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    Clinical Trial Results:
    A Phase 3 Randomized, Double-Blind, Placebo-Controlled Trial of Pembrolizumab (MK-3475) Plus Chemotherapy Versus Chemotherapy Plus Placebo for the First-Line Treatment of Persistent, Recurrent, or Metastatic Cervical Cancer (KEYNOTE-826)

    Summary
    EudraCT number
    2018-001440-53
    Trial protocol
    DE   FR   ES   PL   IT  
    Global end of trial date
    04 Jun 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    24 May 2025
    First version publication date
    24 May 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    MK-3475-826
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03635567
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    JAPAC-CTI: 184183, MSD: KEYNOTE-826
    Sponsors
    Sponsor organisation name
    Merck Sharp & Dohme LLC
    Sponsor organisation address
    126 East Lincoln Avenue, P.O. Box 2000, Rahway, NJ, United States, 07065
    Public contact
    Clinical Trials Disclosure, Merck Sharp & Dohme LLC, ClinicalTrialsDisclosure@msd.com
    Scientific contact
    Clinical Trials Disclosure, Merck Sharp & Dohme LLC, ClinicalTrialsDisclosure@msd.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
    04 Jun 2024
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    03 Oct 2022
    Global end of trial reached?
    Yes
    Global end of trial date
    04 Jun 2024
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The purpose of this study is to assess the efficacy and safety of pembrolizumab (MK-3475) plus one of four platinum-based chemotherapy regimens compared to the efficacy and safety of placebo plus one of four platinum-based chemotherapy regimens in the treatment of adult women with persistent, recurrent, or metastatic cervical cancer. Possible chemotherapy regimens include: paclitaxel plus cisplatin with or without bevacizumab and paclitaxel plus carboplatin with or without bevacizumab. The primary study hypotheses are that the combination of pembrolizumab plus chemotherapy is superior to placebo plus chemotherapy with respect to: 1) Progression-free Survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST 1.1) as assessed by the Investigator, or, 2) Overall Survival (OS).
    Protection of trial subjects
    This study was conducted in conformance with Good Clinical Practice standards and applicable country and/or local statutes and regulations regarding ethical committee review, informed consent, and the protection of human subjects participating in biomedical research.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    25 Oct 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Argentina: 40
    Country: Number of subjects enrolled
    Australia: 8
    Country: Number of subjects enrolled
    Canada: 36
    Country: Number of subjects enrolled
    Chile: 57
    Country: Number of subjects enrolled
    Colombia: 43
    Country: Number of subjects enrolled
    France: 36
    Country: Number of subjects enrolled
    Germany: 10
    Country: Number of subjects enrolled
    Israel: 24
    Country: Number of subjects enrolled
    Italy: 39
    Country: Number of subjects enrolled
    Japan: 57
    Country: Number of subjects enrolled
    Korea, Republic of: 24
    Country: Number of subjects enrolled
    Mexico: 38
    Country: Number of subjects enrolled
    Peru: 41
    Country: Number of subjects enrolled
    Russian Federation: 40
    Country: Number of subjects enrolled
    Spain: 12
    Country: Number of subjects enrolled
    Taiwan: 16
    Country: Number of subjects enrolled
    Türkiye: 24
    Country: Number of subjects enrolled
    Ukraine: 26
    Country: Number of subjects enrolled
    United States: 46
    Worldwide total number of subjects
    617
    EEA total number of subjects
    97
    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)
    517
    From 65 to 84 years
    100
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    883 participants were screened and 617 participants were randomized to receive either Pembrolizumab+Chemotherapy or Placebo+Chemotherapy.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Pembrolizumab+Chemotherapy
    Arm description
    On Day 1 of each 21-day cycle, participants received an intravenous (IV) infusion of pembrolizumab 200 mg for up to 35 cycles (up to approximately 2 years) PLUS Investigator choice of chemotherapy for up to 6 cycles (paclitaxel 175 mg/m^2 PLUS cisplatin 50 mg/m^2 WITH or WITHOUT bevacizumab 15 mg/kg per local label OR paclitaxel 175 mg/m^2 PLUS carboplatin Area Under the Curve (AUC) 5 for up to 6 cycles, WITH or WITHOUT bevacizumab 15 mg/kg per local label). All treatments were administered until disease progression or toxicity. Eligible participants who stopped the initial course of pembrolizumab with Stable Disease (SD) or better but progressed after discontinuation may have been able to initiate a second course of pembrolizumab for up to 17 cycles (up to approximately 1 additional year) at the investigator's discretion.
    Arm type
    Experimental

    Investigational medicinal product name
    Pembrolizumab
    Investigational medicinal product code
    Other name
    MK-3475 KEYTRUDA®
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    IV infusion

    Investigational medicinal product name
    Paclitaxel
    Investigational medicinal product code
    Other name
    TAXOL®
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    IV infusion

    Investigational medicinal product name
    Bevacizumab
    Investigational medicinal product code
    Other name
    AVASTIN®
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    IV infusion

    Investigational medicinal product name
    Carboplatin
    Investigational medicinal product code
    Other name
    PARAPLATIN®
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    IV infusion

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    PLATINOL®
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    IV infusion

    Arm title
    Placebo+Chemotherapy
    Arm description
    On Day 1 of each 21-day cycle, participants received an IV infusion of placebo (Normal Saline or Dextrose solution) for up to 35 cycles (up to approximately 2 years) PLUS Investigator choice of chemotherapy for up to 6 cycles (paclitaxel 175 mg/m^2 PLUS cisplatin 50 mg/m^2 WITH or WITHOUT bevacizumab 15 mg/kg per local label OR paclitaxel 175 mg/m^2 PLUS carboplatin AUC 5 for up to 6 cycles, WITH or WITHOUT bevacizumab 15 mg/kg per local label). All treatments were administered until disease progression or toxicity.
    Arm type
    Active comparator

    Investigational medicinal product name
    Paclitaxel
    Investigational medicinal product code
    Other name
    TAXOL®
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    IV infusion

    Investigational medicinal product name
    Cisplatin
    Investigational medicinal product code
    Other name
    PLATINOL®
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    IV infusion

    Investigational medicinal product name
    Carboplatin
    Investigational medicinal product code
    Other name
    PARAPLATIN®
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    IV infusion

    Investigational medicinal product name
    Bevacizumab
    Investigational medicinal product code
    Other name
    AVASTIN®
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    IV infusion

    Investigational medicinal product name
    Placebo to pembrolizumab
    Investigational medicinal product code
    Other name
    Normal Saline or Dextrose solution
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    IV infusion

    Number of subjects in period 1
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Started
    308
    309
    Treated
    307
    309
    Received Second Course of Pembrolizumab
    12
    0
    Completed
    0
    0
    Not completed
    308
    309
         Consent withdrawn by subject
    11
    16
         Death
    194
    235
         Sponsor Decision
    99
    57
         Lost to follow-up
    4
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Pembrolizumab+Chemotherapy
    Reporting group description
    On Day 1 of each 21-day cycle, participants received an intravenous (IV) infusion of pembrolizumab 200 mg for up to 35 cycles (up to approximately 2 years) PLUS Investigator choice of chemotherapy for up to 6 cycles (paclitaxel 175 mg/m^2 PLUS cisplatin 50 mg/m^2 WITH or WITHOUT bevacizumab 15 mg/kg per local label OR paclitaxel 175 mg/m^2 PLUS carboplatin Area Under the Curve (AUC) 5 for up to 6 cycles, WITH or WITHOUT bevacizumab 15 mg/kg per local label). All treatments were administered until disease progression or toxicity. Eligible participants who stopped the initial course of pembrolizumab with Stable Disease (SD) or better but progressed after discontinuation may have been able to initiate a second course of pembrolizumab for up to 17 cycles (up to approximately 1 additional year) at the investigator's discretion.

