tumor staining cells. Biomarker analysis set was a subset of the safety analysis set included subjects who had at least one screening biomarker assessment. Here, "Overall Number of Subjects Analysed" signifies number of subjects evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    Baseline (prior to first dose)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    299
    307
    Units: % of PD-L1+ cells
    arithmetic mean (standard deviation)
        Positive Immune Cells
    7.4 ± 7.06
    8.3 ± 8.47
        Tumor Staining Cells
    12.7 ± 24.90
    18.3 ± 31.12
    No statistical analyses for this end point

    Secondary: Mean Percentage (%) of Total Tumor Area Occupied by Cluster of Differentiation 8 (CD8+) Cells

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    End point title
    Mean Percentage (%) of Total Tumor Area Occupied by Cluster of Differentiation 8 (CD8+) Cells
    End point description
    Description: CD8+ cells are the type of T-lymphocytes. Mean percentage of total tumor area occupied by CD8+ Cells has been reported. Area was measured in millimeter square (mm^2). Biomarker analysis set was a subset of the safety analysis set included subjects who had at least one screening biomarker assessment. Here, "Overall Number of Subjects Analysed" signifies number of subjects evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    Baseline (prior to first dose)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    289
    294
    Units: % of tumor area occupied by CD8+ cells
        arithmetic mean (standard deviation)
    4.9 ± 6.03
    5.8 ± 6.55
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With Positive and Negative Pathology of Neck Dissection

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    End point title
    Percentage of Subjects With Positive and Negative Pathology of Neck Dissection
    End point description
    Percentage of subjects with positive and negative pathology of neck dissection were reported. Positive pathology included live tumor cells present or 10% or greater vital tumor tissues. Negative pathology included no live tumor cells present, complete tumor regression, no evidence of vital tumor tissues, less than 10% vital tumor tissue, or not consistent with disease under study. Analysis population included all subjects who had received at least one dose of study drug and who had salvage neck dissection.
    End point type
    Secondary
    End point timeframe
    From randomization until PD as per investigator assessment (up to 37 months)
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    14
    15
    Units: percentage of subjects
    number (not applicable)
        Negative Pathology
    7.14
    26.70
        Positive pathology
    71.43
    40.00
        Pathology not reported
    21.43
    33.30
    No statistical analyses for this end point

    Secondary: Maximum Plasma Concentration (Cmax) of Avelumab

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    End point title
    Maximum Plasma Concentration (Cmax) of Avelumab [6]
    End point description
    Maximum observed plasma concentration (Cmax) of Avelumab is reported. PK concentration analysis was a subset of the safety analysis set and included subjects who had at least one post-dose concentration measurement above the lower limit of quantitation (LLQ) for avelumab or cisplatin. Here’ 'overall number of subjects analysed' signifies subjects evaluable for this endpoint and ‘n’ signifies subjects evaluable at specified time point.
    End point type
    Secondary
    End point timeframe
    Pre-dose and end of infusion on Day 1 of lead-in phase, Days 8, 25 of CRT phase, Day 1 of Cycle 1 and 2 (each cycle 28 days)
    Notes
    [6] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint was planned to be analyzed for the arms specified
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Number of subjects analysed
    236
    Units: nanogram per milliliter
    geometric mean (geometric coefficient of variation)
        Lead-in/Day 1 (n= 236)
    203.6 ± 31
        CRT/Day 8 (n= 207)
    190.9 ± 66
        CRT/Day 25 (n= 189)
    162.4 ± 114
        Cycle 1 Day 1 (n= 152)
    142 ± 117
        Cycle 2 Day 1 (n= 128)
    154.9 ± 97
    No statistical analyses for this end point

    Secondary: Predose Plasma Concentration (Ctrough) of Avelumab

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    End point title
    Predose Plasma Concentration (Ctrough) of Avelumab [7]
    End point description
    Ctrough refers to plasma concentration of Avelumab observed just before treatment administration. PK concentration analysis was a subset of the safety analysis set and included subjects who had at least one post-dose concentration measurement above the lower limit of quantitation (LLQ) for avelumab or cisplatin. Here’ 'overall number of subjects analysed' signifies subjects evaluable for this endpoint and ‘n’ signifies subjects evaluable at specified time point.
    End point type
    Secondary
    End point timeframe
    Pre-dose on Day 1 of lead-in phase, Days 8, 25 of CRT phase, Day 1 of Cycle 1, 2, 5, 8, 11 (each cycle 28 days)
    Notes
    [7] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint was planned to be analyzed for the arms specified
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Number of subjects analysed
    267
    Units: microgram per milliliter
    geometric mean (geometric coefficient of variation)
        Lead-in/Day 1 (n =263)
    2.988 ± 1590
        CRT/Day 8 (n =267)
    11.9 ± 63
        CRT/Day 25 (n =251)
    6.284 ± 138
        Cycle 1/Day 1 (n =183)
    2.354 ± 131
        Cycle 2/Day 1 (n =198)
    17.56 ± 70
        Cycle 5/Day 1 (n =147)
    24.35 ± 66
        Cycle 8/Day 1 (n =125)
    29.59 ± 69
        Cycle 11/Day 1 (n =113)
    30.85 ± 79
    No statistical analyses for this end point

