Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| 2022-500177-13 | Other Identifier | European Medicines Agency |
Not provided
Not provided
Sponsor decision to terminate study
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
The goals of this clinical study are to learn more about the safety, tolerability and effectiveness of magrolimab in combination with bevacizumab and 5-fluorouracil, irinotecan, and leucovorin (FOLFIRI) in previously treated participants with advanced inoperable metastatic colorectal cancer (mCRC).
The primary objectives of this study are: (safety run-in cohort) to evaluate safety and tolerability, and the recommended Phase 2 dose (RP2D) and (randomized cohort) to evaluate the efficacy of magrolimab in combination with bevacizumab and 5-fluorouracil, irinotecan, and leucovorin (FOLFIRI) in previously treated participants with advanced inoperable metastatic colorectal cancer (mCRC).
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Safety Run-in Cohort: Magrolimab + Bevacizumab + FOLFIRI | Experimental | Participants will receive magrolimab + bevacizumab + FOLFIRI as mentioned below:
|
|
| Randomized Cohort: Magrolimab + Bevacizumab + FOLFIRI | Experimental | Participants will receive magrolimab + bevacizumab + FOLFIRI as mentioned below:
|
|
| Randomized Cohort: Bevacizumab + FOLFIRI | Active Comparator | Participants will receive bevacizumab + FOLFIRI as mentioned below:
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Magrolimab | Drug | Administered intravenous infusion |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety Run-in Cohort: Number of Participants Experiencing Dose-limiting Toxicities (DLTs) According to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 | DLT was defined as any,
| First dose date up to 28 days |
| Safety Run-in Cohort: Percentage of Participants Experiencing Adverse Events (AEs) According to the NCI-CTCAE Version 5.0 | Treatment-emergent adverse events (TEAEs) were defined as any AE that begun on or after the date of first dose of study drug up to the date of last dose of study treatment plus 30 days or the day before initiation of subsequent anticancer therapy, whichever came first. An AE was any untoward medical occurrence in a clinical study participant administered a study drug that did not necessarily have a causal relationship with the treatment. | First dose date up to last dose date (up to 36 weeks) plus 30 days |
| Safety Run-in Cohort: Percentage of Participants Experiencing Laboratory Abnormalities According to NCI-CTCAE Version 5.0 | Treatment-emergent laboratory abnormalities were defined as values that increase at least 1 toxicity grade after the date of first dose of study drug up to the date of last dose of study treatment plus 30 days or the day before initiation of subsequent anticancer therapy, whichever came first. | First dose date up to last dose date (up to 36 weeks) plus 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| Randomized Cohort: Objective Response Rate (ORR) as Determined by Investigator Assessment Using RECIST Version 1.1 | ORR was defined as the percentage of participants who achieve complete response (CR) or partial response (PR) that was confirmed at least 4 weeks after initial documentation of response, as determined by investigator assessment per RECIST, Version 1.1. CR was defined as disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Clopper-Pearson estimates were used in outcome measure analysis. Percentages were rounded off. |
Not provided
Key Inclusion Criteria:
Key Exclusion Criteria:
Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Gilead Study Director | Gilead Sciences | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| City of Hope ( City of Hope National Medical Center, City of Hope Medical Center ) | Duarte | California | 91010 | United States | ||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | Fakih MG, Tejani M, Ren X, Landes D, Werneke S, Curtis KK et al. 439TiP A phase II (ph2), randomized study of magrolimab with bevacizumab and FOLFIRI in previously treated patients with advanced inoperable metastatic colorectal cancer (mCRC). Annals of Oncology 2022; 33(7):S735. |
| Label | URL |
|---|---|
| Gilead Clinical Trials Website | View source |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Participants were enrolled at study sites in Australia, Belgium, Canada, France, Germany, Hong Kong, Italy, Spain, the United States and Puerto Rico.
124 participants were screened.
