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    Clinical Trial Results:
    A multicenter, open-label, single-arm study of the safety and antitumoral efficacy of nivolumab in combination with selective internal radiation therapy (SIRT) using SIR-Spheres for the treatment of patients with hepatocellular carcinoma that are candidates for locoregional therapies.

    Summary
    EudraCT number
    2017-000232-34
    Trial protocol
    ES  
    Global end of trial date
    30 Apr 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    06 Feb 2022
    First version publication date
    06 Feb 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    NASIR-HCC
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03380130
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    BMS protocol code: CA209-992
    Sponsors
    Sponsor organisation name
    Clínica Universidad de Navarra/Universidad de Navarra
    Sponsor organisation address
    Avenida Pío XII, 36, Pamplona, Spain, 31008
    Public contact
    UCEC, Clinica Universidad de Navarra, 34 948255400, ucicec@unav.es
    Scientific contact
    UCEC, Clinica Universidad de Navarra, 34 948255400, ucicec@unav.es
    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
    27 Apr 2021
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    30 Apr 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Apr 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the safety of nivolumab in combination with SIRT using SIR-Spheres. The secondary objective is to evaluate the antitumoral activity of nivolumab in combination with SIRT using SIR-Spheres.
    Protection of trial subjects
    NA
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    18 Oct 2017
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 42
    Worldwide total number of subjects
    42
    EEA total number of subjects
    42
    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)
    20
    From 65 to 84 years
    22
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Child Pugh A subjects with intermediate or advanced hepatocellular carcinoma who are candidates to locoregional therapies but not good candidates to TACE were recruited.

    Pre-assignment
    Screening details
    40 patients were planned. 53 patients were screened, there were 11 screening failures and 42 patients received SIRT and are included in the safety analysis, while 41 received at least one dose of nivolumab and are included in the efficacy analysis. 14 patients completed the study as planned.

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

    Arms
    Arm title
    Experimental group
    Arm description
    Nivolumab in combination with SIR-Spheres Y90 resin microspheres. Patients were treated wih SIR-Spheres followed 3 weeks later by nivolumab every 2 weeks for up to 24 doses or until discontinuation based on protocol instructions.
    Arm type
    Experimental

    Investigational medicinal product name
    Nivolumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Nivolumab was administered IV starting 3 weeks after SIRT at a dose of 240 mg IV over 30 minutes every 2 weeks for up to 24 doses unless tumor progression, unacceptable toxicity or death.

    Investigational medicinal product name
    SIR-Spheres
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Implant
    Routes of administration
    Implantation
    Dosage and administration details
    SIR-Spheres Y90 resin microspheres was the non-investigational product. Y90 activity was calculated according to targeted liver volume and status of cirrhosis. SIRT evaluation and treatment were performed as a single-day procedure at Clínica Universidad de Navarra.

    Number of subjects in period 1
    Experimental group
    Started
    42
    Completed
    14
    Not completed
    28
         Physician decision
    4
         Disease progression
    17
         Adverse event, non-fatal
    7

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Treatment period
    Reporting group description
    -

    Reporting group values
    Treatment period Total
    Number of subjects
    42 42
    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)
    20 20
        From 65-84 years
    22 22
        85 years and over
    0 0
    Age continuous
    Units: years
        median (inter-quartile range (Q1-Q3))
    65 (49 to 79) -
    Gender categorical
    Units: Subjects
        Female
    6 6
        Male
    36 36

    End points

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    End points reporting groups
    Reporting group title
    Experimental group
    Reporting group description
    Nivolumab in combination with SIR-Spheres Y90 resin microspheres. Patients were treated wih SIR-Spheres followed 3 weeks later by nivolumab every 2 weeks for up to 24 doses or until discontinuation based on protocol instructions.