    Secondary: Dose Normalized Maximum Plasma Concentration (Cmax [dn]) of Total and Free Cisplastin

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    End point title
    Dose Normalized Maximum Plasma Concentration (Cmax [dn]) of Total and Free Cisplastin
    End point description
    Dose normalized (dn) Cmax was calculated by dividing Cmax by the exact dose of total or free Cisplastin (in mg) administered to a subject. PK concentration analysis was a subset of the safety analysis set and included subjects who had at least one post-dose concentration measurement above the lower limit of quantitation (LLQ) for avelumab or cisplatin. Here’ 'overall number of subjects analysed' signifies subjects evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    Pre-dose, mid-infusion, end of infusion, 3, 4, and 24 hours post dose on Day 1 of CRT phase
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    12
    23
    Units: nanogram per milliliter per milligram
    geometric mean (geometric coefficient of variation)
        Total Cisplastin
    26.23 ± 36
    25.33 ± 26
        Free Cisplastin
    11.84 ± 29
    7.286 ± 96
    No statistical analyses for this end point

    Secondary: Dose Normalized Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast[dn]) of Total and Free Cisplatin

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    End point title
    Dose Normalized Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast[dn]) of Total and Free Cisplatin
    End point description
    Area under the plasma concentration time-curve from time zero to the time of last measured concentration (AUClast). AUClast (dn) was calculated by dividing AUClast by the exact dose of cisplastin (in mg) administered to a subject. PK concentration analysis was a subset of the safety analysis set and included subjects who had at least one post-dose concentration measurement above the lower limit of quantitation (LLQ) for avelumab or cisplatin. Here, 'overall number of subjects analysed' signifies subjects evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    Pre-dose, mid-infusion, end of infusion, 3, 4, and 24 hours post dose on Day 1 of CRT phase
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    10
    20
    Units: nanogram*hour/milliliter/milligram
    geometric mean (geometric coefficient of variation)
        Total Cisplatin
    299.1 ± 30
    332.7 ± 17
        Free Cisplatin
    36.53 ± 51
    29.08 ± 49
    No statistical analyses for this end point

    Secondary: Maximum Plasma Concentration (Cmax) of Total and Free Cisplatin

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    End point title
    Maximum Plasma Concentration (Cmax) of Total and Free Cisplatin
    End point description
    Maximum observed plasma concentration (Cmax) of total and free Cisplatin is reported. PK concentration analysis was a subset of the safety analysis set and included subjects who had at least one post-dose concentration measurement above the lower limit of quantitation (LLQ) for avelumab or cisplatin. Here’ 'overall number of subjects analysed' signifies subjects evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    Pre-dose, mid-infusion, end of infusion, 3, 4, and 24 hours post dose on Day 1 of CRT phase
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    12
    23
    Units: nanogram per milliliter
    geometric mean (geometric coefficient of variation)
        Total Cisplastin
    3781 ± 44
    4001 ± 34
        Free Cisplastin
    1710 ± 53
    1151 ± 109
    No statistical analyses for this end point

    Secondary: Time to Attain Maximum Observed Plasma Concentration (Tmax) of Total and Free Cisplatin

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    End point title
    Time to Attain Maximum Observed Plasma Concentration (Tmax) of Total and Free Cisplatin
    End point description
    Time to reach maximum observed plasma concentration (Tmax) of total and free Cisplatin. PK concentration analysis was a subset of the safety analysis set and included subjects who had at least one post-dose concentration measurement above the lower limit of quantitation (LLQ) for avelumab or cisplatin. Here’ 'overall number of subjects analysed' signifies subjects evaluable for this endpoint.
    End point type
    Secondary
    End point timeframe
    Pre-dose, mid-infusion, end of infusion, 3, 4, and 24 hours post dose on Day 1 of CRT phase
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    12
    23
    Units: hour
    median (full range (min-max))
        Total Cisplastin
    1.000 (0.500 to 2.40)
    1.170 (0.983 to 24.0)
        Free Cisplastin
    1.000 (0.500 to 1.17)
    1.000 (0.500 to 2.12)
    No statistical analyses for this end point

    Secondary: Number of Subjects With Anti-Drug Antibodies (ADA) Against Avelumab by Never and Ever Positive Status

