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    Clinical Trial Results:
    Pivotal Study of Derazantinib in Patients With Inoperable or Advanced Intrahepatic Cholangiocarcinoma and FGFR2 Gene Fusions or FGFR2 Gene Mutations or Amplifications

    Summary
    EudraCT number
    2016-004448-12
    Trial protocol
    IT   GB   DE   IE   ES  
    Global end of trial date
    25 Oct 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    10 Nov 2023
    First version publication date
    10 Nov 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    DZB-CS-301
    Additional study identifiers
    ISRCTN number
    ISRCTN12345678
    US NCT number
    NCT12345678
    WHO universal trial number (UTN)
    U1234-1234-1234
    Sponsors
    Sponsor organisation name
    Basilea Pharmaceutica International Ltd, Allschwil
    Sponsor organisation address
    Hegenheimermattweg 167b, Allschwil, Switzerland, 4123
    Public contact
    Dr Manuel Häckl, MD, Basilea Pharmaceutica International Ltd, Allschwil, +41 76 302 53 10, manuel.haeckl@basilea.com
    Scientific contact
    Dr Manuel Häckl, MD, Basilea Pharmaceutica International Ltd, Allschwil, +41 76 302 53 10, manuel.haeckl@basilea.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
    09 Dec 2022
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    25 Oct 2022
    Global end of trial reached?
    Yes
    Global end of trial date
    25 Oct 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Primary objective Substudy 1: To evaluate the anti-cancer activity by Objective Response Rate (ORR) by blinded independent central review as per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 in patients with inoperable or advanced iCCA whose tumors harbor FGFR2 fusions (by FISH performed by a central laboratory) and who received at least one prior regimen of systemic therapy. Substudy 2: To evaluate the anti-tumor activity of derazantinib by progression-free survival at 3 months (PFS3) based on survival status or blinded independent central review (RECIST 1.1) in patients with inoperable or advanced iCCA whose tumors harbor FGFR2 mutations or amplifications, and who received at least one prior regimen of systemic therapy.
    Protection of trial subjects
    The study was conducted according to the ethical principles that have their origins in the World Medical Association’s Declaration of Helsinki, the International Council for Harmonisation (ICH) E6 Good Clinical Practice, and all applicable national and local laws and regulations for the conduct of clinical research and the protection of personal data. If conflicts between local laws and regulations arose, the more stringent requirements were adopted.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    28 Sep 2017
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Canada: 7
    Country: Number of subjects enrolled
    France: 4
    Country: Number of subjects enrolled
    United States: 70
    Country: Number of subjects enrolled
    Spain: 8
    Country: Number of subjects enrolled
    United Kingdom: 5
    Country: Number of subjects enrolled
    Germany: 3
    Country: Number of subjects enrolled
    Italy: 50
    Worldwide total number of subjects
    147
    EEA total number of subjects
    65
    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)
    102
    From 65 to 84 years
    45
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A total of 729 patients underwent molecular screening, and 148 were enrolled. One patient was subsequently not confirmed to have fibroblast growth factor receptor 2 (FGFR2) fusion, and was excluded from the Safety/ITT population, meaning that for all Safety/ITT population analyses 147 patients were included (Substudy 1 = 103, Substudy = 44).

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

    Arms
    Arm title
    Derazantinib
    Arm description
    Derazantinib was administered orally at 300 mg once daily
    Arm type
    Experimental

    Investigational medicinal product name
    Derazantinib
    Investigational medicinal product code
    BAL101553
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Derazantinib, an investigational drug was supplied as 100 mg powder-filled capsules for oral administration in this open-label study. All patients received derazantinib at 300 mg once daily. Derazantinib capsules were administered 1 hour before, or at least 2 hours after, a meal.

