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    Clinical Trial Results:
    A Phase III/IV, Single Arm, Multicenter Study of Atezolizumab (Tecentriq) to Investigate Long-term Safety and Efficacy in Previously-treated Patients with Locally Advanced or Metastatic Non-small Cell Lung Cancer (TAIL)

    Summary
    EudraCT number
    2017-001409-34
    Trial protocol
    SI   SE   DK   LV   PL   GB   NL   ES   GR   IT  
    Global end of trial date
    07 Apr 2022

    Results information
    Results version number
    v2(current)
    This version publication date
    09 Feb 2024
    First version publication date
    31 Mar 2023
    Other versions
    v1
    Version creation reason

    Trial information

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    Trial identification
    Sponsor protocol code
    MO39171
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03285763
    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
    07 Apr 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    07 Apr 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of this trial was to evaluate the long-term safety and efficacy of atezolizumab treatment in participants with Stage IIIb or Stage IV Non-small Cell Lung Cancer (NSCLC) who had progressed after standard systemic chemotherapy (including if given in combination with anti-programmed cell death protein 1 [anti-PD-1] therapy, after anti-PD-1 as monotherapy, or after tyrosine kinase inhibitor [TKI] therapy).
    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
    17 Oct 2017
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety, Efficacy
    Long term follow-up duration
    30 Months
    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
    Brazil: 22
    Country: Number of subjects enrolled
    China: 30
    Country: Number of subjects enrolled
    Colombia: 3
    Country: Number of subjects enrolled
    Costa Rica: 5
    Country: Number of subjects enrolled
    Denmark: 15
    Country: Number of subjects enrolled
    Greece: 40
    Country: Number of subjects enrolled
    Guatemala: 3
    Country: Number of subjects enrolled
    Italy: 78
    Country: Number of subjects enrolled
    Latvia: 10
    Country: Number of subjects enrolled
    Lebanon: 10
    Country: Number of subjects enrolled
    Malaysia: 30
    Country: Number of subjects enrolled
    Mexico: 39
    Country: Number of subjects enrolled
    Morocco: 5
    Country: Number of subjects enrolled
    Netherlands: 30
    Country: Number of subjects enrolled
    Panama: 3
    Country: Number of subjects enrolled
    Peru: 7
    Country: Number of subjects enrolled
    Philippines: 10
    Country: Number of subjects enrolled
    Poland: 51
    Country: Number of subjects enrolled
    Slovenia: 4
    Country: Number of subjects enrolled
    Spain: 159
    Country: Number of subjects enrolled
    Sweden: 19
    Country: Number of subjects enrolled
    United Arab Emirates: 1
    Country: Number of subjects enrolled
    United Kingdom: 33
    Worldwide total number of subjects
    615
    EEA total number of subjects
    406
    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)
    308
    From 65 to 84 years
    303
    85 years and over
    4

    Subject disposition

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    Recruitment
    Recruitment details
    Participants were enrolled at 111 sites across 24 countries.

    Pre-assignment
    Screening details
    Four enrolled participants died without receiving study treatment.

    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 with Stage IIIb or State IV NSCLC who had progressed after standard systemic chemotherapy received atezolizumab until Investigator-assessed loss of clinical benefit, unacceptable toxicity, investigator or participant’s decision to withdraw from therapy, or death (whichever occurred first).
    Arm type
    Experimental

    Investigational medicinal product name
    Atezolizumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Participants received 1200 milligrams (mg) of atezolizumab administered by intravenous infusion on Day 1 of every 3-week cycle until Investigator-assessed loss of clinical benefit, unacceptable toxicity, investigator or participant’s decision to withdraw from therapy, or death (whichever occurred first).

    Number of subjects in period 1
    Atezolizumab
    Started
    615
    Completed
    13
    Not completed
    602
         Physician decision
    2
         Consent withdrawn by subject
    33
         Study Terminated By Sponsor
    79
         Death
    470
         Lost to follow-up
    18

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Atezolizumab
    Reporting group description
    Participants with Stage IIIb or State IV NSCLC who had progressed after standard systemic chemotherapy received atezolizumab until Investigator-assessed loss of clinical benefit, unacceptable toxicity, investigator or participant’s decision to withdraw from therapy, or death (whichever occurred first).

    Reporting group values
    Atezolizumab Total
    Number of subjects
    615 615
    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)
    308 308
        From 65-84 years
    303 303
        85 years and over
    4 4
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    63.7 ± 9.9 -
    Gender Categorical
    Units: Participants
        Female
    245 245
        Male
    370 370
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    93 93
        Not Hispanic or Latino
    509 509
        Unknown or Not Reported
    13 13
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    44 44
        Asian
    76 76
        Native Hawaiian or Other Pacific Islander
    1 1
        Black or African American
    4 4
        White
    483 483
        More than one race
    5 5
        Unknown or Not Reported
    2 2
    Region
    Units: Subjects
        EMEA (Europe, the Middle East, and Africa)
    455 455
        Asia
    70 70
        LATAM (Latin America)
    90 90
    ECOG Performance Status
    ECOG Performance Status is graded from 0-5 with a lower number representing no or limited impact on daily living activities and a higher number represents greater impact on daily living activities. ECOG performance status 0 (fully active), ECOG performance status 1 (restricted in physically strenuous activity), ECOG performance status 2 (ambulatory and capable of selfcare; unable to carry out work activities).
    Units: Subjects
        ECOG performance status 0
    193 193
        ECOG performance status 1
    361 361
        ECOG performance status 2
    61 61
    Smoking Status
    Units: Subjects
        Never
    127 127
        Current
    115 115
        Previous
    373 373
    eGFR (mL/min/1.73 m^2) at baseline
    Units: Subjects
        15-<30
    2 2
        30-<60
    77 77
        60-<90
    251 251
        >=90
    283 283
        Missing
    2 2

    End points

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    End points reporting groups
    Reporting group title
    Atezolizumab
    Reporting group description
    Participants with Stage IIIb or State IV NSCLC who had progressed after standard systemic chemotherapy received atezolizumab until Investigator-assessed loss of clinical benefit, unacceptable toxicity, investigator or participant’s decision to withdraw from therapy, or death (whichever occurred first).

    Primary: Percentage of Participants with Adverse Events

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    End point title
    Percentage of Participants with Adverse Events [1]
    End point description
    An adverse event (AE) was defined as any untoward medical occurrence in a participant administered a pharmaceutical product, regardless of causal attribution. An AE can therefore be any unfavorable and unitended sign (including an abnormal laboratory finding), symptom or disease temporally associated with the use of a pharmaceutical product whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as a AEs. The safety population was based on all participants who received any dose of atezolizumab during the study treatment.
    End point type
    Primary
    End point timeframe
    Baseline up to 4 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: No statistical analyses were conducted.
    End point values
    Atezolizumab
    Number of subjects analysed
    615
    Units: Percentage of Participants
        number (not applicable)
    91.7
    No statistical analyses for this end point

    Secondary: Progression-Free Survival (PFS) Based on Disease Status as Evaluated By the Investigator in Accordance With Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1 (v.1.1)

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    End point title
    Progression-Free Survival (PFS) Based on Disease Status as Evaluated By the Investigator in Accordance With Response Evaluation Criteria in Solid Tumors (RECIST), Version 1.1 (v.1.1)
    End point description
    PFS according to RECIST 1.1 was defined as the time (in months) from initiation of study treatment to the first documented disease progression as determined by the investigator per RECIST 1.1, or death from any cause, whichever occurred first. The safety population was based on all participants who received any dose of atezolizumab during the study treatment. This was a single-arm study. The study population was participants with Stage IIIB or Stage IV NSCLC. The primary objective of this study was to understand the safety in this participant population (without distinction of Stage IIIB and IV) and it was not planned to analyze them separately as per the protocol.
    End point type
    Secondary
    End point timeframe
    Baseline up to disease progression or death whichever occurs first (up to 4 years)
    End point values
    Atezolizumab
    Number of subjects analysed
    615
    Units: Months
        median (confidence interval 95%)
    2.7 (2.3 to 2.8)
    No statistical analyses for this end point

    Secondary: Percentage of Participants Alive 2 Years After Initiation of Treatment