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    End point title
    Number of Subjects With Anti-Drug Antibodies (ADA) Against Avelumab by Never and Ever Positive Status [8]
    End point description
    ADA never-positive was defined as no positive ADA results at any time point; ADA-negative subjects (titer less than< cut point) and ADA ever-positive was defined as at least one positive ADA result at any time point; ADA-positive subjects (titer greater than or equal to cut point). Immunogenicity analysis set was a subset of the safety analysis set which included subjects who had at least 1 ADA/nAb sample collected for avelumab in Avelumab + Standard of Care Chemotherapy (SOC CRT) arm.
    End point type
    Secondary
    End point timeframe
    pre-dose on Day 1 up to 30 Days after the end of treatment
    Notes
    [8] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint was planned to be analyzed for the arms specified
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Number of subjects analysed
    331
    Units: subjects
        ADA never-positive
    277
        ADA ever-positive
    54
    No statistical analyses for this end point

    Secondary: Number of Subjects With Neutralizing Antibodies (nAb) Against Avelumab by Never and Ever Positive Status

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    End point title
    Number of Subjects With Neutralizing Antibodies (nAb) Against Avelumab by Never and Ever Positive Status
    End point description
    End point type
    Secondary
    End point timeframe
    Day 1 of lead-in phase and on Days 8 and 25 of CRT phase
    End point values
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Number of subjects analysed
    0 [9]
    0 [10]
    Units: subjects
    Notes
    [9] - Due to study termination and program decision data for nAb was not collected and analyzed.
    [10] - Due to study termination and program decision data for nAb was not collected and analyzed.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline up to 44 months
    Adverse event reporting additional description
    Same event may appear as AE, serious AE, here distinct events are presented. Event may be serious in 1 participant and non-serious in another or 1 subject may have experienced both serious, non-serious event. Safety analysis set evaluated.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    23.0
    Reporting groups
    Reporting group title
    Avelumab + Standard of Care Chemotherapy (SOC CRT)
    Reporting group description
    Participants with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) were administered with avelumab 10 milligram per kilogram (mg/kg) intravenous (IV) injection on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase participants also received SOC CRT: cisplatin 100 milligram per square meter (mg/m^2) on Days 1, 22, 43 and intensity-modulated radiation therapy (IMRT) 5 days a week. CRT phase was followed by maintenance phase (12 months) in which participants received avelumab 10 mg/kg IV injection every 2 weeks. All participants were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose participants were followed up on Day 90 via telephone call thereafter in long term (LT) follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Reporting group title
    Placebo + SOC CRT
    Reporting group description
    Participants with LA SCCHN were administered with placebo IV injection matched to avelumab on Day 1 of the Lead-in Phase (7 days) and on Days 8, 25 and 39 in CRT phase (63 days). In CRT phase participants also received SOC CRT: cisplatin mg/m^2 on Days 1, 22 and 43 + IMRT 5 days a week. CRT phase was followed by maintenance phase (12 months) in which participants received placebo IV injection every 2 weeks. All participants were followed for safety 30 days after the last study treatment administration or until the time of initiation of new systemic anticancer treatment. If any concern arose participants were followed up on Day 90 via telephone call thereafter in long term follow up period every 16 weeks for survival and new systemic anticancer treatment.