    Number of subjects in period 1
    Derazantinib
    Started
    147
    Completed
    0
    Not completed
    147
         Clinical progression
    23
         Adverse event, serious fatal
    5
         Physician decision
    5
         Consent withdrawn by subject
    4
         Radiographic disease progression
    91
         Adverse event, non-fatal
    8
         Other reasons
    10
         Lost to follow-up
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Derazantinib
    Reporting group description
    Derazantinib was administered orally at 300 mg once daily

    Reporting group values
    Derazantinib Total
    Number of subjects
    147 147
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    58.0 ± 12.28 -
    Gender categorical
    Units: Subjects
        Female
    92 92
        Male
    55 55
    Race
    Units: Subjects
        Asian
    7 7
        Black or African American
    8 8
        White
    123 123
        More than one race
    5 5
        Unknown or Not Reported
    4 4
    Subject analysis sets

    Subject analysis set title
    Substudy 1
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Substudy 1 (safety and intent-to-treat (ITT) population) comprised of patients with inoperable or advanced iCCA with FGFR2 fusions and who had received any amount of study drug Derazantinib was administered orally at 300 mg once daily

    Subject analysis set title
    Substudy 2
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Substudy 2 (safety and intent-to-treat (ITT) population) comprised of patients with with inoperable or advanced iCCA with FGFR2 mutations or amplifications and who had received any amount of study drug Derazantinib was administered orally at 300 mg once daily

    Subject analysis set title
    mITT Substudy 2
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    mITT Population: included all patients in the Safety/ITT population, who had at least one post-baseline disease assessment (at least one post-baseline imaging assessment in accordance with RECIST 1.1, or documented clinical progression [every effort was made to objectively assess radiographic progression]), or reported death during the treatment period.

    Subject analysis sets values
    Substudy 1 Substudy 2 mITT Substudy 2
    Number of subjects
    103
    44
    43
    Age categorical
    Units: Subjects
        In utero
        Preterm newborn infants (gestational age < 37 wks)
        Newborns (0-27 days)
        Infants and toddlers (28 days-23 months)
        Children (2-11 years)
        Adolescents (12-17 years)
        Adults (18-64 years)
        From 65-84 years
        85 years and over
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    56.5 ± 12.28
    61.3 ± 11.75
    ±
    Gender categorical
    Units: Subjects
        Female
    67
    25
        Male
    36
    19
    Race
    Units: Subjects
        Asian
    3
    4
        Black or African American
    8
    0
        White
    86
    37
        More than one race
    4
    1
        Unknown or Not Reported
    2
    2

    End points

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    End points reporting groups
    Reporting group title
    Derazantinib
    Reporting group description
    Derazantinib was administered orally at 300 mg once daily

    Subject analysis set title
    Substudy 1
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Substudy 1 (safety and intent-to-treat (ITT) population) comprised of patients with inoperable or advanced iCCA with FGFR2 fusions and who had received any amount of study drug Derazantinib was administered orally at 300 mg once daily

    Subject analysis set title
    Substudy 2
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Substudy 2 (safety and intent-to-treat (ITT) population) comprised of patients with with inoperable or advanced iCCA with FGFR2 mutations or amplifications and who had received any amount of study drug Derazantinib was administered orally at 300 mg once daily

    Subject analysis set title
    mITT Substudy 2
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    mITT Population: included all patients in the Safety/ITT population, who had at least one post-baseline disease assessment (at least one post-baseline imaging assessment in accordance with RECIST 1.1, or documented clinical progression [every effort was made to objectively assess radiographic progression]), or reported death during the treatment period.

    Primary: Substudy 1: Objective Response Rate (ORR)

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    End point title
    Substudy 1: Objective Response Rate (ORR) [1]
    End point description
    ORR was defined as the proportion of patients who achieved a confirmed clinical response (CR) or partial response (PR) by blinded independent central review using the internationally recognized criteria for the radiological assessment in tumor response of solid tumors (RECIST) Version 1.1
    End point type
    Primary
    End point timeframe
    From first dose and up to 54 months
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: There is no comparator group for a statistical analysis. The statistical analysis is of descriptive nature.
    End point values
    Substudy 1
    Number of subjects analysed
    103
    Units: Proportion of patients
        number (confidence interval 95%)
    22.3 (14.7 to 31.6)
    No statistical analyses for this end point

    Primary: Substudy 2: Progression Free Survival at 3 Months (PFS 3)

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    End point title
    Substudy 2: Progression Free Survival at 3 Months (PFS 3) [2]
    End point description
    PFS was calculated from the first date of receiving study drug until radiographic disease progression by blinded independent central review or death.
    End point type
    Primary
    End point timeframe
    From first dose and up to 54 months
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: There is no comparator group for a statistical analysis. The statistical analysis is of descriptive nature.
    End point values
    mITT Substudy 2
    Number of subjects analysed
    43
    Units: Percentage of participants
        number (confidence interval 95%)
    62.8 (46.7 to 77.0)
    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 calculated from the first date of receiving study drug until death
    End point type
    Secondary
    End point timeframe
    From first dose and up to 54 months
    End point values
    Substudy 1 Substudy 2
    Number of subjects analysed
    103
    44
    Units: Months
        median (confidence interval 95%)
    17.2 (12.5 to 22.4)
    11.9 (8.4 to 15.9)
    No statistical analyses for this end point