    Reporting group title
    Placebo+Chemotherapy
    Reporting group description
    On Day 1 of each 21-day cycle, participants received an IV infusion of placebo (Normal Saline or Dextrose solution) for up to 35 cycles (up to approximately 2 years) PLUS Investigator choice of chemotherapy for up to 6 cycles (paclitaxel 175 mg/m^2 PLUS cisplatin 50 mg/m^2 WITH or WITHOUT bevacizumab 15 mg/kg per local label OR paclitaxel 175 mg/m^2 PLUS carboplatin AUC 5 for up to 6 cycles, WITH or WITHOUT bevacizumab 15 mg/kg per local label). All treatments were administered until disease progression or toxicity.

    Reporting group values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy Total
    Number of subjects
    308 309 617
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    260 257 517
        From 65-84 years
    48 52 100
        85 years and over
    0 0 0
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    51.7 ( 11.9 ) 50.7 ( 12.7 ) -
    Sex: Female, Male
    Units: Participants
        Female
    308 309 617
        Male
    0 0 0
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    18 21 39
        Asian
    65 45 110
        Native Hawaiian or Other Pacific Islander
    0 0 0
        Black or African American
    4 2 6
        White
    170 190 360
        More than one race
    32 34 66
        Unknown or Not Reported
    19 17 36
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    109 121 230
        Not Hispanic or Latino
    193 184 377
        Unknown or Not Reported
    6 4 10
    Programmed Cell Death-Ligand 1 (PD-L1) Combined Positive Score (CPS) Status
    Participants were assessed for their PD-L1 tumor expression level by immunohistochemistry assay using tumor tissue. Randomization of participants in the study were stratified by their PD-L1 CPS at baseline (PD-L1 CPS<1, 1≤ PD-L1 CPS<10, or PD-L1 CPS≥10).
    Units: Subjects
        PD-L1 CPS<1
    35 34 69
        1≤ PD-L1 CPS<10
    115 116 231
        PD-L1 CPS≥10
    158 159 317
    Metastatic at Initial Diagnosis
    Randomization of participants was stratified by whether they were metastatic at initial diagnosis (Yes or No). Metastatic was defined as Stage IVB based on the Fédération Internationale de Gynécologie et d’Obstétrique (FIGO) (2009).
    Units: Subjects
        Metastatic at Initial Diagnosis = Yes
    94 96 190
        Metastatic at Initial Diagnosis = No
    214 213 427
    Investigator Choice to Use Bevacizumab
    Randomization of participants was stratified by the Investigator's choice for the participant to receive bevacizumab (Yes or No).
    Units: Subjects
        Received Bevacizumab = Yes
    196 193 389
        Received Bevacizumab = No
    112 116 228

    End points

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    End points reporting groups
    Reporting group title
    Pembrolizumab+Chemotherapy
    Reporting group description
    On Day 1 of each 21-day cycle, participants received an intravenous (IV) infusion of pembrolizumab 200 mg for up to 35 cycles (up to approximately 2 years) PLUS Investigator choice of chemotherapy for up to 6 cycles (paclitaxel 175 mg/m^2 PLUS cisplatin 50 mg/m^2 WITH or WITHOUT bevacizumab 15 mg/kg per local label OR paclitaxel 175 mg/m^2 PLUS carboplatin Area Under the Curve (AUC) 5 for up to 6 cycles, WITH or WITHOUT bevacizumab 15 mg/kg per local label). All treatments were administered until disease progression or toxicity. Eligible participants who stopped the initial course of pembrolizumab with Stable Disease (SD) or better but progressed after discontinuation may have been able to initiate a second course of pembrolizumab for up to 17 cycles (up to approximately 1 additional year) at the investigator's discretion.

    Reporting group title
    Placebo+Chemotherapy
    Reporting group description
    On Day 1 of each 21-day cycle, participants received an IV infusion of placebo (Normal Saline or Dextrose solution) for up to 35 cycles (up to approximately 2 years) PLUS Investigator choice of chemotherapy for up to 6 cycles (paclitaxel 175 mg/m^2 PLUS cisplatin 50 mg/m^2 WITH or WITHOUT bevacizumab 15 mg/kg per local label OR paclitaxel 175 mg/m^2 PLUS carboplatin AUC 5 for up to 6 cycles, WITH or WITHOUT bevacizumab 15 mg/kg per local label). All treatments were administered until disease progression or toxicity.

    Primary: Progression-free Survival (PFS) per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Investigator in Participants with Programmed Cell Death-Ligand 1 (PD-L1) Combined Positive Score (CPS) ≥1

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    End point title
    Progression-free Survival (PFS) per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Investigator in Participants with Programmed Cell Death-Ligand 1 (PD-L1) Combined Positive Score (CPS) ≥1
    End point description
    PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD was defined as ≥ 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. Note: The appearance of one or more new lesions was also considered PD. The PFS per RECIST 1.1 as assessed by Investigator for all randomized participants with PD-L1 CPS ≥1 is presented. All randomized participants with PD-L1 CPS ≥1 based on the treatment group to which they were randomized were analyzed.
    End point type
    Primary
    End point timeframe
    Up to approximately 46 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    273
    275
    Units: Months
        median (confidence interval 95%)
    10.5 (9.7 to 12.3)
    8.2 (6.3 to 8.5)
    Statistical analysis title
    PFS in CPS ≥1 Participants
    Statistical analysis description
    Treatment comparison (hazard ratio [HR]) was based on Cox regression model with Efron's method of tie handling with treatment as a covariate stratified by metastatic at initial diagnosis (FIGO [2009] stage IVB) (yes or no), bevacizumab use (yes or no), and PD-L1 status (CPS<1, CPS 1 to <10, or CPS ≥10).
    Comparison groups
    Pembrolizumab+Chemotherapy v Placebo+Chemotherapy
    Number of subjects included in analysis
    548
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001 [1]
    Method
    Stratified Log-Rank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.58
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.47
         upper limit
    0.71
    Notes
    [1] - No formal hypothesis testing performed; nominal p-value provided for treatment comparison.