    Serious adverse events
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Total subjects affected by serious adverse events
         subjects affected / exposed
    184 / 348 (52.87%)
    177 / 344 (51.45%)
         number of deaths (all causes)
    86
    62
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Malignant melanoma
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Non-small cell lung cancer
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal neoplasm
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal carcinoma
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transitional cell cancer of the renal pelvis and ureter
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Plasmacytoma
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour haemorrhage
         subjects affected / exposed
    4 / 348 (1.15%)
    4 / 344 (1.16%)
         occurrences causally related to treatment / all
    0 / 4
    1 / 5
         deaths causally related to treatment / all
    0 / 2
    0 / 3
    Vascular disorders
    Capillary leak syndrome
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Circulatory collapse
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Embolism
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematoma
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemorrhage
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Lymphorrhoea
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    2 / 348 (0.57%)
    4 / 344 (1.16%)
         occurrences causally related to treatment / all
    1 / 2
    2 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Shock
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Phlebitis superficial
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular rupture
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Vasculitis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Venous haemorrhage
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Surgical and medical procedures
    Gastrostomy
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    2 / 348 (0.57%)
    6 / 344 (1.74%)
         occurrences causally related to treatment / all
    2 / 2
    5 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    2 / 348 (0.57%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chills
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Condition aggravated
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Death
         subjects affected / exposed
    2 / 348 (0.57%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
         deaths causally related to treatment / all
    1 / 2
    0 / 2
    Fatigue
         subjects affected / exposed
    2 / 348 (0.57%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    1 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Disease progression
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 348 (0.29%)
    6 / 344 (1.74%)
         occurrences causally related to treatment / all
    1 / 1
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperpyrexia
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperthermia
         subjects affected / exposed
    0 / 348 (0.00%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypothermia
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ill-defined disorder
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malaise
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mucosal inflammation
         subjects affected / exposed
    5 / 348 (1.44%)
    6 / 344 (1.74%)
         occurrences causally related to treatment / all
    6 / 6
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain
         subjects affected / exposed
    0 / 348 (0.00%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Performance status decreased
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    12 / 348 (3.45%)
    3 / 344 (0.87%)
         occurrences causally related to treatment / all
    5 / 15
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sudden death
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Swelling
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Scrotal oedema
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute respiratory failure
         subjects affected / exposed
    2 / 348 (0.57%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 2
    1 / 1
    Asphyxia
         subjects affected / exposed
    1 / 348 (0.29%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Aspiration
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Atelectasis
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cough
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    5 / 348 (1.44%)
    7 / 344 (2.03%)
         occurrences causally related to treatment / all
    1 / 5
    3 / 9
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    2 / 348 (0.57%)
    3 / 344 (0.87%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 4
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Hypoxia
         subjects affected / exposed
    1 / 348 (0.29%)
    3 / 344 (0.87%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Laryngeal haemorrhage
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Laryngeal inflammation
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Laryngeal oedema
         subjects affected / exposed
    5 / 348 (1.44%)
    4 / 344 (1.16%)
         occurrences causally related to treatment / all
    7 / 7
    4 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Laryngeal necrosis
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Laryngeal stenosis
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Obstructive airways disorder
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oropharyngeal pain
         subjects affected / exposed
    1 / 348 (0.29%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    1 / 1
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pharyngeal haemorrhage
         subjects affected / exposed
    2 / 348 (0.57%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 2
         deaths causally related to treatment / all
    1 / 1
    0 / 1
    Pharyngeal inflammation
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pharyngeal necrosis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pharyngeal oedema
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pharyngeal stenosis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pharyngeal ulceration
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia aspiration
         subjects affected / exposed
    5 / 348 (1.44%)
    5 / 344 (1.45%)
         occurrences causally related to treatment / all
    1 / 5
    3 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Pneumonitis
         subjects affected / exposed
    6 / 348 (1.72%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    5 / 6
    1 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Pneumothorax
         subjects affected / exposed
    1 / 348 (0.29%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Productive cough
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Respiratory arrest
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Respiratory distress
         subjects affected / exposed
    2 / 348 (0.57%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    0 / 348 (0.00%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    0 / 2