    Secondary: Substudy 2: Objective Response Rate

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    End point title
    Substudy 2: Objective Response Rate
    End point description
    ORR was defined as the proportion of patients who achieved a confirmed clinical response (CR) or partial response (PR) by blinded independent central review using the internationally recognized criteria for the radiological assessment in tumor response of solid tumors (RECIST) Version 1.1.
    End point type
    Secondary
    End point timeframe
    From first dose and up to 54 months
    End point values
    mITT Substudy 2
    Number of subjects analysed
    43
    Units: Percentage of participants
        number (confidence interval 95%)
    9.3 (2.6 to 22.1)
    No statistical analyses for this end point

    Secondary: Number of Patients With Grade 3-5 Treatment-emergent Adverse Events (TEAEs)

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    End point title
    Number of Patients With Grade 3-5 Treatment-emergent Adverse Events (TEAEs)
    End point description
    Number of patients experiencing TEAE of Grade 3 to 5 according to Common Terminology Criteria for Adverse Events (CTCAE)
    End point type
    Secondary
    End point timeframe
    TEAEs were defined as all events occurring after drug treatment began and up to 30 days after last study drug administration
    End point values
    Substudy 1 Substudy 2
    Number of subjects analysed
    103
    44
    Units: Number of patients
        Patients with unrelated TEAEs of Grade 3-5
    31
    16
        Patients with related TEAEs of Grade 3-5
    35
    10
        Patients without TEAEs of Grade 3-5
    37
    18
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first administration of study medication up to 30 days after the last administration.
    Adverse event reporting additional description
    Treatment-emergent adverse events and serious adverse events
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.0
    Reporting groups
    Reporting group title
    Substudy 1
    Reporting group description
    Substudy 1

    Reporting group title
    Substudy 2
    Reporting group description
    Substudy 2

