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    Clinical Trial Results:
    An Open Label, Single Arm, Multicenter, Safety Study of Atezolizumab in Locally Advanced or Metastatic Urothelial or Non-urothelial Carcinoma of the Urinary Tract

    Summary
    EudraCT number
    2016-002625-11
    Trial protocol
    GR   EE   LT   DE   HU   IE   DK   CZ   PT   GB   BG   NL   PL   ES   BE   SK   HR   IT  
    Global end of trial date
    12 Dec 2022

    Results information
    Results version number
    v3(current)
    This version publication date
    22 Mar 2024
    First version publication date
    27 Dec 2023
    Other versions
    v1 , v2
    Version creation reason

    Trial information

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    Trial identification
    Sponsor protocol code
    MO29983
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02928406
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    F. Hoffmann-La Roche AG
    Sponsor organisation address
    Grenzacherstrasse 124, Basel, Switzerland, CH-4070
    Public contact
    F. Hoffmann-La Roche AG, F. Hoffmann-La Roche AG, 41 616878333, global.trial_information@roche.com
    Scientific contact
    F. Hoffmann-La Roche AG, F. Hoffmann-La Roche AG, 41 616878333, global.trial_information@roche.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    12 Dec 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    12 Dec 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of the trial was to assess the safety of atezolizumab as second- to fourth-line treatment for participants with locally advanced or metastatic urothelial or non-urothelial cancer of the urinary tract in addition to evaluating the efficacy of atezolizumab and potential tumor biomarkers associated with atezolizumab.
    Protection of trial subjects
    All study subjects were required to read and sign and Informed Consent Form.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    30 Nov 2016
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety
    Long term follow-up duration
    4 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Argentina: 8
    Country: Number of subjects enrolled
    Australia: 58
    Country: Number of subjects enrolled
    Austria: 17
    Country: Number of subjects enrolled
    Belgium: 20
    Country: Number of subjects enrolled
    Brazil: 32
    Country: Number of subjects enrolled
    Bulgaria: 3
    Country: Number of subjects enrolled
    Canada: 17
    Country: Number of subjects enrolled
    China: 3
    Country: Number of subjects enrolled
    Colombia: 8
    Country: Number of subjects enrolled
    Croatia: 12
    Country: Number of subjects enrolled
    Czechia: 10
    Country: Number of subjects enrolled
    Denmark: 20
    Country: Number of subjects enrolled
    Estonia: 3
    Country: Number of subjects enrolled
    Germany: 55
    Country: Number of subjects enrolled
    Greece: 40
    Country: Number of subjects enrolled
    Hungary: 33
    Country: Number of subjects enrolled
    India: 11
    Country: Number of subjects enrolled
    Ireland: 15
    Country: Number of subjects enrolled
    Italy: 270
    Country: Number of subjects enrolled
    Lebanon: 5
    Country: Number of subjects enrolled
    Lithuania: 11
    Country: Number of subjects enrolled
    Netherlands: 34
    Country: Number of subjects enrolled
    Poland: 20
    Country: Number of subjects enrolled
    Portugal: 14
    Country: Number of subjects enrolled
    Romania: 20
    Country: Number of subjects enrolled
    Russian Federation: 10
    Country: Number of subjects enrolled
    Saudi Arabia: 5
    Country: Number of subjects enrolled
    Slovakia: 9
    Country: Number of subjects enrolled
    Spain: 170
    Country: Number of subjects enrolled
    Switzerland: 25
    Country: Number of subjects enrolled
    Taiwan: 6
    Country: Number of subjects enrolled
    United Kingdom: 40
    Worldwide total number of subjects
    1004
    EEA total number of subjects
    776
    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)
    378
    From 65 to 84 years
    613
    85 years and over
    13

    Subject disposition

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    Recruitment
    Recruitment details
    This study was conducted at 172 centers in 32 countries

    Pre-assignment
    Screening details
    -

    Pre-assignment period milestones
    Number of subjects started
    1004
    Number of subjects completed
    997

    Pre-assignment subject non-completion reasons
    Reason: Number of subjects
    Did not receive study treatment: 7
    Period 1
    Period 1 title
    Overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    Atezolizumab
    Arm description
    Participants received atezolizumab every 3 weeks (Q3W) until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurred first).
    Arm type
    Experimental

    Investigational medicinal product name
    Atezolizumab
    Investigational medicinal product code
    Other name
    MPDL3280A
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Atezolizumab 1200 milligrams (mg) was administered by intravenous (IV) infusion Q3W.

    Number of subjects in period 1 [1]
    Atezolizumab
    Started
    997
    Completed
    0
    Not completed
    997
         Consent withdrawn by subject
    40
         Physician decision
    1
         Death
    775
         Non-compliance
    1
         Study terminated by sponsor
    57
         Various reasonse
    72
         Progressive disease
    3
         Lost to follow-up
    48
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: This number is based on the safety population, that is those participants who were enrolled and received at least one dose of study treatment

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Atezolizumab
    Reporting group description
    Participants received atezolizumab every 3 weeks (Q3W) until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurred first).

    Reporting group values
    Atezolizumab Total
    Number of subjects
    997 997
    Age Categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    375 375
        From 65-84 years
    609 609
        85 years and over
    13 13
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    66.6 ( 10.00 ) -
    Gender Categorical
    Units: Participants
        Female
    225 225
        Male
    772 772
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    11 11
        Asian
    30 30
        Native Hawaiian or Other Pacific Islander
    0 0
        Black or African American
    4 4
        White
    920 920
        More than one race
    0 0
        Unknown or Not Reported
    32 32
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    112 112
        Not Hispanic or Latino
    820 820
        Unknown or Not Reported
    65 65

    End points

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    End points reporting groups
    Reporting group title
    Atezolizumab
    Reporting group description
    Participants received atezolizumab every 3 weeks (Q3W) until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurred first).

    Subject analysis set title
    Intent to Treat (ITT)
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    This is the ITT population

    Primary: Percentage of Participants With Adverse Events (AEs)

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    End point title
    Percentage of Participants With Adverse Events (AEs) [1]
    End point description
    AEs were defined as any untoward medical occurrence in a subject administered a pharmaceutical product, regardless of causal attribution. An AE can be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. New disease, exacerbation of existing disease, recurrence of an intermittent medical condition not present at baseline, any deterioration in a laboratory value or other clinical test associated with symptoms or leading to a change in study/concomitant treatment or discontinuation from study drug as well as events related to protocol-mandated interventions are considered AEs. The safety population included all enrolled participants who received at least one dose of study medication.
    End point type
    Primary
    End point timeframe
    Baseline up to end of study (up to approximately 6 years)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The incidence of AEs are summarized by frequency tables. Corresponding 95% Clopper-Pearson confidence intervals (CIs) are also presented, as applicable. Complicated statistical methods for AEs analysis are rarely used, and there is a reliance on simple approaches to display information such as in frequency tables and descriptive statistics.
    End point values
    Atezolizumab
    Number of subjects analysed
    900
    Units: Percentage of participants
        number (not applicable)
    90.3
    No statistical analyses for this end point

    Secondary: Progression Free Survival (PFS) as per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)

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    End point title
    Progression Free Survival (PFS) as per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
    End point description
    PFS was defined as the date of first occurrence of tumor progression (earliest of the dates of the RECIST component indicating tumor progression) or date of death (in the absence of tumor progression) by any cause, whichever occurred first, or date of censoring minus date of start of study treatment plus 1.
    End point type
    Secondary
    End point timeframe
    Randomization up to disease progression or death from any cause, whichever occurred first (up to approximately 6 years)
    End point values
    Intent to Treat (ITT)
    Number of subjects analysed
    1004
    Units: Months
        median (confidence interval 95%)
    2.20 (2.14 to 2.40)
    No statistical analyses for this end point

    Secondary: PFS as per Modified Response Evaluation Criteria in Solid Tumors (Modified RECIST)

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    End point title
    PFS as per Modified Response Evaluation Criteria in Solid Tumors (Modified RECIST)
    End point description
    PFS as per Modified RECIST was defined as: - date of first occurrence of tumor progression after a modified confirmed response if the participant was a responder according to modified RECIST or - date of first occurrence of tumor progression in case the participant was not a responder according to modified RECIST or - date of death (in the absence of tumor progression) by any cause, or - date of censoring whichever occurred first, minus date of start of study treatment plus 1 The ITT population included all enrolled participants.
    End point type
    Secondary
    End point timeframe
    Randomization up to disease progression or death from any cause, whichever occurred first (up to approximately 6 years)
    End point values
    Intent to Treat (ITT)
    Number of subjects analysed
    1004
    Units: Months
        median (confidence interval 95%)
    2.79 (2.37 to 3.45)
    No statistical analyses for this end point

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    OS was defined as date of death (due to any cause) or censoring minus date of start of study treatment plus 1. The intent-to-treat (ITT) population included all enrolled participants.
    End point type
    Secondary
    End point timeframe
    Randomization until death from any cause (up to approximately 6 years)
    End point values
    Intent to Treat (ITT)
    Number of subjects analysed
    1004
    Units: Months
        median (confidence interval 95%)
    8.57 (7.75 to 9.72)
    No statistical analyses for this end point

