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    Clinical Trial Results:
    A PHASE 2, OPEN-LABEL, SINGLE-ARM TRIAL OF TRASTUZUMAB DERUXTECAN (DS-8201A) IN HER2-POSITIVE, UNRESECTABLE OR METASTATIC GASTRIC OR GASTROESOPHAGEAL JUNCTION (GEJ) ADENOCARCINOMA SUBJECTS WHO HAVE PROGRESSED ON OR AFTER A TRASTUZUMAB-CONTAINING REGIMEN

    Summary
    EudraCT number
    2019-001512-34
    Trial protocol
    ES   BE   IT  
    Global end of trial date

    Results information
    Results version number
    v1
    This version publication date
    01 Mar 2022
    First version publication date
    01 Mar 2022
    Other versions
    v2

    Trial information

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    Trial identification
    Sponsor protocol code
    DS8201-A-U205
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04014075
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Daiichi Sankyo Inc.
    Sponsor organisation address
    211 Mt. Airy Rd., Basking Ridge, United States, 07920
    Public contact
    Global Clinical Director, Daiichi Sankyo Inc., +1 908-992-6400, CTRinfo@dsi.com
    Scientific contact
    Global Clinical Director, Daiichi Sankyo Inc., +1 908-992-6400, CTRinfo@dsi.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
    Interim
    Date of interim/final analysis
    09 Apr 2021
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    09 Apr 2021
    Global end of trial reached?
    No
    General information about the trial
    Main objective of the trial
    To investigate the efficacy of Trastuzumab Deruxtecan (DS-8201a) based on objective response rate (ORR) by independent central review based on Response Evaluation Criteria in Solid Tumors (RECIST), version (v)1.1
    Protection of trial subjects
    The study protocol, amendments, the informed consent form(s) (ICF[s]), and information sheets were approved by the appropriate and applicable Independent Ethics Committees (IECs) or Institutional Review Boards (IRBs). The study was conducted in compliance with the protocol, the ethical principles that have their origin in the Declaration of Helsinki, the International Council for Harmonisation (ICH) consolidated Guideline E6 for Good Clinical Practice (GCP) (CPMP/ICH/135/95), and applicable regulatory requirement(s).
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    26 Nov 2019
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United States: 34
    Country: Number of subjects enrolled
    European Union: 45
    Worldwide total number of subjects
    79
    EEA total number of subjects
    0
    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)
    46
    From 65 to 84 years
    33
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    A total of 79 participants who met all inclusion criteria and no exclusion criteria were enrolled and treated at clinic centers in United States, Spain, Italy, United Kingdom, and Belgium. Primary results reported is from baseline up to data cut-off date of 09 April 2021.

    Pre-assignment
    Screening details
    A total of 89 participants were screened and 10 participants failed screening. The results presented are based on primary analysis up to 16 months. Data collection is still on-going and additional results will be provided after study completion.

    Period 1
    Period 1 title
    Overall (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    This was an open-label study.

    Arms
    Arm title
    Trastuzumab Deruxtecan
    Arm description
    Participants who have centrally confirmed HER2-positive gastric or gastro-esophageal junction cancer received an intravenous (IV) infusion 6.4 mg/kg dose of trastuzumab deruxtecan every 3 weeks, until progression of disease or withdrawal from treatment for other reasons.
    Arm type
    Experimental

    Investigational medicinal product name
    DS-8201a
    Investigational medicinal product code
    Other name
    Trastuzumab deruxtecan
    Pharmaceutical forms
    Powder for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Antibody component covalently conjugated to a drug component, prepared by dilution based on body weight for intravenous (IV) infusion.

    Number of subjects in period 1
    Trastuzumab Deruxtecan
    Started
    79
    Completed
    23
    Not completed
    56
         Physician decision
    1
         Adverse event, non-fatal
    9
         Death
    2
         Progressive Disease
    39
         Miscellaneous
    1
         Withdrawal by Subject
    2
         Clinical Progression
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall
    Reporting group description
    -

    Reporting group values
    Overall Total
    Number of subjects
    79 79
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    46 46
        From 65-84 years
    33 33
        85 years and over
    0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    59.3 ( 11.8 ) -
    Gender categorical
    Units: Subjects
        Female
    22 22
        Male
    57 57

    End points

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    End points reporting groups
    Reporting group title
    Trastuzumab Deruxtecan
    Reporting group description
    Participants who have centrally confirmed HER2-positive gastric or gastro-esophageal junction cancer received an intravenous (IV) infusion 6.4 mg/kg dose of trastuzumab deruxtecan every 3 weeks, until progression of disease or withdrawal from treatment for other reasons.