    Serious adverse events
    Substudy 1 Substudy 2
    Total subjects affected by serious adverse events
         subjects affected / exposed
    37 / 103 (35.92%)
    16 / 44 (36.36%)
         number of deaths (all causes)
    74
    25
         number of deaths resulting from adverse events
    11
    5
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Tumour haemorrhage
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Peripheral arterial occlusive disease
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vena cava thrombosis
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Surgical and medical procedures
    Liver transplant
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Disease progression
         subjects affected / exposed
    9 / 103 (8.74%)
    3 / 44 (6.82%)
         occurrences causally related to treatment / all
    0 / 9
    0 / 3
         deaths causally related to treatment / all
    0 / 9
    0 / 3
    General physical health deterioration
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Death
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Reproductive system and breast disorders
    Prostatitis
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Hypoxia
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 103 (0.97%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchial obstruction
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 103 (0.97%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Laryngeal oedema
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Oropharyngeal pain
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Product issues
    Device occlusion
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aspartate aminotransferase increased
         subjects affected / exposed
    2 / 103 (1.94%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood bilirubin increased
         subjects affected / exposed
    2 / 103 (1.94%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Traumatic intracranial haematoma
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Atrioventricular block second degree
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bundle branch block left
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Tremor
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Presyncope
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Paraesthesia
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic encephalopathy
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Encephalopathy
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Visual acuity reduced
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Ascites
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diverticular perforation
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain
         subjects affected / exposed
    6 / 103 (5.83%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    2 / 7
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal varices haemorrhage
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Nausea
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric perforation
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholangitis
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Jaundice cholestatic
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperbilirubinaemia
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic failure
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Renal and urinary disorders
    Nephrolithiasis
         subjects affected / exposed
    1 / 103 (0.97%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal tubular necrosis
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute kidney injury
         subjects affected / exposed
    1 / 103 (0.97%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    COVID-19 pneumonia
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacteraemia
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Arthritis bacterial
         subjects affected / exposed
    1 / 103 (0.97%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intervertebral discitis
         subjects affected / exposed
    0 / 103 (0.00%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 103 (0.97%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subcutaneous abscess
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sialoadenitis
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Meningitis bacterial
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peritonitis
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 103 (0.97%)
    0 / 44 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hyponatraemia
         subjects affected / exposed
    2 / 103 (1.94%)
    1 / 44 (2.27%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Substudy 1 Substudy 2
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    103 / 103 (100.00%)
    43 / 44 (97.73%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    24 / 103 (23.30%)
    5 / 44 (11.36%)
         occurrences all number
    30
    7
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    7 / 103 (6.80%)
    2 / 44 (4.55%)
         occurrences all number
    9
    2
    Oedema peripheral
         subjects affected / exposed
    5 / 103 (4.85%)
    4 / 44 (9.09%)
         occurrences all number
    5
    5
    Mucosal inflammation
         subjects affected / exposed
    3 / 103 (2.91%)
    3 / 44 (6.82%)
         occurrences all number
    3
    3
    Fatigue
         subjects affected / exposed
    34 / 103 (33.01%)
    13 / 44 (29.55%)
         occurrences all number
    37
    16
    Asthenia
         subjects affected / exposed
    25 / 103 (24.27%)
    6 / 44 (13.64%)
         occurrences all number
    27
    8
    Respiratory, thoracic and mediastinal disorders