    Secondary: Percentage of Participants With Best Overall Response (BOR) as Assessed by RECIST v1.1

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    End point title
    Percentage of Participants With Best Overall Response (BOR) as Assessed by RECIST v1.1
    End point description
    BOR was assessed by the investigators according to the RECIST v1.1. BOR was defined as a complete response (CR) or partial response (PR) determined on two consecutive investigator assessments >= 4 weeks apart in participants with measurable disease at baseline. CR = Disappearance of all target lesions. Any pathological lymph nodes (whether target or nontarget) must have reduction in short axis to <10 millimeters (mm); PR = At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters. Progressive Disease (PD) = At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (nadir), including baseline. In addition to the relative increase of 20%, the sum must have demonstrated an absolute increase of at least 5 mm. Stable Disease (SD) = Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum on study.
    End point type
    Secondary
    End point timeframe
    Randomization up to disease progression or death from any cause, whichever occurred first (up to approximately 6 years)
    End point values
    Intent to Treat (ITT)
    Number of subjects analysed
    1004
    Units: Percentage of participants
        number (confidence interval 95%)
    15.7 (13.5 to 18.1)
    No statistical analyses for this end point

    Secondary: Percentage of Participants With BOR as Assessed by Modified RECIST

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    End point title
    Percentage of Participants With BOR as Assessed by Modified RECIST
    End point description
    BOR was assessed by the investigators according to the modified RECIST. BOR was defined as complete response (CR) or partial response (PR). CR includes complete disappearance of all tumor lesions and no new measurable or unmeasurable lesions confirmed by a consecutive assessment >=4 weeks from the first documented date. PR is a decrease in the sum of the diameters of all target and all new measurable lesions >=30%, relative to baseline, in the absence of CR confirmed by a consecutive assessment >=4 weeks from the first documented date. The assessment of BOR included post-screening RECIST assessments obtained up to: 1) death from any cause, 2) last evaluable RECIST assessment in the absence of death, 3) start of a subsequent anti-cancer therapy, whichever occurred first. The ITT population included all enrolled participants.
    End point type
    Secondary
    End point timeframe
    Randomization up to disease progression or death from any cause, whichever occurred first (up to approximately 6 years)
    End point values
    Intent to Treat (ITT)
    Number of subjects analysed
    1004
    Units: Percentage of participants
        number (confidence interval 95%)
    16.4 (14.2 to 18.9)
    No statistical analyses for this end point

    Secondary: Percentage of Participants With Disease Control as Assessed by RECIST v1.1

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    End point title
    Percentage of Participants With Disease Control as Assessed by RECIST v1.1
    End point description
    Disease control was determined separately on disease status using RECIST v1.1 by the investigator. Disease control rate was defined as the sum of the complete response, partial response, and stable disease rates. The ITT population included all enrolled participants.
    End point type
    Secondary
    End point timeframe
    Randomization up to disease progression or death from any cause, whichever occurred first (up to approximately 6 years)
    End point values
    Intent to Treat (ITT)
    Number of subjects analysed
    1004
    Units: Percentage of participants
        number (confidence interval 95%)
    39.9 (36.9 to 43.0)
    No statistical analyses for this end point

    Secondary: Percentage of Participants With Disease Control as Assessed by Modified RECIST

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    End point title
    Percentage of Participants With Disease Control as Assessed by Modified RECIST
    End point description
    Disease control was determined separately on disease status using modified RECIST by the investigator. Disease control rate was defined as the sum of the complete response, partial response, and stable disease rates. The ITT population included all enrolled participants.
    End point type
    Secondary
    End point timeframe
    Randomization up to disease progression or death from any cause, whichever occurred first (up to approximately 6 years)
    End point values
    Intent to Treat (ITT)
    Number of subjects analysed
    1004
    Units: Percentage of participants
        number (confidence interval 95%)
    46.0 (42.9 to 49.2)
    No statistical analyses for this end point

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

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    End point title
    Duration of Response (DOR) as Assessed by RECIST v1.1
    End point description
    Duration of response was determined separately on disease status using RECIST v1.1 by the investigator. For overall responders, DoR was defined as the time from the date of first occurrence of a confirmed response (complete response or partial response) to date of tumor progression or death from any cause, or to censoring date: 1) end of response coincided with the date of tumor progression or death (in the absence of tumor progression) used for the PFS endpoint, 2) for a participant without disease progression or death following a response, the censored end of response coincided with the PFS censoring date (that was latest RECIST assessment or start of subsequent cancer therapy, whichever occurred first). The ITT population included all enrolled participants. Only participants with a response were analyzed for this outcome measure.
    End point type
    Secondary
    End point timeframe
    Time from first occurrence of a documented response to disease progression or death from any cause, whichever occurred first (up to approximately 6 years)
    End point values
    Intent to Treat (ITT)
    Number of subjects analysed
    158
    Units: Months
        median (confidence interval 95%)
    27.79 (18.89 to 43.30)
    No statistical analyses for this end point

    Secondary: DOR as Assessed by Modified RECIST

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    End point title
    DOR as Assessed by Modified RECIST
    End point description
    DOR was determined separately on disease status using modified RECIST by the investigator. For overall responders, DoR was defined as the time from the date of first occurrence of a confirmed response (complete response or partial response) to date of tumor progression following that confirmed response or death from any cause, or to censoring date: 1) end of response was the date of tumor progression after that confirmed response or death (in the absence of tumor progression), 2) for a participant without disease progression or death following a response, the censored end of response was the latest RECIST assessment or start of subsequent cancer therapy, whichever occurred first. The ITT population included all enrolled participants. Only participants with a response were analyzed for this outcome measure.
    End point type
    Secondary
    End point timeframe
    Time from first occurrence of a documented response to disease progression or death from any cause, whichever occurred first (up to approximately 6 years)
    End point values
    Intent to Treat (ITT)
    Number of subjects analysed
    165
    Units: Months
        median (confidence interval 95%)
    29.73 (21.72 to 43.30)
    No statistical analyses for this end point

    Secondary: Change From Baseline in Health-Related Quality of Life (HRQoL), as Assessed Using European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire Core 30 (QLQ-C30) Score