Not provided
| ID | Title | Description |
|---|---|---|
| FG000 | Safety Run-in Cohort: Magrolimab + Bevacizumab + FOLFIRI | Participants received magrolimab + bevacizumab + FOLFIRI intravenous infusions for 36 weeks as mentioned below:
|
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
Not provided
Not provided
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Oct 31, 2023 | May 5, 2025 |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
|
| Bevacizumab | Drug | Administered intravenous infusion |
|
| Irinotecan | Drug | Administered intravenous infusion |
|
|
| Fluorouracil | Drug | Administered intravenous infusion |
|
| Leucovorin | Drug | Administered intravenous infusion |
|
| Randomized Cohort: Progression-free Survival (PFS) as Determined by Investigator Assessment Using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 | PFS was defined as the time from the date of randomization until the earliest date of documented disease progression (PD) as determined by investigator assessment using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST V1.1), or death from any cause, whichever occurred first. PD was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. Kaplan-Meier (KM) estimates were used in outcome measure analysis. | Up to 83.4 weeks |
| Up to 83.4 weeks |
| Randomized Cohort: Duration of Response (DOR) as Determined by Investigator Assessment Per RECIST Version 1.1 | DOR was defined as time from first documentation of CR or PR to the earliest date of documented disease progression as determined by investigator assessment, per RECIST V1.1, or death from any cause, whichever occurred first. PD was defined in outcome measure #4. CR and PR were defined in outcome measure #5. KM estimates were used in outcome measure analysis. | Up to 83.4 weeks |
| Randomized Cohort: Overall Survival (OS) | OS was defined as time from date of randomization to death from any cause. KM estimates were used in outcome measure analysis. | Up to 83.4 weeks |
| Randomized Cohort: Change From Baseline of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ) - Core Questionnaire EORTC-QLQ-C30 Score | EORTC QLQ-C30 is a quality of life (QOL) questionnaire for cancer participants, that has 30 items. 5 functional scales (physical, role, emotional, cognitive, and social functioning), 1 global health status scale, 3 symptom scales (fatigue, nausea and vomiting, and pain), and 6 single items (dyspnea, insomnia, loss of appetite, constipation, diarrhea, and financial difficulties). Scoring of the QLQ-C30 was performed according to QLQ-C30 Scoring manual. All of the scales and single-item measures range in score from 0 to 100. Higher score for the functioning scales and global health status denote a better level of functioning (i.e. a better state of the participant), while higher scores on the symptom and single-item scales indicated a higher level of symptoms (i.e. a worse state of the participant). | Baseline, Day 1 of Cycles 2, 3, 4 and last cycle (Cycle 8) (Each cycle was of 28 days) |
| Randomized Cohort: Number of Participants With 5-level EuroQol 5 Dimensions Questionnaire (EQ-5D-5L) Score | EQ-5D-5L was an instrument for use as a measure of health outcome. The EQ-5D-5L consisted of 2 sections: EuroQoL (5 dimensions) (EQ-5D) descriptive system and the EuroQoL visual analogue scale (EQ-VAS). EQ-5D comprised the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension had 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. Number of participants per category were reported. | Day 1 of Cycles 2, 3, 4 and last cycle (Cycle 8) (Each cycle is of 28 days) |
| Randomized Cohort: Change From Baseline in the EuroQoL Visual Analogue Scale (EQ-VAS) Score | The EQ-VAS recorded the participants' self-rated health on a vertical VAS, where the end points were labeled "the best health you can imagine" and "the worst health you can imagine." The scale range from 0 to 100, where '100' rating denotes the best health and '0' rating denotes the worst health. The EQ-VAS is used as a quantitative measure of health outcome that reflects the participants' own judgment. | Baseline, Day 1 of Cycles 2, 3, 4 and last cycle (Cycle 8) (Each cycle is of 28 days) |
