Acute Myeloid Leukemia
Conditions
Keywords
Antibodies, monoclonal, Antibody drug conjugate, Antigens, cluster of differentiation 33 (CD33), Drug therapy, Immunotherapy
Brief summary
The purpose of this study in AML patients is to test whether vadastuximab talirine (SGN-CD33A; 33A) combined with either azacitidine or decitabine improves remission rates and extends overall survival as compared to placebo combined with either azacitidine or decitabine.
Detailed description
Hypomethylating agents (HMAs), such as decitabine or azacitidine, are considered a standard treatment for older patients with AML. The primary goals of this study are to test whether patients treated with an HMA (either decitabine or azacitidine) in combination with 33A will have better anti-tumor activity and/or survive longer than patients treated with an HMA in combination with placebo. Patients who meet eligibility criteria will be randomly assigned to one of two treatment groups: 1) 33A plus HMA (Experimental Arm); or 2) placebo plus HMA (Comparator Arm). In addition to evaluating survival and remission rates, the minimal residual disease (MRD)-negative remission rate, duration of remission, event free- and leukemia-free survival, and safety and tolerability will be compared between arms.
Interventions
33A, 10 mcg/kg, every 4 weeks via intravenous (IV) push
Volume equivalent to 10 mcg/kg, every 4 weeks via IV push
75 mg/m2 given subcutaneously (SC) or IV x 7 days, every 4 weeks
20 mg/m2 given IV x 5 days, every 4 weeks
Sponsors
Study design
Eligibility
Inclusion criteria
* Newly diagnosed, previously untreated, cytologically/histologically confirmed de novo or secondary AML according to World Health Organization (WHO) classification (except for acute promyelocytic leukemia (APL)) * Intermediate or adverse cytogenetic risk * Eligible for therapy with either decitabine or azacitidine * Acceptable hematologic and organ function
Exclusion criteria
* AML associated with favorable risk karyotypes including inv(16), t(8;21), t(16;16), or t(15;17) * Patients who are candidates for allogeneic stem cell transplant at the time of enrollment * Patients with a history of one of the following myeloproliferative neoplasms: essential thrombocythemia, polycythemia vera, and primary myelofibrosis * Received prior treatment with HMA or chemotherapy for antecedent myelodysplastic syndrome (MDS)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival | Up to 1.5 years | Time from randomization to death due to any cause |
| Composite Complete Remission (CRc) Rate | Up to 1.5 years | Number of patients who achieved complete remission (CR) or complete remission with incomplete blood count recovery (CRi) according to the modified response criteria for acute myeloid leukemia (AML) per Cheson 2003. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Event-free Survival | Up to approximately 11.24 months | Event-free survival is calculated from the time of randomization to the first documentation of progression, relapse, or death, whichever comes first. Patients who do not have event (progression, relapse, or death) prior to analysis cutoff date are censored at the date of last response assessment. Patients who started another anticancer therapy before progression, relapse, or death are censored at the date of last response assessment prior to the start of new therapy. Patients who do not have response assessment post-baseline are censored at the date of randomization. |
| Leukemia-free Survival | Up to approximately 9.49 months | Leukemia-free survival is calculated from the first documentation of blast clearance (CR, CRi, mLFS) to the first documentation of disease relapse or death, whichever comes first. Patients who are in remission at the time of analysis cutoff are censored at the date of last response assessment. Patients who started another anticancer therapy before relapse or death are censored at the date of last response assessment prior to start of new therapy. |
| Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events | Up to 1.5 years | Treatment-emergent adverse events (TEAEs) are presented and defined as newly occurring (not present at baseline) or worsening after first dose of investigational product. SAE = serious adverse event. Study treatment in this data set refers to blinded study treatment. |
| Minimal Residual Disease (MRD)-Negative Composite Complete Remission Rate | Up to 1.5 years | Number of patients who achieve both remission (CR or CRi) and MRD-negative status |
| Time to Complete Remission | Up to 1.5 years | Time to CR or CRi is the time from randomization to the first documentation of CR/CRi |
| Mortality Rates at Day 30 and Day 60 | Up to 60 days | 30- and 60-day survival from date of randomization. Estimated using Kaplan-Meier method. |
| Incidence of Grade 3 or Higher Laboratory Abnormalities | Up to 1.5 years | Participants who experienced a laboratory grade increase to Grade 3 or higher (per National Cancer Institute's Common Terminology Criteria for Adverse Events \[NCI CTCAE\], v4.03) |