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    End point title
    Change From Baseline in Health-Related Quality of Life (HRQoL), as Assessed Using European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire Core 30 (QLQ-C30) Score
    End point description
    The EORTC QLQ-C30 included global health status, functional scales (physical, role, emotional, cognitive, and social), symptom scales (fatigue, nausea/vomiting, and pain) and single items (dyspnoea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Most questions used a 4-point scale (1 'Not at all' to 4 'Very much'; 2 questions used 7-point scale [1 'very poor' to 7 'Excellent']). Scores were averaged and transformed to 0 - 100 scale. Higher scores on the global health status and functional scales indicated better health status/function. Higher scores on the symptoms scales and symptom items indicated greater symptom burden. The ITT population included all enrolled participants who completed the questionnaire at baseline and had 1 post-baseline assessment.
    End point type
    Secondary
    End point timeframe
    Baseline, Day 1 of Cycles 1, 2, 3 and thereafter every 9 weeks for 54 weeks from study treatment start; and then every 12 weeks until progression/study discontinuation (up to approximately 6 years) (Cycle length = 21 days)
    End point values
    Intent to Treat (ITT)
    Number of subjects analysed
    964
    Units: Score on a scale
    arithmetic mean (standard deviation)
        Physical score Baseline
    70.62 ( 23.784 )
        Physical score Cycle(C) 2 Day(D) 1
    -3.43 ( 16.923 )
        Physical score C3D1
    -3.98 ( 18.854 )
        Physical score C4D1
    -2.01 ( 18.647 )
        Physical score C7D1
    1.72 ( 19.408 )
        Physical score C10D1
    3.10 ( 17.494 )
        Physical score C13D1
    3.32 ( 16.829 )
        Physical score C16D1
    3.62 ( 19.790 )
        Physical score C19D1
    3.27 ( 20.591 )
        Physical score C23D1
    4.16 ( 19.298 )
        Physical score C27D1
    4.90 ( 20.032 )
        Physical score C31D1
    6.50 ( 20.053 )
        Physical score C35D1
    4.95 ( 24.876 )
        Physical score C39D1
    7.33 ( 22.307 )
        Physical score C43D1
    6.06 ( 19.840 )
        Physical score C47D1
    6.56 ( 19.682 )
        Physical score C51D1
    4.85 ( 22.585 )
        Physical score C55D1
    4.93 ( 19.110 )
        Physical score C59D1
    5.69 ( 21.916 )
        Physical score C63D1
    7.64 ( 18.894 )
        Physical score C67D1
    8.66 ( 23.154 )
        Physical score C71D1
    3.50 ( 19.652 )
        Physical score C75D1
    6.67 ( 17.914 )
        Physical score C79D1
    1.00 ( 18.245 )
        Physical score C83D1
    -4.15 ( 7.908 )
        Physical score C87D1
    -10.00 ( 14.142 )
        Physical score C91D1
    -20.00 ( 9999999 )
        Physical score Discontinuation visit
    -13.87 ( 26.541 )
        Role score Baseline
    67.29 ( 31.545 )
        Role score C2D1
    -5.38 ( 25.918 )
        Role score C3D1
    -4.31 ( 27.800 )
        Role score C4D1
    -1.45 ( 29.012 )
        Role score C7D1
    1.81 ( 29.762 )
        Role score C10D1
    3.25 ( 27.060 )
        Role score C13D1
    5.73 ( 26.659 )
        Role score C16D1
    4.10 ( 28.314 )
        Role score C19D1
    2.28 ( 28.10 )
        Role score C23D1
    2.70 ( 32.535 )
        Role score C27D1
    6.56 ( 30.725 )
        Role score C31D1
    9.18 ( 31.951 )
        Role score C35D1
    4.86 ( 34.899 )
        Role score C39D1
    10.81 ( 33.457 )
        Role score C43D1
    6.58 ( 31.276 )
        Role score C47D1
    7.21 ( 31.464 )
        Role score C51D1
    6.91 ( 31.914 )
        Role score C55D1
    5.06 ( 21.136 )
        Role score C59D1
    8.03 ( 23.736 )
        Role score C63D1
    5.66 ( 24.664 )
        Role score C67D1
    2.90 ( 34.116 )
        Role score C71D1
    4.65 ( 29.171 )
        Role score C75D1
    5.57 ( 22.335 )
        Role score C79D1
    4.18 ( 31.934 )
        Role score C83D1
    -4.16 ( 14.743 )
        Role score C87D1
    -8.30 ( 11.738 )
        Role score C91D1
    -16.60 ( 9999999 )
        Role score Discontinuation visit
    -17.61 ( 35.664 )
        Emotional score Baseline
    75.89 ( 22.274 )
        Emotional score C2D1
    0.79 ( 18.975 )
        Emotional score C3D1
    1.55 ( 18.868 )
        Emotional score C4D1
    1.04 ( 19.530 )
        Emotional score C7D1
    3.05 ( 18.978 )
        Emotional score C10D1
    4.39 ( 17.733 )
        Emotional score C13D1
    3.96 ( 17.669 )
        Emotional score C16D1
    5.79 ( 20.044 )
        Emotional score C19D1
    4.90 ( 20.156 )
        Emotional score C23D1
    5.45 ( 20.057 )
        Emotional score C27D1
    5.94 ( 19.538 )
        Emotional score C31D1
    10.17 ( 19.057 )
        Emotional score C35D1
    8.90 ( 19.361 )
        Emotional score C39D1
    9.80 ( 20.883 )
        Emotional score C43D1
    8.22 ( 20.618 )
        Emotional score C47D1
    7.21 ( 19.762 )
        Emotional score C51D1
    9.23 ( 20.377 )
        Emotional score C55D1
    8.48 ( 18.359 )
        Emotional score C59D1
    9.88 ( 17.890 )
        Emotional score C63D1
    9.12 ( 16.766 )
        Emotional score C67D1
    8.52 ( 20.452 )
        Emotional score C71D1
    7.56 ( 18.345 )
        Emotional score C75D1
    7.33 ( 21.430 )
        Emotional score C79D1
    5.84 ( 22.465 )
        Emotional score C83D1
    8.34 ( 8.913 )
        Emotional score C87D1
    0.00 ( 47.235 )
        Emotional score C91D1
    -33.40 ( 9999999 )
        Emotional score Discontinuation visit
    -7.49 ( 23.771 )
        Cognitive score Baseline
    85.43 ( 20.943 )
        Cognitive score C2D1
    -1.83 ( 19.255 )
        Cognitive score C3D1
    -2.40 ( 18.344 )
        Cognitive score C4D1
    -1.58 ( 15.886 )
        Cognitive score C7D1
    0.00 ( 16.737 )
        Cognitive score C10D1
    -0.78 ( 16.763 )
        Cognitive score C13D1
    -0.37 ( 14.476 )
        Cognitive score C16D1
    0.44 ( 16.743 )
        Cognitive score C19D1
    -0.10 ( 17.221 )
        Cognitive score C23D1
    -1.27 ( 17.973 )
        Cognitive score C27D1
    -0.68 ( 17.324 )
        Cognitive score C31D1
    1.38 ( 14.715 )
        Cognitive score C35D1
    0.32 ( 15.112 )
        Cognitive score C39D1
    -1.46 ( 15.238 )
        Cognitive score C43D1
    -2.19 ( 16.623 )
        Cognitive score C47D1
    -0.68 ( 14.702 )
        Cognitive score C51D1
    -0.23 ( 16.051 )
        Cognitive score C55D1
    1.79 ( 14.791 )
        Cognitive score C59D1
    -0.31 ( 17.271 )
        Cognitive score C63D1
    -1.25 ( 15.615 )
        Cognitive score C67D1
    -3.98 ( 16.909 )
        Cognitive score C71D1
    -5.42 ( 13.946 )
        Cognitive score C75D1
    -6.67 ( 15.951 )
        Cognitive score C79D1
    -8.34 ( 13.792 )
        Cognitive score C83D1
    -6.24 ( 12.382 )
        Cognitive score C87D1
    0.00 ( 0.00 )
        Cognitive score C91D1
    0.00 ( 9999999 )
        Cognitive score Discontinuation visit
    -9.76 ( 23.884 )
        Social score Baseline
    74.56 ( 26.597 )
        Social score C2D1
    -1.25 ( 26.277 )
        Social score C3D1
    -0.02 ( 24.058 )
        Social score C4D1
    -0.38 ( 25.568 )
        Social score C7D1
    0.24 ( 26.865 )
        Social score C10D1
    3.78 ( 25.930 )
        Social score C13D1
    4.43 ( 23.550 )
        Social score C16D1
    3.99 ( 23.579 )
        Social score C19D1
    24.45 ( 25.186 )
        Social score C23D1
    1.65 ( 28.106 )
        Social score C27D1
    4.24 ( 24.482 )
        Social score C31D1
    7.65 ( 28.007 )
        Social score C35D1
    5.02 ( 26.279 )
        Social score C39D1
    6.96 ( 26.070 )
        Social score C43D1
    5.26 ( 25.704 )
        Social score C47D1
    4.96 ( 27.412 )