    Primary: Percentage of Participants With Objective Response Rate (ORR) Based on Independent Central Review Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma

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    End point title
    Percentage of Participants With Objective Response Rate (ORR) Based on Independent Central Review Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma [1]
    End point description
    The Objective Response Rate (ORR) was the defined as the percentage of participants who achieved a best overall response of confirmed Complete Response (CR) or Partial Response (PR), assessed by independent central review (ICR) committee based on RECIST version 1.1. CR was defined as a disappearance of all target lesions and PR was defined as at least a 30% decrease in the sum of diameters of target lesions. Confirmed ORR based on ICR is reported. Objective response rate was assessed in the Full Analysis Set at data cut-off date of 09 April 2021.
    End point type
    Primary
    End point timeframe
    Up to 16 months (data cut-off)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analyses was performed.
    End point values
    Trastuzumab Deruxtecan
    Number of subjects analysed
    79
    Units: Percentage of Participants
        number (confidence interval 95%)
    38.0 (27.3 to 49.6)
    No statistical analyses for this end point

    Secondary: Progression-Free Survival (PFS) Based on Independent Central Review Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma

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    End point title
    Progression-Free Survival (PFS) Based on Independent Central Review Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma
    End point description
    Progression-free survival (PFS) by independent central review was defined as the time from the date of enrollment to the earlier of the dates of the first objective documentation of disease progression (as per RECIST v1.1) or death due to any cause. Progressive disease was defined as at least a 20% increase in the sum of diameters of target lesions. Progression-free survival (PFS) was assessed in the Full Analysis Set at data cut-off date of 09 April 2021.
    End point type
    Secondary
    End point timeframe
    Up to 16 months (data cut-off)
    End point values
    Trastuzumab Deruxtecan
    Number of subjects analysed
    79
    Units: months
        median (confidence interval 95%)
    5.5 (4.2 to 7.3)
    No statistical analyses for this end point

    Secondary: Progression-Free Survival (PFS) Based on Investigator Assessment Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma

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    End point title
    Progression-Free Survival (PFS) Based on Investigator Assessment Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma
    End point description
    Progression-free survival (PFS) by investigator assessment was defined as the time from the date of enrollment to the earlier of the dates of the first objective documentation of disease progression (as per RECIST v1.1) or death due to any cause. Progressive disease was defined as at least a 20% increase in the sum of diameters of target lesions. Progression-free survival (PFS) was assessed in the Full Analysis Set at data cut-off date of 09 April 2021.
    End point type
    Secondary
    End point timeframe
    Up to 16 months (data cut-off)
    End point values
    Trastuzumab Deruxtecan
    Number of subjects analysed
    79
    Units: months
        median (confidence interval 95%)
    5.5 (4.1 to 6.9)
    No statistical analyses for this end point

    Secondary: Objective Response Rate (ORR) Based on Investigator Assessment Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma

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    End point title
    Objective Response Rate (ORR) Based on Investigator Assessment Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma
    End point description
    The Objective Response Rate (ORR) was defined as the percentage of participants who achieved a best overall response of confirmed Complete Response (CR) or Partial Response (PR), assessed by investigator assessment based on RECIST version 1.1. CR was defined as a disappearance of all target lesions and PR was defined as at least a 30% decrease in the sum of diameters of target lesions. Confirmed ORR based on investigator assessment is reported. Objective response rate was assessed in the Full Analysis Set at data cut-off date of 09 April 2021.
    End point type
    Secondary
    End point timeframe
    Up to 16 months (data cut-off)
    End point values
    Trastuzumab Deruxtecan
    Number of subjects analysed
    79
    Units: Percentage of Participants
        number (confidence interval 95%)
    34.2 (23.9 to 45.7)
    No statistical analyses for this end point

    Secondary: Overall Survival (OS) Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma

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    End point title
    Overall Survival (OS) Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma
    End point description
    Overall survival (OS) was defined as the time from the date of first dose of study drug to the date of death due to any cause. Overall survival (OS) was assessed in the Full Analysis Set at data cut-off date of 09 April 2021.
    End point type
    Secondary
    End point timeframe
    Up to 16 months (data cut-off)
    End point values
    Trastuzumab Deruxtecan
    Number of subjects analysed
    79 [2]
    Units: months
        median (confidence interval 95%)
    99.9 (11.5 to 99.9)
    Notes
    [2] - 99.9=NA, media OS and upper 95% CI was not estimable due to insufficient number of OS events
    No statistical analyses for this end point