    Respiratory tract oedema
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stridor
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tonsillar haemorrhage
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Tracheal stenosis
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    3 / 348 (0.86%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Delirium
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Suicidal ideation
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Suicide attempt
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Product issues
    Device malfunction
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device dislocation
         subjects affected / exposed
    1 / 348 (0.29%)
    3 / 344 (0.87%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Embedded device
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood creatinine increased
         subjects affected / exposed
    7 / 348 (2.01%)
    6 / 344 (1.74%)
         occurrences causally related to treatment / all
    6 / 7
    6 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    C-reactive protein increased
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eastern Cooperative Oncology Group performance status worsened
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Hepatic enzyme increased
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Liver function test abnormal
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Liver function test increased
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lymphocyte count decreased
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    4 / 348 (1.15%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    5 / 5
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oxygen saturation decreased
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Weight decreased
         subjects affected / exposed
    6 / 348 (1.72%)
    3 / 344 (0.87%)
         occurrences causally related to treatment / all
    4 / 6
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    White blood cell count decreased
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Femoral neck fracture
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrostomy failure
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (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
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nerve injury
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Overdose
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatic injury
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Post procedural fever
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Post procedural haemorrhage
         subjects affected / exposed
    2 / 348 (0.57%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Radiation associated pain
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Radiation fibrosis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Radiation injury
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Radiation mucositis
         subjects affected / exposed
    0 / 348 (0.00%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Radiation necrosis
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Radiation skin injury
         subjects affected / exposed
    3 / 348 (0.86%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    6 / 6
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stoma site inflammation
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stoma site pain
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subdural haemorrhage
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thermal burn
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tracheal obstruction
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tracheal haemorrhage
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Osteoradionecrosis
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Acute coronary syndrome
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Angina pectoris
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute myocardial infarction
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bradycardia
         subjects affected / exposed
    1 / 348 (0.29%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 1
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 348 (0.29%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Cardiac failure congestive
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardio-respiratory arrest
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Sinus tachycardia
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tachycardia
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Brain hypoxia
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cerebral ischaemia
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Coma
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Depressed level of consciousness
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epilepsy
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dizziness
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Presyncope
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subacute combined cord degeneration
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    8 / 348 (2.30%)
    12 / 344 (3.49%)
         occurrences causally related to treatment / all
    7 / 9
    10 / 12
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    9 / 348 (2.59%)
    5 / 344 (1.45%)
         occurrences causally related to treatment / all
    9 / 9
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bone marrow failure
         subjects affected / exposed
    2 / 348 (0.57%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lymphadenopathy
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Leukopenia
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    5 / 348 (1.44%)
    3 / 344 (0.87%)
         occurrences causally related to treatment / all
    5 / 5
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Splenic haematoma
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Deafness
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tinnitus
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vertigo
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Pterygium
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Retinal detachment
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    0 / 348 (0.00%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 348 (0.29%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    2 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 348 (0.29%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dry mouth
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Duodenal ulcer perforation
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspepsia
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dysphagia
         subjects affected / exposed
    15 / 348 (4.31%)
    13 / 344 (3.78%)
         occurrences causally related to treatment / all
    13 / 19
    11 / 14
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Faecaloma
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric perforation
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Haematemesis
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Haematochezia
