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    Clinical Trial Results:
    A Phase 3, Open Label, Randomized, Non-Inferiority Pharmacokinetic Study of Nivolumab Subcutaneous (Nivo SC) Versus Intravenous (Nivo IV) Administration in Participants with Stage IIIA/B/C/D or Stage IV Adjuvant Melanoma Following Complete Resection

    Summary
    EudraCT number
    2021-003208-42
    Trial protocol
    ES   BE   PL   DE   IT  
    Global end of trial date
    08 Feb 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Feb 2025
    First version publication date
    22 Feb 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CA209-6GE
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Bristol-Myers Squibb
    Sponsor organisation address
    Chaussée de la Hulpe 185, Brussels, Belgium, 1170
    Public contact
    EU Study Start-Up Unit, Bristol-Myers Squibb International Corporation, Clinical.Trials@bms.com
    Scientific contact
    Bristol-Myers Squibb Study Director, Bristol-Myers Squibb, Clinical.Trials@bms.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
    08 Feb 2024
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    08 Feb 2024
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To assess the safety and tolerability of nivolumab SC co-formulated with rHuPH20 and nivolumab IV
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and in compliance with all International Conference on Harmonization Good Clinical Practice Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were followed.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Apr 2022
    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
    Spain: 10
    Country: Number of subjects enrolled
    Italy: 1
    Country: Number of subjects enrolled
    Belgium: 1
    Country: Number of subjects enrolled
    United States: 2
    Worldwide total number of subjects
    14
    EEA total number of subjects
    12
    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)
    12
    From 65 to 84 years
    2
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    14 participants were randomized and treated

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Arm A
    Arm description
    Nivo SC (BMS-986298) 600 mg with 8,000 U of rHuPH20 administered via 2 sequential injections Q2W. Nivo SC will be administered in-clinic through cycle 5, Day 1.
    Arm type
    Experimental

    Investigational medicinal product name
    nivolumab/rHuPH20
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    150 mg/mL/2,000 U/mL Nivolumab/rHuPH20

    Arm title
    Arm B
    Arm description
    -Nivo IV (BMS-936558) 240 mg Q2W for Cycles 1 through 4. -Nivo IV 480 mg Q4W Cycle 5 onwards for up to total of 52 weeks. -All dosing will be performed in-clinic.
    Arm type
    Experimental

    Investigational medicinal product name
    nivolumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravascular use
    Dosage and administration details
    10mg/mL

    Number of subjects in period 1
    Arm A Arm B
    Started
    6
    8
    Completed
    5
    6
    Not completed
    1
    2
         Physician decision
    -
    1
         Disease recurrence
    1
    -
         other reasons
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Arm A
    Reporting group description
    Nivo SC (BMS-986298) 600 mg with 8,000 U of rHuPH20 administered via 2 sequential injections Q2W. Nivo SC will be administered in-clinic through cycle 5, Day 1.

    Reporting group title
    Arm B
    Reporting group description
    -Nivo IV (BMS-936558) 240 mg Q2W for Cycles 1 through 4. -Nivo IV 480 mg Q4W Cycle 5 onwards for up to total of 52 weeks. -All dosing will be performed in-clinic.

    Reporting group values
    Arm A Arm B Total
    Number of subjects
    6 8 14
    Age Categorical
    Units: Participants
        <=18 years
    0 0 0
        Between 18 and 65 years
    5 7 12
        >=65 years
    1 1 2
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    55.2 ( 11.51 ) 55.4 ( 11.11 ) -
    Sex: Female, Male
    Units: Participants
        Female
    3 5 8
        Male
    3 3 6
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0 0
        Asian
    0 0 0
        Native Hawaiian or Other Pacific Islander
    0 0 0
        Black or African American
    0 0 0
        White
    6 8 14
        More than one race
    0 0 0
        Unknown or Not Reported
    0 0 0
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    0 0 0
        Not Hispanic or Latino
    6 8 14
        Unknown or Not Reported
    0 0 0

    End points

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    End points reporting groups
    Reporting group title
    Arm A
    Reporting group description
    Nivo SC (BMS-986298) 600 mg with 8,000 U of rHuPH20 administered via 2 sequential injections Q2W. Nivo SC will be administered in-clinic through cycle 5, Day 1.

    Reporting group title
    Arm B
    Reporting group description
    -Nivo IV (BMS-936558) 240 mg Q2W for Cycles 1 through 4. -Nivo IV 480 mg Q4W Cycle 5 onwards for up to total of 52 weeks. -All dosing will be performed in-clinic.