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    End point title
    Percentage of Participants Alive 2 Years After Initiation of Treatment
    End point description
    The overall survival (OS) rate at 2 years, was defined as the percentage of participants remaining alive 2 years after initiation of study treatment. The safety population was based on all participants who received any dose of atezolizumab during the study treatment.
    End point type
    Secondary
    End point timeframe
    Baseline up to Year 2
    End point values
    Atezolizumab
    Number of subjects analysed
    615
    Units: Percentage of Participants
        number (not applicable)
    26.7
    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 the time (in months) from initiation of study treatment to death from any cause. The safety population was based on all participants who received any dose of atezolizumab during the study treatment.
    End point type
    Secondary
    End point timeframe
    Baseline up to death (up to 4 years)
    End point values
    Atezolizumab
    Number of subjects analysed
    615
    Units: Months
        median (confidence interval 95%)
    11.2 (8.9 to 12.7)
    No statistical analyses for this end point

    Secondary: EuroQol 5-Dimension 5-Level (EQ-5D-5L) Questionnaire

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    End point title
    EuroQol 5-Dimension 5-Level (EQ-5D-5L) Questionnaire
    End point description
    The EQ-5D-5L was a self-reported health status questionnaire that consisted of six questions used to calculate a health utility score for use in health economic analysis. The EQ-5D-5L has two components: a five-item health state profile that assesses mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, as well as a visual analog scale (VAS) that measures health state. Overall scores range from 0 to 1, with low scores representing a higher level of dysfunction. The safety population was based on all participants who received any dose of atezolizumab during the study treatment. EQ-5D-5L was planned to be utilized for economic modeling only outside of the statistical analysis plan. There is no data to report.
    End point type
    Secondary
    End point timeframe
    Day 1 of first 3 cycles (21-day cycle), then every 6 weeks for 48 weeks; thereafter every 9 weeks until disease progression or until treatment discontinuation (up to 4 years)
    End point values
    Atezolizumab
    Number of subjects analysed
    0 [2]
    Units: Percentage of Participants
        number (not applicable)
    Notes
    [2] - EQ-5D-5L was planned to be utilized for economic modeling outside of the statistical analysis plan.
    No statistical analyses for this end point

    Secondary: European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire Supplemental Lung Cancer Module (EORTC QLQ-LC13)