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Large intestinal obstruction
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mouth haemorrhage
         subjects affected / exposed
    2 / 348 (0.57%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mouth swelling
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    7 / 348 (2.01%)
    9 / 344 (2.62%)
         occurrences causally related to treatment / all
    9 / 9
    10 / 11
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Odynophagia
         subjects affected / exposed
    3 / 348 (0.86%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    2 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal obstruction
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophagitis
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oral pain
         subjects affected / exposed
    1 / 348 (0.29%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumoperitoneum
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Salivary hypersecretion
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stomatitis
         subjects affected / exposed
    7 / 348 (2.01%)
    4 / 344 (1.16%)
         occurrences causally related to treatment / all
    10 / 10
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tongue ulceration
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tongue haemorrhage
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    11 / 348 (3.16%)
    13 / 344 (3.78%)
         occurrences causally related to treatment / all
    14 / 14
    12 / 15
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholelithiasis
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatitis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatotoxicity
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Erythema multiforme
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rash
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (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
    12 / 348 (3.45%)
    11 / 344 (3.20%)
         occurrences causally related to treatment / all
    11 / 12
    11 / 11
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hydronephrosis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nephritis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oliguria
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal disorder
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    0 / 348 (0.00%)
    4 / 344 (1.16%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal tubular necrosis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary retention
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endocrine disorders
    Hyperthyroidism
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Adrenal insufficiency
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthritis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Back pain
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematoma muscle
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neck pain
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oligoarthritis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Osteonecrosis of jaw
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Abdominal abscess
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abscess oral
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anal abscess
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Appendicitis
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacterial infection
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchitis bacterial
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Candida infection
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    3 / 348 (0.86%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    2 / 4
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    2 / 348 (0.57%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related sepsis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endocarditis
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endocarditis candida
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterocolitis infectious
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Epididymitis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epiglottitis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    1 / 348 (0.29%)
    3 / 344 (0.87%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infectious pleural effusion
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Localised infection
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    2 / 348 (0.57%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung abscess
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection bacterial
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenic infection
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenic sepsis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal candidiasis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oral candidiasis
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Parotitis
         subjects affected / exposed
    2 / 348 (0.57%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oral infection
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pharyngitis
         subjects affected / exposed
    0 / 348 (0.00%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumococcal sepsis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    25 / 348 (7.18%)
    20 / 344 (5.81%)
         occurrences causally related to treatment / all
    8 / 30
    8 / 21
         deaths causally related to treatment / all
    0 / 1
    0 / 2
    Pneumonia bacterial
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    4 / 348 (1.15%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    7 / 348 (2.01%)
    5 / 344 (1.45%)
         occurrences causally related to treatment / all
    3 / 9
    3 / 5
         deaths causally related to treatment / all
    1 / 2
    0 / 0
    Sinusitis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin infection
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Soft tissue infection
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Staphylococcal sepsis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stoma site abscess
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stoma site infection
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    2 / 348 (0.57%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular device infection
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Osteomyelitis
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Adult failure to thrive
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cachexia
         subjects affected / exposed
    2 / 348 (0.57%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 2
    0 / 1
    Decreased appetite
         subjects affected / exposed
    5 / 348 (1.44%)
    3 / 344 (0.87%)
         occurrences causally related to treatment / all
    7 / 7
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    9 / 348 (2.59%)
    15 / 344 (4.36%)
         occurrences causally related to treatment / all
    7 / 10
    9 / 15
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diabetes mellitus inadequate control
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diabetic ketoacidosis
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Electrolyte imbalance