    Secondary: Duration of Response (DoR) Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma

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    End point title
    Duration of Response (DoR) Following Treatment With DS8201a in Participants With HER2-Positive Unresectable or Metastatic Gastric or Gastro-Esophageal Junction (GEJ) Adenocarcinoma
    End point description
    Duration of Response (DOR) was defined as the time from the date of the first documentation of objective response (complete response [CR] or partial response [PR]) to the date of the first objective documentation of progressive disease (PD) or death due to any cause. DoR based on independent central review. Duration of Response (DOR) was assessed in the Full Analysis Set at data cut-off date of 09 April 2021.
    End point type
    Secondary
    End point timeframe
    Up to 16 months (data cut-off)
    End point values
    Trastuzumab Deruxtecan
    Number of subjects analysed
    79 [3]
    Units: months
        median (confidence interval 95%)
    8.1 (4.1 to 99.9)
    Notes
    [3] - 99.9=NA, upper 95% CI was not estimable, curve representing upper CI for survivor function > 0.5
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events (AE) were collected from the date of signing the informed consent form up to 47 days after last dose of the study drug, up 17 months.
    Adverse event reporting additional description
    A Treatment-emergent adverse event (TEAE) is defined as an AE that occurs, having been absent before the first dose of study drug, or has worsened in severity or seriousness after the initiating the study drug until 47 days after last dose of the study drug.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    23
    Reporting groups
    Reporting group title
    Trastuzumab Deruxtecan
    Reporting group description
    Participants who have centrally confirmed HER2-positive gastric or gastro-esophageal junction cancer received an intravenous (IV) infusion 6.4 mg/kg dose of trastuzumab deruxtecan every 3 weeks, until progression of disease or withdrawal from treatment for other reasons.