| Duration of Remission | Up to approximately 9.5 months | Duration of remission is calculated from the first documentation of CR or CRi to the first documentation of disease relapse or death, whichever comes first. Patients who are in remission at the time of analysis cutoff are censored at the date of last response assessment. Patients who started another anticancer therapy before relapse or death are censored at the date of last response assessment prior to start of new therapy. |
Countries
Australia, Austria, Belgium, Czechia, France, Germany, Hungary, Israel, Italy, Luxembourg, Poland, South Korea, Spain, Taiwan, United Kingdom, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| 33A + HMA 33A plus azacitidine or decitabine
33A: 33A, 10 mcg/kg, every 4 weeks via intravenous (IV) push
azacitidine: 75 mg/m2 given subcutaneously (SC) or IV x 7 days, every 4 weeks
decitabine: 20 mg/m2 given IV x 5 days, every 4 weeks | 117 |
| Placebo + HMA placebo plus azacitidine or decitabine
placebo: Volume equivalent to 10 mcg/kg, every 4 weeks via IV push
azacitidine: 75 mg/m2 given subcutaneously (SC) or IV x 7 days, every 4 weeks
decitabine: 20 mg/m2 given IV x 5 days, every 4 weeks | 123 |
| Total | 240 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Death | 46 | 32 |
| Overall Study | Physician Decision | 3 | 2 |
| Overall Study | Study Termination by Sponsor | 64 | 81 |
| Overall Study | Withdrawal by Subject | 4 | 8 |
Baseline characteristics
| Characteristic | Placebo + HMA | Total | 33A + HMA |
|---|---|---|---|
| Age, Continuous | 75.0 years | 75.0 years | 75.0 years |
| Age, Customized Age Group 65 - 74 years | 55 Participants | 110 Participants | 55 Participants |
| Age, Customized Age Group >65 years | 3 Participants | 6 Participants | 3 Participants |
| Age, Customized Age Group 75 - 79 years | 41 Participants | 74 Participants | 33 Participants |
| Age, Customized Age Group >= 80 years | 24 Participants | 50 Participants | 26 Participants |
| Eastern Cooperative Oncology Group (ECOG) Performance Status Grade 0: Normal activity | 23 Participants | 46 Participants | 23 Participants |
| Eastern Cooperative Oncology Group (ECOG) Performance Status Grade 1: Symptoms but ambulatory | 80 Participants | 158 Participants | 78 Participants |
| Eastern Cooperative Oncology Group (ECOG) Performance Status Grade 2: In bed less than 50% of the time | 20 Participants | 36 Participants | 16 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 2 Participants | 5 Participants | 3 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 111 Participants | 209 Participants | 98 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 10 Participants | 26 Participants | 16 Participants |
| Race/Ethnicity, Customized Race American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race/Ethnicity, Customized Race Asian | 16 Participants | 28 Participants | 12 Participants |
| Race/Ethnicity, Customized Race Black or African American | 1 Participants | 4 Participants | 3 Participants |
| Race/Ethnicity, Customized Race Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race/Ethnicity, Customized Race Not Reportable | 10 Participants | 23 Participants | 13 Participants |
| Race/Ethnicity, Customized Race Other | 1 Participants | 3 Participants | 2 Participants |
| Race/Ethnicity, Customized Race Unknown | 1 Participants | 3 Participants | 2 Participants |
| Race/Ethnicity, Customized Race White | 94 Participants | 179 Participants | 85 Participants |
| Region of Enrollment Australia | 11 participants | 21 participants | 10 participants |
| Region of Enrollment Austria | 0 participants | 3 participants | 3 participants |
| Region of Enrollment Belgium | 8 participants | 12 participants | 4 participants |
| Region of Enrollment Czechia | 6 participants | 9 participants | 3 participants |
| Region of Enrollment France | 10 participants | 23 participants | 13 participants |
| Region of Enrollment Germany | 6 participants | 8 participants | 2 participants |
| Region of Enrollment Hungary | 6 participants | 11 participants | 5 participants |
| Region of Enrollment Israel | 7 participants | 12 participants | 5 participants |
| Region of Enrollment Italy | 3 participants | 5 participants | 2 participants |
| Region of Enrollment South Korea | 7 participants | 13 participants | 6 participants |
| Region of Enrollment Spain | 6 participants | 11 participants | 5 participants |
| Region of Enrollment Taiwan | 5 participants | 10 participants | 5 participants |
| Region of Enrollment United Kingdom | 3 participants | 8 participants | 5 participants |
| Region of Enrollment United States | 45 participants | 94 participants | 49 participants |
| Sex: Female, Male Female | 67 Participants | 136 Participants | 69 Participants |
| Sex: Female, Male Male | 56 Participants | 104 Participants | 48 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 43 / 111 | 34 / 128 |
| other Total, other adverse events | 105 / 111 | 123 / 128 |
| serious Total, serious adverse events | 92 / 111 | 89 / 128 |
Outcome results
Composite Complete Remission (CRc) Rate
Number of patients who achieved complete remission (CR) or complete remission with incomplete blood count recovery (CRi) according to the modified response criteria for acute myeloid leukemia (AML) per Cheson 2003.