        Social score C51D1
    6.34 ( 24.541 )
        Social score C55D1
    6.55 ( 21.946 )
        Social score C59D1
    8.03 ( 22.369 )
        Social score C63D1
    6.29 ( 22.695 )
        Social score C67D1
    5.80 ( 27.491 )
        Social score C71D1
    3.50 ( 21.995 )
        Social score C75D1
    10.01 ( 22.041 )
        Social score C79D1
    5.84 ( 28.767 )
        Social score C83D1
    18.75 ( 27.383 )
        Social score C87D1
    8.30 ( 11.738 )
        Social score C91D1
    33.30 ( 9999999 )
        Social score Discontinuation visit
    -12.20 ( 33.586 )
        Fatigue score Baseline
    36.04 ( 26.343 )
        Fatigue score C2D1
    5.58 ( 22.444 )
        Fatigue score C3D1
    5.01 ( 23.869 )
        Fatigue score C4D1
    3.27 ( 23.637 )
        Fatigue score C7D1
    -2.56 ( 24.879 )
        Fatigue score C10D1
    -3.95 ( 23.633 )
        Fatigue score C13D1
    -2.46 ( 23.492 )
        Fatigue score C16D1
    -4.97 ( 25.081 )
        Fatigue score C19D1
    -4.73 ( 26.358 )
        Fatigue score C23D1
    -3.34 ( 26.603 )
        Fatigue score C27D1
    -6.01 ( 24.252 )
        Fatigue score C31D1
    -10.09 ( 25.731 )
        Fatigue score C35D1
    -8.95 ( 28.738 )
        Fatigue score C39D1
    -9.76 ( 28.299 )
        Fatigue score C43D1
    -7.75 ( 28.295 )
        Fatigue score C47D1
    -7.95 ( 24.164 )
        Fatigue score C51D1
    -9.68 ( 25.102 )
        Fatigue score C55D1
    -7.73 ( 24.710 )
        Fatigue score C59D1
    -9.46 ( 21.528 )
        Fatigue score C63D1
    -7.13 ( 21.259 )
        Fatigue score C67D1
    -6.76 ( 28.838 )
        Fatigue score C71D1
    -5.42 ( 23.187 )
        Fatigue score C75D1
    -3.70 ( 26.146 )
        Fatigue score C79D1
    -6.66 ( 23.200 )
        Fatigue score C83D1
    -4.18 ( 13.215 )
        Fatigue score C87D1
    -5.55 ( 39.386 )
        Fatigue score C91D1
    22.30 ( 9999999 )
        Fatigue score Discontinuation visit
    13.35 ( 28.962 )
        Nausea/Vomiting score Baseline
    6.94 ( 14.538 )
        Nausea/Vomiting score C2D1
    3.53 ( 16.328 )
        Nausea/Vomiting score C3D1
    2.43 ( 15.445 )
        Nausea/Vomiting score C4D1
    1.77 ( 14.485 )
        Nausea/Vomiting score C7D1
    0.81 ( 14.300 )
        Nausea/Vomiting score C10D1
    -0.36 ( 12.603 )
        Nausea/Vomiting score C13D1
    -0.52 ( 11.533 )
        Nausea/Vomiting score C16D1
    -1.06 ( 12.109 )
        Nausea/Vomiting score C19D1
    -0.72 ( 10.436 )
        Nausea/Vomiting score C23D1
    0.13 ( 10.880 )
        Nausea/Vomiting score C27D1
    -0.14 ( 11.838 )
        Nausea/Vomiting score C31D1
    -1.53 ( 8.939 )
        Nausea/Vomiting score C35D1
    -2.91 ( 9.461 )
        Nausea/Vomiting score C39D1
    -2.93 ( 10.421 )
        Nausea/Vomiting score C43D1
    -3.29 ( 8.614 )
        Nausea/Vomiting score C47D1
    -2.93 ( 8.879 )
        Nausea/Vomiting score C51D1
    -2.86 ( 8.960 )
        Nausea/Vomiting score C55D1
    -3.03 ( 9.123 )
        Nausea/Vomiting score C59D1
    -2.47 ( 9.388 )
        Nausea/Vomiting score C63D1
    -3.46 ( 9.446 )
        Nausea/Vomiting score C67D1
    -2.90 ( 9.494 )
        Nausea/Vomiting score C71D1
    -2.33 ( 8.587 )
        Nausea/Vomiting score C75D1
    -2.09 ( 5.642 )
        Nausea/Vomiting score C79D1
    -2.51 ( 6.118 )
        Nausea/Vomiting score C83D1
    0.00 ( 0.000 )
        Nausea/Vomiting score C87D1
    8.30 ( 11.738 )
        Nausea/Vomiting score C91D1
    0.00 ( 4.69 )
        Nausea/Vomiting score Discontinuation visit
    19.358 ( 9999999 )
        Pain score Baseline
    33.97 ( 31.221 )
        Pain score C2D1
    0.06 ( 23.064 )
        Pain score C3D1
    1.54 ( 26.411 )
        Pain score C4D1
    -0.13 ( 27.312 )
        Pain score C7D1
    -2.61 ( 30.687 )
        Pain score C10D1
    -3.90 ( 26.146 )
        Pain score C13D1
    -4.02 ( 25.814 )
        Pain score C16D1
    -5.74 ( 29.692 )
        Pain score C19D1
    -6.83 ( 27.035 )
        Pain score C23D1
    -5.98 ( 28.577 )
        Pain score C27D1
    -9.29 ( 26.684 )
        Pain score C31D1
    -10.10 ( 25.864 )
        Pain score C35D1
    -9.71 ( 33.050 )
        Pain score C39D1
    -11.54 ( 30.400 )
        Pain score C43D1
    -8.56 ( 29.125 )
        Pain score C47D1
    -10.36 ( 29.157 )
        Pain score C51D1
    -6.58 ( 29.875 )
        Pain score C55D1
    -8.04 ( 26.779 )
        Pain score C59D1
    -8.96 ( 27.033 )
        Pain score C63D1
    -5.04 ( 30.238 )
        Pain score C67D1
    -5.80 ( 32.632 )
        Pain score C71D1
    -8.54 ( 29.178 )
        Pain score C75D1
    -12.01 ( 30.999 )
        Pain score C79D1
    -6.67 ( 32.628 )
        Pain score C83D1
    -8.35 ( 30.876 )
        Pain score C87D1
    -16.70 ( 23.617 )
        Pain score C91D1
    33.30 ( 9999999 )
        Pain score Discontinuation visit
    9.53 ( 33.994 )
        Dyspnoea score Baseline
    16.23 ( 24.815 )
        Dyspnoea score C2D1
    1.03 ( 22.912 )
        Dyspnoea score C3D1
    3.29 ( 24.647 )
        Dyspnoea score C4D1
    0.88 ( 22.962 )
        Dyspnoea score C7D1
    -0.57 ( 23.661 )
        Dyspnoea score C10D1
    -1.09 ( 22.079 )
        Dyspnoea score C13D1
    -0.30 ( 23.616 )
        Dyspnoea score C16D1
    -1.06 ( 22.042 )
        Dyspnoea score C19D1
    -0.21 ( 22.650 )
        Dyspnoea score C23D1
    -0.26 ( 24.014 )
        Dyspnoea score C27D1
    1.10 ( 25.791 )
        Dyspnoea score C31D1
    -3.98 ( 24.725 )
        Dyspnoea score C35D1
    -4.20 ( 23.647 )
        Dyspnoea score C39D1
    -3.30 ( 22.794 )
        Dyspnoea score C43D1
    -2.63 ( 24.798 )
        Dyspnoea score C47D1
    -3.19 ( 23.669 )
        Dyspnoea score C51D1
    -2.90 ( 23.379 )
        Dyspnoea score C55D1
    -2.97 ( 20.366 )
        Dyspnoea score C59D1
    -1.24 ( 21.421 )
        Dyspnoea score C63D1
    -1.26 ( 20.616 )
        Dyspnoea score C67D1
    -3.62 ( 23.530 )
        Dyspnoea score C71D1
    -3.88 ( 22.066 )
        Dyspnoea score C75D1
    0.00 ( 27.800 )
        Dyspnoea score C79D1
    1.67 ( 25.301 )
        Dyspnoea score C83D1
    12.50 ( 17.252 )
        Dyspnoea score C87D1
    50.00 ( 23.617 )
        Dyspnoea score C91D1
    66.70 ( 9999999 )
        Dyspnoea score Discontinuation visit
    8.71 ( 29.191 )
        Insomnia score Baseline
    27.26 ( 30.907 )
        Insomnia score C2D1
    -1.35 ( 28.522 )
        Insomnia score C3D1
    -1.59 ( 29.084 )
        Insomnia score C4D1
    -2.09 ( 30.102 )
        Insomnia score C7D1
    -5.92 ( 31.614 )
        Insomnia score C10D1
    -5.70 ( 28.263 )
        Insomnia score C13D1
    -3.87 ( 30.033 )
        Insomnia score C16D1
    -6.88 ( 33.594 )
        Insomnia score C19D1
    -6.62 ( 28.337 )
        Insomnia score C23D1
    -5.64 ( 29.969 )
        Insomnia score C27D1
    -6.28 ( 29.791 )
        Insomnia score C31D1
    -12.54 ( 30.360 )
        Insomnia score C35D1
    -9.39 ( 33.797 )
        Insomnia score C39D1
    -10.26 ( 33.217 )
        Insomnia score C43D1
    -4.83 ( 34.298 )
        Insomnia score C47D1
    -4.57 ( 31.091 )
        Insomnia score C51D1
    -4.28 ( 28.901 )
        Insomnia score C55D1
    -2.38 ( 33.548 )
        Insomnia score C59D1
    -4.94 ( 27.784 )
        Insomnia score C63D1
    -1.89 ( 29.540 )
        Insomnia score C67D1
    -4.35 ( 31.901 )
        Insomnia score C71D1
    -9.30 ( 31.972 )
        Insomnia score C75D1
    -6.95 ( 29.451 )
        Insomnia score C79D1
    -6.95 ( 29.451 )
        Insomnia score C83D1
    -16.69 ( 35.646 )
        Insomnia score C87D1
    -0.05 ( 47.164 )
        Insomnia score C91D1
    33.30 ( 9999999 )
        Insomnia score Discontinuation visit
    8.07 ( 33.114 )
        Appetite Loss score Baseline
    21.21 ( 30.066 )
        Appetite Loss score C2D1
    7.36 ( 27.805 )
