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The proposal is a phase II clinical study designed to assess the feasibility of durvalumab (MEDI4736) in HIV-1-infected individuals with solid tumors. Additionally, to obtain data that lets understand the possible benefit of this treatment in cancer patients and HIV infection, exploring if activity of durvalumab (MEDI4736) could be higher in cancer that has been produced at least in part due to the chronic immunosupression. Simultaneously, it will allow us to investigate the effect of disrupting this immunoregulatory pathway might have in reversing cancer pathways and HIV-specific T-cell function during persistent chronic HIV infection in humans.
PD-1/ PD-L1 coinhibitory pathway plays a significant role in the regulation of the immune response in both chronic infectious diseases and cancer.
Preclinical and animal data support the safety and promising activity of anti-PD-1 antibody in HIV-1 infection.
Demonstrated anticancer activity and safety profile of durvalumab (MEDI4736) in cancer clinical trials.
Unlikely drug interactions of durvalumab (MEDI4736) and antiretroviral treatments.
The proposal is a phase II clinical study designed to assess the feasibility of durvalumab (MEDI4736) in HIV-1-infected individuals with solid tumors. Additionally, to obtain data that lets understand the possible benefit of this treatment in cancer patients and HIV infection, exploring if activity of durvalumab (MEDI4736) could be higher in cancer that has been produced at least in part due to the chronic immunosupression. Simultaneously, it will allow us to investigate the effect of disrupting this immunoregulatory pathway might have in reversing cancer pathways and HIV-specific T-cell function during persistent chronic HIV infection in humans.
In this regard, our hypothesis is:
HIV patients with cancer have a similar outcome in terms of tolerability when treated with durvalumab (MEDI4736) monotherapy at the recommended dose than non HIV infected patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1 | Experimental | Durvalumab (MEDI4736) monotherapy at the recommended dose of 1500mg every 4 weeks in solid tumors in HIV-1-infected patients |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Durvalumab | Drug | Durvalumab monotherapy of 1500mg every 4 weeks in solid tumors in HIV-1-infected patients until progression significant clinical deterioration, unacceptable toxicity, any criterion for withdrawal from the trial or trial drug is fulfilled |
| Measure | Description | Time Frame |
|---|---|---|
| Best Response During the Treatment Period | To explore the feasibility of durvalumab (MEDI4736) monotherapy at the recommended dose of 1500mg in solid tumors in HIV-1-infected patients The best overall response is a result of a combination of tumor responses in target and nontarget lesions according to Response Evaluation Criteria in Solid Tumors (RECIST). | From the first dose until last follow up, assessed up to 24 month |
| Measure | Description | Time Frame |
|---|---|---|
| Duration of Response Global | Only patients with best response Stable disease, Partial Response or Complete response during the treatment period are included in the response analysis. Duration of response is the time from response (R) to progression/death (P/D). | From the time from first response evaluation to progression or death, assessed up to 24 months. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| María González-Cao, MD | Instituto Oncológico Dr Rosell | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| ICO-Badalona | Badalona | Barcelona | 08916 | Spain | ||
| Consorci Sanitari de Terrassa |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32271353 | Derived | Gonzalez-Cao M, Moran T, Dalmau J, Garcia-Corbacho J, Bracht JWP, Bernabe R, Juan O, de Castro J, Blanco R, Drozdowskyj A, Argilaguet J, Meyerhans A, Blanco J, Prado JG, Carrillo J, Clotet B, Massuti B, Provencio M, Molina-Vila MA, Mayo de Las Casa C, Garzon M, Cao P, Huang CY, Martinez-Picado J, Rosell R. Assessment of the Feasibility and Safety of Durvalumab for Treatment of Solid Tumors in Patients With HIV-1 Infection: The Phase 2 DURVAST Study. JAMA Oncol. 2020 Jul 1;6(7):1063-1067. doi: 10.1001/jamaoncol.2020.0465. |
| Label | URL |
|---|---|
| Web page of the sponsor where users can find more information about Fundación GECP studies | View source |
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Screening details:
Histologically advanced/metatasic lung cancer, head and neck cancer, cervical cancer, melanoma, anal cancer, pancreatic cancer, gastrio-esophageal cancer, triple negative breast cancer, bladder or renal cancer, Cholangiocarcinoma, Kaposi sarcoma, lymphomas, ovarian cancer or Merkel cell carcinoma. HIV infection. Undetectable viral load at last test
Between April 2017 and July 2018, a total of 20 patients were enrolled in the study from 7 different sites.