    Epistaxis
         subjects affected / exposed
    9 / 103 (8.74%)
    3 / 44 (6.82%)
         occurrences all number
    9
    3
    Dyspnoea
         subjects affected / exposed
    10 / 103 (9.71%)
    2 / 44 (4.55%)
         occurrences all number
    10
    3
    Cough
         subjects affected / exposed
    14 / 103 (13.59%)
    7 / 44 (15.91%)
         occurrences all number
    15
    7
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    15 / 103 (14.56%)
    0 / 44 (0.00%)
         occurrences all number
    15
    0
    Depression
         subjects affected / exposed
    7 / 103 (6.80%)
    1 / 44 (2.27%)
         occurrences all number
    7
    1
    Anxiety
         subjects affected / exposed
    8 / 103 (7.77%)
    2 / 44 (4.55%)
         occurrences all number
    8
    2
    Investigations
    Aspartate aminotransferase increased
         subjects affected / exposed
    46 / 103 (44.66%)
    13 / 44 (29.55%)
         occurrences all number
    52
    15
    Blood alkaline phosphatase increased
         subjects affected / exposed
    17 / 103 (16.50%)
    9 / 44 (20.45%)
         occurrences all number
    18
    11
    Alanine aminotransferase increased
         subjects affected / exposed
    36 / 103 (34.95%)
    13 / 44 (29.55%)
         occurrences all number
    43
    15
    Blood phosphorus increased
         subjects affected / exposed
    13 / 103 (12.62%)
    2 / 44 (4.55%)
         occurrences all number
    20
    2
    Blood creatinine increased
         subjects affected / exposed
    17 / 103 (16.50%)
    7 / 44 (15.91%)
         occurrences all number
    18
    8
    White blood cell count decreased
         subjects affected / exposed
    6 / 103 (5.83%)
    3 / 44 (6.82%)
         occurrences all number
    11
    3
    Neutrophil count decreased
         subjects affected / exposed
    4 / 103 (3.88%)
    3 / 44 (6.82%)
         occurrences all number
    6
    3
    Weight decreased
         subjects affected / exposed
    17 / 103 (16.50%)
    6 / 44 (13.64%)
         occurrences all number
    17
    6
    Platelet count decreased
         subjects affected / exposed
    10 / 103 (9.71%)
    5 / 44 (11.36%)
         occurrences all number
    20
    5
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    13 / 103 (12.62%)
    3 / 44 (6.82%)
         occurrences all number
    13
    3
    Dysgeusia
         subjects affected / exposed
    20 / 103 (19.42%)
    11 / 44 (25.00%)
         occurrences all number
    20
    11
    Headache
         subjects affected / exposed
    12 / 103 (11.65%)
    5 / 44 (11.36%)
         occurrences all number
    14
    6
    Peripheral sensory neuropathy
         subjects affected / exposed
    1 / 103 (0.97%)
    3 / 44 (6.82%)
         occurrences all number
    1
    3
    Tremor
         subjects affected / exposed
    8 / 103 (7.77%)
    1 / 44 (2.27%)
         occurrences all number
    9
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    16 / 103 (15.53%)
    6 / 44 (13.64%)
         occurrences all number
    18
    6
    Thrombocytopenia
         subjects affected / exposed
    7 / 103 (6.80%)
    1 / 44 (2.27%)
         occurrences all number
    8
    1
    Eye disorders
    Cornea verticillata
         subjects affected / exposed
    7 / 103 (6.80%)
    1 / 44 (2.27%)
         occurrences all number
    7
    1
    Dry eye
         subjects affected / exposed
    20 / 103 (19.42%)
    7 / 44 (15.91%)
         occurrences all number
    20
    7
    Keratitis
         subjects affected / exposed
    2 / 103 (1.94%)
    3 / 44 (6.82%)
         occurrences all number
    2
    3
    Vision blurred
         subjects affected / exposed
    26 / 103 (25.24%)
    6 / 44 (13.64%)
         occurrences all number
    26
    8
    Xerophthalmia
         subjects affected / exposed
    9 / 103 (8.74%)
    5 / 44 (11.36%)
         occurrences all number
    11
    6
    Visual impairment
         subjects affected / exposed
    5 / 103 (4.85%)
    3 / 44 (6.82%)
         occurrences all number
    5
    4
    Visual acuity reduced
         subjects affected / exposed
    7 / 103 (6.80%)
    0 / 44 (0.00%)
         occurrences all number
    7
    0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    26 / 103 (25.24%)
    6 / 44 (13.64%)
         occurrences all number
    30
    6
    Abdominal distension
         subjects affected / exposed
    3 / 103 (2.91%)
    3 / 44 (6.82%)
         occurrences all number
    3
    3
    Abdominal pain upper
         subjects affected / exposed
    10 / 103 (9.71%)
    1 / 44 (2.27%)
         occurrences all number
    12
    1
    Vomiting
         subjects affected / exposed
    30 / 103 (29.13%)
    15 / 44 (34.09%)
         occurrences all number
    43
    23
    Nausea
         subjects affected / exposed
    41 / 103 (39.81%)
    18 / 44 (40.91%)
         occurrences all number
    51
    23
    Gastrooesophageal reflux disease
         subjects affected / exposed
    6 / 103 (5.83%)
    1 / 44 (2.27%)
         occurrences all number
    6
    2
    Dyspepsia
         subjects affected / exposed
    10 / 103 (9.71%)
    2 / 44 (4.55%)
         occurrences all number
    10
    2
    Dry mouth
         subjects affected / exposed
    30 / 103 (29.13%)
    17 / 44 (38.64%)
         occurrences all number
    32
    17
    Diarrhoea
         subjects affected / exposed
    34 / 103 (33.01%)
    14 / 44 (31.82%)
         occurrences all number
    52
    21
    Constipation
         subjects affected / exposed
    28 / 103 (27.18%)
    8 / 44 (18.18%)
         occurrences all number
    31
    10
    Skin and subcutaneous tissue disorders
    Nail discolouration