        Appetite Loss score C3D1
    6.15 ( 26.405 )
        Appetite Loss score C4D1
    1.97 ( 28.206 )
        Appetite Loss score C7D1
    -1.14 ( 29.837 )
        Appetite Loss score C10D1
    -2.89 ( 26.152 )
        Appetite Loss score C13D1
    -3.72 ( 27.719 )
        Appetite Loss score C16D1
    -4.94 ( 26.392 )
        Appetite Loss score C19D1
    -3.73 ( 23.565 )
        Appetite Loss score C23D1
    -1.02 ( 24.532 )
        Appetite Loss score C27D1
    -3.28 ( 25.136 )
        Appetite Loss score C31D1
    -5.20 ( 23.643 )
        Appetite Loss score C35D1
    -7.77 ( 28.847 )
        Appetite Loss score C39D1
    -6.96 ( 26.064 )
        Appetite Loss score C43D1
    -5.26 ( 22.473 )
        Appetite Loss score C47D1
    -3.15 ( 23.515 )
        Appetite Loss score C51D1
    -4.29 ( 21.919 )
        Appetite Loss score C55D1
    -4.16 ( 27.749 )
        Appetite Loss score C59D1
    -6.92 ( 23.892 )
        Appetite Loss score C63D1
    -4.40 ( 25.347 )
        Appetite Loss score C67D1
    -7.24 ( 19.765 )
        Appetite Loss score C71D1
    -3.10 ( 20.328 )
        Appetite Loss score C75D1
    -1.39 ( 6.797 )
        Appetite Loss score C79D1
    -3.34 ( 23.929 )
        Appetite Loss score C83D1
    0.03 ( 35.639 )
        Appetite Loss score C87D1
    16.65 ( 23.547 )
        Appetite Loss score C91D1
    33.30 ( 9999999 )
        Appetite Loss score Discontinuation visit
    14.68 ( 32.487 )
        Constipation score Baseline
    24.98 ( 31.584 )
        Constipation score C2D1
    0.74 ( 26.700 )
        Constipation score C3D1
    -1.41 ( 29.876 )
        Constipation score C4D1
    -3.48 ( 27.560 )
        Constipation score C7D1
    -3.91 ( 29.908 )
        Constipation score C10D1
    -4.95 ( 29.467 )
        Constipation score C13D1
    -6.40 ( 30.010 )
        Constipation score C16D1
    -7.05 ( 28.513 )
        Constipation score C19D1
    -5.38 ( 25.523 )
        Constipation score C23D1
    -5.64 ( 26.619 )
        Constipation score C27D1
    -6.01 ( 29.384 )
        Constipation score C31D1
    -12.53 ( 27.131 )
        Constipation score C35D1
    -12.30 ( 28.388 )
        Constipation score C39D1
    -10.25 ( 29.267 )
        Constipation score C43D1
    -8.77 ( 27.953 )
        Constipation score C47D1
    -9.46 ( 27.868 )
        Constipation score C51D1
    -9.52 ( 30.108 )
        Constipation score C55D1
    -8.33 ( 25.624 )
        Constipation score C59D1
    -9.87 ( 22.079 )
        Constipation score C63D1
    -9.43 ( 22.052 )
        Constipation score C67D1
    -8.69 ( 20.408 )
        Constipation score C71D1
    -8.52 ( 23.112 )
        Constipation score C75D1
    -4.16 ( 14.933 )
        Constipation score C79D1
    -8.33 ( 30.334 )
        Constipation score C83D1
    -12.49 ( 17.234 )
        Constipation score C87D1
    0.00 ( 0.00 )
        Constipation score C91D1
    0.00 ( 9999999 )
        Constipation score Discontinuation visit
    4.13 ( 33.230 )
        Diarrhoea score Baseline
    6.84 ( 16.552 )
        Diarrhoea score C2D1
    1.23 ( 18.840 )
        Diarrhoea score C3D1
    0.33 ( 19.495 )
        Diarrhoea score C4D1
    -0.32 ( 18.847 )
        Diarrhoea score C7D1
    0.38 ( 18.060 )
        Diarrhoea score C10D1
    1.57 ( 21.110 )
        Diarrhoea score C13D1
    1.81 ( 20.267 )
        Diarrhoea score C16D1
    0.71 ( 15.774 )
        Diarrhoea score C19D1
    1.45 ( 19.838 )
        Diarrhoea score C23D1
    -0.25 ( 18.251 )
        Diarrhoea score C27D1
    -1.37 ( 15.677 )
        Diarrhoea score C31D1
    -0.31 ( 15.374 )
        Diarrhoea score C35D1
    1.29 ( 19.755 )
        Diarrhoea score C39D1
    -2.56 ( 14.252 )
        Diarrhoea score C43D1
    -1.31 ( 12.684 )
        Diarrhoea score C47D1
    -2.25 ( 15.915 )
        Diarrhoea score C51D1
    -1.41 ( 15.356 )
        Diarrhoea score C55D1
    -1.19 ( 10.933 )
        Diarrhoea score C59D1
    -1.85 ( 13.595 )
        Diarrhoea score C63D1
    -1.26 ( 11.240 )
        Diarrhoea score C67D1
    -1.45 ( 13.964 )
        Diarrhoea score C71D1
    -2.32 ( 13.390 )
        Diarrhoea score C75D1
    -1.33 ( 15.138 )
        Diarrhoea score C79D1
    -3.33 ( 14.892 )
        Diarrhoea score C83D1
    4.16 ( 21.341 )
        Diarrhoea score C87D1
    0.00 ( 0.00 )
        Diarrhoea score C91D1
    0.00 ( 9999999 )
        Diarrhoea score Discontinuation visit
    0.30 ( 22.379 )
        Financial difficulties score Baseline
    17.34 ( 27.147 )
        Financial difficulties score C2D1
    -1.86 ( 21.216 )
        Financial difficulties score C3D1
    -1.42 ( 22.408 )
        Financial difficulties score C4D1
    -1.54 ( 22.497 )
        Financial difficulties score C7D1
    -4.14 ( 24.057 )
        Financial difficulties score C10D1
    -3.88 ( 24.021 )
        Financial difficulties score C13D1
    -4.06 ( 22.615 )
        Financial difficulties score C16D1
    -2.84 ( 25.172 )
        Financial difficulties score C19D1
    -4.14 ( 26.023 )
        Financial difficulties score C23D1
    -5.35 ( 24.042 )
        Financial difficulties score C27D1
    -5.19 ( 23.867 )
        Financial difficulties score C31D1
    -9.48 ( 26.489 )
        Financial difficulties score C35D1
    -3.96 ( 25.517 )
        Financial difficulties score C39D1
    -4.76 ( 25.615 )
        Financial difficulties score C43D1
    -2.63 ( 22.942 )
        Financial difficulties score C47D1
    -0.90 ( 25.869 )
        Financial difficulties score C51D1
    -5.63 ( 25.191 )
        Financial difficulties score C55D1
    -4.76 ( 26.541 )
        Financial difficulties score C59D1
    -6.79 ( 24.551 )
        Financial difficulties score C63D1
    -6.92 ( 22.984 )
        Financial difficulties score C67D1
    -6.52 ( 24.693 )
        Financial difficulties score C71D1
    -6.98 ( 17.154 )
        Financial difficulties score C75D1
    -14.68 ( 23.740 )
        Financial difficulties score C79D1
    -1.68 ( 20.157 )
        Financial difficulties score C83D1
    -4.18 ( 33.028 )
        Financial difficulties score C87D1
    -16.70 ( 23.617 )
        Financial difficulties score C91D1
    0.00 ( 9999999 )
        Financial difficulties score Discontinuation visit
    2.41 ( 27.481 )
        Global health status Baseline
    59.01 ( 22.821 )
        Global health status C2D1
    -1.48 ( 19.541 )
        Global health status C3D1
    -0.27 ( 19.770 )
        Global health status C4D1
    0.82 ( 20.587 )
        Global health status C7D1
    3.64 ( 20.564 )
        Global health status C10D1
    3.63 ( 19.943 )
        Global health status C13D1
    6.01 ( 19.679 )
        Global health status C16D1
    5.76 ( 21.404 )
        Global health status C19D1
    4.88 ( 20.838 )
        Global health status C23D1
    5.21 ( 21.759 )
        Global health status C27D1
    6.22 ( 24.016 )
        Global health status C31D1
    8.10 ( 22.827 )
        Global health status C35D1
    11.17 ( 22.555 )
        Global health status C39D1
    8.52 ( 23.857 )
        Global health status C43D1
    8.56 ( 22.846 )
        Global health status C47D1
    5.30 ( 24.608 )
        Global health status C51D1
    7.51 ( 20.985 )
        Global health status C55D1
    8.49 ( 20.309 )
        Global health status C59D1
    9.57 ( 18.900 )
        Global health status C63D1
    8.34 ( 19.604 )
        Global health status C67D1
    7.43 ( 22.369 )
        Global health status C71D1
    9.30 ( 21.904 )
        Global health status C75D1
    10.67 ( 19.301 )
        Global health status C79D1
    10.43 ( 16.196 )
        Global health status C83D1
    10.44 ( 15.292 )
        Global health status C87D1
    4.20 ( 17.678 )
        Global health status C91D1
    -8.30 ( 9999999 )
        Global health status Discontinuation visit
    -10.94 ( 27.334 )
    No statistical analyses for this end point