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| ID | Title | Description |
|---|---|---|
| FG000 | Experimental Arm | Durvalumab (MEDI4736) monotherapy at the recommended dose of 1500mg every 4 weeks in solid tumors in HIV-1-infected patients Durvalumab: Durvalumab monotherapy of 1500mg every 4 weeks in solid tumors in HIV-1-infected patients until progression significant clinical deterioration, unacceptable toxicity, any criterion for withdrawal from the trial or trial drug is fulfilled. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Experimental Arm | Durvalumab (MEDI4736) monotherapy at the recommended dose of 1500mg every 4 weeks in solid tumors in HIV-1-infected patients Durvalumab: Durvalumab monotherapy of 1500mg every 4 weeks in solid tumors in HIV-1-infected patients until progression significant clinical deterioration, unacceptable toxicity, any criterion for withdrawal from the trial or trial drug is fulfilled. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Best Response During the Treatment Period | To explore the feasibility of durvalumab (MEDI4736) monotherapy at the recommended dose of 1500mg in solid tumors in HIV-1-infected patients The best overall response is a result of a combination of tumor responses in target and nontarget lesions according to Response Evaluation Criteria in Solid Tumors (RECIST). | Posted | Number | participants | From the first dose until last follow up, assessed up to 24 month |
|
24 month
The severity of AE will be determined using CTCAE version 4.0.3
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Experimental Arm | Durvalumab (MEDI4736) monotherapy at the recommended dose of 1500mg every 4 weeks in solid tumors in HIV-1-infected patients Durvalumab: Durvalumab monotherapy of 1500mg every 4 weeks in solid tumors in HIV-1-infected patients until progression significant clinical deterioration, unacceptable toxicity, any criterion for withdrawal from the trial or trial drug is fulfilled. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Vascular arterial ischemia | Vascular disorders | MedDRA (12.1) | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hypotension | Vascular disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Eva Pereira | Fundación GECP | +34 934302006 | gecp@gecp.org |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Nov 14, 2018 | Jun 2, 2022 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| C000613593 | durvalumab |
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Durvalumab will be supplied in glass vials containing 500 mg of liquid solution at a concentration of 50 mg/mL for intravenous(IV) administration
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|
| Progression Free Survival (PFS) | Defined as the length of time from the date of diagnose to the date of the first documented progression of disease. "Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions".A patient who does not progresses neither dies, is censored at the last tumor evaluation where no progression is detected. | From the date of randomization until end of follow up, assessed up to 24 months. |
| Duration of Response- Dolutegravir/ no Dolutegravir | Only patients with best response Stable disease, Partial Response or Complete response during the treatment period are included in the response analysis. Duration of response is the time from response (R) to progression/death (P/D). | From the date of first response until progression or death, assessed up to 24 months. |
| Duration of Response by Treatment With INSTIs or no INSTIs | Only patients with best response Stable disease, Partial Response or Complete response during the treatment period are included in the response analysis. Duration of response is the time from response to progression/death. | From the date of the first response until progression or death, assessed up to 24 months |
| OS Analysis by PD-L1 | Kaplan Meier method will be used to estimate the survival function. OS will be mesure at 24 months. | OS is defined as the time from the inclusion date to the death, due to any cause. A patient who does not dies, is censored up to 24 months |
| OS Analysis by Integrase Inhibitors | OS is defined as the time from the inclusion date to the death, due to any cause. A patient who does not dies, is censored at the last contact date up to 24 months. | From the time from the inclusion date to the death, due to any cause. A patient who does not dies, is censored up to 24 months |
| OS Analysis by Dolutegravir | OS is defined as the time from the inclusion date to the death, due to any cause. A patient who does not dies, is censored up to 24 months | From the time from the inclusion date to the death, due to any cause. A patient who does not dies, is censored up to 24 months |
| PFS Analysis by PD-L1 | Progression Free Survival defined as the length of time from the date of diagnosis to the date of the first documented progression of disease | PFS is defined as the time from the inclusion date to the progression or death, due to any cause, up to 24 months patient who does not progresses neither dies, is censored at the last tumor evaluation where no progression is detected. |
| PFS Analysis by Integrase Inhibitors | Defined as the length of time from the date of diagnosis to the date of the first documented progression of disease | From the inclusion date to the progression or death, due to any cause, up to 24 months. patient who does not progresses neither dies, is censored at the last tumor evaluation where no progression is detected. |
| PFS Analysis by Dolutegravir | PFS is defined as the time from the inclusion date to the progression or death, due to any cause, date. | From the inclusion date to the progression or death, due to any cause, assessed up to 24 months. |
| Terrassa |
| Barcelona |
| 08220 |
| Spain |
| H. Clínic i Provincial de Barcelona | Barcelona | 08036 | Spain |
| H. Universitario Quirón Dexeus | Barcelona | 08036 | Spain |
| Hospital Puerta de Hierro | Madrid | 28222 | Spain |