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Failure to thrive
         subjects affected / exposed
    2 / 348 (0.57%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fluid overload
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypercalcaemia
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    2 / 348 (0.57%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperglycaemic hyperosmolar nonketotic syndrome
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoalbuminaemia
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    0 / 348 (0.00%)
    2 / 344 (0.58%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    4 / 348 (1.15%)
    3 / 344 (0.87%)
         occurrences causally related to treatment / all
    4 / 4
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    4 / 348 (1.15%)
    7 / 344 (2.03%)
         occurrences causally related to treatment / all
    3 / 4
    6 / 10
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypophagia
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 344 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ketoacidosis
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malnutrition
         subjects affected / exposed
    2 / 348 (0.57%)
    3 / 344 (0.87%)
         occurrences causally related to treatment / all
    0 / 2
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolic disorder
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 344 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Avelumab + Standard of Care Chemotherapy (SOC CRT) Placebo + SOC CRT
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    344 / 348 (98.85%)
    340 / 344 (98.84%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    32 / 348 (9.20%)
    28 / 344 (8.14%)
         occurrences all number
    63
    54
    Hypotension
         subjects affected / exposed
    22 / 348 (6.32%)
    14 / 344 (4.07%)
         occurrences all number
    26
    16
    Lymphoedema
         subjects affected / exposed
    18 / 348 (5.17%)
    15 / 344 (4.36%)
         occurrences all number
    19
    17
    General disorders and administration site conditions
    Chills
         subjects affected / exposed
    39 / 348 (11.21%)
    7 / 344 (2.03%)
         occurrences all number
    43
    8
    Asthenia
         subjects affected / exposed
    63 / 348 (18.10%)
    58 / 344 (16.86%)
         occurrences all number
    124
    102
    Fatigue
         subjects affected / exposed
    116 / 348 (33.33%)
    127 / 344 (36.92%)
         occurrences all number
    227
    232
    Localised oedema
         subjects affected / exposed
    22 / 348 (6.32%)
    20 / 344 (5.81%)
         occurrences all number
    24
    25
    Malaise
         subjects affected / exposed
    20 / 348 (5.75%)
    23 / 344 (6.69%)
         occurrences all number
    39
    39
    Mucosal inflammation
         subjects affected / exposed
    146 / 348 (41.95%)
    131 / 344 (38.08%)
         occurrences all number
    333
    289
    Oedema peripheral
         subjects affected / exposed
    19 / 348 (5.46%)
    16 / 344 (4.65%)
         occurrences all number
    27
    23
    Pyrexia
         subjects affected / exposed
    87 / 348 (25.00%)
    45 / 344 (13.08%)
         occurrences all number
    140
    69
    Pain
         subjects affected / exposed
    23 / 348 (6.61%)
    28 / 344 (8.14%)
         occurrences all number
    26
    41
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    74 / 348 (21.26%)
    63 / 344 (18.31%)
         occurrences all number
    96
    85
    Dysphonia
         subjects affected / exposed
    51 / 348 (14.66%)
    47 / 344 (13.66%)
         occurrences all number
    64
    78
    Dyspnoea
         subjects affected / exposed
    33 / 348 (9.48%)
    33 / 344 (9.59%)
         occurrences all number
    39
    36
    Hiccups
         subjects affected / exposed
    26 / 348 (7.47%)
    23 / 344 (6.69%)
         occurrences all number
    33
    32
    Pharyngeal inflammation
         subjects affected / exposed
    24 / 348 (6.90%)
    23 / 344 (6.69%)
         occurrences all number
    48
    35
    Oropharyngeal pain
         subjects affected / exposed
    75 / 348 (21.55%)
    92 / 344 (26.74%)
         occurrences all number
    131
    150
    Productive cough
         subjects affected / exposed
    40 / 348 (11.49%)
    31 / 344 (9.01%)
         occurrences all number
    53
    37
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    26 / 348 (7.47%)
    34 / 344 (9.88%)
         occurrences all number
    27
    42
    Insomnia
         subjects affected / exposed
    57 / 348 (16.38%)
    47 / 344 (13.66%)
         occurrences all number
    67
    56
    Depression
         subjects affected / exposed
    10 / 348 (2.87%)
    18 / 344 (5.23%)
         occurrences all number
    10
    21
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    56 / 348 (16.09%)
    30 / 344 (8.72%)
         occurrences all number
    92
    43
    Aspartate aminotransferase increased
         subjects affected / exposed
    55 / 348 (15.80%)
    26 / 344 (7.56%)
         occurrences all number
    87
    39
    Amylase increased
         subjects affected / exposed
    22 / 348 (6.32%)
    10 / 344 (2.91%)
         occurrences all number
    41
    11
    Blood creatinine increased
         subjects affected / exposed
    88 / 348 (25.29%)
    73 / 344 (21.22%)
         occurrences all number
    196
    167
    Blood alkaline phosphatase increased
         subjects affected / exposed
    22 / 348 (6.32%)
    9 / 344 (2.62%)
         occurrences all number
    36
    21
    Blood urea increased
         subjects affected / exposed
    18 / 348 (5.17%)
    17 / 344 (4.94%)
         occurrences all number
    26
    33
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    23 / 348 (6.61%)
    15 / 344 (4.36%)
         occurrences all number
    49
    24
    Lymphocyte count decreased
         subjects affected / exposed
    40 / 348 (11.49%)
    42 / 344 (12.21%)
         occurrences all number
    153
    204
    Neutrophil count decreased
         subjects affected / exposed
    64 / 348 (18.39%)
    60 / 344 (17.44%)
         occurrences all number
    115
    117
    Weight decreased
         subjects affected / exposed
    157 / 348 (45.11%)
    171 / 344 (49.71%)
         occurrences all number
    282
    333
    Platelet count decreased
         subjects affected / exposed
    40 / 348 (11.49%)
    33 / 344 (9.59%)
         occurrences all number
    66
    75
    White blood cell count decreased
         subjects affected / exposed
    69 / 348 (19.83%)
    64 / 344 (18.60%)
         occurrences all number
    164
    203
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    24 / 348 (6.90%)
    6 / 344 (1.74%)
         occurrences all number
    40
    18
    Radiation skin injury
         subjects affected / exposed
    135 / 348 (38.79%)
    136 / 344 (39.53%)
         occurrences all number
    216
    223
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    41 / 348 (11.78%)
    33 / 344 (9.59%)
         occurrences all number
    45
    40
    Dysgeusia
         subjects affected / exposed
    106 / 348 (30.46%)
    119 / 344 (34.59%)
         occurrences all number
    154