    Primary: PFS per RECIST 1.1 as Assessed by Investigator in All Participants

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    End point title
    PFS per RECIST 1.1 as Assessed by Investigator in All Participants
    End point description
    PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD was defined as ≥ 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. Note: The appearance of one or more new lesions was also considered PD. The PFS per RECIST 1.1 as assessed by Investigator for all randomized participants is presented. All randomized participants based on the treatment group to which they were randomized were analyzed.
    End point type
    Primary
    End point timeframe
    Up to approximately 46 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    308
    309
    Units: Months
        median (confidence interval 95%)
    10.4 (9.1 to 12.2)
    8.2 (6.4 to 8.4)
    Statistical analysis title
    PFS in All Participants
    Statistical analysis description
    Treatment comparison (HR) was based on Cox regression model with Efron's method of tie handling with treatment as a covariate stratified by metastatic at initial diagnosis (FIGO [2009] stage IVB) (yes or no), bevacizumab use (yes or no), and PD-L1 status (CPS<1, CPS 1 to <10, or CPS ≥10).
    Comparison groups
    Pembrolizumab+Chemotherapy v Placebo+Chemotherapy
    Number of subjects included in analysis
    617
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001 [2]
    Method
    Stratified Log-Rank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.61
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.5
         upper limit
    0.74
    Notes
    [2] - No formal hypothesis testing performed; nominal p-value provided for treatment comparison.

    Primary: PFS per RECIST 1.1 as Assessed by Investigator in Participants with PD-L1 CPS ≥10

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    End point title
    PFS per RECIST 1.1 as Assessed by Investigator in Participants with PD-L1 CPS ≥10
    End point description
    PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD was defined as ≥ 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. Note: The appearance of one or more new lesions was also considered PD. The PFS per RECIST 1.1 as assessed by Investigator for all randomized participants with PD-L1 CPS ≥10 is presented. All randomized participants with PD-L1 CPS ≥10 based on the treatment group to which they were randomized were analyzed.
    End point type
    Primary
    End point timeframe
    Up to approximately 46 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    158
    159
    Units: Months
        median (confidence interval 95%)
    10.4 (8.9 to 15.1)
    8.1 (6.2 to 8.8)
    Statistical analysis title
    PFS in Participants with PD-L1 CPS ≥10
    Statistical analysis description
    Treatment comparison (HR) was based on Cox regression model with Efron's method of tie handling with treatment as a covariate stratified by metastatic at initial diagnosis (FIGO [2009] stage IVB) (yes or no), bevacizumab use (yes or no), and PD-L1 status (CPS<1, CPS 1 to <10, or CPS ≥10).
    Comparison groups
    Pembrolizumab+Chemotherapy v Placebo+Chemotherapy
    Number of subjects included in analysis
    317
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001 [3]
    Method
    Stratified Log-Rank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.52
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.4
         upper limit
    0.68
    Notes
    [3] - No formal hypothesis testing performed; nominal p-value provided for treatment comparison.

    Primary: Overall Survival (OS) in Participants with PD-L1 CPS ≥1

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    End point title
    Overall Survival (OS) in Participants with PD-L1 CPS ≥1
    End point description
    OS was defined as the time from randomization to death due to any cause. The OS for all randomized participants with PD-L1 CPS ≥1 is presented. All randomized participants with PD-L1 CPS ≥1 based on the treatment group to which they were randomized were analyzed.
    End point type
    Primary
    End point timeframe
    Up to approximately 46 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    273
    275
    Units: Months
        median (confidence interval 95%)
    28.6 (22.1 to 38.0)
    16.5 (14.5 to 20.0)
    Statistical analysis title
    OS in Participants with PD-L1 CPS ≥1
    Statistical analysis description
    Treatment comparison (HR) was based on Cox regression model with Efron's method of tie handling with treatment as a covariate stratified by metastatic at initial diagnosis (FIGO [2009] stage IVB) (yes or no), bevacizumab use (yes or no), and PD-L1 status (CPS<1, CPS 1 to <10, or CPS ≥10).
    Comparison groups
    Pembrolizumab+Chemotherapy v Placebo+Chemotherapy
    Number of subjects included in analysis
    548
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001 [4]
    Method
    Stratified Log-Rank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.49
         upper limit
    0.74
    Notes
    [4] - No formal hypothesis testing performed; nominal p-value provided for treatment comparison.

    Primary: OS in All Participants

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    End point title
    OS in All Participants
    End point description
    OS was defined as the time from randomization to death due to any cause. The OS for all randomized participants is presented. All randomized participants based on the treatment group to which they were randomized were analyzed.
    End point type
    Primary
    End point timeframe
    Up to approximately 46 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    308
    309
    Units: Months
        median (confidence interval 95%)
    26.4 (21.3 to 32.5)
    16.8 (14.6 to 19.4)
    Statistical analysis title
    OS in All Participants
    Statistical analysis description
    Treatment comparison (HR) was based on Cox regression model with Efron's method of tie handling with treatment as a covariate stratified by metastatic at initial diagnosis (FIGO [2009] stage IVB) (yes or no), bevacizumab use (yes or no), and PD-L1 status (CPS<1, CPS 1 to <10, or CPS ≥10).
    Comparison groups
    Pembrolizumab+Chemotherapy v Placebo+Chemotherapy
    Number of subjects included in analysis
    617
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001 [5]
    Method
    Stratified Log-Rank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.63
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.52
         upper limit
    0.77
    Notes
    [5] - No formal hypothesis testing performed; nominal p-value based on log-rank test provided for treatment comparison.

    Primary: OS in Participants with PD-L1 CPS ≥10

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    End point title
    OS in Participants with PD-L1 CPS ≥10
    End point description
    OS was defined as the time from randomization to death due to any cause. The OS for all randomized participants with PD-L1 CPS ≥10 is presented. A value of 9999 means that the upper limit not reached at time of data cut-off due to insufficient number of participants with an event. All randomized participants with PD-L1 CPS ≥10 based on the treatment group to which they were randomized were analyzed.
    End point type
    Primary
    End point timeframe
    Up to approximately 46 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    158
    159
    Units: Months
        median (confidence interval 95%)
    29.6 (20.6 to 9999)
    17.4 (14.0 to 24.7)
    Statistical analysis title
    OS in Participants with PD-L1 CPS ≥10
    Statistical analysis description
    Treatment comparison (HR) was based on Cox regression model with Efron's method of tie handling with treatment as a covariate stratified by metastatic at initial diagnosis (FIGO [2009] stage IVB) (yes or no), bevacizumab use (yes or no), and PD-L1 status (CPS<1, CPS 1 to <10, or CPS ≥10).
    Comparison groups
    Pembrolizumab+Chemotherapy v Placebo+Chemotherapy
    Number of subjects included in analysis
    317
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001 [6]
    Method
    Stratified Log-Rank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.58
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.44
         upper limit
    0.78
    Notes
    [6] - No formal hypothesis testing performed; nominal p-value provided for treatment comparison.