    Serious adverse events
    Trastuzumab Deruxtecan
    Total subjects affected by serious adverse events
         subjects affected / exposed
    29 / 79 (36.71%)
         number of deaths (all causes)
    22
         number of deaths resulting from adverse events
    10
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Malignant Neoplasm Progression
         subjects affected / exposed
    2 / 79 (2.53%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Lymphangiosis Carcinomatosa
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Tumour Haemorrhage
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Animal Bite
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Exposure To Communicable Disease
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Basal Ganglia Infarction
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cerebrovascular Accident
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Generalised Tonic-Clonic Seizure
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Disease Progression
         subjects affected / exposed
    2 / 79 (2.53%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Hyperpyrexia
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    4 / 79 (5.06%)
         occurrences causally related to treatment / all
    2 / 4
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    3 / 79 (3.80%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    2 / 79 (2.53%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dysphagia
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Enteritis
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Haematemesis
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intestinal Obstruction
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Hepatobiliary disorders
    Bile Duct Stenosis
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatotoxicity
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Interstitial Lung Disease
         subjects affected / exposed
    2 / 79 (2.53%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    1 / 1
    Pneumonitis
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary Embolism
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute Kidney Injury
         subjects affected / exposed
    2 / 79 (2.53%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Hydronephrosis
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary Tract Obstruction
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Covid-19
         subjects affected / exposed
    2 / 79 (2.53%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Pneumonia
         subjects affected / exposed
    2 / 79 (2.53%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Bacterial Sepsis
         subjects affected / exposed
    2 / 79 (2.53%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Covid-19 Pneumonia
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Device Related Infection
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Staphylococcal infection
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Wound Infection
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Product issues
    Device Occlusion
         subjects affected / exposed
    1 / 79 (1.27%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Trastuzumab Deruxtecan
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    79 / 79 (100.00%)
    Vascular disorders
    Hypotension
         subjects affected / exposed
    4 / 79 (5.06%)
         occurrences all number
    4
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    32 / 79 (40.51%)
         occurrences all number
    32
    Asthenia
         subjects affected / exposed
    12 / 79 (15.19%)
         occurrences all number
    12
    Pyrexia
         subjects affected / exposed
    8 / 79 (10.13%)
         occurrences all number
    8
    Oedema Peripheral
         subjects affected / exposed
    4 / 79 (5.06%)
         occurrences all number
    4
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    7 / 79 (8.86%)
         occurrences all number
    7
    Cough
         subjects affected / exposed
    6 / 79 (7.59%)
         occurrences all number
    6
    Epistaxis
         subjects affected / exposed
    6 / 79 (7.59%)
         occurrences all number
    6
    Interstitial Lung Disease
         subjects affected / exposed
    4 / 79 (5.06%)
         occurrences all number
    4
    Pneumonitis
         subjects affected / exposed
    4 / 79 (5.06%)
         occurrences all number
    4
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    5 / 79 (6.33%)
         occurrences all number
    5
    Depression
         subjects affected / exposed
    4 / 79 (5.06%)
         occurrences all number
    4
    Investigations
    Weight Decreased
         subjects affected / exposed
    27 / 79 (34.18%)
         occurrences all number
    27
    Platelet Count Decreased
         subjects affected / exposed
    13 / 79 (16.46%)
         occurrences all number
    13
    Neutrophil Count Decreased
         subjects affected / exposed
    12 / 79 (15.19%)
         occurrences all number
    12
    Aspartate Aminotransferase Increased
         subjects affected / exposed
    9 / 79 (11.39%)
         occurrences all number
    9
    White Blood Cell Count Decreased
         subjects affected / exposed
    7 / 79 (8.86%)
         occurrences all number
    7
    Alanine Aminotransferase Increased
         subjects affected / exposed
    6 / 79 (7.59%)
         occurrences all number
    6
    Blood Alkaline Phosphatase Increased
         subjects affected / exposed
    6 / 79 (7.59%)
         occurrences all number
    6
    Blood Bilirubin Increased
         subjects affected / exposed
    4 / 79 (5.06%)
         occurrences all number
    4
    Nervous system disorders
    Headache
         subjects affected / exposed
    6 / 79 (7.59%)
         occurrences all number
    6
    Dizziness
         subjects affected / exposed
    5 / 79 (6.33%)
         occurrences all number
    5
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    27 / 79 (34.18%)
         occurrences all number
    27
    Neutropenia
         subjects affected / exposed
    8 / 79 (10.13%)
         occurrences all number
    8
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    52 / 79 (65.82%)
         occurrences all number
    52
    Vomiting
         subjects affected / exposed
    33 / 79 (41.77%)
         occurrences all number
    33
    Diarrhoea
         subjects affected / exposed
    27 / 79 (34.18%)
         occurrences all number
    27
    Constipation
         subjects affected / exposed
    21 / 79 (26.58%)
         occurrences all number
    21
    Abdominal Pain
         subjects affected / exposed
    13 / 79 (16.46%)
         occurrences all number
    13
    Gastrooesophageal Reflux Disease
         subjects affected / exposed
    8 / 79 (10.13%)
         occurrences all number
    8
    Ascites
         subjects affected / exposed
    5 / 79 (6.33%)
         occurrences all number
    5
    Dysphagia
         subjects affected / exposed
    5 / 79 (6.33%)
         occurrences all number
    5
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    19 / 79 (24.05%)
         occurrences all number
    19
    Renal and urinary disorders
    Urinary Retention
         subjects affected / exposed
    5 / 79 (6.33%)
         occurrences all number
    5
    Acute Kidney Injury
         subjects affected / exposed
    4 / 79 (5.06%)
         occurrences all number
    4
    Musculoskeletal and connective tissue disorders
    Back Pain
         subjects affected / exposed
    7 / 79 (8.86%)
         occurrences all number
    7
    Infections and infestations
    Covid-19
         subjects affected / exposed
    4 / 79 (5.06%)
         occurrences all number
    4
    Device Related Infection
         subjects affected / exposed
    4 / 79 (5.06%)
         occurrences all number
    4
    Metabolism and nutrition disorders
    Decreased Appetite
         subjects affected / exposed
    26 / 79 (32.91%)
         occurrences all number
    26
    Hypokalaemia
         subjects affected / exposed
    12 / 79 (15.19%)
         occurrences all number
    12
    Hypoalbuminaemia
         subjects affected / exposed
    6 / 79 (7.59%)
         occurrences all number
    6
    Hyponatraemia
         subjects affected / exposed
    6 / 79 (7.59%)
         occurrences all number
    6
    Hypophosphataemia
         subjects affected / exposed
    4 / 79 (5.06%)
         occurrences all number
    4

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    17 Sep 2020
    Updated endpoints to provide clarification, updated study schema, updated inclusion and exclusion criteria, updated guidelines for dose modifications, updated concomitant medications, treatments, and procedures, updated treatment period section, updated PK assessments due to COVID-19 infection, updated PK, biomarker, and AE analyses to provide clarification, added instructions related to COVID-19

    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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