| Randomized Cohort: Change From Baseline of the Functional Assessment of Cancer Therapy (FACT) Colorectal Symptom Index (FCSI) Score | The FCSI was a set of brief, clinically relevant, colorectal cancer symptoms for assessing symptomatic response. It comprised the most important symptoms associated with colorectal cancer, including energy, pain, weight, diarrhea, nausea, swelling or cramps in the stomach area, appetite, ability to enjoy life, and overall quality of life. The 9 questions were combined in three algorithms to provide information for 3 domains: colorectal cancer symptoms, physical well-being, and functional well-being. Each of the 9 items were scored from "0" to "4" representing "Not at All" through to "Very Much True". The raw score for all items was transformed to a 0-100 scale, and the average for each of the 3 subscales was calculated; high scores illustrated an improved state. | Baseline, Day 1 of Cycles 2, 3, 4 and last cycle (Cycle 8) (Each cycle is of 28 days) |
| Safety Run-in and Randomized Cohorts: Magrolimab Concentration Versus Time | Predose: Day 15, 29, 57, 113 and 169; Postdose: Day 57 (1 hour) |
| Safety Run-in and Randomized Cohorts: Percentage of Participants With Antidrug Antibodies (ADA) to Magrolimab | Up to 36 weeks |
| USC Norris Comprehensive Cancer Center |
| Los Angeles |
| California |
| 90033 |
| United States |
| Stanford Cancer Center | Palo Alto | California | 94305 | United States |
| Torrance Memorial Physician Network | Redondo Beach | California | 90277 | United States |
| University of California Los Angeles (UCLA) | Santa Monica | California | 90095 | United States |
| Orlando Health Cancer Institute | Orlando | Florida | 32806 | United States |
| Fort Wayne Medical Oncology and Hematology, Inc. | Fort Wayne | Indiana | 46845 | United States |
| University of Kansas | Westwood | Kansas | 66205 | United States |
| University of Michigan | Ann Arbor | Michigan | 48106 | United States |
| Roswell Park Cancer Institute | Buffalo | New York | 14263 | United States |
| Hematology Oncology Associates of Central New York, PC | East Syracuse | New York | 13057 | United States |
| AdventHealth | Rochester | New York | 14642 | United States |
| Pennsylvania Hospital | Philadelphia | Pennsylvania | 19104 | United States |
| Fox Chase Cancer Center | Philadelphia | Pennsylvania | 19111 | United States |
| Avera Cancer Institute | Sioux Falls | South Dakota | 57105 | United States |
| Sarah Cannon Research Institute | Nashville | Tennessee | 327203 | United States |
| Texas Oncology | Dallas | Texas | 75246 | United States |
| Baylor College of Medicine Medical Center | Houston | Texas | 77030 | United States |
| Virginia Cancer Specialists, PC | Arlington | Virginia | 22205 | United States |
| Seattle Cancer Care Alliance (SCCA) | Seattle | Washington | 98103 | United States |
| Westmead Hospital | Blacktown | New South Wales | 2148 | Australia |
| Kinghorn Cancer Centre | Darlinghurst | New South Wales | 2010 | Australia |
| Southside Cancer Care Centre | Miranda | New South Wales | 2228 | Australia |
| Genesis Care North Shore | St Leonards | New South Wales | 2065 | Australia |
| Princess Alexandra Hospital | Woolloongabba | Queensland | 4102 | Australia |
| Flinders Medical Centre | Bedford Park | South Australia | 5042 | Australia |
| Austin Health | Heidelberg | Victoria | 3084 | Australia |
| The Alfred Hospital | Melbourne | Victoria | 3004 | Australia |
| Hôpital de Jolimont | Haine-Saint-Paul | 7100 | Belgium |
| Centre Hospitalizer De L'Ardenne | Libramont-Chevigny | 6800 | Belgium |
| The Ottawa Hospital Cancer Centre | Ottawa | K1H 8L6 | Canada |
| Princess Margaret Cancer Centre | Toronto | M5G 1X6 | Canada |
| Centre Hospitalier Regional Universitaire Hopital Besancon | Besançon | 25030 | France |
| Centre Léon Bérard - Centre de Lutte contre le Cancer | Lyon | 69008 | France |
| Hopital franco brittanique | Paris | 75012 | France |
| CHU de Tours | Tours | 37000 | France |
| Carl Gustav Carus Management GMBH | Dresden | 01307 | Germany |