    Primary: Number of Participants with Adverse Events

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    End point title
    Number of Participants with Adverse Events [1]
    End point description
    An adverse event (AE) is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in a clinical investigation participant administered study treatment that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory finding), symptom, or disease temporally associated with the use of study treatment, whether or not considered related to the study treatment.
    End point type
    Primary
    End point timeframe
    From first dose to 100 days post last dose (Approximately up to 14 Months)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis done for this endpoint
    End point values
    Arm A Arm B
    Number of subjects analysed
    6
    8
    Units: Participants
        Any Grade
    6
    8
        Grade 3 to 4
    0
    2
        Grade 5
    0
    0
    No statistical analyses for this end point

    Primary: Number of Participants with Serious Adverse Events

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    End point title
    Number of Participants with Serious Adverse Events [2]
    End point description
    A serious adverse event (SAE) is defined as any untoward medical occurrence that, at any dose: - Results in death. - Is life-threatening (defined as an event in which the participant was at risk of death at the time of the event; it does not refer to an event which hypothetically might have caused death if it were more severe). - Requires inpatient hospitalization or causes prolongation of existing hospitalization.
    End point type
    Primary
    End point timeframe
    From first dose to 100 days post last dose (Approximately up to 14 Months)
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis done for this endpoint
    End point values
    Arm A Arm B
    Number of subjects analysed
    6
    8
    Units: Participants
        Any Grade
    0
    0
        Grade 3 to 4
    0
    0
        Grade 5
    0
    0
    No statistical analyses for this end point

    Primary: Number of Participants with Treatment Related Adverse Events

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    End point title
    Number of Participants with Treatment Related Adverse Events [3]
    End point description
    An adverse event (AE) is defined as any new untoward medical occurrence or worsening of a pre-existing medical condition in a clinical investigation participant administered study treatment. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory finding), symptom or disease.
    End point type
    Primary
    End point timeframe
    From first dose to 100 days post last dose (Approximately up to 14 Months)
    Notes
    [3] - 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 analysis done for this endpoint
    End point values
    Arm A Arm B
    Number of subjects analysed
    6
    8
    Units: Participants
        Any Grade
    6
    8
        Grade 3 to 4
    0
    2
        Grade 5
    0
    0
    No statistical analyses for this end point

    Primary: Number of Participants with Treatment Related Serious Adverse Events

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    End point title
    Number of Participants with Treatment Related Serious Adverse Events [4]
    End point description
    A serious adverse event (SAE) is defined as any untoward medical occurrence that, at any dose: - Results in death. - Is life-threatening (defined as an event in which the participant was at risk of death at the time of the event; it does not refer to an event which hypothetically might have caused death if it were more severe). - Requires inpatient hospitalization or causes prolongation of existing hospitalization.
    End point type
    Primary
    End point timeframe
    From first dose to 100 days post last dose (Approximately up to 14 Months)
    Notes
    [4] - 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 analysis done for this endpoint
    End point values
    Arm A Arm B
    Number of subjects analysed
    6
    8
    Units: Participants
        Any Grade
    0
    0
        Grade 3 to 4
    0
    0
        Grade 5
    0
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse Events and Serious Adverse Events: (From first dose to last dose + 100 days): Approximately 14 Months All-Cause mortality (From randomization to end of study): Approximately 14 Months
    Adverse event reporting additional description
    The number at Risk for All-Cause Mortality represents all Randomized Participants. The number at Risk for Serious Adverse Events and Other (Not Including Serious) Adverse Events represents all participants that received at least 1 dose of study medication
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    26.1
    Reporting groups
    Reporting group title
    Arm A
    Reporting group description
    Nivo SC (BMS-986298) 600 mg with 8,000 U of rHuPH20 administered via 2 sequential injections Q2W. Nivo SC will be administered in-clinic through cycle 5, Day 1.

    Reporting group title
    Arm B
    Reporting group description
    -Nivo IV (BMS-936558) 240 mg Q2W for Cycles 1 through 4. -Nivo IV 480 mg Q4W Cycle 5 onwards for up to total of 52 weeks. -All dosing will be performed in-clinic.