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    End point title
    European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire Supplemental Lung Cancer Module (EORTC QLQ-LC13)
    End point description
    The EORTC QLQ-LC13 consisted of 13 items that address key lung cancer symptoms (cough, hemoptysis, dyspnea, and site-specific pain), treatment-related adverse effects (sore mouth, dysphagia, peripheral neuropathy and alopecia) and pain medication. The dysphagia scale is multi-item, while the rest are single-item scales. The scales are linearly transformed so that each score has a range from 0 to 100. A high scale score represents a higher response level (e.g. a high score for global health status represents a high QoL). A high score for the symptom scale represents a high level of symptoms. A >=10-point change in the EORTC scale score was perceived by participants as clinically significant. Values presented after baseline represent the change from baseline. The safety population was based on all participants who received any dose of atezolizumab during the study treatment. 9999999 = no data. Values presented after baseline represent the change from baseline.
    End point type
    Secondary
    End point timeframe
    Day 1 of first 3 cycles (21-day cycle), then every 6 weeks for 48 weeks; thereafter every 9 weeks until disease progression or until treatment discontinuation (up to 4 years)
    End point values
    Atezolizumab
    Number of subjects analysed
    615
    Units: Units on a scale
    arithmetic mean (standard deviation)
        Dyspnoea: Baseline
    24.82 ± 21.64
        Dyspnoea: Cycle (C) 02 Day (D) 01
    2.41 ± 15.59
        Dyspnoea: Tumor Assessment Wk 006
    1.59 ± 18.91
        Dyspnoea: Tumor Assessment Wk 012
    -0.62 ± 19.40
        Dyspnoea: Tumor Assessment Wk 018
    -0.50 ± 17.91
        Dyspnoea: Tumor Assessment Wk 024
    -2.84 ± 17.90
        Dyspnoea: Tumor Assessment Wk 030
    -1.17 ± 21.29
        Dyspnoea: Tumor Assessment Wk 036
    -3.91 ± 20.51
        Dyspnoea: Tumor Assessment Wk 042
    -3.97 ± 19.10
        Dyspnoea: Tumor Assessment Wk 048
    -3.65 ± 20.44
        Dyspnoea: Tumor Assessment Wk 054
    2.38 ± 16.98
        Dyspnoea: Tumor Assessment Wk 057
    -5.25 ± 18.13
        Dyspnoea: Tumor Assessment Wk 060
    -1.11 ± 11.05
        Dyspnoea: Tumor Assessment Wk 066
    1.09 ± 19.53
        Dyspnoea: Tumor Assessment Wk 072
    4.76 ± 30.67
        Dyspnoea: Tumor Assessment Wk 075
    -2.22 ± 18.52
        Dyspnoea: Tumor Assessment Wk 078
    0.00 ± 42.31
        Dyspnoea: Tumor Assessment Wk 084
    -2.92 ± 16.07
        Dyspnoea: Tumor Assessment Wk 090
    -17.78 ± 12.67
        Dyspnoea: Tumor Assessment Wk 093
    -3.57 ± 19.38
        Dyspnoea: Tumor Assessment Wk 096
    13.33 ± 27.67
        Dyspnoea: Tumor Assessment Wk 102
    -5.95 ± 19.24
        Dyspnoea: Tumor Assessment Wk 108
    -8.89 ± 26.53
        Dyspnoea: Tumor Assessment Wk 111
    -6.88 ± 17.02
        Dyspnoea: Tumor Assessment Wk 114
    -16.67 ± 23.57
        Dyspnoea: Tumor Assessment Wk 120
    -5.85 ± 14.04
        Dyspnoea: Tumor Assessment Wk 126
    -18.52 ± 27.96
        Dyspnoea: Tumor Assessment Wk 129
    -7.19 ± 13.57
        Dyspnoea: Tumor Assessment Wk 132
    -22.22 ± 9999999
        Dyspnoea: Tumor Assessment Wk 138
    -1.71 ± 11.87
        Dyspnoea: Tumor Assessment Wk 144
    0.00 ± 9999999
        Dyspnoea: Tumor Assessment Wk 147
    -3.70 ± 7.86
        Dyspnoea: Tumor Assessment Wk 156
    6.94 ± 23.71
        Dyspnoea: Tumor Assessment Wk 165
    3.70 ± 23.13
        Dyspnoea: Tumor Assessment Wk 174
    0.00 ± 9999999
        Dyspnoea: Tumor Assessment Wk 183
    -11.11 ± 9999999
        Coughing: Baseline
    33.84 ± 25.94
        Coughing: C2D1
    0.80 ± 21.89
        Coughing: Tumor Assessment Wk 006
    -0.68 ± 24.84
        Coughing: Tumor Assessment Wk 012
    -4.44 ± 28.35
        Coughing: Tumor Assessment Wk 018
    -7.88 ± 25.61
        Coughing: Tumor Assessment Wk 024
    -7.83 ± 26.95
        Coughing: Tumor Assessment Wk 030
    -7.18 ± 26.30
        Coughing: Tumor Assessment Wk 036
    -9.32 ± 25.71
        Coughing: Tumor Assessment Wk 042
    -13.18 ± 25.71
        Coughing: Tumor Assessment Wk 048
    -9.26 ± 30.76
        Coughing: Tumor Assessment Wk 054
    -2.38 ± 24.33
        Coughing: Tumor Assessment Wk 057
    -13.22 ± 28.57
        Coughing: Tumor Assessment Wk 060
    -9.09 ± 21.56
        Coughing: Tumor Assessment Wk 066
    -10.69 ± 28.32
        Coughing: Tumor Assessment Wk 072
    -4.76 ± 23.00
        Coughing: Tumor Assessment Wk 075
    -18.33 ± 28.19
        Coughing: Tumor Assessment Wk 078
    0.00 ± 33.33
        Coughing: Tumor Assessment Wk 084
    -16.67 ± 31.72
        Coughing: Tumor Assessment Wk 090
    -16.67 ± 18.26
        Coughing: Tumor Assessment Wk 093
    -16.67 ± 30.77
        Coughing: Tumor Assessment Wk 096
    6.67 ± 14.91
        Coughing: Tumor Assessment Wk 102
    -23.81 ± 25.43
        Coughing: Tumor Assessment Wk 108
    -6.67 ± 27.89
        Coughing: Tumor Assessment Wk 111
    -11.11 ± 30.43
        Coughing: Tumor Assessment Wk 114
    -16.67 ± 23.57
        Coughing: Tumor Assessment Wk 120
    -12.28 ± 29.84
        Coughing: Tumor Assessment Wk 126
    0.00 ± 33.33
        Coughing: Tumor Assessment Wk 129
    -11.76 ± 26.20
        Coughing: Tumor Assessment Wk 132
    0.00 ± 9999999
        Coughing: Tumor Assessment Wk 138
    -14.29 ± 31.25
        Coughing: Tumor Assessment Wk 144
    33.33 ± 9999999
        Coughing: Tumor Assessment Wk 147
    -22.22 ± 40.82
        Coughing: Tumor Assessment Wk 156
    -12.50 ± 53.27
        Coughing: Tumor Assessment Wk 165
    0.00 ± 33.33
        Coughing: Tumor Assessment Wk 174
    33.33 ± 9999999
        Coughing: Tumor Assessment Wk 183
    0.00 ± 9999999
        Haemoptysis: Baseline
    3.02 ± 10.15
        Haemoptysis: C2D1
    0.60 ± 9.05
        Haemoptysis: Tumor Assessment Wk 006
    0.10 ± 9.81
        Haemoptysis: Tumor Assessment Wk 012
    0.15 ± 9.77
        Haemoptysis: Tumor Assessment Wk 018
    -0.18 ± 8.96
        Haemoptysis: Tumor Assessment Wk 024
    -0.67 ± 9.06
        Haemoptysis: Tumor Assessment Wk 030
    -0.29 ± 10.31
        Haemoptysis: Tumor Assessment Wk 036
    -1.79 ± 10.27
        Haemoptysis: Tumor Assessment Wk 042
    0.00 ± 11.43
        Haemoptysis: Tumor Assessment Wk 048
    -0.46 ± 8.83
        Haemoptysis: Tumor Assessment Wk 054
    0.00 ± 13.07
        Haemoptysis: Tumor Assessment Wk 057
    0.00 ± 10.91
        Haemoptysis: Tumor Assessment Wk 060
    0.00 ± 14.91
        Haemoptysis: Tumor Assessment Wk 066
    -2.52 ± 8.89
        Haemoptysis: Tumor Assessment Wk 072
    0.00 ± 0.00
        Haemoptysis: Tumor Assessment Wk 075
    -3.33 ± 10.13
        Haemoptysis: Tumor Assessment Wk 078
    0.00 ± 0.00
        Haemoptysis: Tumor Assessment Wk 084
    -2.63 ± 9.11
        Haemoptysis: Tumor Assessment Wk 090
    5.56 ± 13.61
        Haemoptysis: Tumor Assessment Wk 093
    1.19 ± 14.29
        Haemoptysis: Tumor Assessment Wk 096
    0.00 ± 0.00
        Haemoptysis: Tumor Assessment Wk 102
    -2.38 ± 8.74
        Haemoptysis: Tumor Assessment Wk 108
    0.00 ± 0.00
        Haemoptysis: Tumor Assessment Wk 111
    -3.17 ± 10.03
        Haemoptysis: Tumor Assessment Wk 114
    0.00 ± 0.00
        Haemoptysis: Tumor Assessment Wk 120
    -1.75 ± 13.49
        Haemoptysis: Tumor Assessment Wk 126
    0.00 ± 0.00
        Haemoptysis: Tumor Assessment Wk 129
    -1.96 ± 14.29
        Haemoptysis: Tumor Assessment Wk 132
    0.00 ± 9999999
        Haemoptysis: Tumor Assessment Wk 138
    -2.38 ± 15.82
        Haemoptysis: Tumor Assessment Wk 144
    0.00 ± 9999999
        Haemoptysis: Tumor Assessment Wk 147
    0.00 ± 9999999
        Haemoptysis: Tumor Assessment Wk 156
    0.00 ± 0.00
        Haemoptysis: Tumor Assessment Wk 165
    0.00 ± 33.33
        Haemoptysis: Tumor Assessment Wk 174
    -33.33 ± 9999999
        Haemoptysis: Tumor Assessment Wk 183
    0.00 ± 9999999
        Sore mouth: Baseline