| Klinikum rechts der Isar der TU Munchen Zentrum fur klinische Studien der Klinik und Poliklinik fur Innere Medizin III | München | 81675 | Germany |
| Hong Kong Integrated Oncology Centre | Hong Kong | 0 | Hong Kong |
| Queen Mary Hospital | Hong Kong | Hong Kong |
| Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" - Medical Oncology Department | Meldola | 47014 | Italy |
| Istituto Oncologico Veneto (IOV)- IRCCS | Padova | 35128 | Italy |
| Azienda Ospedaliera Universitaria Pisana- UO Oncologia Medica | Pisa | 56126 | Italy |
| Istituto di Ricovero e Cura a Carattere Scientifico - Istituto Clinico Humanitas | San Giovanni Rotondo | 71013 | Italy |
| San Bortolo General Hospital- Oncology Department | Vicenza | 36100 | Italy |
| Pan American Center for Oncology Trials, LLC | San Juan | PR | 00902 | Puerto Rico |
| Hospital Universitari Vall d'Hebron | Barcelona | 8035 | Spain |
| Institut Català d'Oncologia- Hospital Duran I Reynals | L'Hospitalet de Llobregat | 8908 | Spain |
| Hospital General Universitario Gregorio Marañón | Madrid | 28007 | Spain |
| Hospital Universitario 12 de Octubre | Madrid | 28041 | Spain |
| Hospital HM Sanchinarro | Madrid | 28050 | Spain |
| FG001 | Randomized Cohort: Magrolimab + Bevacizumab + FOLFIRI | Participants received magrolimab + bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
|
| FG002 | Randomized Cohort: Bevacizumab + FOLFIRI | Participants received bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
|
| COMPLETED |
|
| NOT COMPLETED |
|
|
All Enrolled Analysis Set included all participants who received a study subject identification number in the study after screening.
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Safety Run-in Cohort: Magrolimab + Bevacizumab + FOLFIRI | Participants received magrolimab + bevacizumab + FOLFIRI intravenous infusions for 36 weeks as mentioned below:
|
| BG001 | Randomized Cohort: Magrolimab + Bevacizumab + FOLFIRI | Participants received magrolimab + bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
|
| BG002 | Randomized Cohort: Bevacizumab + FOLFIRI | Participants received bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
|
| BG003 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Count of Participants | Participants |
|
| 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 | Safety Run-in Cohort: Number of Participants Experiencing Dose-limiting Toxicities (DLTs) According to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 | DLT was defined as any,
| Participants in DLT-Evaluable Analysis Set were analyzed. DLT-Evaluable Analysis Set was defined as all participants in Safety Run-in cohort who met one of the following criteria in the DLT-evaluable period (defined as the first 28 days):
| Posted | Count of Participants | Participants | First dose date up to 28 days |
|
|
| ||||||||||||||||||||||||||
| Primary | Safety Run-in Cohort: Percentage of Participants Experiencing Adverse Events (AEs) According to the NCI-CTCAE Version 5.0 | Treatment-emergent adverse events (TEAEs) were defined as any AE that begun on or after the date of first dose of study drug up to the date of last dose of study treatment plus 30 days or the day before initiation of subsequent anticancer therapy, whichever came first. An AE was any untoward medical occurrence in a clinical study participant administered a study drug that did not necessarily have a causal relationship with the treatment. | Participants in the Safety Run-in Cohort in the Safety Analysis Set were analyzed. The Safety Analysis Set included all participants who took at least 1 dose of any study drug. | Posted | Number | percentage of participants | First dose date up to last dose date (up to 36 weeks) plus 30 days |
| ||||||||||||||||||||||||||||
| Primary | Safety Run-in Cohort: Percentage of Participants Experiencing Laboratory Abnormalities According to NCI-CTCAE Version 5.0 | Treatment-emergent laboratory abnormalities were defined as values that increase at least 1 toxicity grade after the date of first dose of study drug up to the date of last dose of study treatment plus 30 days or the day before initiation of subsequent anticancer therapy, whichever came first. | Participants in the Safety Run-in Cohort in the Safety Analysis Set were analyzed. | Posted | Number | percentage of participants | First dose date up to last dose date (up to 36 weeks) plus 30 days |