    Primary: Safety

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    End point title
    Safety [1]
    End point description
    The primary endpoints were the rate and type of adverse events (AEs), serious AEs (SAEs), events of liver decompensation, and transient and permanent drug discontinuations due to toxicity.
    End point type
    Primary
    End point timeframe
    End of follow up
    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: Safety was the primary endpoint. Results are shown in the corresponding section.
    End point values
    Experimental group
    Number of subjects analysed
    42
    Units: Safety
    0
    No statistical analyses for this end point

    Secondary: Objective response rate

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    End point title
    Objective response rate
    End point description
    End point type
    Secondary
    End point timeframe
    End of follow up
    End point values
    Experimental group
    Number of subjects analysed
    41
    Units: Percentage
        number (confidence interval 95%)
    41.5 (26.3 to 57.9)
    No statistical analyses for this end point

    Secondary: Disease control rate

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    End point title
    Disease control rate
    End point description
    End point type
    Secondary
    End point timeframe
    End of follow up
    End point values
    Experimental group
    Number of subjects analysed
    41
    Units: Percentage
        number (confidence interval 95%)
    92.7 (80.1 to 98.5)
    No statistical analyses for this end point

    Secondary: Time to progression

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    End point title
    Time to progression
    End point description
    End point type
    Secondary
    End point timeframe
    End of follow up
    End point values
    Experimental group
    Number of subjects analysed
    41
    Units: months
        median (inter-quartile range (Q1-Q3))
    8.8 (7.0 to 10.5)
    No statistical analyses for this end point

    Secondary: Progression-free survival

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    End point title
    Progression-free survival
    End point description
    End point type
    Secondary
    End point timeframe
    End of follow up
    End point values
    Experimental group
    Number of subjects analysed
    41
    Units: months
        median (inter-quartile range (Q1-Q3))
    9.0 (7.0 to 10.9)
    No statistical analyses for this end point

    Secondary: Overall survival

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    End point title
    Overall survival
    End point description
    End point type
    Secondary
    End point timeframe
    End of follow up
    End point values
    Experimental group
    Number of subjects analysed
    41
    Units: months
        median (inter-quartile range (Q1-Q3))
    20.9 (17.7 to 24.1)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were assessed continuously during the study and for 100 days post last treatment and evaluated according to the NCI CTCAE Version 4.03 dated 14-Jun-2010.
    Adverse event reporting additional description
    Additional information: 2 SAEs in the same subject (Pyrexia and Liver abscess ) were related to SIRT.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    ND
    Reporting groups
    Reporting group title
    Experimental group
    Reporting group description
    -