    3.58 ± 12.33
        Sore mouth: C2D1
    0.67 ± 15.76
        Sore mouth: Tumor Assessment Wk 006
    0.49 ± 16.95
        Sore mouth: Tumor Assessment Wk 012
    0.00 ± 16.55
        Sore mouth: Tumor Assessment Wk 018
    -0.73 ± 14.00
        Sore mouth: Tumor Assessment Wk 024
    -1.13 ± 14.24
        Sore mouth: Tumor Assessment Wk 030
    -2.03 ± 14.16
        Sore mouth: Tumor Assessment Wk 036
    -2.54 ± 15.02
        Sore mouth: Tumor Assessment Wk 042
    -1.57 ± 16.99
        Sore mouth: Tumor Assessment Wk 048
    -4.29 ± 15.97
        Sore mouth: Tumor Assessment Wk 054
    2.56 ± 16.45
        Sore mouth: Tumor Assessment Wk 057
    -1.75 ± 11.65
        Sore mouth: Tumor Assessment Wk 060
    -3.33 ± 10.54
        Sore mouth: Tumor Assessment Wk 066
    -2.56 ± 14.53
        Sore mouth: Tumor Assessment Wk 072
    0.00 ± 0.00
        Sore mouth: Tumor Assessment Wk 075
    -2.50 ± 13.89
        Sore mouth: Tumor Assessment Wk 078
    6.67 ± 14.91
        Sore mouth: Tumor Assessment Wk 084
    -1.75 ± 13.30
        Sore mouth: Tumor Assessment Wk 090
    0.00 ± 0.00
        Sore mouth: Tumor Assessment Wk 093
    2.38 ± 8.74
        Sore mouth: Tumor Assessment Wk 096
    0.00 ± 0.00
        Sore mouth: Tumor Assessment Wk 102
    1.19 ± 6.30
        Sore mouth: Tumor Assessment Wk 108
    0.00 ± 0.00
        Sore mouth: Tumor Assessment Wk 111
    3.17 ± 10.03
        Sore mouth: Tumor Assessment Wk 114
    33.33 ± 47.14
        Sore mouth: Tumor Assessment Wk 120
    7.02 ± 17.84
        Sore mouth: Tumor Assessment Wk 126
    11.11 ± 19.25
        Sore mouth: Tumor Assessment Wk 129
    0.00 ± 0.00
        Sore mouth: Tumor Assessment Wk 132
    33.33 ± 9999999
        Sore mouth: Tumor Assessment Wk 138
    2.38 ± 8.91
        Sore mouth: Tumor Assessment Wk 144
    0.00 ± 9999999
        Sore mouth: Tumor Assessment Wk 147
    0.00 ± 0.00
        Sore mouth: Tumor Assessment Wk 156
    0.00 ± 0.00
        Sore mouth: Tumor Assessment Wk 165
    0.00 ± 0.00
        Sore mouth: Tumor Assessment Wk 174
    0.00 ± 9999999
        Sore mouth: Tumor Assessment Wk 183
    0.00 ± 9999999
        Dysphagia: Baseline
    5.46 ± 14.73
        Dysphagia: C2D1
    0.20 ± 13.92
        Dysphagia: Tumor Assessment Wk 006
    -1.38 ± 13.74
        Dysphagia: Tumor Assessment Wk 012
    -0.15 ± 16.63
        Dysphagia: Tumor Assessment Wk 018
    0.74 ± 16.08
        Dysphagia: Tumor Assessment Wk 024
    -1.59 ± 11.26
        Dysphagia: Tumor Assessment Wk 030
    -1.46 ± 10.30
        Dysphagia: Tumor Assessment Wk 036
    -1.83 ± 16.00
        Dysphagia: Tumor Assessment Wk 042
    -1.59 ± 13.60
        Dysphagia: Tumor Assessment Wk 048
    -0.48 ± 15.53
        Dysphagia: Tumor Assessment Wk 054
    -2.56 ± 9.25
        Dysphagia: Tumor Assessment Wk 057
    -0.58 ± 9.94
        Dysphagia: Tumor Assessment Wk 060
    0.00 ± 0.00
        Dysphagia: Tumor Assessment Wk 066
    -1.28 ± 11.36
        Dysphagia: Tumor Assessment Wk 072
    0.00 ± 0.00
        Dysphagia: Tumor Assessment Wk 075
    0.00 ± 15.10
        Dysphagia: Tumor Assessment Wk 078
    0.00 ± 0.00
        Dysphagia: Tumor Assessment Wk 084
    -2.63 ± 11.96
        Dysphagia: Tumor Assessment Wk 090
    0.00 ± 0.00
        Dysphagia: Tumor Assessment Wk 093
    -2.38 ± 8.74
        Dysphagia: Tumor Assessment Wk 096
    6.67 ± 14.91
        Dysphagia: Tumor Assessment Wk 102
    -2.38 ± 8.74
        Dysphagia: Tumor Assessment Wk 108
    0.00 ± 0.00
        Dysphagia: Tumor Assessment Wk 111
    0.00 ± 10.54
        Dysphagia: Tumor Assessment Wk 114
    0.00 ± 0.00
        Dysphagia: Tumor Assessment Wk 120
    -1.75 ± 7.65
        Dysphagia: Tumor Assessment Wk 126
    0.00 ± 0.00
        Dysphagia: Tumor Assessment Wk 129
    0.00 ± 0.00
        Dysphagia: Tumor Assessment Wk 132
    0.00 ± 9999999
        Dysphagia: Tumor Assessment Wk 138
    0.00 ± 0.00
        Dysphagia: Tumor Assessment Wk 144
    0.00 ± 9999999
        Dysphagia: Tumor Assessment Wk 147
    0.00 ± 0.00
        Dysphagia: Tumor Assessment Wk 156
    4.17 ± 11.79
        Dysphagia: Tumor Assessment Wk 165
    0.00 ± 0.00
        Dysphagia: Tumor Assessment Wk 174
    0.00 ± 9999999
        Dysphagia: Tumor Assessment Wk 183
    0.00 ± 9999999
        Peripheral neuropathy: Baseline
    17.77 ± 26.96
        Peripheral neuropathy: C2D1
    -0.20 ± 22.29
        Peripheral neuropathy: Tumor Assessment Wk 006
    -0.58 ± 21.80
        Peripheral neuropathy: Tumor Assessment Wk 012
    0.15 ± 24.20
        Peripheral neuropathy: Tumor Assessment Wk 018
    -2.56 ± 26.56
        Peripheral neuropathy: Tumor Assessment Wk 024
    -3.15 ± 25.30
        Peripheral neuropathy: Tumor Assessment Wk 030
    -3.19 ± 24.17
        Peripheral neuropathy: Tumor Assessment Wk 036
    -6.23 ± 25.29
        Peripheral neuropathy: Tumor Assessment Wk 042
    -7.45 ± 28.35
        Peripheral neuropathy: Tumor Assessment Wk 048
    -8.92 ± 27.58
        Peripheral neuropathy: Tumor Assessment Wk 054
    -7.69 ± 19.97
        Peripheral neuropathy: Tumor Assessment Wk 057
    -6.32 ± 20.19
        Peripheral neuropathy: Tumor Assessment Wk 060
    -13.33 ± 17.21
        Peripheral neuropathy: Tumor Assessment Wk 066
    -3.85 ± 22.53
        Peripheral neuropathy: Tumor Assessment Wk 072
    -4.76 ± 23.00
        Peripheral neuropathy: Tumor Assessment Wk 075
    -10.83 ± 26.57
        Peripheral neuropathy: Tumor Assessment Wk 078
    -6.67 ± 27.89
        Peripheral neuropathy: Tumor Assessment Wk 084
    -9.65 ± 28.90
        Peripheral neuropathy: Tumor Assessment Wk 090
    0.00 ± 21.08
        Peripheral neuropathy: Tumor Assessment Wk 093
    -5.95 ± 30.16
        Peripheral neuropathy: Tumor Assessment Wk 096
    6.67 ± 14.91
        Peripheral neuropathy: Tumor Assessment Wk 102
    -8.33 ± 26.64
        Peripheral neuropathy: Tumor Assessment Wk 108
    -6.67 ± 14.91
        Peripheral neuropathy: Tumor Assessment Wk 111
    -14.29 ± 34.27
        Peripheral neuropathy: Tumor Assessment Wk 114
    -16.67 ± 23.57
        Peripheral neuropathy: Tumor Assessment Wk 120
    -14.04 ± 32.04
        Peripheral neuropathy: Tumor Assessment Wk 126
    -11.11 ± 19.25
        Peripheral neuropathy: Tumor Assessment Wk 129
    -7.84 ± 25.08
        Peripheral neuropathy: Tumor Assessment Wk 132
    0.00 ± 9999999
        Peripheral neuropathy: Tumor Assessment Wk 138
    -19.05 ± 33.88
        Peripheral neuropathy: Tumor Assessment Wk 144
    0.00 ± 9999999
        Peripheral neuropathy: Tumor Assessment Wk 147
    -22.22 ± 40.82
        Peripheral neuropathy: Tumor Assessment Wk 156
    -12.50 ± 50.20
        Peripheral neuropathy: Tumor Assessment Wk 165
    11.11 ± 19.25
        Peripheral neuropathy: Tumor Assessment Wk 174
    33.33 ± 9999999
        Peripheral neuropathy: Tumor Assessment Wk 183
    33.33 ± 9999999
        Alopecia: Baseline
    13.95 ± 27.14
        Alopecia: C2D1
    -5.64 ± 24.32
        Alopecia: Tumor Assessment Wk 006
    -4.31 ± 24.84
        Alopecia: Tumor Assessment Wk 012
    -5.98 ± 25.39
        Alopecia: Tumor Assessment Wk 018
    -6.85 ± 24.59
        Alopecia: Tumor Assessment Wk 024
    -8.11 ± 24.16
        Alopecia: Tumor Assessment Wk 030
    -6.96 ± 25.93
        Alopecia: Tumor Assessment Wk 036
    -6.52 ± 25.79
        Alopecia: Tumor Assessment Wk 042
    -6.67 ± 26.13
        Alopecia: Tumor Assessment Wk 048
    -7.51 ± 26.55
        Alopecia: Tumor Assessment Wk 054
    2.56 ± 9.25
        Alopecia: Tumor Assessment Wk 057
    -6.43 ± 27.77
        Alopecia: Tumor Assessment Wk 060
    0.00 ± 15.71
        Alopecia: Tumor Assessment Wk 066
    -6.41 ± 26.44
        Alopecia: Tumor Assessment Wk 072
    9.52 ± 16.27
        Alopecia: Tumor Assessment Wk 075
    -6.67 ± 27.43
        Alopecia: Tumor Assessment Wk 078
    13.33 ± 18.26
        Alopecia: Tumor Assessment Wk 084
    -6.14 ± 26.68
        Alopecia: Tumor Assessment Wk 090
    5.56 ± 13.61
        Alopecia: Tumor Assessment Wk 093
    -4.76 ± 28.28
        Alopecia: Tumor Assessment Wk 096
    6.67 ± 14.91
