| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
| Patients with newly diagnosed metastatic pancreatic cancer  | 
 
 
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| E.1.1.1 | Medical condition in easily understood language  | 
| Patients with newly diagnosed metastatic pancreatic cancer  | 
 
 
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| E.1.1.2 | Therapeutic area  | Diseases [C] - Cancer [C04] | 
| MedDRA Classification | 
| E.1.3 | Condition being studied is a rare disease  |  No  | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial  | 
| We aim to test the feasibility of Methimazole at a starting dose of 5 mg/day in patients with advanced pancreatic cancer  | 
 
 
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| E.2.2 | Secondary objectives of the trial  | 
| We aim to test the effects of pharmacologically induced subclinical hypothyroidism on cancer progression compared to a retrospective control group matched for sex, age, cancer entity, stage of disease and chemotherapy regimens.  | 
 
 
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| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
•	> 18 years •	Histologically proven malignancy (pancreatic ductal adenocarcinoma) •	Radiologically confirmed metastatic disease by RECIST criteria  •	Leucocyte count > 3 G/l | 
 
 
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| E.4 | Principal exclusion criteria | 
•	Current thyreostatic therapy •	Current T4 or T3 substitution therapy •	TSH < 0.4 uIqU/ml or > 4 uIU/ml •	AST, ALT > 3x ULN •	GFR < 30 ml/min •	Known allergy against methimazole •	Pregnancy / breastfeeding •	ECOG ≥ 2 •	Participation in another interventional study | 
 
 
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| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| •	Presence of subclinical hypothyroidism (TSH > 4 uIU/ml) after 12 weeks treatment with methimazole | 
 
 
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| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
| After 12 weeks of treatment | 
 
 
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| E.5.2 | Secondary end point(s) | 
•	quality of life (ThyPRO; EORTC QLQ-C30 Version 3; EORTC QLQ-FA12) •	number of interruptions of methimazole treatment due to fatigue •	number of interruptions of methimazole treatment due to leucopenia •	number of interruptions of methimazole treatment due to elevated liver parameters •	progression-free survival (interval from start of chemotherapy until progression of disease or death of any cause) •	best clinical benefit rate (stable disease + partial response + complete response) compared to the matched control group •	best objective response rate (partial response + complete response) compared to the matched control group •	CRP/Albumin ratio after 12 weeks compared to the matched control group •	Neutrophil-to-lymphocyte ratio after 12 weeks compared to the matched control group •	Leucocyte-to-lymphocyte ratio after 12 weeks compared to the matched control group •	Platelet-to-lymphocyte ratio after 12 weeks compared to the matched control group •	Monocyte-to-lymphocyte ratio after 12 weeks compared to the matched control group •	CA 19-9, CEA after 12 weeks compared to the matched control group | 
 
 
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| E.5.2.1 | Timepoint(s) of evaluation of this end point | 
| After 12 weeks of treatment | 
 
 
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| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis |  No  | 
| E.6.2 | Prophylaxis |  No  | 
| E.6.3 | Therapy |  No  | 
| E.6.4 | Safety |  No  | 
| E.6.5 | Efficacy |  Yes  | 
| E.6.6 | Pharmacokinetic |  No  | 
| E.6.7 | Pharmacodynamic |  No  | 
| E.6.8 | Bioequivalence |  No  | 
| E.6.9 | Dose response |  No  | 
| E.6.10 | Pharmacogenetic |  No  | 
| E.6.11 | Pharmacogenomic |  No  | 
| E.6.12 | Pharmacoeconomic |  No  | 
| E.6.13 | Others |  No  | 
| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) |  No  | 
| E.7.1.1 | First administration to humans |  No  | 
| E.7.1.2 | Bioequivalence study |  No  | 
| E.7.1.3 | Other |  No  | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) |  No  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  No  | 
| E.7.4 | Therapeutic use (Phase IV) |  Yes  | 
| E.8 Design of the trial | 
| E.8.1 | Controlled |  No  | 
| E.8.1.1 | Randomised |  No  | 
| E.8.1.2 | Open |  Yes  | 
| E.8.1.3 | Single blind |  No  | 
| E.8.1.4 | Double blind  |  No  | 
| E.8.1.5 | Parallel group |  No  | 
| E.8.1.6 | Cross over  |  No  | 
| E.8.1.7 | Other |  No  | 
| E.8.2 |  Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) |  No  | 
| E.8.2.2 | Placebo  |  No  | 
| E.8.2.3 | Other |  No  | 
| E.8.2.4 | Number of treatment arms in the trial | 1 | 
| E.8.3 | 
                                The trial involves single site in the Member State concerned
                             |  No  | 
| E.8.4 |  The trial involves multiple sites in the Member State concerned  |  Yes  | 
| E.8.4.1 | Number of sites anticipated in Member State concerned | 2 | 
| E.8.5 | The trial involves multiple Member States |  No  | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.1 | Trial being conducted both within and outside the EEA |  No  | 
| E.8.6.2 | Trial being conducted completely outside of the EEA |  No  | 
| E.8.7 | Trial has a data monitoring committee |  No  | 
| E.8.8 | 
                        Definition of the end of the trial and justification where it is not the last
                        visit of the last subject undergoing the trial
                     | 
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| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 3 | 
| E.8.9.1 | In the Member State concerned months | 0 | 
| E.8.9.1 | In the Member State concerned days | 0 | 
| E.8.9.2 | In all countries concerned by the trial years | 3 | 
| E.8.9.2 | In all countries concerned by the trial months | 0 | 
| E.8.9.2 | In all countries concerned by the trial days | 0 |