    Secondary: Objective Response Rate (ORR) Per RECIST 1.1 as Assessed by Investigator

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    End point title
    Objective Response Rate (ORR) Per RECIST 1.1 as Assessed by Investigator
    End point description
    ORR was defined as the percentage of the participants in the analysis population who have a Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters). The ORR per RECIST 1.1 as assessed by Investigator is presented. All randomized participants based on the treatment group to which they were randomized were analyzed.
    End point type
    Secondary
    End point timeframe
    Up to approximately 46 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    308
    309
    Units: Percentage of Participants
        number (confidence interval 95%)
    66.2 (60.7 to 71.5)
    51.5 (45.7 to 57.2)
    Statistical analysis title
    ORR - Pembro+Chemo vs. Placebo+Chemo
    Statistical analysis description
    Treatment comparison was based on Miettinen & Nurminen method stratified by metastatic at initial diagnosis (FIGO [2009] stage IVB) (yes or no), bevacizumab use (yes or no), and PD-L1 status (CPS<1, CPS 1 to <10, or CPS ≥10).
    Comparison groups
    Pembrolizumab+Chemotherapy v Placebo+Chemotherapy
    Number of subjects included in analysis
    617
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.0001 [7]
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in Percentage
    Point estimate
    14.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    7.4
         upper limit
    22.3
    Notes
    [7] - No formal hypothesis testing performed; nominal p-value provided for treatment comparison

    Secondary: Percentage of Participants that were PFS Event-Free (PFS Rate) at Month 12 Per RECIST 1.1 as Assessed by Investigator

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    End point title
    Percentage of Participants that were PFS Event-Free (PFS Rate) at Month 12 Per RECIST 1.1 as Assessed by Investigator
    End point description
    PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD was defined as ≥ 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. Note: The appearance of one or more new lesions was also considered PD. PFS Rate was defined as the percentage of participants that were PFS event-free at Month 12. The PFS Rate per RECIST 1.1 as assessed by Investigator at Month 12 is presented. All randomized participants based on the treatment group to which they were randomized were analyzed.
    End point type
    Secondary
    End point timeframe
    12 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    308
    309
    Units: Percentage of Participants
        number (confidence interval 95%)
    44.7 (38.9 to 50.4)
    33.1 (27.7 to 38.7)
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR) Per RECIST 1.1 as Assessed by Investigator

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    End point title
    Duration of Response (DOR) Per RECIST 1.1 as Assessed by Investigator
    End point description
    For participants who demonstrate CR or PR, DOR was defined as the time from first documented evidence of CR or PR until disease progression or death. The DOR per RECIST 1.1 as assessed by Investigator is presented. All randomized participants based on the treatment group to which they were randomized who demonstrated CR or PR were analyzed.
    End point type
    Secondary
    End point timeframe
    Up to approximately 46 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    204
    159
    Units: Months
        median (confidence interval 95%)
    18.0 (10.5 to 32.3)
    10.4 (8.3 to 13.3)
    No statistical analyses for this end point

    Secondary: PFS per RECIST 1.1 as Assessed by Blinded Independent Central Review (BICR)

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    End point title
    PFS per RECIST 1.1 as Assessed by Blinded Independent Central Review (BICR)
    End point description
    PFS was defined as the time from randomization to the first documented PD or death due to any cause, whichever occurs first. Per RECIST 1.1, PD was defined as ≥ 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. Note: The appearance of one or more new lesions was also considered PD. The PFS per RECIST 1.1 as assessed by BICR is presented. All randomized participants based on the treatment group to which they were randomized were analyzed.
    End point type
    Secondary
    End point timeframe
    Up to approximately 46 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    308
    309
    Units: Months
        median (confidence interval 95%)
    12.3 (10.3 to 17.9)
    8.3 (8.1 to 9.0)
    Statistical analysis title
    PFS per RECIST 1.1 as Assessed by BICR
    Statistical analysis description
    Treatment comparison (HR) was based on Cox regression model with Efron's method of tie handling with treatment as a covariate stratified by metastatic at initial diagnosis (FIGO [2009] stage IVB) (yes or no), bevacizumab use (yes or no), and PD-L1 status (CPS<1, CPS 1 to <10, or CPS ≥10).
    Comparison groups
    Pembrolizumab+Chemotherapy v Placebo+Chemotherapy
    Number of subjects included in analysis
    617
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001 [8]
    Method
    Stratified Log-Rank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.49
         upper limit
    0.74
    Notes
    [8] - No formal hypothesis testing performed; nominal p-value provided for treatment comparison

    Secondary: Number of Participants Who Experienced an Adverse Event (AE)

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    End point title
    Number of Participants Who Experienced an Adverse Event (AE)
    End point description
    An AE was any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who experienced an AE is presented. All randomized participants who received at least one dose of study treatment were analyzed.
    End point type
    Secondary
    End point timeframe
    Up to approximately 66 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    307
    309
    Units: Number of participants
    305
    307
    No statistical analyses for this end point

    Secondary: Number of Participants Who Experienced a Serious AE (SAE)

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    End point title
    Number of Participants Who Experienced a Serious AE (SAE)
    End point description
    An SAE was defined as any untoward medical occurrence that, at any dose: a.) Resulted in death; b.) Was life-threatening; c.) Required inpatient hospitalization or prolongation of existing hospitalization; d.) Resulted in persistent or significant disability/incapacity; e.) Was a congenital anomaly/birth defect; f.) Other important medical events; h.) Was a new cancer (that is not a condition of the study) or i.) Was associated with an overdose. The number of participants who experienced an SAE is presented. All randomized participants who received at least one dose of study treatment were analyzed.
    End point type
    Secondary
    End point timeframe
    Up to approximately 66 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    307
    309
    Units: Number of Participants
    157
    132
    No statistical analyses for this end point

    Secondary: Number of Participants Who Experienced an Immune-related AE (irAE)

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    End point title
    Number of Participants Who Experienced an Immune-related AE (irAE)
    End point description
    AEs associated with pembrolizumab exposure may be a result of an immune response. These irAEs may occur shortly after the first dose or several months after the last dose of pembrolizumab treatment and may affect more than one body system simultaneously. For this study irAEs included, but were not limited to: -Pneumonitis; -Diarrhea/Colitis; -Aspartate transaminase (AST)/Alanine transaminase (ALT) elevation or Increased bilirubin; -Type 1 diabetes mellitus or Hyperglycemia; -Hypophysitis; -Hyperthyroidism; -Hypothyroidism; -Nephritis and Renal dysfunction; and -Myocarditis. The number of participants who experienced an irAE is presented. All randomized participants who received at least one dose of study treatment were analyzed.
    End point type
    Secondary
    End point timeframe
    Up to approximately 66 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    307
    309
    Units: Number of Participants
    134
    92
    No statistical analyses for this end point

    Secondary: Number of Participants Who Discontinued Study Treatment Due to an AE

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    End point title
    Number of Participants Who Discontinued Study Treatment Due to an AE
    End point description
    The number of participants who discontinued study treatment due to an AE is presented. All randomized participants who received at least one dose of study treatment were analyzed.
    End point type
    Secondary
    End point timeframe
    Up to approximately 63 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    307
    309
    Units: Number of Participants
    126
    92
    No statistical analyses for this end point

    Secondary: Number of Participants with a 10-point Change from Baseline in Quality of Life (QoL) Based on the European Organisation for the Research & Treatment of Cancer (EORTC) QoL Questionnaire-30 (QLQ-C30) Combined Global Score