        Alopecia: Tumor Assessment Wk 102
    -4.76 ± 26.78
        Alopecia: Tumor Assessment Wk 108
    20.00 ± 18.26
        Alopecia: Tumor Assessment Wk 111
    -3.17 ± 27.70
        Alopecia: Tumor Assessment Wk 114
    16.67 ± 23.57
        Alopecia: Tumor Assessment Wk 120
    3.51 ± 29.18
        Alopecia: Tumor Assessment Wk 126
    22.22 ± 19.25
        Alopecia: Tumor Assessment Wk 129
    5.88 ± 17.62
        Alopecia: Tumor Assessment Wk 132
    0.00 ± 9999999
        Alopecia: Tumor Assessment Wk 138
    -4.76 ± 28.81
        Alopecia: Tumor Assessment Wk 144
    0.00 ± 9999999
        Alopecia: Tumor Assessment Wk 147
    -7.41 ± 36.43
        Alopecia: Tumor Assessment Wk 156
    -4.17 ± 45.21
        Alopecia: Tumor Assessment Wk 165
    0.00 ± 0.00
        Alopecia: Tumor Assessment Wk 174
    0.00 ± 9999999
        Alopecia: Tumor Assessment Wk 183
    33.33 ± 9999999
        Pain in chest: Baseline
    14.20 ± 21.62
        Pain in chest: C2D1
    0.13 ± 19.74
        Pain in chest: Tumor Assessment Wk 006
    0.10 ± 23.99
        Pain in chest: Tumor Assessment Wk 012
    -0.75 ± 22.35
        Pain in chest: Tumor Assessment Wk 018
    -1.12 ± 18.38
        Pain in chest: Tumor Assessment Wk 024
    -2.74 ± 18.16
        Pain in chest: Tumor Assessment Wk 030
    -1.77 ± 20.82
        Pain in chest: Tumor Assessment Wk 036
    -2.96 ± 20.39
        Pain in chest: Tumor Assessment Wk 042
    -2.41 ± 20.02
        Pain in chest: Tumor Assessment Wk 048
    -4.35 ± 22.80
        Pain in chest: Tumor Assessment Wk 054
    0.00 ± 20.10
        Pain in chest: Tumor Assessment Wk 057
    -6.06 ± 21.36
        Pain in chest: Tumor Assessment Wk 060
    7.41 ± 22.22
        Pain in chest: Tumor Assessment Wk 066
    -3.33 ± 20.48
        Pain in chest: Tumor Assessment Wk 072
    -14.29 ± 17.82
        Pain in chest: Tumor Assessment Wk 075
    -6.14 ± 18.75
        Pain in chest: Tumor Assessment Wk 078
    -16.67 ± 19.25
        Pain in chest: Tumor Assessment Wk 084
    -7.41 ± 16.16
        Pain in chest: Tumor Assessment Wk 090
    -6.67 ± 14.91
        Pain in chest: Tumor Assessment Wk 093
    -1.33 ± 15.15
        Pain in chest: Tumor Assessment Wk 096
    -8.33 ± 16.67
        Pain in chest: Tumor Assessment Wk 102
    -8.97 ± 15.08
        Pain in chest: Tumor Assessment Wk 108
    -13.33 ± 18.26
        Pain in chest: Tumor Assessment Wk 111
    -5.00 ± 16.31
        Pain in chest: Tumor Assessment Wk 114
    -33.33 ± 0.00
        Pain in chest: Tumor Assessment Wk 120
    -7.41 ± 18.28
        Pain in chest: Tumor Assessment Wk 126
    -11.11 ± 19.25
        Pain in chest: Tumor Assessment Wk 129
    -6.25 ± 18.13
        Pain in chest: Tumor Assessment Wk 132
    -33.33 ± 9999999
        Pain in chest: Tumor Assessment Wk 138
    -5.13 ± 22.96
        Pain in chest: Tumor Assessment Wk 144
    -33.33 ± 9999999
        Pain in chest: Tumor Assessment Wk 147
    -4.17 ± 21.36
        Pain in chest: Tumor Assessment Wk 156
    -9.52 ± 16.27
        Pain in chest: Tumor Assessment Wk 165
    11.11 ± 19.25
        Pain in chest: Tumor Assessment Wk 174
    0.00 ± 9999999
        Pain in chest: Tumor Assessment Wk 183
    33.33 ± 9999999
        Pain in arm or shoulder: Baseline
    16.09 ± 24.63
        Pain in arm or shoulder: C2D1
    1.81 ± 21.67
        Pain in arm or shoulder: Tumor Assessment Wk 006
    -0.30 ± 23.85
        Pain in arm or shoulder: Tumor Assessment Wk 012
    0.75 ± 24.09
        Pain in arm or shoulder: Tumor Assessment Wk 018
    3.15 ± 28.78
        Pain in arm or shoulder: Tumor Assessment Wk 024
    -0.68 ± 23.56
        Pain in arm or shoulder: Tumor Assessment Wk 030
    0.00 ± 25.86
        Pain in arm or shoulder: Tumor Assessment Wk 036
    -2.20 ± 22.11
        Pain in arm or shoulder: Tumor Assessment Wk 042
    -1.19 ± 24.51
        Pain in arm or shoulder: Tumor Assessment Wk 048
    -2.38 ± 24.95
        Pain in arm or shoulder: Tumor Assessment Wk 054
    2.56 ± 21.35
        Pain in arm or shoulder: Tumor Assessment Wk 057
    1.72 ± 26.80
        Pain in arm or shoulder: Tumor Assessment Wk 060
    -6.67 ± 21.08
        Pain in arm or shoulder: Tumor Assessment Wk 066
    0.64 ± 21.38
        Pain in arm or shoulder: Tumor Assessment Wk 072
    4.76 ± 23.00
        Pain in arm or shoulder: Tumor Assessment Wk 075
    -4.27 ± 23.17
        Pain in arm or shoulder: Tumor Assessment Wk 078
    16.67 ± 19.25
        Pain in arm or shoulder: Tumor Assessment Wk 084
    -9.01 ± 23.11
        Pain in arm or shoulder: Tumor Assessment Wk 090
    0.00 ± 23.57
        Pain in arm or shoulder: Tumor Assessment Wk 093
    -9.88 ± 20.29
        Pain in arm or shoulder: Tumor Assessment Wk 096
    -8.33 ± 16.67
        Pain in arm or shoulder: Tumor Assessment Wk 102
    -4.94 ± 20.05
        Pain in arm or shoulder: Tumor Assessment Wk 108
    0.00 ± 23.57
        Pain in arm or shoulder: Tumor Assessment Wk 111
    -6.35 ± 20.05
        Pain in arm or shoulder: Tumor Assessment Wk 114
    16.67 ± 23.57
        Pain in arm or shoulder: Tumor Assessment Wk 120
    -7.02 ± 21.02
        Pain in arm or shoulder: Tumor Assessment Wk 126
    22.22 ± 19.25
        Pain in arm or shoulder: Tumor Assessment Wk 129
    -7.84 ± 18.74
        Pain in arm or shoulder: Tumor Assessment Wk 132
    0.00 ± 9999999
        Pain in arm or shoulder: Tumor Assessment Wk 138
    -11.90 ± 16.57
        Pain in arm or shoulder: Tumor Assessment Wk 144
    -33.33 ± 9999999
        Pain in arm or shoulder: Tumor Assessment Wk 147
    -11.11 ± 16.67
        Pain in arm or shoulder: Tumor Assessment Wk 156
    -12.50 ± 17.25
        Pain in arm or shoulder: Tumor Assessment Wk 165
    -11.11 ± 19.25
        Pain in arm or shoulder: Tumor Assessment Wk 174
    -33.33 ± 9999999
        Pain in arm or shoulder: Tumor Assessment Wk 183
    0.00 ± 9999999
        Pain in other parts: Baseline
    25.46 ± 30.26
        Pain in other parts: C2D1
    -0.49 ± 27.84
        Pain in other parts: Tumor Assessment Wk 006
    1.12 ± 31.80
        Pain in other parts: Tumor Assessment Wk 012
    0.93 ± 28.33
        Pain in other parts: Tumor Assessment Wk 018
    -1.19 ± 23.89
        Pain in other parts: Tumor Assessment Wk 024
    -1.41 ± 23.11
        Pain in other parts: Tumor Assessment Wk 030
    -0.62 ± 21.95
        Pain in other parts: Tumor Assessment Wk 036
    -4.17 ± 19.45
        Pain in other parts: Tumor Assessment Wk 042
    -4.17 ± 24.52
        Pain in other parts: Tumor Assessment Wk 048
    -0.98 ± 23.72
        Pain in other parts: Tumor Assessment Wk 054
    11.11 ± 16.41
        Pain in other parts: Tumor Assessment Wk 057
    -5.23 ± 20.41
        Pain in other parts: Tumor Assessment Wk 060
    3.70 ± 11.11
        Pain in other parts: Tumor Assessment Wk 066
    -0.67 ± 27.35
        Pain in other parts: Tumor Assessment Wk 072
    4.76 ± 12.60
        Pain in other parts: Tumor Assessment Wk 075
    -2.70 ± 25.31
        Pain in other parts: Tumor Assessment Wk 078
    16.67 ± 19.25
        Pain in other parts: Tumor Assessment Wk 084
    -3.92 ± 26.92
        Pain in other parts: Tumor Assessment Wk 090
    6.67 ± 14.91
        Pain in other parts: Tumor Assessment Wk 093
    -10.26 ± 22.65
        Pain in other parts: Tumor Assessment Wk 096
    0.00 ± 0.00
        Pain in other parts: Tumor Assessment Wk 102
    -8.97 ± 22.23
        Pain in other parts: Tumor Assessment Wk 108
    6.67 ± 14.91
        Pain in other parts: Tumor Assessment Wk 111
    -8.33 ± 28.36
        Pain in other parts: Tumor Assessment Wk 114
    16.67 ± 23.57
        Pain in other parts: Tumor Assessment Wk 120
    -3.92 ± 20.01
        Pain in other parts: Tumor Assessment Wk 126
    33.33 ± 33.33
        Pain in other parts: Tumor Assessment Wk 129
    -6.25 ± 18.13
        Pain in other parts: Tumor Assessment Wk 132
    0.00 ± 9999999
        Pain in other parts: Tumor Assessment Wk 138
    -10.26 ± 21.01
        Pain in other parts: Tumor Assessment Wk 144
    0.00 ± 9999999
        Pain in other parts: Tumor Assessment Wk 147