|
| |||||||||||||||||||||||||||
| Primary | Randomized Cohort: Progression-free Survival (PFS) as Determined by Investigator Assessment Using Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 | PFS was defined as the time from the date of randomization until the earliest date of documented disease progression (PD) as determined by investigator assessment using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST V1.1), or death from any cause, whichever occurred first. PD was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. Kaplan-Meier (KM) estimates were used in outcome measure analysis. | Participants in the Randomized Cohorts in the Intent-to-treat Analysis Set were analyzed. Intent-to-treat Analysis Set included all participants who were randomized in the study. | Posted | Median | 95% Confidence Interval | months | Up to 83.4 weeks |
| |||||||||||||||||||||||||||
| Secondary | Randomized Cohort: Objective Response Rate (ORR) as Determined by Investigator Assessment Using RECIST Version 1.1 | ORR was defined as the percentage of participants who achieve complete response (CR) or partial response (PR) that was confirmed at least 4 weeks after initial documentation of response, as determined by investigator assessment per RECIST, Version 1.1. CR was defined as disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Clopper-Pearson estimates were used in outcome measure analysis. Percentages were rounded off. | Participants in the Randomized Cohorts in the Intent-to-Treat Analysis Set were analyzed. | Posted | Number | 95% Confidence Interval | percentage of participants | Up to 83.4 weeks |
| |||||||||||||||||||||||||||
| Secondary | Randomized Cohort: Duration of Response (DOR) as Determined by Investigator Assessment Per RECIST Version 1.1 | DOR was defined as time from first documentation of CR or PR to the earliest date of documented disease progression as determined by investigator assessment, per RECIST V1.1, or death from any cause, whichever occurred first. PD was defined in outcome measure #4. CR and PR were defined in outcome measure #5. KM estimates were used in outcome measure analysis. | Participants in the Randomized Cohorts in the Intent-to-Treat Analysis Set with objective response were analyzed. | Posted | Median | 95% Confidence Interval | months | Up to 83.4 weeks |
| |||||||||||||||||||||||||||
| Secondary | Randomized Cohort: Overall Survival (OS) | OS was defined as time from date of randomization to death from any cause. KM estimates were used in outcome measure analysis. | Participants in the Randomized Cohort in the Intent-to-Treat Analysis Set were analyzed. | Posted | Median | 95% Confidence Interval | months | Up to 83.4 weeks |
| |||||||||||||||||||||||||||
| Secondary | Randomized Cohort: Change From Baseline of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ) - Core Questionnaire EORTC-QLQ-C30 Score | EORTC QLQ-C30 is a quality of life (QOL) questionnaire for cancer participants, that has 30 items. 5 functional scales (physical, role, emotional, cognitive, and social functioning), 1 global health status scale, 3 symptom scales (fatigue, nausea and vomiting, and pain), and 6 single items (dyspnea, insomnia, loss of appetite, constipation, diarrhea, and financial difficulties). Scoring of the QLQ-C30 was performed according to QLQ-C30 Scoring manual. All of the scales and single-item measures range in score from 0 to 100. Higher score for the functioning scales and global health status denote a better level of functioning (i.e. a better state of the participant), while higher scores on the symptom and single-item scales indicated a higher level of symptoms (i.e. a worse state of the participant). | Participants in the Randomized cohort in the Intent-to-treat Analysis Set with available data were analyzed. Data was collected until Cycle 8. | Posted | Mean | Standard Deviation | Score on a scale | Baseline, Day 1 of Cycles 2, 3, 4 and last cycle (Cycle 8) (Each cycle was of 28 days) |