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    End point title
    Number of Participants with a 10-point Change from Baseline in Quality of Life (QoL) Based on the European Organisation for the Research & Treatment of Cancer (EORTC) QoL Questionnaire-30 (QLQ-C30) Combined Global Score
    End point description
    The EORTC QLQ-C30 is a questionnaire to assess the QoL of participants. Responses to "How would you rate your overall health during the past week?" (Item 29) & “How would you rate your overall quality of life during the past week?” (Item 30) are scored on a 7-point scale (1= Very poor to 7=Excellent). Raw scores are standardized with linear transformation from 0-100. A higher combined score indicates a better overall health status. Participant post-baseline scores were classified as "Improved": a ≥10-point improvement in score & confirmed by the next visit; "Stable": a ≥10-point increase or <10-point change in score OR a <10-point change in score & a ≥10-point increase in score at the next visit; or "Deteriorated": a ≥10-point deterioration in score when the criteria for improvement/stability weren’t met. Participants who didn’t meet the above criteria were reported as "Other". All randomized participants who received ≥1 dose of treatment & completed ≥1 EORTC QLQ-C30 were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline (Cycle 1 Day 1: Predose) and up to approximately 46 months
    End point values
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy
    Number of subjects analysed
    279
    282
    Units: Number of Participants
        Improved
    122
    86
        Stable
    106
    139
        Deteriorated
    42
    48
        Other
    9
    9
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to approximately 66 months
    Adverse event reporting additional description
    AEs included all participants who received ≥1 dose of study drug. All-Cause Mortality included all randomized participants. Per protocol, MedDRA preferred terms "Neoplasm progression", "Malignant neoplasm progression" & "Disease progression" not related to study treatment are excluded as AEs. Data are reported by treatment received.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    27.0
    Reporting groups
    Reporting group title
    Pembrolizumab+Chemotherapy
    Reporting group description
    On Day 1 of each 21-day cycle, participants received an intravenous (IV) infusion of pembrolizumab 200 mg for up to 35 cycles (up to approximately 2 years) PLUS Investigator choice of chemotherapy for up to 6 cycles (paclitaxel 175 mg/m^2 PLUS cisplatin 50 mg/m^2 WITH or WITHOUT bevacizumab 15 mg/kg per local label OR paclitaxel 175 mg/m^2 PLUS carboplatin Area Under the Curve (AUC) 5 for up to 6 cycles, WITH or WITHOUT bevacizumab 15 mg/kg per local label). All treatments were administered until disease progression or toxicity. Eligible participants who stopped the initial course of pembrolizumab with Stable Disease (SD) or better but progressed after discontinuation may have been able to initiate a second course of pembrolizumab for up to 17 cycles (up to approximately 1 additional year) at the investigator's discretion.

    Reporting group title
    Placebo+Chemotherapy
    Reporting group description
    On Day 1 of each 21-day cycle, participants received an IV infusion of placebo (Normal Saline or Dextrose solution) for up to 35 cycles (up to approximately 2 years) PLUS Investigator choice of chemotherapy for up to 6 cycles (paclitaxel 175 mg/m^2 PLUS cisplatin 50 mg/m^2 WITH or WITHOUT bevacizumab 15 mg/kg per local label OR paclitaxel 175 mg/m^2 PLUS carboplatin AUC 5 for up to 6 cycles, WITH or WITHOUT bevacizumab 15 mg/kg per local label). All treatments were administered until disease progression or toxicity.

    Reporting group title
    Pembrolizumab (Second Course)
    Reporting group description
    Eligible participants received up to 17 additional administrations (up to approximately 1 year) of pembrolizumab 200 mg IV on Day 1 of each 21-day cycle.