    -12.50 ± 24.80
        Pain in other parts: Tumor Assessment Wk 156
    -14.29 ± 17.82
        Pain in other parts: Tumor Assessment Wk 165
    0.00 ± 0.00
        Pain in other parts: Tumor Assessment Wk 174
    0.00 ± 9999999
        Pain in other parts: Tumor Assessment Wk 183
    0.00 ± 9999999
        Dyspnoea at Resting: Baseline
    10.47 ± 19.79
        Dyspnoea at Resting: C2D1
    2.53 ± 19.17
        Dyspnoea at Resting: Tumor Assessment Wk 006
    1.68 ± 20.59
        Dyspnoea at Resting: Tumor Assessment Wk 012
    1.65 ± 19.61
        Dyspnoea at Resting: Tumor Assessment Wk 018
    1.83 ± 17.07
        Dyspnoea at Resting: Tumor Assessment Wk 024
    -0.23 ± 15.90
        Dyspnoea at Resting: Tumor Assessment Wk 030
    2.03 ± 21.76
        Dyspnoea at Resting: Tumor Assessment Wk 036
    0.37 ± 20.18
        Dyspnoea at Resting: Tumor Assessment Wk 042
    -0.40 ± 19.01
        Dyspnoea at Resting: Tumor Assessment Wk 048
    0.95 ± 17.92
        Dyspnoea at Resting: Tumor Assessment Wk 054
    2.38 ± 8.91
        Dyspnoea at Resting: Tumor Assessment Wk 057
    -2.38 ± 19.96
        Dyspnoea at Resting: Tumor Assessment Wk 060
    0.00 ± 0.00
        Dyspnoea at Resting: Tumor Assessment Wk 066
    3.27 ± 17.96
        Dyspnoea at Resting: Tumor Assessment Wk 072
    9.52 ± 31.71
        Dyspnoea at Resting: Tumor Assessment Wk 075
    -0.83 ± 17.68
        Dyspnoea at Resting: Tumor Assessment Wk 078
    20.00 ± 50.55
        Dyspnoea at Resting: Tumor Assessment Wk 084
    -0.88 ± 16.42
        Dyspnoea at Resting: Tumor Assessment Wk 090
    11.11 ± 45.54
        Dyspnoea at Resting: Tumor Assessment Wk 093
    4.76 ± 23.51
        Dyspnoea at Resting: Tumor Assessment Wk 096
    13.33 ± 29.81
        Dyspnoea at Resting: Tumor Assessment Wk 102
    -1.19 ± 16.93
        Dyspnoea at Resting: Tumor Assessment Wk 108
    -6.67 ± 27.89
        Dyspnoea at Resting: Tumor Assessment Wk 111
    -1.59 ± 16.59
        Dyspnoea at Resting: Tumor Assessment Wk 114
    -16.67 ± 23.57
        Dyspnoea at Resting: Tumor Assessment Wk 120
    -1.75 ± 13.49
        Dyspnoea at Resting: Tumor Assessment Wk 126
    -11.11 ± 19.25
        Dyspnoea at Resting: Tumor Assessment Wk 129
    -1.96 ± 14.29
        Dyspnoea at Resting: Tumor Assessment Wk 132
    0.00 ± 9999999
        Dyspnoea at Resting: Tumor Assessment Wk 138
    7.69 ± 19.97
        Dyspnoea at Resting: Tumor Assessment Wk 144
    0.00 ± 9999999
        Dyspnoea at Resting: Tumor Assessment Wk 147
    7.41 ± 14.70
        Dyspnoea at Resting: Tumor Assessment Wk 156
    20.83 ± 17.25
        Dyspnoea at Resting: Tumor Assessment Wk 165
    11.11 ± 19.25
        Dyspnoea at Resting: Tumor Assessment Wk 174
    0.00 ± 9999999
        Dyspnoea at Resting: Tumor Assessment Wk 183
    33.33 ± 9999999
        Dyspnoea at Walking: Baseline
    27.31 ± 26.59
        Dyspnoea at Walking: C2D1
    2.52 ± 21.43
        Dyspnoea at Walking: Tumor Assessment Wk 006
    1.18 ± 23.65
        Dyspnoea at Walking: Tumor Assessment Wk 012
    -1.21 ± 26.37
        Dyspnoea at Walking: Tumor Assessment Wk 018
    -1.29 ± 24.94
        Dyspnoea at Walking: Tumor Assessment Wk 024
    -3.83 ± 26.23
        Dyspnoea at Walking: Tumor Assessment Wk 030
    -2.32 ± 26.39
        Dyspnoea at Walking: Tumor Assessment Wk 036
    -3.94 ± 27.74
        Dyspnoea at Walking: Tumor Assessment Wk 042
    -3.88 ± 25.78
        Dyspnoea at Walking: Tumor Assessment Wk 048
    -6.48 ± 27.77
        Dyspnoea at Walking: Tumor Assessment Wk 054
    2.38 ± 27.62
        Dyspnoea at Walking: Tumor Assessment Wk 057
    -7.02 ± 23.35
        Dyspnoea at Walking: Tumor Assessment Wk 060
    -3.03 ± 17.98
        Dyspnoea at Walking: Tumor Assessment Wk 066
    -1.89 ± 25.67
        Dyspnoea at Walking: Tumor Assessment Wk 072
    4.76 ± 29.99
        Dyspnoea at Walking: Tumor Assessment Wk 075
    -4.17 ± 22.88
        Dyspnoea at Walking: Tumor Assessment Wk 078
    -6.67 ± 54.77
        Dyspnoea at Walking: Tumor Assessment Wk 084
    -6.14 ± 23.06
        Dyspnoea at Walking: Tumor Assessment Wk 090
    -5.56 ± 38.97
        Dyspnoea at Walking: Tumor Assessment Wk 093
    -5.95 ± 24.09
        Dyspnoea at Walking: Tumor Assessment Wk 096
    13.33 ± 38.01
        Dyspnoea at Walking: Tumor Assessment Wk 102
    -8.33 ± 26.64
        Dyspnoea at Walking: Tumor Assessment Wk 108
    -20.00 ± 29.81
        Dyspnoea at Walking: Tumor Assessment Wk 111
    -9.52 ± 26.13
        Dyspnoea at Walking: Tumor Assessment Wk 114
    -16.67 ± 23.57
        Dyspnoea at Walking: Tumor Assessment Wk 120
    -7.02 ± 21.02
        Dyspnoea at Walking: Tumor Assessment Wk 126
    -33.33 ± 33.33
        Dyspnoea at Walking: Tumor Assessment Wk 129
    -9.80 ± 19.60
        Dyspnoea at Walking: Tumor Assessment Wk 132
    -33.33 ± 9999999
        Dyspnoea at Walking: Tumor Assessment Wk 138
    -2.38 ± 24.33
        Dyspnoea at Walking: Tumor Assessment Wk 144
    0.00 ± 9999999
        Dyspnoea at Walking: Tumor Assessment Wk 147
    -3.70 ± 26.06
        Dyspnoea at Walking: Tumor Assessment Wk 156
    4.17 ± 37.53
        Dyspnoea at Walking: Tumor Assessment Wk 165
    11.11 ± 38.49
        Dyspnoea at Walking: Tumor Assessment Wk 174
    0.00 ± 9999999
        Dyspnoea at Walking: Tumor Assessment Wk 183
    -33.33 ± 9999999
        Dyspnoea at Climbing Stairs: Baseline
    37.12 ± 29.57
        Dyspnoea at Climbing Stairs: C2D1
    2.23 ± 22.71
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 006
    1.39 ± 26.23
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 012
    -1.66 ± 27.20
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 018
    -2.04 ± 26.17
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 024
    -4.73 ± 24.90
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 030
    -2.61 ± 28.66
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 036
    -6.81 ± 29.72
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 042
    -5.81 ± 26.17
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 048
    -3.70 ± 29.37
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 054
    2.38 ± 24.33
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 057
    -6.90 ± 27.75
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 060
    -3.03 ± 17.98
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 066
    1.89 ± 26.49
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 072
    0.00 ± 33.33
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 075
    -1.67 ± 28.19
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 078
    -13.33 ± 29.81
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 084
    -1.75 ± 24.44
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 090
    -26.67 ± 14.91
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 093
    -9.52 ± 23.76
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 096
    13.33 ± 29.81
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 102
    -8.33 ± 26.64
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 108
    0.00 ± 33.33
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 111
    -9.52 ± 23.90
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 114
    -16.67 ± 23.57
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 120
    -8.77 ± 18.73
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 126
    -11.11 ± 38.49
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 129
    -9.80 ± 22.87
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 132
    -33.33 ± 9999999
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 138
    -11.90 ± 24.83
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 144
    0.00 ± 9999999
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 147
    -14.81 ± 17.57
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 156
    -4.17 ± 27.82
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 165
    -11.11 ± 19.25
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 174
    0.00 ± 9999999
        Dyspnoea at Climbing Stairs: Tumor Asses. Wk 183
    -33.33 ± 9999999
    No statistical analyses for this end point