| H. La Paz | Madrid | Spain |
| Hospital Virgen del Rocío | Seville | 41013 | Spain |
| Hospital La Fe | Valencia | Spain |
| Publication of the results of DURVAST study in this article on JAMA Oncology in 2020 | View source |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| ECOG | ECOG Performance Status Scale: It describes a patient's level of functioning in terms of their ability to care for themself, daily activity, and physical ability GRADES: ECOG 0: Fully active. ECOG 1: Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature ECOG 2: Ambulatory and capable of all selfcare but unable to carry out any work activities; up and about more than 50% of waking hours ECOG 3: Capable of only limited selfcare; confined to bed or chair more than 50% of waking hours ECOG 4: Completely disabled ECOG 5: Dead | Number | participants |
|
| Smoking status | Number | participants |
|
| Type of Cancer | Number | participants |
|
| LungCancer(Y/N) | Number | participants |
|
| Lung cancer type | Number | participants |
|
| NSCLC histology | Number | participants |
|
| Metastasis by cancer type | Number | participants |
|
| Number of metastatic sites | Number | participants |
|
| Basal CD4-count cells/mm3 | Number | participants |
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| HIV-1 group transmission | Number | participants |
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| Nº of prior systemic therapies | Number | participants |
|
| Time since cancer diagnosis | Mean | Standard Deviation | years |
|
| Time since HIV diagnosis | Mean | Standard Deviation | years |
|
| CD4 at baseline | Mean | Standard Deviation | cells/mm^3 |
|
| Plasma Viral load at baseline | Mean | Standard Deviation | copies/mL |
|
| Treatment duration | Mean | Standard Deviation | Month |
|
| Time on treatment and PD-L1 | Distribution of time on treatment (months) by PD-L1 A total of 15 patients has PD-L1 evaluated | Mean | Standard Deviation | Month |
|
| Distribution of time on treatment for patients with Integrase Inhibitors | Distribution of time on treatment(months) for patients with/without Integrase Inhibitors in total of all population. | Mean | Standard Deviation | Months |
|
| Units | Counts |
|---|---|
| Participants |
|
|
| Secondary | Duration of Response Global | Only patients with best response Stable disease, Partial Response or Complete response during the treatment period are included in the response analysis. Duration of response is the time from response (R) to progression/death (P/D). | Applying a Kaplan -Meyer model the median duration of response is estimated for each type of cancer | Posted | Median | Standard Deviation | Months | From the time from first response evaluation to progression or death, assessed up to 24 months. |
|
|
|
| Secondary | Progression Free Survival (PFS) | Defined as the length of time from the date of diagnose to the date of the first documented progression of disease. "Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions".A patient who does not progresses neither dies, is censored at the last tumor evaluation where no progression is detected. | Posted | Median | 95% Confidence Interval | Months | From the date of randomization until end of follow up, assessed up to 24 months. |
|
|
|
| Secondary | Duration of Response- Dolutegravir/ no Dolutegravir | Only patients with best response Stable disease, Partial Response or Complete response during the treatment period are included in the response analysis. Duration of response is the time from response (R) to progression/death (P/D). | Kaplan Meier Estimated median duration of response- Dolutegravir/ no Dolutegravir patients | Posted | Median | 95% Confidence Interval | Month | From the date of first response until progression or death, assessed up to 24 months. |
|
|
|
| Secondary | Duration of Response by Treatment With INSTIs or no INSTIs | Only patients with best response Stable disease, Partial Response or Complete response during the treatment period are included in the response analysis. Duration of response is the time from response to progression/death. | Descriptive analysis of response duration - INSTIs (Integrase Inhibitors) or no INSTIs (No Integrase Inhibitors) treated patients | Posted | Median | 95% Confidence Interval | Month | From the date of the first response until progression or death, assessed up to 24 months |
|
|
|
| Secondary | OS Analysis by PD-L1 | Kaplan Meier method will be used to estimate the survival function. OS will be mesure at 24 months. | Kaplan-Meier model- Summary results of OS - Strata PD-L1 patients | Posted | Median | 95% Confidence Interval | Months | OS is defined as the time from the inclusion date to the death, due to any cause. A patient who does not dies, is censored up to 24 months |
|
|
|
| Secondary | OS Analysis by Integrase Inhibitors | OS is defined as the time from the inclusion date to the death, due to any cause. A patient who does not dies, is censored at the last contact date up to 24 months. | Kaplan-Meier model- Summary results of OS- Strata Integrase Inhibitors | Posted | Median | 95% Confidence Interval | Months | From the time from the inclusion date to the death, due to any cause. A patient who does not dies, is censored up to 24 months |
|
|
|
| Secondary | OS Analysis by Dolutegravir | OS is defined as the time from the inclusion date to the death, due to any cause. A patient who does not dies, is censored up to 24 months | Kaplan-Meier model- Summary results of OS- Strata patients treated with or without Dolutegravir | Posted | Median | 95% Confidence Interval | Month | From the time from the inclusion date to the death, due to any cause. A patient who does not dies, is censored up to 24 months |
|
|
|