    Serious adverse events
    Arm A Arm B
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 8 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Arm A Arm B
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    6 / 6 (100.00%)
    8 / 8 (100.00%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    0 / 6 (0.00%)
    4 / 8 (50.00%)
         occurrences all number
    0
    4
    Lymphoedema
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    General disorders and administration site conditions
    Puncture site erythema
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Administration site reaction
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    2
    0
    Asthenia
         subjects affected / exposed
    4 / 6 (66.67%)
    1 / 8 (12.50%)
         occurrences all number
    6
    1
    Device related thrombosis
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Fatigue
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Impaired healing
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Injection site pain
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Mucosal inflammation
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Puncture site inflammation
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Puncture site pain
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Puncture site pruritus
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Pyrexia
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    2
    Reproductive system and breast disorders
    Menstrual disorder
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Respiratory, thoracic and mediastinal disorders
    Catarrh
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Cough
         subjects affected / exposed
    3 / 6 (50.00%)
    1 / 8 (12.50%)
         occurrences all number
    3
    1
    Dyspnoea
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Productive cough
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Throat irritation
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    0 / 6 (0.00%)
    3 / 8 (37.50%)
         occurrences all number
    0
    3
    Insomnia
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Investigations
    Blood bilirubin increased
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Blood glucose increased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Haemoglobin decreased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Lipase increased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Platelet count decreased
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Injury, poisoning and procedural complications
    Multiple injuries
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Skin laceration
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 8 (12.50%)
         occurrences all number
    1
    1
    Headache
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 8 (12.50%)
         occurrences all number
    1
    2
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Gastrointestinal disorders
    Abdominal discomfort
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Colitis
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Diarrhoea
         subjects affected / exposed
    3 / 6 (50.00%)
    1 / 8 (12.50%)
         occurrences all number
    4
    1
    Dry mouth
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 8 (25.00%)
         occurrences all number
    1
    2
    Dyspepsia
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Gastrointestinal toxicity
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Nausea
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 8 (12.50%)
         occurrences all number
    15
    1
    Tongue pruritus
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Skin and subcutaneous tissue disorders
    Rash maculo-papular
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 8 (25.00%)
         occurrences all number
    0
    3
    Drug eruption
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Ecchymosis
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Eczema nummular
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Erythema
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 8 (12.50%)
         occurrences all number
    2
    1
    Pruritus
         subjects affected / exposed
    2 / 6 (33.33%)
    2 / 8 (25.00%)
         occurrences all number
    4
    2
    Rash
         subjects affected / exposed
    0 / 6 (0.00%)
    2 / 8 (25.00%)
         occurrences all number
    0
    2
    Renal and urinary disorders
    Renal colic
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 8 (12.50%)
         occurrences all number
    1
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 8 (12.50%)
         occurrences all number
    1
    1
    Groin pain
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Muscle contracture
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Musculoskeletal stiffness
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Infections and infestations
    Anal abscess
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Body tinea
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Bronchiolitis
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    COVID-19
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Conjunctivitis
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Diverticulitis
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Gastrointestinal viral infection
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Influenza
         subjects affected / exposed
    1 / 6 (16.67%)
    2 / 8 (25.00%)
         occurrences all number
    1
    2
    Nasopharyngitis
         subjects affected / exposed
    2 / 6 (33.33%)
    1 / 8 (12.50%)
         occurrences all number
    2
    1
    Oral herpes
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Sinusitis
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Urinary tract infection
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 8 (0.00%)
         occurrences all number
    1
    0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    1
    Hypokalaemia
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 8 (12.50%)
         occurrences all number
    0
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    25 May 2023
     Bristol-Myers Squibb has made a strategic decision to terminate the CA2096GE trial. This decision was not related to any safety concerns. Study recruitment has closed and treatment of ongoing, active participants will continue per Protocol Amendment 01. Changes implemented in this amendment aim to alleviate participant and site burden and include updates to sample collection, study procedures, and study design.  Pharmacokinetic (PK) co-primary endpoints, and secondary endpoints have been removed. Efficacy, patient-reported outcomes (PROs), and biomarker analyses will not be completed. Samples already collected for PK and immunogenicity assessments will be analyzed bioanalytically for nivolumab concentrations and anti-drug antibodies (ADAs) and reported as listings. Further collections for PK, ADAs, biomarkers, and PROs will be discontinued. Only safety assessments will be conducted.  Part 2 was removed (Part 2 was scheduled to start when 90% of participants in Part 1 were enrolled).  Balanced the frequency of clinic visits between treatment arms.

    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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