    Secondary: Progression-Free Survival Based on Disease Status as Evaluated By the Investigator in Accordance With Modified RECIST

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    End point title
    Progression-Free Survival Based on Disease Status as Evaluated By the Investigator in Accordance With Modified RECIST
    End point description
    PFS was defined as the time (in months) from initiation of study treatment to the first documented disease progression or death from any cause, whichever occurred first. PFS will be calculated based on disease status evaluated by the investigator according to modified RECIST. The safety population was based on all participants who received any dose of atezolizumab during the study treatment.This was a single-arm study. The study population was participants with Stage IIIB or Stage IV NSCLC. The primary objective of this study was to understand the safety in this participant population (without distinction of Stage IIIB and IV) and it was not planned to analyze them separately as per the protocol.
    End point type
    Secondary
    End point timeframe
    Baseline up to disease progression or death whichever occurs first (up to 4 years)
    End point values
    Atezolizumab
    Number of subjects analysed
    615
    Units: Months
        median (confidence interval 95%)
    3.7 (3.0 to 4.2)
    No statistical analyses for this end point

    Secondary: Percentage of Participants Alive 3 Years After Initiation of Treatment

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    End point title
    Percentage of Participants Alive 3 Years After Initiation of Treatment
    End point description
    The OS rate at 3 years, was defined as the percentage of participants remaining alive 3 years after initiation of study treatment. The safety population was based on all participants who received any dose of atezolizumab during the study treatment.
    End point type
    Secondary
    End point timeframe
    Baseline up to Year 3
    End point values
    Atezolizumab
    Number of subjects analysed
    615
    Units: Percentage of Participants
        number (not applicable)
    19.6
    No statistical analyses for this end point

    Secondary: Duration of Response as Assessed by the Investigator According to RECIST v.1.1

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    End point title
    Duration of Response as Assessed by the Investigator According to RECIST v.1.1
    End point description
    DOR was defined as the time from the first tumor assessment that supported the participant’s objective response (CR or PR, whichever was first reported) to documented disease progression as determined by the investigator according to RECIST v1.1 or death from any cause, whichever occurred first, among participants who had a best overall response as CR or PR. The safety population was based on all participants who received any dose of atezolizumab during the study treatment.
    End point type
    Secondary
    End point timeframe
    From date of first objective response up to disease progression or death whichever occurs first (up to 4 years)
    End point values
    Atezolizumab
    Number of subjects analysed
    615
    Units: Months
        median (confidence interval 95%)
    16.6 (9.7 to 20.3)
    No statistical analyses for this end point

    Secondary: Duration of Response as Assessed by the Investigator According to Modified RECIST

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    End point title
    Duration of Response as Assessed by the Investigator According to Modified RECIST
    End point description
    DOR was defined as the duration from the first tumor assessment that supports the participant's objective response (CR or PR, whichever is first recorded) to disease progression or death due to any cause, whichever occurred first. The safety population was based on all participants who received any dose of atezolizumab during the study treatment.
    End point type
    Secondary
    End point timeframe
    From date of first objective response up to disease progression or death whichever occurs first (up to 4 years)
    End point values
    Atezolizumab
    Number of subjects analysed
    615
    Units: Months
        median (confidence interval 95%)
    20.5 (16.6 to 28.8)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Objective Reponse as Assessed by the Investigator According to RECIST v1.1

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    End point title
    Percentage of Participants with Objective Reponse as Assessed by the Investigator According to RECIST v1.1
    End point description
    Objective response rate (ORR), according to RECIST v1.1, was defined as the percentage of participants with a confirmed best overall response (BOR), either complete response (CR) or partial response (PR), as determined by the investigator using RECIST v1.1. The safety population was based on all participants who received any dose of atezolizumab during the study treatment.
    End point type
    Secondary
    End point timeframe
    Baseline up to disease progression or death whichever occurs first (up to 4 years)
    End point values
    Atezolizumab
    Number of subjects analysed
    615
    Units: Percentage of Participants
        number (not applicable)
    11.5
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Objective Reponse as Assessed by the Investigator According to Modified RECIST

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    End point title
    Percentage of Participants with Objective Reponse as Assessed by the Investigator According to Modified RECIST
    End point description
    The investigator-assessed ORR was defined as the proportion of participants whose confirmed BOR is either a PR or CR per modified RECIST. The safety population was based on all participants who received any dose of atezolizumab during the study treatment.
    End point type
    Secondary
    End point timeframe
    Baseline up to disease progression or death whichever occurs first (up to 4 years)
    End point values
    Atezolizumab
    Number of subjects analysed
    615
    Units: Percentage of Participants
        number (not applicable)
    12.4
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline up to 4 years
    Adverse event reporting additional description
    The ITT population consisted of 619 enrolled participants and the safety population consisted of the 615 participants who received at least one dose of atezolizumab, which was the primary analysis population for the study. Four enrolled participants died before receiving the treatment and were excluded from the safety population.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    24
    Reporting groups
    Reporting group title
    Atezolizumab
    Reporting group description
    Participants with Stage IIIb or State IV NSCLC who had progressed after standard systemic chemotherapy received atezolizumab until Investigator-assessed loss of clinical benefit, unacceptable toxicity, investigator or participant’s decision to withdraw from therapy, or death (whichever occurred first).