    Secondary: Change from Baseline in European Quality of Life (EuroQoL) Group 5-Dimension 5-Level (EQ-5D-5L) Self Report Questionnaire Health Utility Score

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    End point title
    Change from Baseline in European Quality of Life (EuroQoL) Group 5-Dimension 5-Level (EQ-5D-5L) Self Report Questionnaire Health Utility Score
    End point description
    The EuroQol 5-Dimension Questionnaire (EQ-5D-5L) is a self-report health status questionnaire that consists of 6 questions used to calculate a health utility score for use in health economic analysis. There are two components to the EuroQol EQ-5D: 1) five health dimensions that assess mobility, self-care, usual activities, pain/discomfort, and anxiety/depression; 2) a visual analogue scale (VAS) that measures health state. There are 5 response levels for each dimension (1=no problems, 2=slight problems, 3=moderate problems, 4=severe problems, and 5=extreme problems) with the highest level representing the worst outcome. The VAS is scored on a scale from 0 to 100, with 0 representing the worst imaginable health and 100 representing the best imaginable health. The ITT population included all enrolled participants who completed the questionnaire at baseline and had 1 post-baseline assessment.
    End point type
    Secondary
    End point timeframe
    Baseline, Day 1 of Cycles 1, 2, 3 and thereafter every 9 weeks for 54 weeks from study treatment start; and then every 12 weeks until progression/study discontinuation (up to approximately 6 years) (Cycle length = 21 days)
    End point values
    Intent to Treat (ITT)
    Number of subjects analysed
    960
    Units: Score on a scale
    arithmetic mean (standard deviation)
        Mobility Baseline
    1.9 ( 1.03 )
        Mobility C2D1
    0.1 ( 0.90 )
        Mobility C3D1
    0.2 ( 0.90 )
        Mobility C4D1
    0.1 ( 0.88 )
        Mobility C7D1
    0.0 ( 0.93 )
        Mobility C10D1
    -0.1 ( 0.90 )
        Mobility C13D1
    -0.1 ( 0.80 )
        Mobility C16D1
    -0.2 ( 0.91 )
        Mobility C19D1
    -0.1 ( 0.92 )
        Mobility C23D1
    -0.1 ( 0.91 )
        Mobility C27D1
    -0.2 ( 0.84 )
        Mobility C31D1
    -0.2 ( 0.88 )
        Mobility C35D1
    -0.1 ( 1.05 )
        Mobility C39D1
    -0.2 ( 0.92 )
        Mobility C43D1
    -0.2 ( 1.04 )
        Mobility C47D1
    -0.2 ( 0.84 )
        Mobility C51D1
    -0.3 ( 0.89 )
        Mobility C55D1
    -0.1 ( 0.79 )
        Mobility C59D1
    -0.2 ( 0.99 )
        Mobility C63D1
    -0.2 ( 1.00 )
        Mobility C67D1
    -0.2 ( 0.93 )
        Mobility C71D1
    -0.1 ( 0.85 )
        Mobility C75D1
    -0.1 ( 0.67 )
        Mobility C79D1
    0.00 ( 0.97 )
        Mobility C83D1
    -0.1 ( 0.83 )
        Mobility C87D1
    1.0 ( 1.41 )
        Mobility C91D1
    2.0 ( 9999999 )
        Mobility Discontinuation visit
    0.5 ( 1.19 )
        Self-Care Baseline
    1.4 ( 0.81 )
        Self-Care C2D1
    0.1 ( 0.72 )
        Self-Care C3D1
    0.2 ( 0.77 )
        Self-Care C4D1
    0.1 ( 0.69 )
        Self-Care C7D1
    0.0 ( 0.72 )
        Self-Care C10D1
    0.0 ( 0.68 )
        Self-Care C13D1
    0.0 ( 0.62 )
        Self-Care C16D1
    -0.1 ( 0.57 )
        Self-Care C19D1
    0.0 ( 0.68 )
        Self-Care C23D1
    0.0 ( 0.67 )
        Self-Care C27D1
    0.0 ( 0.63 )
        Self-Care C31D1
    -0.1 ( 0.62 )
        Self-Care C35D1
    -0.1 ( 0.69 )
        Self-Care C39D1
    -0.1 ( 0.69 )
        Self-Care C43D1
    -0.1 ( 0.83 )
        Self-Care C47D1
    -0.1 ( 0.72 )
        Self-Care C51D1
    -0.1 ( 0.84 )
        Self-Care C55D1
    -0.1 ( 0.66 )
        Self-Care C59D1
    -0.1 ( 0.82 )
        Self-Care C63D1
    -0.1 ( 0.76 )
        Self-Care C67D1
    -0.1 ( 0.75 )
        Self-Care C71D1
    0.0 ( 0.60 )
        Self-Care C75D1
    0.0 ( 0.20 )
        Self-Care C79D1
    0.1 ( 0.45 )
        Self-Care C83D1
    -0.3 ( 0.46 )
        Self-Care C87D1
    0.0 ( 0.00 )
        Self-Care C91D1
    1.0 ( 9999999 )
        Self-Care Discontinuation visit
    0.4 ( 1.04 )
        Usual Activities Baseline
    2.0 ( 1.08 )
        Usual Activities C2D1
    0.2 ( 0.92 )
        Usual Activities C3D1
    0.2 ( 0.99 )
        Usual Activities C4D1
    0.1 ( 0.90 )
        Usual Activities C7D1
    0.0 ( 0.93 )
        Usual Activities C10D1
    -0.1 ( 0.92 )
        Usual Activities C13D1
    -0.2 ( 0.86 )
        Usual Activities C16D1
    -0.1 ( 1.04 )
        Usual Activities C19D1
    0.0 ( 0.98 )
        Usual Activities C23D1
    -0.1 ( 0.93 )
        Usual Activities C27D1
    -0.2 ( 0.92 )
        Usual Activities C31D1
    -0.3 ( 0.96 )
        Usual Activities C35D1
    -0.2 ( 1.10 )
        Usual Activities C39D1
    -0.2 ( 0.96 )
        Usual Activities C43D1
    -0.1 ( 0.93 )
        Usual Activities C47D1
    -0.2 ( 0.86 )
        Usual Activities C51D1
    -0.3 ( 0.91 )
        Usual Activities C55D1
    -0.2 ( 0.91 )
        Usual Activities C59D1
    -0.3 ( 0.95 )
        Usual Activities C63D1
    -0.2 ( 0.85 )
        Usual Activities C67D1
    -0.3 ( 0.80 )
        Usual Activities C71D1
    -0.2 ( 0.68 )
        Usual Activities C75D1
    -0.1 ( 0.49 )
        Usual Activities C79D1
    0.0 ( 0.65 )
        Usual Activities C83D1
    0.1 ( 0.64 )
        Usual Activities C87D1
    0.0 ( 0.00 )
        Usual Activities C91D1
    0.0 ( 9999999 )
        Usual Activities Discontinuation visit
    0.6 ( 1.23 )
        Pain/Discomfort Baseline
    2.3 ( 1.08 )
        Pain/Discomfort C2D1
    0.0 ( 0.82 )
        Pain/Discomfort C3D1
    0.1 ( 0.98 )
        Pain/Discomfort C4D1
    0.0 ( 0.94 )
        Pain/Discomfort C7D1
    0.0 ( 1.04 )
        Pain/Discomfort C10D1
    -0.2 ( 0.96 )
        Pain/Discomfort C13D1
    -0.2 ( 0.96 )
        Pain/Discomfort C16D1
    -0.3 ( 1.02 )
        Pain/Discomfort C19D1
    -0.2 ( 1.04 )
        Pain/Discomfort C23D1
    -0.2 ( 1.04 )
        Pain/Discomfort C27D1
    -0.3 ( 1.03 )
        Pain/Discomfort C31D1
    -0.3 ( 0.96 )
        Pain/Discomfort C35D1
    -0.3 ( 1.05 )
        Pain/Discomfort C39D1
    -0.4 ( 1.05 )
        Pain/Discomfort C43D1
    -0.4 ( 0.98 )
        Pain/Discomfort C47D1
    -0.4 ( 1.03 )
        Pain/Discomfort C51D1
    -0.3 ( 1.07 )
        Pain/Discomfort C55D1
    -0.4 ( 1.00 )
        Pain/Discomfort C59D1
    -0.4 ( 1.05 )
        Pain/Discomfort C63D1
    -0.3 ( 1.04 )
        Pain/Discomfort C67D1
    -0.2 ( 1.20 )
        Pain/Discomfort C71D1
    -0.2 ( 1.09 )
        Pain/Discomfort C75D1
    -0.3 ( 1.11 )
        Pain/Discomfort C79D1
    -0.3 ( 1.02 )
        Pain/Discomfort C83D1
    0.0 ( 0.93 )
        Pain/Discomfort C87D1
    -1.0 ( 0.00 )
        Pain/Discomfort C91D1
    0.0 ( 9999999 )
        Pain/Discomfort Discontinuation visit
    0.3 ( 1.18 )
        Anxiety/Depression Baseline
    1.7 ( 0.87 )
        Anxiety/Depression C2D1
    0.0 ( 0.75 )
        Anxiety/Depression C3D1
    0.0 ( 0.81 )
        Anxiety/Depression C4D1
    0.0 ( 0.87 )
        Anxiety/Depression C7D1
    -0.1 ( 0.81 )
        Anxiety/Depression C10D1
    -0.2 ( 0.74 )
        Anxiety/Depression C13D1
    -0.2 ( 0.78 )
        Anxiety/Depression C16D1
    -0.2 ( 0.78 )
        Anxiety/Depression C19D1
    -0.1 ( 0.78 )
        Anxiety/Depression C23D1
    -0.1 ( 0.88 )
        Anxiety/Depression C27D1
    -0.2 ( 0.73 )
        Anxiety/Depression C31D1
    -0.3 ( 0.75 )
        Anxiety/Depression C35D1
    -0.3 ( 0.74 )
        Anxiety/Depression C39D1
    -0.2 ( 0.78 )
        Anxiety/Depression C43D1
    -0.3 ( 0.80 )
        Anxiety/Depression C47D1
    -0.3 ( 0.77 )
        Anxiety/Depression C51D1
    -0.2 ( 0.78 )
        Anxiety/Depression C55D1
    -0.2 ( 0.73 )
        Anxiety/Depression C59D1
    -0.1 ( 0.68 )
        Anxiety/Depression C63D1
    -0.1 ( 0.82 )
        Anxiety/Depression C67D1
    -0.1 ( 0.76 )
        Anxiety/Depression C71D1
    -0.1 ( 0.78 )
        Anxiety/Depression C75D1
    -0.3 ( 0.82 )
        Anxiety/Depression C79D1
    -0.5 ( 1.00 )
        Anxiety/Depression C83D1
    -0.4 ( 0.74 )
        Anxiety/Depression C87D1
    0.0 ( 1.41 )
        Anxiety/Depression C91D1
    1.0 ( 9999999 )
        Anxiety/Depression Discontinuation visit
    0.3 ( 1.03 )
        Visual Analog Scale (VAS) Baseline
    64.7 ( 20.37 )
        VAS C2D1
    -0.6 ( 14.76 )
        VAS C3D1
    -0.3 ( 17.21 )
        VAS C4D1
    0.3 ( 18.02 )
        VAS C7D1
    3.7 ( 17.47 )
        VAS C10D1
    3.5 ( 17.88 )
        VAS C13D1
    5.8 ( 17.46 )
        VAS C16D1
    6.4 ( 17.87 )
        VAS C19D1
    5.9 ( 16.49 )
        VAS C23D1
    7.7 ( 17.14 )
        VAS C27D1
    8.9 ( 17.99 )
        VAS C31D1
    8.9 ( 17.99 )
        VAS C35D1
    11.0 ( 19.13 )
        VAS C39D1
    9.0 ( 19.31 )
        VAS C43D1
    8.9 ( 17.59 )
        VAS C47D1
    9.0 ( 16.08 )
        VAS C51D1
    7.4 ( 18.85 )
        VAS C55D1
    8.7 ( 18.10 )
        VAS C59D1
    5.3 ( 16.15 )
        VAS C63D1
    18.5 ( 17.08 )
        VAS C67D1
    6.8 ( 18.89 )
        VAS C71D1
    7.7 ( 18.48 )
        VAS C75D1
    8.3 ( 14.89 )
        VAS C79D1
    7.2 ( 13.47 )
        VAS C83D1
    9.0 ( 10.74 )
        VAS C87D1
    7.5 ( 10.61 )
        VAS C91D1
    0.0 ( 9999999 )
        VAS Discontinuation visit
    -8.0 ( 22.60 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline up to end of study (up to approximately 6 years)
    Adverse event reporting additional description
    Serious and other AEs were reported based on the safety population, which included all randomized participants who received any amount of study treatment, regardless of whether a full or partial dose was received. This population was evaluated after the initiation of study treatment.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.1
    Reporting groups
    Reporting group title
    Atezolizumab
    Reporting group description
    Participants received atezolizumab every 3 weeks (Q3W) until investigator assessed loss of clinical benefit, unacceptable toxicity, investigator or participant decision to withdraw from therapy, or death (whichever occurred first).