    Serious adverse events
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy Pembrolizumab (Second Course)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    157 / 307 (51.14%)
    132 / 309 (42.72%)
    4 / 12 (33.33%)
         number of deaths (all causes)
    195
    241
    4
         number of deaths resulting from adverse events
    16
    15
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Cancer pain
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Tumour haemorrhage
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ovarian cancer recurrent
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metastases to central nervous system
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Endometrial adenocarcinoma
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diffuse large B-cell lymphoma
         subjects affected / exposed
    0 / 307 (0.00%)
    0 / 309 (0.00%)
    1 / 12 (8.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Embolism
         subjects affected / exposed
    2 / 307 (0.65%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    Hypertension
         subjects affected / exposed
    0 / 307 (0.00%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    4 / 307 (1.30%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Shock haemorrhagic
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    Orthostatic hypotension
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypertensive urgency
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vena cava embolism
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Subclavian vein thrombosis
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Asthenia
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Death
         subjects affected / exposed
    3 / 307 (0.98%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 3
    0 / 3
    0 / 0
    Pseudocyst
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    9 / 307 (2.93%)
    5 / 309 (1.62%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 9
    1 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fatigue
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infusion site extravasation
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Malaise
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Medical device site laceration
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Hypersensitivity
         subjects affected / exposed
    1 / 307 (0.33%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Drug hypersensitivity
         subjects affected / exposed
    0 / 307 (0.00%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Contrast media allergy
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Anaphylactic shock
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Anaphylactic reaction
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Abnormal uterine bleeding
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pelvic pain
         subjects affected / exposed
    1 / 307 (0.33%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intermenstrual bleeding
         subjects affected / exposed
    2 / 307 (0.65%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Heavy menstrual bleeding
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Female genital tract fistula
         subjects affected / exposed
    8 / 307 (2.61%)
    10 / 309 (3.24%)
    1 / 12 (8.33%)
         occurrences causally related to treatment / all
    5 / 8
    4 / 10
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    Uterine haemorrhage
         subjects affected / exposed
    3 / 307 (0.98%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Vaginal fistula
         subjects affected / exposed
    1 / 307 (0.33%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vulval ulceration
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vaginal haemorrhage
         subjects affected / exposed
    5 / 307 (1.63%)
    4 / 309 (1.29%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 5
    1 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pleurisy
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Oropharyngeal pain
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    4 / 307 (1.30%)
    6 / 309 (1.94%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    2 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    Pulmonary haemorrhage
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Delirium
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Product issues
    Stent malfunction
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Device occlusion
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Device dislocation
         subjects affected / exposed
    2 / 307 (0.65%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urine output decreased
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Liver function test increased
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood pressure increased
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood alkaline phosphatase increased
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Weight decreased
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Femur fracture
         subjects affected / exposed
    1 / 307 (0.33%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cystitis radiation
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ankle fracture
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fibula fracture
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hip fracture
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Humerus fracture
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infusion related reaction
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pelvic fracture
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Post procedural urine leak
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Foot fracture
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis radiation
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal stoma complication
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Procedural pneumothorax
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Radiation proctitis
         subjects affected / exposed
    4 / 307 (1.30%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Wrist fracture
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract stoma complication
         subjects affected / exposed
    1 / 307 (0.33%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Tibia fracture
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Stoma site haemorrhage
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Congenital, familial and genetic disorders
    Pyloric stenosis
         subjects affected / exposed
    0 / 307 (0.00%)
    0 / 309 (0.00%)
    1 / 12 (8.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    4 / 307 (1.30%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bundle branch block
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Mitral valve stenosis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Stress cardiomyopathy
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myocarditis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Nervous system disorders
    Cerebral ischaemia
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Cerebellar infarction
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Idiopathic intracranial hypertension
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypoaesthesia
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hemiparesis
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Encephalitis autoimmune
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    Embolic stroke
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    3 / 307 (0.98%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Posterior reversible encephalopathy syndrome
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral sensory neuropathy
         subjects affected / exposed
    1 / 307 (0.33%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral sensorimotor neuropathy
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral motor neuropathy
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Paraesthesia
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    14 / 307 (4.56%)
    12 / 309 (3.88%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    7 / 14
    9 / 14
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bicytopenia
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lymphadenitis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Leukopenia
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    21 / 307 (6.84%)
    13 / 309 (4.21%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    25 / 25
    13 / 14
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    4 / 307 (1.30%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    4 / 5
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pancytopenia
         subjects affected / exposed
    2 / 307 (0.65%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    3 / 307 (0.98%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Eye disorders
    Optic neuropathy
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Anal haemorrhage
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Anal fistula
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal pain lower
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal pain
         subjects affected / exposed
    2 / 307 (0.65%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Anal ulcer
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    3 / 307 (0.98%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    2 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    0 / 307 (0.00%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastric haemorrhage
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Enterovesical fistula
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Enterocolitis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Duodenal perforation
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    5 / 307 (1.63%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    4 / 5
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gingival bleeding
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastritis
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastric ulcer
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ileus
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Immune-mediated enterocolitis
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    3 / 307 (0.98%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intestinal perforation
         subjects affected / exposed
    2 / 307 (0.65%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    Intestinal pseudo-obstruction
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Large intestine perforation
         subjects affected / exposed
    0 / 307 (0.00%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    Large intestinal obstruction
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    2 / 307 (0.65%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    0 / 307 (0.00%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rectal perforation
         subjects affected / exposed
    2 / 307 (0.65%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rectal haemorrhage
         subjects affected / exposed
    3 / 307 (0.98%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Proctitis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Small intestinal perforation