    Serious adverse events
    Atezolizumab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    198 / 615 (32.20%)
         number of deaths (all causes)
    474
         number of deaths resulting from adverse events
    8
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasm
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cancer pain
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tumour haemorrhage
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bladder cancer
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Prostate cancer
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tumour pain
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Peripheral ischaemia
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hypertension
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Lymphoedema
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Embolism venous
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Peripheral artery thrombosis
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Jugular vein thrombosis
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Limb operation
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    General physical health deterioration
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    1 / 1
    Device related thrombosis
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sudden death
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Chest pain
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Fatigue
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Asthenia
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Systemic inflammatory response syndrome
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Malaise
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    7 / 615 (1.14%)
         occurrences causally related to treatment / all
    4 / 8
         deaths causally related to treatment / all
    0 / 0
    Death
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Non-cardiac chest pain
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Influenza like illness
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Anaphylactic shock
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Anaphylactic reaction
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Pelvic pain
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pneumothorax
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hydrothorax
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemoptysis
         subjects affected / exposed
    3 / 615 (0.49%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    4 / 615 (0.65%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Cough
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Asthma
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    6 / 615 (0.98%)
         occurrences causally related to treatment / all
    1 / 6
         deaths causally related to treatment / all
    0 / 2
    Dyspnoea
         subjects affected / exposed
    9 / 615 (1.46%)
         occurrences causally related to treatment / all
    0 / 9
         deaths causally related to treatment / all
    0 / 0
    Bronchial haemorrhage
         subjects affected / exposed
    3 / 615 (0.49%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 1
    Pneumonitis
         subjects affected / exposed
    10 / 615 (1.63%)
         occurrences causally related to treatment / all
    9 / 10
         deaths causally related to treatment / all
    1 / 1
    Respiratory failure
         subjects affected / exposed
    4 / 615 (0.65%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 2
    Pneumothorax spontaneous
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Acute respiratory failure
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia aspiration
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Respiratory distress
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    5 / 615 (0.81%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Obstructive airways disorder
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Delirium
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Weight decreased
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatic enzyme increased
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood alkaline phosphatase increased
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Ankle fracture
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Joint dislocation
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bone contusion
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infusion related reaction
         subjects affected / exposed
    5 / 615 (0.81%)
         occurrences causally related to treatment / all
    5 / 5
         deaths causally related to treatment / all
    0 / 0
    Spinal cord injury
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal fracture
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Femur fracture
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Pericarditis
         subjects affected / exposed
    4 / 615 (0.65%)
         occurrences causally related to treatment / all
    3 / 4
         deaths causally related to treatment / all
    2 / 2
    Bradycardia
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    3 / 615 (0.49%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Cardiac failure
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Endocarditis noninfective
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Stress cardiomyopathy
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Acute coronary syndrome
         subjects affected / exposed
    4 / 615 (0.65%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 1
    Acute myocardial infarction
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Atrial flutter
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Hemiparesis
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cerebral infarction
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Headache
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Syncope
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Epilepsy
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neurological symptom
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Seizure
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Autonomic nervous system imbalance
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Status epilepticus
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Depressed level of consciousness
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Immune thrombocytopenia
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Autoimmune haemolytic anaemia
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Duodenal ulcer perforation
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Stomatitis
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 1
    Vomiting
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Ileus
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancreatitis
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oesophageal obstruction
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    4 / 615 (0.65%)
         occurrences causally related to treatment / all
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    Constipation
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Hepatic lesion
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Cholelithiasis
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatotoxicity
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholecystitis
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Stevens-Johnson syndrome
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    3 / 615 (0.49%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Nephropathy toxic
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal failure
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Haematuria
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hydronephrosis
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Endocrine disorders
    Adrenal insufficiency
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperthyroidism
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Primary adrenal insufficiency
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypothyroidism
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Spinal pain
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Back pain
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Arthralgia
         subjects affected / exposed
    3 / 615 (0.49%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal chest pain
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Neck pain
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Erysipelas
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    35 / 615 (5.69%)
         occurrences causally related to treatment / all
    2 / 39
         deaths causally related to treatment / all
    1 / 5
    Upper respiratory tract infection
         subjects affected / exposed
    4 / 615 (0.65%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Enterocolitis infectious
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    COVID-19
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Infective exacerbation of chronic obstructive airways disease
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    3 / 615 (0.49%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Pneumonia klebsiella
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    11 / 615 (1.79%)
         occurrences causally related to treatment / all
    0 / 12
         deaths causally related to treatment / all
    0 / 1
    Encephalitis
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infected fistula
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pleural infection
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diverticulitis
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Influenza
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Atypical pneumonia
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia streptococcal
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia escherichia
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    1 / 1
    Liver abscess
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia bacterial
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Pulmonary sepsis
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Bacterial infection
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Hyponatraemia
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Decreased appetite
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Type 2 diabetes mellitus
         subjects affected / exposed
    1 / 615 (0.16%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Dehydration
         subjects affected / exposed
    2 / 615 (0.33%)
         occurrences causally related to treatment / all
    0 / 2
         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
    480 / 615 (78.05%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    44 / 615 (7.15%)
         occurrences all number
    47
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    93 / 615 (15.12%)
         occurrences all number
    123
    Pyrexia
         subjects affected / exposed
    73 / 615 (11.87%)
         occurrences all number
    123
    Fatigue
         subjects affected / exposed
    100 / 615 (16.26%)
         occurrences all number
    111
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    78 / 615 (12.68%)
         occurrences all number
    99
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    46 / 615 (7.48%)
         occurrences all number
    59
    Diarrhoea
         subjects affected / exposed
    72 / 615 (11.71%)
         occurrences all number
    97
    Nausea
         subjects affected / exposed
    67 / 615 (10.89%)
         occurrences all number
    89
    Constipation
         subjects affected / exposed
    55 / 615 (8.94%)
         occurrences all number
    68
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    85 / 615 (13.82%)
         occurrences all number
    97
    Cough
         subjects affected / exposed
    107 / 615 (17.40%)
         occurrences all number
    134
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    46 / 615 (7.48%)
         occurrences all number
    55
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    62 / 615 (10.08%)
         occurrences all number
    87
    Hyperthyroidism
         subjects affected / exposed
    42 / 615 (6.83%)
         occurrences all number
    50
    Musculoskeletal and connective tissue disorders
    Musculoskeletal chest pain
         subjects affected / exposed
    37 / 615 (6.02%)
         occurrences all number
    39
    Back pain
         subjects affected / exposed
    63 / 615 (10.24%)
         occurrences all number
    76
    Pain in extremity
         subjects affected / exposed
    39 / 615 (6.34%)
         occurrences all number
    45
    Arthralgia
         subjects affected / exposed
    83 / 615 (13.50%)
         occurrences all number
    102
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    43 / 615 (6.99%)
         occurrences all number
    60
    Upper respiratory tract infection
         subjects affected / exposed
    36 / 615 (5.85%)
         occurrences all number
    44
    Nasopharyngitis
         subjects affected / exposed
    35 / 615 (5.69%)
         occurrences all number
    44
    Metabolism and nutrition disorders
    Hyperglycaemia
         subjects affected / exposed
    33 / 615 (5.37%)
         occurrences all number
    40
    Decreased appetite
         subjects affected / exposed
    104 / 615 (16.91%)
         occurrences all number
    116

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    16 Jan 2018
    The following updates were made: [1] Background information on atezolizumab was updated; [2] Epidermal growth factor receptor/echinoderm microtubule-associated protein-like 4−anaplastic lymphoma kinase (EGFR/ALK) testing was only mandatory for participants with non-squamous non-small cell lung cancer (NSCLC); [3] The number and sequence of allowed tyrosine kinase inhibitor (TKIs) in eligible participants has been addressed; [4] Appendix 8 was added; [5] Participants with previously detected EGFRT70M mutation who experienced disease progression were with osimertinib were eligible; [6] Participants who were HIV-positive were allowed in the trial; [7] Further detail was provided related to the medical history and demographic data collected in this study during the Screening Period; [8] Sections 4.5.7. and 5.1.2 were updated; [9] Language describing immune-related myocarditis associated with atezolizumab was removed from the protocol; [10] Exploratory efficacy endpoints were revised; [11] An optional substudy was added to the trial; [12] Language was changed throughout the protocol to 'prior to study treatment initiation.'
    14 Jan 2019
    The following updates were made: [1] An appendix was added regarding the risks associated with atezolizumab and guidelines for management of adverse events (AEs) associated with atezolizumab; [2] Updated the dissemination of data and protection of trade secrets, including additional information on confidentiality of study data to reflect GDPR requirements.
    17 Dec 2019
    The following updates were made: [1] Text was modified to define special situations and detail how to record and report them; [2] Traditional herbal medicines could be used at the investigator’s discretion; [3] Clarification on timing of destruction of biological samples; [4] Language was added to clarify that research biosample repository (RBR) samples would destroyed; [5] Instructions about participant withdrawal from the RBR after site closure was modified; [6] The list of atezolizumab risks was updated; [7] Myositis was included in the guidelines for managing participants with atezolizumab associated AEs; [8] the description and management guidelines of systemic immune activation were replaced with descriptions and guidelines for hemophagocytic lymphohistiocytosis and macrophage activation syndrome; [9] The adverse event of special interest (AESI) of hypophysitis was added; [10] Reporting term 'sudden' death' was updated; [11] Text was modified to differentiate between spontaneous and therapeutic/elective abortions and how they were reported; [12] the atezolizumab AE management guidelines were revised to add laboratory and cardiac imaging abnormalities as signs or symptoms that are suggestive of myocarditis; [13] Additional clarifications were included.
    23 Mar 2021
    The following updates were made: [1] Approved indications for atezolizumab were added; [2] Text describing the current knowledge and risks of COVID-19 infection were highlighted; [3] Language was added to indicate that sites should confirm that appropriate temperature conditions were maintained during IMP transit and that the sites were responsible for maintaining records of IMP accountability during the study; [4] Immunosuppressive medications were removed from the prohibited therapy section and added to the permitted therapy section; [5] List of identified risks for atezolizumab was revised; [6] Text was added to clarify macrophage activation syndrome (MAS) as potential risks for atezolizumab; [7] HLH and MAS replaced systemic inflammatory response syndrome on the list of atezolizumab-associated AESIs; [8] Influenza-like illness was removed from the list of immediately reportable AESIs; [9] Text was added to clarify that AEs associated with special situations that also qualified as AESIs would be reported within 24 hours; [10] Text was added to indicate that the Informed Consent Form instruct female participants to inform the investigator if they became pregnant; [11] Updates to Appendix 5 to caution participants considering atezolizumab who had previously experienced a severe or life-threatening skin adverse reaction; [12] The management guidelines for infusion-related reactions associated with atezolizumab were updated; [13] Guidelines for management of atezolizumab-associated dermatological AEs were revised; [14] The management guidelines for Grade 4 myositis were removed; [15] The management guidelines for HLH and MAS were modified; [16] Additional clarifications were included.

    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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