    Serious adverse events
    Atezolizumab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    380 / 997 (38.11%)
         number of deaths (all causes)
    775
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Cancer pain
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chronic myeloid leukaemia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Haemangioma of skin
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intestinal adenocarcinoma
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung adenocarcinoma
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Plasma cell myeloma
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Squamous cell carcinoma of the oral cavity
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tumour pain
         subjects affected / exposed
    4 / 997 (0.40%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Acute myeloid leukaemia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    6 / 997 (0.60%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Hypotension
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Aortic stenosis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypovolaemic shock
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Intermittent claudication
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Jugular vein thrombosis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pelvic venous thrombosis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Peripheral arterial occlusive disease
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Peripheral ischaemia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Venous thrombosis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Hyperpyrexia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    15 / 997 (1.50%)
         occurrences causally related to treatment / all
    7 / 18
         deaths causally related to treatment / all
    0 / 0
    Death
         subjects affected / exposed
    8 / 997 (0.80%)
         occurrences causally related to treatment / all
    0 / 8
         deaths causally related to treatment / all
    0 / 8
    Fatigue
         subjects affected / exposed
    4 / 997 (0.40%)
         occurrences causally related to treatment / all
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    Chest pain
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Pain
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Asthenia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Complication of device insertion
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Influenza like illness
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Malaise
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Performance status decreased
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Systemic inflammatory response syndrome
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular device occlusion
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Systemic immune activation
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Sarcoidosis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Female genital tract fistula
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Scrotal inflammation
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spermatocele
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vaginal haemorrhage
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pneumonitis
         subjects affected / exposed
    11 / 997 (1.10%)
         occurrences causally related to treatment / all
    11 / 11
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    5 / 997 (0.50%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    2 / 2
    Pulmonary embolism
         subjects affected / exposed
    5 / 997 (0.50%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 1
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemoptysis
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Respiratory failure
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    1 / 2
    Bronchopneumopathy
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypoxia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Immune-mediated lung disease
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary thrombosis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory distress
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Delirium
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Depression
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Product issues
    Device occlusion
         subjects affected / exposed
    4 / 997 (0.40%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    4 / 997 (0.40%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Alanine aminotransferase increased
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatic enzyme increased
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Myocardial necrosis marker increased
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Transaminases increased
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    White blood cell count decreased
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Lumbar vertebral fracture
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Femur fracture
         subjects affected / exposed
    4 / 997 (0.40%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Fall
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Ankle fracture
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Craniocerebral injury
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hip fracture
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Humerus fracture
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Incisional hernia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Joint injury
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular procedure complication
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract stoma complication
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Traumatic haemothorax
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Toxicity to various agents
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thoracic vertebral fracture
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Seroma
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rib fracture
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Multiple fractures
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Pericardial effusion
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Left ventricular failure
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Left ventricular dysfunction
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Atrial flutter
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Aortic valve disease
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Acute myocardial infarction
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    4 / 997 (0.40%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 2
    Cardiac failure
         subjects affected / exposed
    5 / 997 (0.50%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 2
    Pericardial haemorrhage
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    1 / 1
    Sinus bradycardia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Cerebral ischaemia
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 1
    Dizziness
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 1
    Cerebrovascular accident
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Aphasia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Loss of consciousness
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Headache
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemorrhagic stroke
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Epilepsy
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Depressed level of consciousness
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cognitive disorder
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cerebral atrophy
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    4 / 997 (0.40%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Autoimmune haemolytic anaemia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancytopenia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Corneal degeneration
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Ascites
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    16 / 997 (1.60%)
         occurrences causally related to treatment / all
    1 / 17
         deaths causally related to treatment / all
    0 / 4
    Abdominal pain
         subjects affected / exposed
    10 / 997 (1.00%)
         occurrences causally related to treatment / all
    0 / 10
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    7 / 997 (0.70%)
         occurrences causally related to treatment / all
    3 / 7
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    6 / 997 (0.60%)
         occurrences causally related to treatment / all
    5 / 6
         deaths causally related to treatment / all
    1 / 1
    Vomiting
         subjects affected / exposed
    6 / 997 (0.60%)
         occurrences causally related to treatment / all
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Constipation
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Ileus
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Nausea
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Abdominal adhesions
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain lower
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Autoimmune colitis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Dyspepsia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Enterovesical fistula
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric haemorrhage
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Immune-mediated enterocolitis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Subileus
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Intestinal perforation
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    1 / 1
    Large intestinal obstruction
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Proctalgia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Proctitis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Incarcerated inguinal hernia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholecystitis acute
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Biliary obstruction
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Acute hepatic failure
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatotoxicity
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Hepatitis
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Autoimmune hepatitis
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Drug-induced liver injury
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    1 / 1
    Hepatic cyst
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatic function abnormal
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperbilirubinaemia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Gallbladder obstruction
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Immune-mediated dermatitis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pemphigoid
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Rash
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin ulcer
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    16 / 997 (1.60%)
         occurrences causally related to treatment / all
    0 / 16
         deaths causally related to treatment / all
    0 / 0
    Renal failure
         subjects affected / exposed
    5 / 997 (0.50%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Urinary retention
         subjects affected / exposed
    5 / 997 (0.50%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Urinary tract obstruction
         subjects affected / exposed
    4 / 997 (0.40%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Chronic kidney disease
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    1 / 5
         deaths causally related to treatment / all
    1 / 1
    Hydronephrosis
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Nephritis
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Renal impairment
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Bladder tamponade
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary bladder haemorrhage
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haematuria
         subjects affected / exposed
    19 / 997 (1.91%)
         occurrences causally related to treatment / all
    0 / 20
         deaths causally related to treatment / all
    0 / 2
    Endocrine disorders
    Adrenal insufficiency
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypophysitis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypothyroidism
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    6 / 997 (0.60%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Synovial cyst
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Flank pain
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Osteoarthritis
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Joint swelling
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Compartment syndrome
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal osteoarthritis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Arthralgia
         subjects affected / exposed
    6 / 997 (0.60%)
         occurrences causally related to treatment / all
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    59 / 997 (5.92%)
         occurrences causally related to treatment / all
    0 / 86
         deaths causally related to treatment / all
    0 / 2
    Urosepsis
         subjects affected / exposed
    19 / 997 (1.91%)
         occurrences causally related to treatment / all
    0 / 20
         deaths causally related to treatment / all
    0 / 2
    Pneumonia
         subjects affected / exposed
    17 / 997 (1.71%)
         occurrences causally related to treatment / all
    0 / 17
         deaths causally related to treatment / all
    0 / 1
    Respiratory tract infection
         subjects affected / exposed
    5 / 997 (0.50%)
         occurrences causally related to treatment / all
    0 / 8
         deaths causally related to treatment / all
    0 / 1
    Pyelonephritis
         subjects affected / exposed
    7 / 997 (0.70%)
         occurrences causally related to treatment / all
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    Cellulitis
         subjects affected / exposed
    5 / 997 (0.50%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    12 / 997 (1.20%)
         occurrences causally related to treatment / all
    1 / 12
         deaths causally related to treatment / all
    0 / 2
    Infection
         subjects affected / exposed
    4 / 997 (0.40%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Soft tissue infection
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Device related infection
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Erysipelas
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Postoperative wound infection
         subjects affected / exposed
    3 / 997 (0.30%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Cystitis
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Diverticulitis
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Encephalitis
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Endocarditis
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Febrile infection
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pyelonephritis acute
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Scrotal abscess
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Septic Shock
         subjects affected / exposed
    4 / 997 (0.40%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 3
    Urinary tract infection bacterial
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Vascular device infection
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Abdominal infection
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal sepsis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Acute hepatitis B
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Anal abscess
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chlamydial infection
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Arthritis infective
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    COVID-19
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Campylobacter gastroenteritis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Candida sepsis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Appendicitis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin infection
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Epididymitis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Escherichia sepsis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infected cyst
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infective aneurysm
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Influenza
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Kidney infection
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Klebsiella bacteraemia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung abscess
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Oral candidiasis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia bacterial
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Post procedural sepsis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory moniliasis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dengue fever
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Stoma site infection
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Subcutaneous abscess
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection pseudomonal
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Streptococcal bacteraemia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    6 / 997 (0.60%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 1
    Hyponatraemia
         subjects affected / exposed
    6 / 997 (0.60%)
         occurrences causally related to treatment / all
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    2 / 997 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Diabetes mellitus inadequate control
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypertriglyceridaemia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolic acidosis
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Type 2 diabetes mellitus
         subjects affected / exposed
    1 / 997 (0.10%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypercalcaemia
         subjects affected / exposed
    5 / 997 (0.50%)
         occurrences causally related to treatment / all
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Atezolizumab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    888 / 997 (89.07%)
    Investigations
    Weight decreased
         subjects affected / exposed
    50 / 997 (5.02%)
         occurrences all number
    53
    Blood creatinine increased
         subjects affected / exposed
    70 / 997 (7.02%)
         occurrences all number
    97
    Nervous system disorders
    Headache
         subjects affected / exposed
    52 / 997 (5.22%)
         occurrences all number
    61
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    211 / 997 (21.16%)
         occurrences all number
    270
    Fatigue
         subjects affected / exposed
    206 / 997 (20.66%)
         occurrences all number
    257
    Pyrexia
         subjects affected / exposed
    156 / 997 (15.65%)
         occurrences all number
    212
    Oedema peripheral
         subjects affected / exposed
    64 / 997 (6.42%)
         occurrences all number
    74
    Pain
         subjects affected / exposed
    57 / 997 (5.72%)
         occurrences all number
    58
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    182 / 997 (18.25%)
         occurrences all number
    213
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    62 / 997 (6.22%)
         occurrences all number
    67
    Vomiting
         subjects affected / exposed
    103 / 997 (10.33%)
         occurrences all number
    124
    Nausea
         subjects affected / exposed
    130 / 997 (13.04%)
         occurrences all number
    161
    Constipation
         subjects affected / exposed
    145 / 997 (14.54%)
         occurrences all number
    170
    Diarrhoea
         subjects affected / exposed
    166 / 997 (16.65%)
         occurrences all number
    219
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    72 / 997 (7.22%)
         occurrences all number
    80
    Cough
         subjects affected / exposed
    104 / 997 (10.43%)
         occurrences all number
    124
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    125 / 997 (12.54%)
         occurrences all number
    170
    Rash
         subjects affected / exposed
    72 / 997 (7.22%)
         occurrences all number
    99
    Renal and urinary disorders
    Haematuria
         subjects affected / exposed
    76 / 997 (7.62%)
         occurrences all number
    96
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    67 / 997 (6.72%)
         occurrences all number
    70
    Musculoskeletal and connective tissue disorders
    Pain in extremity
         subjects affected / exposed
    64 / 997 (6.42%)
         occurrences all number
    68
    Back pain
         subjects affected / exposed
    120 / 997 (12.04%)
         occurrences all number
    139
    Arthralgia
         subjects affected / exposed
    132 / 997 (13.24%)
         occurrences all number
    180
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    152 / 997 (15.25%)
         occurrences all number
    240
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    185 / 997 (18.56%)
         occurrences all number
    212