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Subileus
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 307 (0.00%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Volvulus
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    3 / 307 (0.98%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 3
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Hepatobiliary disease
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Drug-induced liver injury
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis acute
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Biliary obstruction
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Autoimmune hepatitis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatotoxicity
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Immune-mediated cholangitis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Immune-mediated hepatitis
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Dermatitis allergic
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Drug eruption
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rash erythematous
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rash maculo-papular
         subjects affected / exposed
    3 / 307 (0.98%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Skin ulcer
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    11 / 307 (3.58%)
    5 / 309 (1.62%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    6 / 13
    0 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bladder diverticulum
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haematuria
         subjects affected / exposed
    5 / 307 (1.63%)
    4 / 309 (1.29%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 6
    2 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nephropathy
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hydronephrosis
         subjects affected / exposed
    4 / 307 (1.30%)
    4 / 309 (1.29%)
    1 / 12 (8.33%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 4
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Postrenal failure
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract obstruction
         subjects affected / exposed
    1 / 307 (0.33%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urethral fistula
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ureteric stenosis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 307 (0.33%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinoma
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urogenital fistula
         subjects affected / exposed
    5 / 307 (1.63%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 5
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Endocrine disorders
    Hyperthyroidism
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Adrenal insufficiency
         subjects affected / exposed
    3 / 307 (0.98%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypophysitis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Pain in extremity
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Osteoporosis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myositis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myalgia
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Muscular weakness
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Back pain
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Autoimmune myositis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Abdominal sepsis
         subjects affected / exposed
    0 / 307 (0.00%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    Abdominal wall abscess
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abscess
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    COVID-19 pneumonia
         subjects affected / exposed
    1 / 307 (0.33%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    COVID-19
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 307 (0.33%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bacteraemia
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Anal abscess
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Acute hepatitis B
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cytomegalovirus infection
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cystitis
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 307 (0.33%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Empyema
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infected lymphocele
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infected fistula
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Herpes zoster meningoradiculitis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Herpes zoster
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Groin abscess
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fournier's gangrene
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peritonitis
         subjects affected / exposed
    2 / 307 (0.65%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pelvic infection
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Influenza
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 307 (0.33%)
    7 / 309 (2.27%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 7
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Psoas abscess
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary sepsis
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    Sepsis
         subjects affected / exposed
    8 / 307 (2.61%)
    5 / 309 (1.62%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    2 / 8
    1 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    Pyometra
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyelonephritis acute
         subjects affected / exposed
    2 / 307 (0.65%)
    3 / 309 (0.97%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyelonephritis
         subjects affected / exposed
    4 / 307 (1.30%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    2 / 307 (0.65%)
    4 / 309 (1.29%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    16 / 307 (5.21%)
    20 / 309 (6.47%)
    1 / 12 (8.33%)
         occurrences causally related to treatment / all
    3 / 17
    2 / 23
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Staphylococcal bacteraemia
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular device infection
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Wound infection
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hypokalaemia
         subjects affected / exposed
    2 / 307 (0.65%)
    2 / 309 (0.65%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypovolaemia
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cachexia
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Decreased appetite
         subjects affected / exposed
    0 / 307 (0.00%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diabetic ketoacidosis
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Electrolyte imbalance
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    1 / 307 (0.33%)
    1 / 309 (0.32%)
    0 / 12 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Pembrolizumab+Chemotherapy Placebo+Chemotherapy Pembrolizumab (Second Course)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    298 / 307 (97.07%)
    299 / 309 (96.76%)
    8 / 12 (66.67%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Lipoma
         subjects affected / exposed
    0 / 307 (0.00%)
    0 / 309 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    0
    1
    Vascular disorders
    Hypertension
         subjects affected / exposed
    80 / 307 (26.06%)
    71 / 309 (22.98%)
    0 / 12 (0.00%)
         occurrences all number
    117
    117
    0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    64 / 307 (20.85%)
    66 / 309 (21.36%)
    0 / 12 (0.00%)
         occurrences all number
    122
    128
    0
    Fatigue
         subjects affected / exposed
    88 / 307 (28.66%)
    85 / 309 (27.51%)
    0 / 12 (0.00%)
         occurrences all number
    148
    150
    0
    Pyrexia
         subjects affected / exposed
    51 / 307 (16.61%)
    44 / 309 (14.24%)
    0 / 12 (0.00%)
         occurrences all number
    78
    61
    0
    Oedema peripheral
         subjects affected / exposed
    32 / 307 (10.42%)
    30 / 309 (9.71%)
    0 / 12 (0.00%)
         occurrences all number
    38
    36
    0
    Mucosal inflammation
         subjects affected / exposed
    23 / 307 (7.49%)
    10 / 309 (3.24%)
    0 / 12 (0.00%)
         occurrences all number
    32
    14
    0
    Facial pain
         subjects affected / exposed
    0 / 307 (0.00%)
    0 / 309 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    0
    1
    Reproductive system and breast disorders
    Vaginal discharge
         subjects affected / exposed
    17 / 307 (5.54%)
    24 / 309 (7.77%)
    0 / 12 (0.00%)
         occurrences all number
    18
    26
    0
    Pelvic pain
         subjects affected / exposed
    16 / 307 (5.21%)
    33 / 309 (10.68%)
    0 / 12 (0.00%)
         occurrences all number
    18
    39
    0
    Vaginal haemorrhage
         subjects affected / exposed
    25 / 307 (8.14%)
    32 / 309 (10.36%)
    1 / 12 (8.33%)
         occurrences all number
    40
    40
    1
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    22 / 307 (7.17%)
    30 / 309 (9.71%)
    1 / 12 (8.33%)
         occurrences all number
    28
    34
    1
    Cough
         subjects affected / exposed
    40 / 307 (13.03%)
    32 / 309 (10.36%)
    1 / 12 (8.33%)
         occurrences all number
    48
    41
    1
    Asthma
         subjects affected / exposed
    2 / 307 (0.65%)
    0 / 309 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    2
    0
    1
    Epistaxis
         subjects affected / exposed
    31 / 307 (10.10%)
    43 / 309 (13.92%)
    1 / 12 (8.33%)
         occurrences all number
    53
    65
    1
    Oropharyngeal discomfort
         subjects affected / exposed
    0 / 307 (0.00%)
    0 / 309 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    0
    0
    1
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    34 / 307 (11.07%)
    27 / 309 (8.74%)
    2 / 12 (16.67%)
         occurrences all number
    35
    29
    2
    Anxiety
         subjects affected / exposed
    16 / 307 (5.21%)
    13 / 309 (4.21%)
    0 / 12 (0.00%)
         occurrences all number
    16
    14
    0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    45 / 307 (14.66%)
    29 / 309 (9.39%)
    3 / 12 (25.00%)
         occurrences all number
    67
    37
    3
    Aspartate aminotransferase increased
         subjects affected / exposed
    35 / 307 (11.40%)
    24 / 309 (7.77%)
    3 / 12 (25.00%)
         occurrences all number
    57
    32
    3
    Blood alkaline phosphatase increased
         subjects affected / exposed
    27 / 307 (8.79%)
    18 / 309 (5.83%)
    1 / 12 (8.33%)
         occurrences all number
    33
    20
    1
    White blood cell count decreased
         subjects affected / exposed
    37 / 307 (12.05%)
    22 / 309 (7.12%)
    1 / 12 (8.33%)
         occurrences all number
    109
    62
    1
    Weight decreased
         subjects affected / exposed
    35 / 307 (11.40%)
    37 / 309 (11.97%)
    0 / 12 (0.00%)
         occurrences all number
    35
    38
    0
    Platelet count decreased
         subjects affected / exposed
    49 / 307 (15.96%)
    42 / 309 (13.59%)
    1 / 12 (8.33%)
         occurrences all number
    99