    166
    Neuropathy peripheral
         subjects affected / exposed
    11 / 348 (3.16%)
    28 / 344 (8.14%)
         occurrences all number
    12
    45
    Headache
         subjects affected / exposed
    44 / 348 (12.64%)
    41 / 344 (11.92%)
         occurrences all number
    55
    54
    Blood and lymphatic system disorders
    Leukopenia
         subjects affected / exposed
    64 / 348 (18.39%)
    46 / 344 (13.37%)
         occurrences all number
    172
    123
    Anaemia
         subjects affected / exposed
    206 / 348 (59.20%)
    192 / 344 (55.81%)
         occurrences all number
    531
    490
    Neutropenia
         subjects affected / exposed
    102 / 348 (29.31%)
    98 / 344 (28.49%)
         occurrences all number
    192
    169
    Lymphopenia
         subjects affected / exposed
    33 / 348 (9.48%)
    27 / 344 (7.85%)
         occurrences all number
    164
    101
    Thrombocytopenia
         subjects affected / exposed
    45 / 348 (12.93%)
    41 / 344 (11.92%)
         occurrences all number
    92
    81
    Ear and labyrinth disorders
    Ear pain
         subjects affected / exposed
    23 / 348 (6.61%)
    12 / 344 (3.49%)
         occurrences all number
    26
    12
    Hypoacusis
         subjects affected / exposed
    29 / 348 (8.33%)
    30 / 344 (8.72%)
         occurrences all number
    36
    33
    Tinnitus
         subjects affected / exposed
    59 / 348 (16.95%)
    66 / 344 (19.19%)
         occurrences all number
    70
    74
    Gastrointestinal disorders
    Abdominal pain upper
         subjects affected / exposed
    14 / 348 (4.02%)
    18 / 344 (5.23%)
         occurrences all number
    16
    24
    Abdominal pain
         subjects affected / exposed
    11 / 348 (3.16%)
    20 / 344 (5.81%)
         occurrences all number
    13
    22
    Constipation
         subjects affected / exposed
    178 / 348 (51.15%)
    155 / 344 (45.06%)
         occurrences all number
    280
    215
    Diarrhoea
         subjects affected / exposed
    83 / 348 (23.85%)
    66 / 344 (19.19%)
         occurrences all number
    112
    92
    Dry mouth
         subjects affected / exposed
    151 / 348 (43.39%)
    158 / 344 (45.93%)
         occurrences all number
    217
    215
    Dyspepsia
         subjects affected / exposed
    23 / 348 (6.61%)
    21 / 344 (6.10%)
         occurrences all number
    34
    22
    Nausea
         subjects affected / exposed
    210 / 348 (60.34%)
    199 / 344 (57.85%)
         occurrences all number
    346
    340
    Dysphagia
         subjects affected / exposed
    143 / 348 (41.09%)
    152 / 344 (44.19%)
         occurrences all number
    253
    275
    Odynophagia
         subjects affected / exposed
    62 / 348 (17.82%)
    48 / 344 (13.95%)
         occurrences all number
    111
    67
    Oral pain
         subjects affected / exposed
    39 / 348 (11.21%)
    43 / 344 (12.50%)
         occurrences all number
    69
    78
    Stomatitis
         subjects affected / exposed
    92 / 348 (26.44%)
    96 / 344 (27.91%)
         occurrences all number
    167
    184
    Vomiting
         subjects affected / exposed
    112 / 348 (32.18%)
    121 / 344 (35.17%)
         occurrences all number
    195
    210
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    22 / 348 (6.32%)
    20 / 344 (5.81%)
         occurrences all number
    23
    20
    Dermatitis
         subjects affected / exposed
    52 / 348 (14.94%)
    42 / 344 (12.21%)
         occurrences all number
    88
    67
    Dry skin
         subjects affected / exposed
    18 / 348 (5.17%)
    24 / 344 (6.98%)
         occurrences all number
    19
    28
    Erythema
         subjects affected / exposed
    24 / 348 (6.90%)
    27 / 344 (7.85%)
         occurrences all number
    30
    30
    Pruritus
         subjects affected / exposed
    38 / 348 (10.92%)
    24 / 344 (6.98%)
         occurrences all number
    51
    38
    Rash
         subjects affected / exposed
    43 / 348 (12.36%)
    36 / 344 (10.47%)
         occurrences all number
    67
    51
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    18 / 348 (5.17%)
    22 / 344 (6.40%)
         occurrences all number
    42
    37
    Endocrine disorders
    Hyperthyroidism
         subjects affected / exposed
    24 / 348 (6.90%)
    7 / 344 (2.03%)
         occurrences all number
    28
    7
    Hypothyroidism
         subjects affected / exposed
    51 / 348 (14.66%)
    45 / 344 (13.08%)
         occurrences all number
    64
    51
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    17 / 348 (4.89%)
    20 / 344 (5.81%)
         occurrences all number
    18
    25
    Neck pain
         subjects affected / exposed
    30 / 348 (8.62%)
    25 / 344 (7.27%)
         occurrences all number
    45
    28
    Infections and infestations
    Oral candidiasis
         subjects affected / exposed
    25 / 348 (7.18%)
    31 / 344 (9.01%)
         occurrences all number
    36
    40
    Pneumonia
         subjects affected / exposed
    36 / 348 (10.34%)
    25 / 344 (7.27%)
         occurrences all number
    43
    31
    Upper respiratory tract infection
         subjects affected / exposed
    24 / 348 (6.90%)
    21 / 344 (6.10%)
         occurrences all number
    28
    23
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    128 / 348 (36.78%)
    124 / 344 (36.05%)
         occurrences all number
    211
    194
    Dehydration
         subjects affected / exposed
    31 / 348 (8.91%)
    29 / 344 (8.43%)
         occurrences all number
    38
    33
    Hyperglycaemia
         subjects affected / exposed
    31 / 348 (8.91%)
    33 / 344 (9.59%)
         occurrences all number
    65
    74
    Hyperkalaemia
         subjects affected / exposed
    34 / 348 (9.77%)
    32 / 344 (9.30%)
         occurrences all number
    49
    66
    Hypoalbuminaemia
         subjects affected / exposed
    42 / 348 (12.07%)
    36 / 344 (10.47%)
         occurrences all number
    88
    73
    Hypocalcaemia
         subjects affected / exposed
    29 / 348 (8.33%)
    23 / 344 (6.69%)
         occurrences all number
    42
    37
    Hypokalaemia
         subjects affected / exposed
    87 / 348 (25.00%)
    71 / 344 (20.64%)
         occurrences all number
    179
    130
    Hypomagnesaemia
         subjects affected / exposed
    93 / 348 (26.72%)
    84 / 344 (24.42%)
         occurrences all number
    178
    173
    Hyponatraemia
         subjects affected / exposed
    83 / 348 (23.85%)
    68 / 344 (19.77%)
         occurrences all number
    183
    164
    Hypophosphataemia
         subjects affected / exposed
    23 / 348 (6.61%)
    32 / 344 (9.30%)
         occurrences all number
    41
    46

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    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.
    If a subject discontinued all 3 treatments of CRT phase due to death then death is included as discontinuation reason in each treatment disposition summary.Deaths reported as reason of discontinuation at any phase are included in all-cause mortality.
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    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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