         subjects affected / exposed
    2 / 103 (1.94%)
    3 / 44 (6.82%)
         occurrences all number
    2
    3
    Dry skin
         subjects affected / exposed
    14 / 103 (13.59%)
    3 / 44 (6.82%)
         occurrences all number
    14
    3
    Alopecia
         subjects affected / exposed
    16 / 103 (15.53%)
    6 / 44 (13.64%)
         occurrences all number
    17
    6
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    13 / 103 (12.62%)
    1 / 44 (2.27%)
         occurrences all number
    13
    1
    Back pain
         subjects affected / exposed
    15 / 103 (14.56%)
    0 / 44 (0.00%)
         occurrences all number
    15
    0
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    9 / 103 (8.74%)
    2 / 44 (4.55%)
         occurrences all number
    9
    3
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    20 / 103 (19.42%)
    9 / 44 (20.45%)
         occurrences all number
    23
    9
    Dehydration
         subjects affected / exposed
    6 / 103 (5.83%)
    2 / 44 (4.55%)
         occurrences all number
    6
    2
    Hypercalcaemia
         subjects affected / exposed
    11 / 103 (10.68%)
    3 / 44 (6.82%)
         occurrences all number
    11
    3
    Hyperphosphataemia
         subjects affected / exposed
    30 / 103 (29.13%)
    12 / 44 (27.27%)
         occurrences all number
    36
    14
    Hypoalbuminaemia
         subjects affected / exposed
    7 / 103 (6.80%)
    2 / 44 (4.55%)
         occurrences all number
    9
    2
    Hyponatraemia
         subjects affected / exposed
    8 / 103 (7.77%)
    4 / 44 (9.09%)
         occurrences all number
    8
    4
    Vitamin D deficiency
         subjects affected / exposed
    6 / 103 (5.83%)
    2 / 44 (4.55%)
         occurrences all number
    6
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    05 Apr 2017
    • Change the in vitro companion diagnostic device (IVD) designated for use in the trial • As an addition to Section 3.1, blood samples for tumor markers were to be collected for all enrolled subjects. Blood samples for biomarkers and ctDNA were to be collected only if the study passed the interim analysis and collected from newly enrolled subjects.
    13 Apr 2017
    • Clarified that medication could be administered with or without food • Clarifications added concerning exploratory objective and efficacy endpoints • ‘Creatinine clearance of ≥ 60 mL/min as estimated by the Cockcroft-Gault equation’ was added to the inclusion criteria • It was clarified in Section 6.7 Tumor Biopsy, that ‘archived tissue specimens may be submitted if they meet the requirements outlined in the Laboratory Manual.’ • Section 10.6.3 Exploratory Efficacy Analyses was augmented to include that ‘Other analyses such as correlation between tumor and biomarkers, toxicity, responses, and PK parameters to be conducted and to be further described in the Statistical Analysis Plan.’
    10 Oct 2017
    • Made minor change to title page to clarify the designation of the study as phase 2 rather than phase 3. This change was also reflected in the synopsis and elsewhere if noted. • Added the name of the medical monitor to title page.
    25 Sep 2018
    • The change in sponsorship from ArQule Inc. to Basilea Pharmaceutica International Ltd. was implemented in the protocol. • The exploratory evaluation of ORR using modified RECIST criteria was removed from the protocol. • The exploratory objectives were amended so that time to progression by blinded independent central review for derazantinib was to be evaluated overall, and not only by line of prior systemic therapy. The associated exploratory endpoints were updated for consistency. • Inclusion criterion 4 was changed to clarify the approach to the assessment of FGFR2 gene fusion status for the purposes of enrollment. Similar clarification was added to other related sections of the protocol. • Additional ECG assessments were scheduled to coincide with each collection of a plasma sample for pharmacokinetic assessment. • The protocol and Informed Consent Form were changed to specify that metabolites of derazantinib could be assessed from the same samples already planned to determine the population PK parameters of derazantinib. • Change of the safety vendor. • Text restricting the 30-day safety follow-up to adverse events thought to be related to study drug was deleted. • The definition of a related adverse event was clarified to include any adverse event considered definitely, probably, or possibly related to derazantinib, or when the relationship is unknown. • The reference to treatment groups was removed from Section 10.3 (Safety Analyses), along with consistency corrections in the same section. • A change was made to permit an earlier interim analysis if 5 or more objective responses were observed and confirmed based on blinded independent central review before the the previously-required enrollment of 40 evaluable patients
    19 Feb 2019