| |||||||||||||||||||||||||||
| Secondary | Randomized Cohort: Number of Participants With 5-level EuroQol 5 Dimensions Questionnaire (EQ-5D-5L) Score | EQ-5D-5L was an instrument for use as a measure of health outcome. The EQ-5D-5L consisted of 2 sections: EuroQoL (5 dimensions) (EQ-5D) descriptive system and the EuroQoL visual analogue scale (EQ-VAS). EQ-5D comprised the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension had 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. Number of participants per category were reported. | Participants in the Randomized Cohort in the Intent-to-treat Analysis Set with available data were analyzed. | Posted | Count of Participants | Participants | No | Day 1 of Cycles 2, 3, 4 and last cycle (Cycle 8) (Each cycle is of 28 days) |
| |||||||||||||||||||||||||||
| Secondary | Randomized Cohort: Change From Baseline in the EuroQoL Visual Analogue Scale (EQ-VAS) Score | The EQ-VAS recorded the participants' self-rated health on a vertical VAS, where the end points were labeled "the best health you can imagine" and "the worst health you can imagine." The scale range from 0 to 100, where '100' rating denotes the best health and '0' rating denotes the worst health. The EQ-VAS is used as a quantitative measure of health outcome that reflects the participants' own judgment. | Participants in the Randomized Cohort in the Intent-to-treat Analysis Set with available data were analyzed. | Posted | Mean | Standard Deviation | Units on a scale | Baseline, Day 1 of Cycles 2, 3, 4 and last cycle (Cycle 8) (Each cycle is of 28 days) |
| |||||||||||||||||||||||||||
| Secondary | Randomized Cohort: Change From Baseline of the Functional Assessment of Cancer Therapy (FACT) Colorectal Symptom Index (FCSI) Score | The FCSI was a set of brief, clinically relevant, colorectal cancer symptoms for assessing symptomatic response. It comprised the most important symptoms associated with colorectal cancer, including energy, pain, weight, diarrhea, nausea, swelling or cramps in the stomach area, appetite, ability to enjoy life, and overall quality of life. The 9 questions were combined in three algorithms to provide information for 3 domains: colorectal cancer symptoms, physical well-being, and functional well-being. Each of the 9 items were scored from "0" to "4" representing "Not at All" through to "Very Much True". The raw score for all items was transformed to a 0-100 scale, and the average for each of the 3 subscales was calculated; high scores illustrated an improved state. | Participants in the Randomized Cohort in the Intent-to-Treat Analysis Set with available data were analyzed. | Posted | Mean | Standard Deviation | Score on a scale | Baseline, Day 1 of Cycles 2, 3, 4 and last cycle (Cycle 8) (Each cycle is of 28 days) |
| |||||||||||||||||||||||||||
| Secondary | Safety Run-in and Randomized Cohorts: Magrolimab Concentration Versus Time | Participants in the Pharmacokinetic (PK) Analysis Set with available data were analyzed. The PK Analysis Set was defined as all participants who received any amount of magrolimab and have at least 1 measurable posttreatment serum concentration of magrolimab. | Posted | Mean | Standard Deviation | μg/mL | Predose: Day 15, 29, 57, 113 and 169; Postdose: Day 57 (1 hour) |
| ||||||||||||||||||||||||||||
| Secondary | Safety Run-in and Randomized Cohorts: Percentage of Participants With Antidrug Antibodies (ADA) to Magrolimab | Participants in the Immunogenicity Analysis Set with available data were analyzed. Immunogenicity Analysis Set included all participants who received any amount of magrolimab and had at least 1 evaluable anti-drug antibody test result. | Posted | Number | percentage of participants | Up to 36 weeks |
|
All-cause mortality: Up to 83.4 weeks; Adverse events: Up to 36 weeks plus 30 days
All-cause mortality: All Enrolled Analysis Set included all participants who received a study subject identification number in the study after screening. Adverse events: The Safety Analysis Set included all participants who took at least 1 dose of any study drug.