    69
    1
    Neutrophil count decreased
         subjects affected / exposed
    56 / 307 (18.24%)
    48 / 309 (15.53%)
    0 / 12 (0.00%)
         occurrences all number
    152
    143
    0
    Blood creatinine increased
         subjects affected / exposed
    28 / 307 (9.12%)
    34 / 309 (11.00%)
    0 / 12 (0.00%)
         occurrences all number
    44
    42
    0
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    17 / 307 (5.54%)
    12 / 309 (3.88%)
    0 / 12 (0.00%)
         occurrences all number
    24
    17
    0
    Gastroenteritis radiation
         subjects affected / exposed
    8 / 307 (2.61%)
    3 / 309 (0.97%)
    1 / 12 (8.33%)
         occurrences all number
    8
    3
    1
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    22 / 307 (7.17%)
    26 / 309 (8.41%)
    0 / 12 (0.00%)
         occurrences all number
    27
    33
    0
    Dysgeusia
         subjects affected / exposed
    15 / 307 (4.89%)
    20 / 309 (6.47%)
    0 / 12 (0.00%)
         occurrences all number
    17
    24
    0
    Headache
         subjects affected / exposed
    50 / 307 (16.29%)
    57 / 309 (18.45%)
    0 / 12 (0.00%)
         occurrences all number
    76
    99
    0
    Peripheral sensory neuropathy
         subjects affected / exposed
    70 / 307 (22.80%)
    78 / 309 (25.24%)
    0 / 12 (0.00%)
         occurrences all number
    81
    89
    0
    Paraesthesia
         subjects affected / exposed
    28 / 307 (9.12%)
    26 / 309 (8.41%)
    0 / 12 (0.00%)
         occurrences all number
    38
    34
    0
    Neuropathy peripheral
         subjects affected / exposed
    81 / 307 (26.38%)
    80 / 309 (25.89%)
    0 / 12 (0.00%)
         occurrences all number
    105
    97
    0
    Migraine
         subjects affected / exposed
    2 / 307 (0.65%)
    1 / 309 (0.32%)
    1 / 12 (8.33%)
         occurrences all number
    2
    1
    1
    Blood and lymphatic system disorders
    Lymphopenia
         subjects affected / exposed
    15 / 307 (4.89%)
    7 / 309 (2.27%)
    1 / 12 (8.33%)
         occurrences all number
    29
    7
    1
    Leukopenia
         subjects affected / exposed
    40 / 307 (13.03%)
    33 / 309 (10.68%)
    2 / 12 (16.67%)
         occurrences all number
    71
    55
    2
    Anaemia
         subjects affected / exposed
    182 / 307 (59.28%)
    159 / 309 (51.46%)
    2 / 12 (16.67%)
         occurrences all number
    264
    247
    2
    Neutropenia
         subjects affected / exposed
    71 / 307 (23.13%)
    58 / 309 (18.77%)
    0 / 12 (0.00%)
         occurrences all number
    142
    115
    0
    Thrombocytopenia
         subjects affected / exposed
    60 / 307 (19.54%)
    60 / 309 (19.42%)
    0 / 12 (0.00%)
         occurrences all number
    90
    101
    0
    Ear and labyrinth disorders
    Ear discomfort
         subjects affected / exposed
    0 / 307 (0.00%)
    2 / 309 (0.65%)
    1 / 12 (8.33%)
         occurrences all number
    0
    2
    1
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    50 / 307 (16.29%)
    52 / 309 (16.83%)
    0 / 12 (0.00%)
         occurrences all number
    66
    78
    0
    Abdominal pain lower
         subjects affected / exposed
    16 / 307 (5.21%)
    12 / 309 (3.88%)
    0 / 12 (0.00%)
         occurrences all number
    18
    13
    0
    Constipation
         subjects affected / exposed
    89 / 307 (28.99%)
    101 / 309 (32.69%)
    1 / 12 (8.33%)
         occurrences all number
    143
    147
    1
    Abdominal pain upper
         subjects affected / exposed
    30 / 307 (9.77%)
    30 / 309 (9.71%)
    0 / 12 (0.00%)
         occurrences all number
    43
    41
    0
    Diarrhoea
         subjects affected / exposed
    111 / 307 (36.16%)
    93 / 309 (30.10%)
    1 / 12 (8.33%)
         occurrences all number
    203
    174
    1
    Dyspepsia
         subjects affected / exposed
    20 / 307 (6.51%)
    15 / 309 (4.85%)
    1 / 12 (8.33%)
         occurrences all number
    24
    19
    2
    Gastrooesophageal reflux disease
         subjects affected / exposed
    11 / 307 (3.58%)
    13 / 309 (4.21%)
    1 / 12 (8.33%)
         occurrences all number
    11
    14
    1
    Nausea
         subjects affected / exposed
    122 / 307 (39.74%)
    135 / 309 (43.69%)
    1 / 12 (8.33%)
         occurrences all number
    265
    287
    1
    Stomatitis
         subjects affected / exposed
    22 / 307 (7.17%)
    22 / 309 (7.12%)
    1 / 12 (8.33%)
         occurrences all number
    26
    30
    1
    Rectal haemorrhage
         subjects affected / exposed
    16 / 307 (5.21%)
    15 / 309 (4.85%)
    0 / 12 (0.00%)
         occurrences all number
    26
    20
    0
    Vomiting
         subjects affected / exposed
    81 / 307 (26.38%)
    85 / 309 (27.51%)
    1 / 12 (8.33%)
         occurrences all number
    127
    142
    1
    Cheilitis
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    1
    0
    1
    Food poisoning
         subjects affected / exposed
    1 / 307 (0.33%)
    0 / 309 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    1
    0
    1
    Colitis
         subjects affected / exposed
    10 / 307 (3.26%)
    0 / 309 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    11
    0
    1
    Skin and subcutaneous tissue disorders
    Rash maculo-papular
         subjects affected / exposed
    16 / 307 (5.21%)
    9 / 309 (2.91%)
    1 / 12 (8.33%)
         occurrences all number
    20
    13
    2
    Rash
         subjects affected / exposed
    47 / 307 (15.31%)
    36 / 309 (11.65%)
    2 / 12 (16.67%)
         occurrences all number
    66
    48
    2
    Pruritus
         subjects affected / exposed
    40 / 307 (13.03%)
    26 / 309 (8.41%)
    0 / 12 (0.00%)
         occurrences all number
    58
    39
    0
    Dry skin
         subjects affected / exposed
    18 / 307 (5.86%)
    9 / 309 (2.91%)
    0 / 12 (0.00%)
         occurrences all number
    18
    10
    0
    Alopecia
         subjects affected / exposed
    173 / 307 (56.35%)
    179 / 309 (57.93%)
    0 / 12 (0.00%)
         occurrences all number
    173
    181
    0
    Dermatitis
         subjects affected / exposed
    5 / 307 (1.63%)
    6 / 309 (1.94%)
    1 / 12 (8.33%)
         occurrences all number
    8
    7
    1
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    22 / 307 (7.17%)
    23 / 309 (7.44%)
    0 / 12 (0.00%)
         occurrences all number
    27
    29
    0
    Incontinence
         subjects affected / exposed
    3 / 307 (0.98%)
    0 / 309 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    4
    0
    1
    Leukocyturia
         subjects affected / exposed
    5 / 307 (1.63%)
    1 / 309 (0.32%)
    2 / 12 (16.67%)
         occurrences all number
    8
    1
    2
    Proteinuria
         subjects affected / exposed
    54 / 307 (17.59%)
    33 / 309 (10.68%)
    0 / 12 (0.00%)
         occurrences all number
    87
    52
    0
    Haematuria
         subjects affected / exposed
    20 / 307 (6.51%)
    15 / 309 (4.85%)
    0 / 12 (0.00%)
         occurrences all number
    25
    20
    0
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    59 / 307 (19.22%)
    31 / 309 (10.03%)
    0 / 12 (0.00%)
         occurrences all number
    65
    33
    0
    Hyperthyroidism
         subjects affected / exposed
    24 / 307 (7.82%)
    9 / 309 (2.91%)
    0 / 12 (0.00%)
         occurrences all number
    26
    10
    0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    82 / 307 (26.71%)
    78 / 309 (25.24%)
    0 / 12 (0.00%)
         occurrences all number
    128
    126
    0
    Back pain
         subjects affected / exposed
    44 / 307 (14.33%)
    48 / 309 (15.53%)
    0 / 12 (0.00%)
         occurrences all number
    55
    64
    0
    Bone pain
         subjects affected / exposed
    21 / 307 (6.84%)
    18 / 309 (5.83%)
    0 / 12 (0.00%)
         occurrences all number
    22
    22
    0
    Myalgia
         subjects affected / exposed
    57 / 307 (18.57%)
    61 / 309 (19.74%)
    1 / 12 (8.33%)
         occurrences all number
    98
    115
    1
    Pain in extremity
         subjects affected / exposed
    38 / 307 (12.38%)
    27 / 309 (8.74%)
    0 / 12 (0.00%)
         occurrences all number
    60
    52
    0
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    67 / 307 (21.82%)
    74 / 309 (23.95%)
    0 / 12 (0.00%)
         occurrences all number
    123
    111
    0
    Upper respiratory tract infection
         subjects affected / exposed
    13 / 307 (4.23%)
    16 / 309 (5.18%)
    0 / 12 (0.00%)
         occurrences all number
    19
    21
    0
    Nasopharyngitis
         subjects affected / exposed
    20 / 307 (6.51%)
    11 / 309 (3.56%)
    1 / 12 (8.33%)
         occurrences all number
    26
    13
    1
    Influenza
         subjects affected / exposed
    3 / 307 (0.98%)
    13 / 309 (4.21%)
    1 / 12 (8.33%)
         occurrences all number
    3
    14
    1
    Metabolism and nutrition disorders
    Hypoalbuminaemia
         subjects affected / exposed
    18 / 307 (5.86%)
    11 / 309 (3.56%)
    1 / 12 (8.33%)
         occurrences all number
    19
    11
    1
    Hyperglycaemia
         subjects affected / exposed
    13 / 307 (4.23%)
    19 / 309 (6.15%)
    1 / 12 (8.33%)
         occurrences all number
    19
    28
    1
    Hypokalaemia
         subjects affected / exposed
    30 / 307 (9.77%)
    29 / 309 (9.39%)
    1 / 12 (8.33%)
         occurrences all number
    43
    34
    1
    Decreased appetite
         subjects affected / exposed
    62 / 307 (20.20%)
    52 / 309 (16.83%)
    1 / 12 (8.33%)
         occurrences all number
    97
    77
    1
    Hypomagnesaemia
         subjects affected / exposed
    27 / 307 (8.79%)
    19 / 309 (6.15%)
    0 / 12 (0.00%)
         occurrences all number
    38
    31
    0
    Hyponatraemia
         subjects affected / exposed
    21 / 307 (6.84%)
    15 / 309 (4.85%)
    0 / 12 (0.00%)
         occurrences all number
    27
    16
    0
    Hypoproteinaemia
         subjects affected / exposed
    3 / 307 (0.98%)
    0 / 309 (0.00%)
    1 / 12 (8.33%)
         occurrences all number
    4
    0
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    18 Jul 2019
    Amendment 2: The purpose of this amendment was to clarify the stratification factors and treatment duration of the study.
    25 Feb 2020
    Amendment 3: The purpose of this amendment was to modify objectives and hypotheses with an updated multiplicity strategy based on updated results.
    20 May 2020
    Amendment 4: The purpose of this amendment was to modify objectives and hypotheses with an updated multiplicity strategy based on updated results.
    01 Dec 2020
    Amendment 5: The purpose of this amendment was to modify objectives including primary efficacy endpoints.
    21 Jul 2021
    Amendment 6: The purpose of this amendment was to update the dose modification and toxicity management guidelines for immune-related adverse events (irAEs).
    01 Feb 2022
    Amendment 7: The purpose of this amendment was to state that the preplanned second interim analysis (IA2) will not be performed.
    12 Jul 2022
    Amendment 8: The purpose of this amendment was to update the Sponsor name.

    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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    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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