Time frame: Up to 1.5 years
Population: Intent-to-treat analysis set
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| 33A + HMA | Composite Complete Remission (CRc) Rate | 30 participants |
| Placebo + HMA | Composite Complete Remission (CRc) Rate | 26 participants |
Overall Survival
Time from randomization to death due to any cause
Time frame: Up to 1.5 years
Population: Intent-to-treat analysis set
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| 33A + HMA | Overall Survival | 5.1 months |
| Placebo + HMA | Overall Survival | NA months |
Duration of Remission
Duration of remission is calculated from the first documentation of CR or CRi to the first documentation of disease relapse or death, whichever comes first. Patients who are in remission at the time of analysis cutoff are censored at the date of last response assessment. Patients who started another anticancer therapy before relapse or death are censored at the date of last response assessment prior to start of new therapy.
Time frame: Up to approximately 9.5 months
Population: Patients who achieved complete remission (CR) or CR with incomplete hematologic recovery (CRi).
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| 33A + HMA | Duration of Remission | 5.1 months |
| Placebo + HMA | Duration of Remission | 7.5 months |
Event-free Survival
Event-free survival is calculated from the time of randomization to the first documentation of progression, relapse, or death, whichever comes first. Patients who do not have event (progression, relapse, or death) prior to analysis cutoff date are censored at the date of last response assessment. Patients who started another anticancer therapy before progression, relapse, or death are censored at the date of last response assessment prior to the start of new therapy. Patients who do not have response assessment post-baseline are censored at the date of randomization.
Time frame: Up to approximately 11.24 months
Population: Intent-to-treat analysis set
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| 33A + HMA | Event-free Survival | 4.2 months |
| Placebo + HMA | Event-free Survival | 6.7 months |
Incidence of Grade 3 or Higher Laboratory Abnormalities
Participants who experienced a laboratory grade increase to Grade 3 or higher (per National Cancer Institute's Common Terminology Criteria for Adverse Events \[NCI CTCAE\], v4.03)
Time frame: Up to 1.5 years
Population: Safety Analysis Set: 7 patients randomized to the HMA+33A received only HMA and are included in the HMA+Placebo safety set. 1 patient randomized to the HMA+placebo arm received 33A+HMA treatment. 1 patient in the HMA+placebo arm did not receive any study treatment.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Potassium (mEq/L) - High | 1 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Albumin (g/dL) - Low | 2 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Potassium (mEq/L) - Low | 5 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Calcium (mg/dL) - Low | 8 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Sodium (mEq/L) - Low | 13 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Amylase (IU/L) - High | 1 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Triacylglycerol Lipase (IU/L) - High | 10 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Creatinine (mg/dL) - High | 0 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Urate (mg/dL) - High | 4 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Alanine Aminotransferase (IU/L) - High | 0 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Hemoglobin (g/dL) - Low | 59 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Glucose (mg/dL) - High | 12 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Leukocytes (x10^3/uL) - High | 0 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Aspartate Aminotransferase (IU/L) - High | 1 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Leukocytes (x10^3/uL) - Low | 86 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Magnesium (mg/dL) - High | 2 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Lymphocytes (x10^3/uL) - High | 1 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Alkaline Phosphatase (IU/L) - High | 0 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Lymphocytes (x10^3/uL) - Low | 51 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Phosphate (mg/dL) - Low | 17 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Neutrophils (x10^3/uL) - Low | 63 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Platelets (x10^3/uL) - Low | 77 Participants |
| 33A + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Bilirubin (mg/dL) - High | 1 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Platelets (x10^3/uL) - Low | 75 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Alanine Aminotransferase (IU/L) - High | 2 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Albumin (g/dL) - Low | 4 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Alkaline Phosphatase (IU/L) - High | 2 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Amylase (IU/L) - High | 0 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Aspartate Aminotransferase (IU/L) - High | 2 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Bilirubin (mg/dL) - High | 1 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Calcium (mg/dL) - Low | 3 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Creatinine (mg/dL) - High | 1 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Glucose (mg/dL) - High | 9 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Magnesium (mg/dL) - High | 0 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Phosphate (mg/dL) - Low | 9 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Potassium (mEq/L) - High | 0 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Potassium (mEq/L) - Low | 14 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Sodium (mEq/L) - Low | 12 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Triacylglycerol Lipase (IU/L) - High | 4 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Urate (mg/dL) - High | 7 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Hemoglobin (g/dL) - Low | 66 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Leukocytes (x10^3/uL) - High | 3 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Leukocytes (x10^3/uL) - Low | 70 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Lymphocytes (x10^3/uL) - High | 4 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Lymphocytes (x10^3/uL) - Low | 29 Participants |
| Placebo + HMA | Incidence of Grade 3 or Higher Laboratory Abnormalities | Neutrophils (x10^3/uL) - Low | 43 Participants |
Leukemia-free Survival
Leukemia-free survival is calculated from the first documentation of blast clearance (CR, CRi, mLFS) to the first documentation of disease relapse or death, whichever comes first. Patients who are in remission at the time of analysis cutoff are censored at the date of last response assessment. Patients who started another anticancer therapy before relapse or death are censored at the date of last response assessment prior to start of new therapy.