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Safety Run-in Cohort: Magrolimab + Bevacizumab + FOLFIRI | Participants received magrolimab + bevacizumab + FOLFIRI intravenous infusions for 36 weeks as mentioned below:
| 6 | 10 | 5 | 10 | 10 | 10 |
| EG001 | Randomized Cohort: Magrolimab + Bevacizumab + FOLFIRI | Participants received magrolimab + bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
| 2 | 44 | 16 | 44 | 43 | 44 |
| EG002 | Randomized Cohort: Bevacizumab + FOLFIRI | Participants received bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
| 5 | 23 | 6 | 21 | 19 | 21 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Febrile neutropenia | Blood and lymphatic system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Cardiac arrest | Cardiac disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Cardiac failure acute | Cardiac disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Supraventricular tachycardia | Cardiac disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Abdominal pain | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Colitis | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Diarrhoea | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Enteritis | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Malignant gastrointestinal obstruction | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Proctalgia | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Rectourethral fistula | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Pyrexia | General disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Cholecystitis | Hepatobiliary disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Anal abscess | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Bronchitis | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Covid-19 | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Cystitis | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Gastroenteritis | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Herpes zoster | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Perirectal abscess | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Pneumonia | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Sepsis | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Skin infection | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Tooth abscess | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Urinary tract infection | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Vascular device infection | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Infusion related reaction | Injury, poisoning and procedural complications | MedDRA Version 27.0 | Systematic Assessment |
| |
| Post procedural fistula | Injury, poisoning and procedural complications | MedDRA Version 27.0 | Systematic Assessment |
| |
| Wound dehiscence | Injury, poisoning and procedural complications | MedDRA Version 27.0 | Systematic Assessment |
| |
| Liver function test abnormal | Investigations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Decreased appetite | Metabolism and nutrition disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Ischaemic stroke | Nervous system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Transient ischaemic attack | Nervous system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Acute kidney injury | Renal and urinary disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Pneumothorax | Respiratory, thoracic and mediastinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Pulmonary embolism | Respiratory, thoracic and mediastinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Deep vein thrombosis | Vascular disorders | MedDRA Version 27.0 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anaemia | Blood and lymphatic system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Lymphopenia | Blood and lymphatic system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Neutropenia | Blood and lymphatic system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Thrombocytopenia | Blood and lymphatic system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Dry eye | Eye disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Lacrimation increased | Eye disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Vitreous floaters | Eye disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Abdominal distension | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Abdominal pain | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Abdominal pain lower | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Constipation | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Diarrhoea | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Dry mouth | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Dyspepsia | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Gastrooesophageal reflux disease | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Gingival pain | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Haematochezia | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Haemorrhoids | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Mouth ulceration | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Proctalgia | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Rectal haemorrhage | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Rectal tenesmus | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Stomatitis | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Asthenia | General disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Chest pain | General disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Chills | General disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Fatigue | General disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Influenza like illness | General disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Malaise | General disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Mucosal inflammation | General disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Oedema peripheral | General disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Pyrexia | General disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Subcapsular hepatic haematoma | Hepatobiliary disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Covid-19 | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Gingivitis | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Skin infection | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Urinary tract infection | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Viral upper respiratory tract infection | Infections and infestations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Fall | Injury, poisoning and procedural complications | MedDRA Version 27.0 | Systematic Assessment |
| |
| Infusion related reaction | Injury, poisoning and procedural complications | MedDRA Version 27.0 | Systematic Assessment |
| |
| Procedural pain | Injury, poisoning and procedural complications | MedDRA Version 27.0 | Systematic Assessment |
| |
| Stoma complication | Injury, poisoning and procedural complications | MedDRA Version 27.0 | Systematic Assessment |
| |
| Stoma site haemorrhage | Injury, poisoning and procedural complications | MedDRA Version 27.0 | Systematic Assessment |