    Serious adverse events
    Experimental group
    Total subjects affected by serious adverse events
         subjects affected / exposed
    21 / 42 (50.00%)
         number of deaths (all causes)
    27
         number of deaths resulting from adverse events
    6
    Vascular disorders
    Ischaemia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Hepatic encephalopathy
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    Seizure
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal cord compression
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Performance status decreased
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Pyrexia
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Ascites
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Haematemesis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemoperitoneum
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Bile duct obstruction
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Hepatic function abnormal
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Respiratory, thoracic and mediastinal disorders
    Bronchospasm
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypoxia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Renal and urinary disorders
    Renal failure
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal impairment
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Tubulointerstitial nephritis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Anal abscess
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Clostridium bacteraemia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Liver abscess
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Peritonitis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Peritonitis bacterial
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pneumonia
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Postoperative wound infection
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Diabetes mellitus
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperglycaemic hyperosmolar nonketotic syndrome
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 1%
    Non-serious adverse events
    Experimental group
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    42 / 42 (100.00%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Basal cell carcinoma
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Vascular disorders
    Hypertension
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    3
    Haematoma
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Skin ulcer
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Thrombosis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Surgical and medical procedures
    Radiotherapy
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    2
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    9 / 42 (21.43%)
         occurrences all number
    9
    Pyrexia
         subjects affected / exposed
    7 / 42 (16.67%)
         occurrences all number
    8
    Oedema peripheral
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    3
    Fatigue
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    2
    Oedema
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Pain
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Immune system disorders
    Contrast media allergy
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Bronchospasm
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    4
    Cough
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    3
    Asthmatic attack
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Dyspnoea
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Psychiatric disorders
    Depression
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Insomnia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    11 / 42 (26.19%)
         occurrences all number
    18
    Aspartate aminotransferase increased
         subjects affected / exposed
    14 / 42 (33.33%)
         occurrences all number
    17
    Blood bilirubin increased
         subjects affected / exposed
    9 / 42 (21.43%)
         occurrences all number
    12
    Blood creatine increased
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    3
    Amylase increased
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    2
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    2
    Blood glucose increased
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Blood magnesium decreased
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Blood thyroid stimulating hormone decreased
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Glycosylated haemoglobin increased
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Weight decreased
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    White blood cell count decreased
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Injury, poisoning and procedural complications
    Procedural pain
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Rib fracture
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Spinal fracture
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Nervous system disorders
    Hepatic encephalopathy
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    4
    Dizziness
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Headache
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Thrombocytopenia
         subjects affected / exposed
    13 / 42 (30.95%)
         occurrences all number
    16
    Leukopenia
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    6
    Anaemia
         subjects affected / exposed
    5 / 42 (11.90%)
         occurrences all number
    5
    Eosinophilia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Iron deficiency anaemia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Lymphopenia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Monocytosis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Neutropenia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    10 / 42 (23.81%)
         occurrences all number
    10
    Diarrhoea
         subjects affected / exposed
    8 / 42 (19.05%)
         occurrences all number
    8
    Nausea
         subjects affected / exposed
    7 / 42 (16.67%)
         occurrences all number
    7
    Abdominal pain upper
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    4
    Ascites
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    4
    Constipation
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    3
    Vomiting
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    2
    Abdominal discomfort
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Chronic gastritis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Dyspepsia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Epigastric discomfort
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Stomatitis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Hepatobiliary disorders
    Hyperbilirubinaemia
         subjects affected / exposed
    7 / 42 (16.67%)
         occurrences all number
    11
    Hypertransaminasaemia
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    3
    Autoimmune hepatitis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    2
    Hepatic function abnormal
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Liver abscess
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Portal vein thrombosis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    7 / 42 (16.67%)
         occurrences all number
    8
    Rash
         subjects affected / exposed
    3 / 42 (7.14%)
         occurrences all number
    4
    Dermatitis
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    2
    Skin lesion
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Skin ulcer
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Renal and urinary disorders
    Renal impairment
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    2
    Dysuria
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Haematuria
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Nephritis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    5 / 42 (11.90%)
         occurrences all number
    5
    Thyroiditis
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    2
    Hyperthyroidism
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    13 / 42 (30.95%)
         occurrences all number
    13
    Arthritis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Muscular weakness
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Musculoskeletal chest pain
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Musculoskeletal pain
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Neck pain
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Osteoarthritis
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Soft tissue mass
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Spinal pain
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    5 / 42 (11.90%)
         occurrences all number
    8
    Nasopharyngitis
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    2
    Respiratory tract infection
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    2
    Tooth infection
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    2
    Escherichia infection
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Herpes zoster
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Influenza
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Peritonitis bacterial
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Pneumonia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Viral upper respiratory tract infection
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    2
    Hyperuricaemia
         subjects affected / exposed
    2 / 42 (4.76%)
         occurrences all number
    2
    Gout
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Hyperkalaemia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Hypoglycaemia
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Type 2 diabetes mellitus
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Underweight
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1
    Vitamin D deficiency
         subjects affected / exposed
    1 / 42 (2.38%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    25 Sep 2017
    Addition of Hospital de Cruces as a new study site (no. 09). Approved by the IEC/REC on 13/October/2017 and notified to AEMPS on 17/October/2017
    10 Jan 2018
    Substantial modifications and updates to IB version 16, ICF/PIS version 3.0 and protocol version 3.0 (Addition of the EQ5-CD questionnaire, minimal change of the SIR-Spheres Activity calculation method and addition of an ICF/PIS for post-progression treatment). Approved by the IEC/REC on 12/February/2018 and by AEMPS on 15/February/2018
    03 Sep 2018
    Substantial modification to IB version 17 (update of the reference safety information), ICF/PIS version 4.0 (updated with the new European data protection regulation). Approved by the IEC/REC on 01/October/2018 and by AEMPS on 19/October/2018

    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.
    It was determined that the reported protocol deviations had no impact on the interpretability of the study results. The major deviations were notified to the corresponding authorities and a root cause analysis was carried out in each case.
    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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