Time frame: Up to approximately 9.49 months
Population: Patients who achieved CR/CRi
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| 33A + HMA | Leukemia-free Survival | 5.1 months |
| Placebo + HMA | Leukemia-free Survival | 7.5 months |
Minimal Residual Disease (MRD)-Negative Composite Complete Remission Rate
Number of patients who achieve both remission (CR or CRi) and MRD-negative status
Time frame: Up to 1.5 years
Population: Intent-to-treat analysis set
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| 33A + HMA | Minimal Residual Disease (MRD)-Negative Composite Complete Remission Rate | MRD-negative CRc rate | 18 participants |
| 33A + HMA | Minimal Residual Disease (MRD)-Negative Composite Complete Remission Rate | MRD-negative CR rate | 8 participants |
| 33A + HMA | Minimal Residual Disease (MRD)-Negative Composite Complete Remission Rate | MRD-negative CRi rate | 10 participants |
| Placebo + HMA | Minimal Residual Disease (MRD)-Negative Composite Complete Remission Rate | MRD-negative CRc rate | 10 participants |
| Placebo + HMA | Minimal Residual Disease (MRD)-Negative Composite Complete Remission Rate | MRD-negative CR rate | 5 participants |
| Placebo + HMA | Minimal Residual Disease (MRD)-Negative Composite Complete Remission Rate | MRD-negative CRi rate | 5 participants |
Mortality Rates at Day 30 and Day 60
30- and 60-day survival from date of randomization. Estimated using Kaplan-Meier method.
Time frame: Up to 60 days
Population: Intent-to-Treat Analysis Set
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| 33A + HMA | Mortality Rates at Day 30 and Day 60 | 30-day Mortality Rate | 11 percentage of participants |
| 33A + HMA | Mortality Rates at Day 30 and Day 60 | 60-day Mortality Rate | 23 percentage of participants |
| Placebo + HMA | Mortality Rates at Day 30 and Day 60 | 30-day Mortality Rate | 6 percentage of participants |
| Placebo + HMA | Mortality Rates at Day 30 and Day 60 | 60-day Mortality Rate | 13 percentage of participants |
Time to Complete Remission
Time to CR or CRi is the time from randomization to the first documentation of CR/CRi
Time frame: Up to 1.5 years
Population: Intent-to-Treat Analysis Set - Patients who Achieved CR/CRi.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| 33A + HMA | Time to Complete Remission | 9.3 weeks |
| Placebo + HMA | Time to Complete Remission | 9.4 weeks |
Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events
Treatment-emergent adverse events (TEAEs) are presented and defined as newly occurring (not present at baseline) or worsening after first dose of investigational product. SAE = serious adverse event. Study treatment in this data set refers to blinded study treatment.
Time frame: Up to 1.5 years
Population: Safety analysis set: 7 patients randomized to the HMA+33A received only HMA and are included in the HMA+Placebo safety set. 1 patient randomized to the HMA+placebo arm received 33A+HMA treatment. 1 patient in the HMA+placebo arm did not receive any study treatment.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| 33A + HMA | Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events | Patients with any AE related to study treatment | 83 Participants |
| 33A + HMA | Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events | Patients with any SAE related to study treatment | 51 Participants |
| 33A + HMA | Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events | Patients with any SAE | 92 Participants |
| 33A + HMA | Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events | Patients with Grade 3 or Higher AE | 103 Participants |
| 33A + HMA | Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events | Patient with any TEAE | 111 Participants |
| Placebo + HMA | Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events | Patients with Grade 3 or Higher AE | 112 Participants |
| Placebo + HMA | Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events | Patient with any TEAE | 125 Participants |
| Placebo + HMA | Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events | Patients with any AE related to study treatment | 59 Participants |
| Placebo + HMA | Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events | Patients with any SAE | 89 Participants |
| Placebo + HMA | Type, Incidence, Severity, Seriousness, and Relatedness of Adverse Events | Patients with any SAE related to study treatment | 20 Participants |