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    19 May 2017
    The following updates were made to the protocol: [1] The term “immune-mediated” was changed to “immune-related” throughout the protocol; [2] The term “antitherapeutic antibody” was replaced with “anti-drug antibody;” [3] Updates were made to the eligibility criteria; [4] Language was updated to match current recommendations for atezolizumab administration; [5] Tumor response evaluations were revised; [6] Language for HBV serology was updated; [7] Language was added that clarified the use of biomarker samples after participant withdrew consent; [8] Language for electrocardiogram assessments was updated; [9] The list of AESI's was updated; [10] Correction to the reporting of infusion-related reactions; [11] The definition of abnormal liver function tests was revised; [12] Specific details related to the reporting of deaths was revised; [13] Language related to hospitalization or prolonged hospitalization was revised; [14] Two additional subgroup analyses were added; [15] Language related to protocol deviations was revised; [16] Link to the Roche Global Policy on Sharing of Clinical Trials was updated; [17] Appendices 1, 8 and 9 were updated; [18] Appendix 10 was added; [19] Additional minor changes were made to improve clarity and consistency.
    22 Feb 2018
    The following updates were made to the protocol: [1] Addition of appendix 11.
    08 Oct 2018
    The following updates were made to the protocol: [1] Appendix 11 was updated to include the changes made to the TECENTRIQ® International Brochure versions 12 and 13.
    22 Oct 2019
    The following updates were made to the protocol: [1] The Medical Moinitor changed; [2] The interruption period of atezolizumab changed; [3] "Immune-related" was changed to "immune-mediated;" [4] Quality tolerance limits were introduced.
    03 Mar 2021
    The following updates were made to the protocol: [1] Text was added to describe the potential consequences of COVID-19 on atezolizumab therapy; [2] text was added to indicate that sites could confirm that appropriate temperature conditions had been maintained during Investigational Medicinal Product (IMP) transit; [3] text was added to clarify what were considered potential risks for atezolizumab; [4] the list of adverse events of special interest (AESIs) were updated; [5] reporting requirements for IRRs were updated; [6]
    17 Dec 2021
    The following updates were made to the protocol: [1] Benefit-risk assessment and guidance on concomitant administration of coronavirus disease 2019 vaccines with atezolizumab was added; [2] Language was added to indicate that sites could confirm that appropriate temperature conditions had been maintained during IMP transit; [3] Public information source could be used to obtain information about survival status about participants who withdrew; [4] The protocol was updated to align with the current Roche Atezolizumab protocol template; [5] The Roche Global Policy on Continued Access to Investigational Medicinal Product was added; [6] The responsibilities of the Principal Investigator and the role of the Medical Monitor were clarified; [7] The serious adverse events and adverse events of special interest reporting timelines were corrected; [8] Language clarified that study adverse event reports would not be derived from patient reported outcome (PRO) data by the Sponsor; [9] Additional language regarding Roche's data retention policy, study compliance with applicable laws and study data management, sharing and application was added; [10] The language regarding the informed consent form revision and the re-consenting in accordance with local applicable laws and IRB/EC policy was clarified; [11] The guidelines for management of suspected anaphylactic reaction were updated; [12] The term “primary biliary cholangitis” replaced “primary biliary cirrhosis;” [13] Adverse Event management guidelines were updated; [14] The study synopsis was simplified; [15] Additional minor changes were made to improve clarity and consistency.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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