| Secondary | PFS Analysis by PD-L1 | Progression Free Survival defined as the length of time from the date of diagnosis to the date of the first documented progression of disease | Summary results Strata by PD-L1 results in cancer patients | Posted | Median | 95% Confidence Interval | Month | PFS is defined as the time from the inclusion date to the progression or death, due to any cause, up to 24 months patient who does not progresses neither dies, is censored at the last tumor evaluation where no progression is detected. |
|
|
|
| Secondary | PFS Analysis by Integrase Inhibitors | Defined as the length of time from the date of diagnosis to the date of the first documented progression of disease | Kaplan-Meier model- Summary results of PFS by the effect of the presence of Integrase Inhibitors | Posted | Median | 95% Confidence Interval | Months | From the inclusion date to the progression or death, due to any cause, up to 24 months. patient who does not progresses neither dies, is censored at the last tumor evaluation where no progression is detected. |
|
|
|
| Secondary | PFS Analysis by Dolutegravir | PFS is defined as the time from the inclusion date to the progression or death, due to any cause, date. | Effect of the presence of Dolutegravir, in the PFS in cancer patients | Posted | Median | 95% Confidence Interval | Month | From the inclusion date to the progression or death, due to any cause, assessed up to 24 months. |
|
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|
| 4 |
| 20 |
| 11 |
| 20 |
| 20 |
| 20 |
| Respiratory insufficiency | Respiratory, thoracic and mediastinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Hemoptysis | Respiratory, thoracic and mediastinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Upper respiratory infection | Respiratory, thoracic and mediastinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Creatinine increased | Blood and lymphatic system disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Hypercalcemia | Blood and lymphatic system disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Death NOS | General disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Pain | General disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Confusion | Psychiatric disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Pancreatitis | Gastrointestinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Oral hemorrhage | Gastrointestinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Thromboembolic event | Vascular disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Gastric hemorrhage | Gastrointestinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Hepatic toxicity | Hepatobiliary disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Lung infection | Infections and infestations | MedDRA (12.1) | Non-systematic Assessment |
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| Coronavirus infection | Infections and infestations | MedDRA (12.1) | Non-systematic Assessment |
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| Thromboembolic event | Vascular disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Hypertension | Vascular disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Asthenia | General disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Pain | General disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Fever | General disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Anxiety | Psychiatric disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Confusion | Psychiatric disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Dyspnea | Respiratory, thoracic and mediastinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Prostate syndrom | Reproductive system and breast disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Serum amylase increased | Investigations | MedDRA (12.1) | Non-systematic Assessment |
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| Creatinine increased | Investigations | MedDRA (12.1) | Non-systematic Assessment |
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| Arrhythmia | Cardiac disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Percardial effusion | Cardiac disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Anemia | Blood and lymphatic system disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Neutropenia | Blood and lymphatic system disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Upper respiratory infection | Respiratory, thoracic and mediastinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Sore throat | Respiratory, thoracic and mediastinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Respiratory insufficiency | Respiratory, thoracic and mediastinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Hemoptysis | Respiratory, thoracic and mediastinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Ataxia | Nervous system disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Headache | Nervous system disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Somnolence | Nervous system disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Dysphagia | Gastrointestinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Mucositis oral | Gastrointestinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Pancreatitis | Gastrointestinal disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Dysuria | Renal and urinary disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Hepatic toxicity | Hepatobiliary disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Seborreic dermatitis | Skin and subcutaneous tissue disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Anorexia | Metabolism and nutrition disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Hyperkalemia | Metabolism and nutrition disorders | MedDRA (12.1) | Non-systematic Assessment |
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| Lung infection | Infections and infestations | MedDRA (12.1) | Non-systematic Assessment |
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| Non respiratory infection | Infections and infestations | MedDRA (12.1) | Non-systematic Assessment |
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| NSCLC |
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