    • Study expanded by adding a separate group of patients with FGFR2 gene mutations or amplifications to assess the potential expanded utility of derazantinib in the treatment of iCCA. • The original primary objective of the study was adjusted to allow both the original patients (now termed Substudy 1 and Substudy 2) to be included in the primary objectives. The primary objective of Substudy 2 was to evaluate the anti-tumor activity of derazantinib by progression-free survival at 3 months (PFS3). • Addressed requests by Health Authorities among others considering Clinical Trial Applications in additional countries, including: Revision of sections related to pregnancy and contraception; revision of sections related to QT/QTc; revision of sections related to UV-light protection. • Implemented central ECG assessments. • Defined subgroups of patients who underwent a more intensive biomarker and/or PK assessment schedule. • Clarifications added concerning screening procedures for genomic aberrations. • The secondary objectives of the study were amended to include for Substudy 2 an objective to evaluate the anti-cancer activity by ORR by central radiology. • Exploratory endpoints were added. • For patient-reported outcomes, an additional outcome for HRQOL (the EuroQoL-5D visual analog scale) was included. • Various inclusion and exclusion criteria were updated • A complete eye examination was added to the list of assessments to be conducted at the 30-day Safety Follow-up Visit. • Relevant examinations and laboratory tests were updated • Provision for informed consent to participate in the study to be provided by the patient’s legal representative was removed.
    22 Jul 2019
    • Section 3.4 was amended to clarify that for patients who demonstrate continued benefit from derazantinib at the time of study closure, the Sponsor aims to provide continued access to derazantinib. • Clarified that patients considered eligible for enrollment in Substudy 2 should have exhausted all satisfactory treatment alternatives. • Exclusion criterion 9 was amended to require patients enrolled in the study to have serum potassium levels within normal ranges. • Section 7.3.3 was clarified that in the event of a prolonged QTc interval ≥ 501 ms being observed on at least two separate ECGs (CTCAE v4.03 Grade 3 event), derazantinib was to be withheld until the QTc has returned to ≤ 470 msec, and a decision made whether to continue treatment with derazantinib. • Clarified the position for patients who were enrolled and dosed on the basis of a positive local test result for FGFR2 gene fusion (Substudy 1). • For the management of patients whose FGFR2 gene fusion status was not centrally confirmed after treatment has commenced, the a case by case assessment was required for these patients. • Inclusion criterion 9 was amended to ensure that ‘highly effective’ contraceptive measures were required during the study; ‘acceptable’ birth control methods were not sufficient. • Clarifications to tumor assessment methods were added. • Clarification in Appendix 8 (List of FGFR2 mutations eligible for enrollment in Substudy 2) that newly detected mutations could be added to the list
    06 Sep 2019
    • CYP2C8 ligands were added to the list of CYP enzymes in Appendix 4, substrates of which should be avoided or used with caution. • A requirement was added to Section 6.8 for patients who discontinue study drug treatment to have a tumor assessment as soon as possible after discontinuation. • It was clarified that the Substudy 2 sample size refers to mITT-evaluable patients. • Section 10.7 was amended to clarify that in Substudy 2, a decision to proceed with Stage 2 or stop for futility was to be made as soon as the number of events allows it, and that enrollment in Stage 2 was to be suspended if the required number of patients was not reached at the time of full enrollment to Stage 1. • Time windows were introduced for PK sample collection and the collection of the 10 and 12 hours samples was made optional. • The list of FGFR2 mutations eligible for enrollment in Substudy 2 was updated in Appendix 8.
    17 Nov 2020
    • Details were added throughout the protocol update and clarify details of alternative NGS testing options for prospective patient enrollment in Substudy 2. • The FGFR2 genetic aberration status required for eligibility for Substudy 2 was clarified, along with the testing requirements. • The definition of adequate renal function for eligibility for enrollment into the study, was updated to a creatinine clearance of ≥ 30 mL/min as estimated by the Cockcroft-Gault equation. • Details regarding prohibited prior anti-cancer treatments were updated. • Further clarification was made regarding previous treatments with an FGFR inhibitor, which exclude the patient from eligibility for the study. • Further details were added regarding ophthalmological exclusion criteria. • Patients with any severe infections were added to exclusions from study . • References to a biomarker study were changed to pharmacodynamic assessments, and the processes for collecting archival tumor and blood and urine samples, and for conducting pharmacodynamic analyses, were clarified accordingly. • Administration of derazantinib with a light meal was permitted in the event of nausea or vomiting which is assessed as moderate (CTCAE Grade ≥ 2). • Advice relating to dose delays/reductions in the event of a CTCAE Grade 4 adverse event was revised. • The CSP was updated to include a new requirement to perform complete ophthalmological examination. • Transaminase elevations (AST and ALT increased) were removed from the list of potential risks, and upgraded to an identified risk. Phototoxicity was removed from the list of potential risks. The list of important potential risks was updated to include hyponatremia, and redefined ‘creatinine increase’ as ‘blood creatinine increased / renal disorders’. • Removed the list of FGFR2 genetic aberrations (GAs) eligible for enrollment in Substudy 2 from Appendix 8, in favor of a description of the categories of applicable GAs

    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.
    The following secondary endpoints could not be shown due to the restrictions of the EudraCT system; duration of response and progression free survival. The figures are on CT.gov: https://clinicaltrials.gov/study/NCT03230318
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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