| |
| Aspartate aminotransferase increased | Investigations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Blood alkaline phosphatase increased | Investigations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Lymphocyte count decreased | Investigations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Neutrophil count decreased | Investigations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Platelet count decreased | Investigations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Weight decreased | Investigations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Weight increased | Investigations | MedDRA Version 27.0 | Systematic Assessment |
| |
| White blood cell count decreased | Investigations | MedDRA Version 27.0 | Systematic Assessment |
| |
| Decreased appetite | Metabolism and nutrition disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Hyperglycaemia | Metabolism and nutrition disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Hypoalbuminaemia | Metabolism and nutrition disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Hypokalaemia | Metabolism and nutrition disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Hyponatraemia | Metabolism and nutrition disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Hypophosphataemia | Metabolism and nutrition disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Bone pain | Musculoskeletal and connective tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Flank pain | Musculoskeletal and connective tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Muscle spasms | Musculoskeletal and connective tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Muscular weakness | Musculoskeletal and connective tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Musculoskeletal chest pain | Musculoskeletal and connective tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Musculoskeletal pain | Musculoskeletal and connective tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Dizziness | Nervous system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Dysgeusia | Nervous system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Lethargy | Nervous system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Neuropathy peripheral | Nervous system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Paraesthesia | Nervous system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Peripheral sensory neuropathy | Nervous system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Tremor | Nervous system disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Anxiety | Psychiatric disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Insomnia | Psychiatric disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Acute kidney injury | Renal and urinary disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Dysuria | Renal and urinary disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Urinary retention | Renal and urinary disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Erectile dysfunction | Reproductive system and breast disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Dysphonia | Respiratory, thoracic and mediastinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Epistaxis | Respiratory, thoracic and mediastinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Hiccups | Respiratory, thoracic and mediastinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Productive cough | Respiratory, thoracic and mediastinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Rhinorrhoea | Respiratory, thoracic and mediastinal disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Alopecia | Skin and subcutaneous tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Dermatitis acneiform | Skin and subcutaneous tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Dry skin | Skin and subcutaneous tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Hyperhidrosis | Skin and subcutaneous tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Palmar-plantar erythrodysaesthesia syndrome | Skin and subcutaneous tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Petechiae | Skin and subcutaneous tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Skin hyperpigmentation | Skin and subcutaneous tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Skin ulcer | Skin and subcutaneous tissue disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Deep vein thrombosis | Vascular disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Flushing | Vascular disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Hypertension | Vascular disorders | MedDRA Version 27.0 | Systematic Assessment |
| |
| Hypotension | Vascular disorders | MedDRA Version 27.0 | Systematic Assessment |
|
After conclusion of the study and without prior written approval from Gilead, investigators in this study may communicate, orally present, or publish in scientific journals or other media only after the following conditions have been met:
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Gilead Clinical Study Information Center | Gilead Sciences | 1-833-445-3230 (GILEAD-0) | GileadClinicalTrials@gilead.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jul 16, 2024 | May 5, 2025 | SAP_001.pdf |
Not provided
| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| C000629291 | magrolimab |
| D000068258 | Bevacizumab |
| D000077146 | Irinotecan |
| D005472 | Fluorouracil |
| D002955 | Leucovorin |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D002166 | Camptothecin |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D014498 | Uracil |
| D011744 | Pyrimidinones |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D005575 | Formyltetrahydrofolates |
| D013763 | Tetrahydrofolates |
| D005492 | Folic Acid |
| D011622 | Pterins |
| D011621 | Pteridines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D003067 | Coenzymes |
| D045762 | Enzymes and Coenzymes |
Not provided
Not provided
| Between 18 and 65 years |
|
| >=65 years |
|
| Male |
|
| Not Hispanic or Latino |
|
| Unknown or Not Reported |
|
| Asian |
|
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
| Australia |
|
| Spain |
|
| Puerto Rico |
|
| Belgium |
|
| Italy |
|
| Canada |
|
| France |
|
| Germany |
|
| Hong Kong |
|
| Units | Counts |
|---|---|
| Participants |
|
|
|
|
| OG001 | Randomized Cohort: Bevacizumab + FOLFIRI | Participants received bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
|
|
|
|
| OG001 | Randomized Cohort: Bevacizumab + FOLFIRI | Participants received bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
|
|
|
|
|
|
|
|
| OG001 | Randomized Cohort: Bevacizumab + FOLFIRI | Participants received bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
|
|
|
| Randomized Cohort: Bevacizumab + FOLFIRI |
Participants received bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
|
|
|
Participants received bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
|
|
|
| OG001 | Randomized Cohort: Bevacizumab + FOLFIRI | Participants received bevacizumab + FOLFIRI intravenous infusions for 34 weeks as mentioned below:
|
|
|
|
|
|
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|
| Slight Problems |
|
| Moderate Problems |
|
| Severe Problems |
|
| Extreme Problems |
|