Trial Outcomes & Findings for Effect of Zoledronic Acid as Anti-Cancer Treatment in Metastatic Breast Cancer Patients (NCT NCT01129336)

NCT ID: NCT01129336

Last Updated: 2014-05-20

Results Overview

Complete Response (CR): disappearance of all target lesions. Any pathological lymph nodes (target or non-target) must have exhibited a reduction in short axis to \< 10 mm. Partial Response (PR): at least a 30% decrease in sum of diameters of target lesions, taking as reference the baseline sum of diameters. Progressive Disease (PD): at least 20% increase in sum of diameters of target lesions taking as reference the smallest sum on study accompanied by an absolute increase of at least 5 mm or appearance of one or more new lesions. Stable Disease (SD): neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference smallest sum diameters. PFS is time from enrollment to date of first documented disease progression or death due to any cause. A participant is considered to be censored when data on time to event is missing due to a subject being lost to follow-up or non-occurrence of the outcome event before the completion of the trial.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

44 participants

Primary outcome timeframe

up to 18 months

Results posted on

2014-05-20

Participant Flow

80 patients were screened. 44 patients received treatment.

Participant milestones

Participant milestones
Measure
Patients Without Bone Metastases
Patients with no bone metastasis were randomized into a 1:1 ratio to standard therapy plus zoledronic acid 4mg IV Zoledronic acid administration monthly during Months 1-18.
Patients With Bone Metastases
Patients with bone metastasis received standard therapy + zoledronic acid for 18 months (discontinued upon disease progression/secondary malignancy)
Overall Study
STARTED
15
29
Overall Study
Completed Treatment
1
3
Overall Study
COMPLETED
3
13
Overall Study
NOT COMPLETED
12
16

Reasons for withdrawal

Reasons for withdrawal
Measure
Patients Without Bone Metastases
Patients with no bone metastasis were randomized into a 1:1 ratio to standard therapy plus zoledronic acid 4mg IV Zoledronic acid administration monthly during Months 1-18.
Patients With Bone Metastases
Patients with bone metastasis received standard therapy + zoledronic acid for 18 months (discontinued upon disease progression/secondary malignancy)
Overall Study
Protocol Violation
1
0
Overall Study
Disease Progression
1
4
Overall Study
Lost to Follow-up
1
0
Overall Study
Withdrawal by Subject
7
4
Overall Study
Adverse Event
0
1
Overall Study
Missing Study Completion Status
2
3
Overall Study
Death
0
4

Baseline Characteristics

Effect of Zoledronic Acid as Anti-Cancer Treatment in Metastatic Breast Cancer Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Patients Without Bone Metastases
n=15 Participants
Patients with no bone metastasis were randomized into a 1:1 ratio to standard therapy plus zoledronic acid 4mg IV Zoledronic acid administration monthly during Months 1-18.
Patients With Bone Metastases
n=29 Participants
Patients with bone metastasis received standard therapy + zoledronic acid for 18 months (discontinued upon disease progression/secondary malignancy)
Total
n=44 Participants
Total of all reporting groups
Age, Continuous
53.48 Years
STANDARD_DEVIATION 12.293 • n=5 Participants
59.47 Years
STANDARD_DEVIATION 14.535 • n=7 Participants
57.43 Years
STANDARD_DEVIATION 13.965 • n=5 Participants
Sex: Female, Male
Female
15 Participants
n=5 Participants
29 Participants
n=7 Participants
44 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: up to 18 months

Population: All Enrolled Patients population, which included all enrolled patients regardless of whether they received study drug.

Complete Response (CR): disappearance of all target lesions. Any pathological lymph nodes (target or non-target) must have exhibited a reduction in short axis to \< 10 mm. Partial Response (PR): at least a 30% decrease in sum of diameters of target lesions, taking as reference the baseline sum of diameters. Progressive Disease (PD): at least 20% increase in sum of diameters of target lesions taking as reference the smallest sum on study accompanied by an absolute increase of at least 5 mm or appearance of one or more new lesions. Stable Disease (SD): neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference smallest sum diameters. PFS is time from enrollment to date of first documented disease progression or death due to any cause. A participant is considered to be censored when data on time to event is missing due to a subject being lost to follow-up or non-occurrence of the outcome event before the completion of the trial.

Outcome measures

Outcome measures
Measure
Patients Without Bone Metastases
n=15 Participants
Patients with no bone metastasis were randomized into a 1:1 ratio to standard therapy plus zoledronic acid 4mg IV Zoledronic acid administration monthly during Months 1-18.
Patients With Bone Metastases
n=29 Participants
Patients with bone metastasis received standard therapy + zoledronic acid for 18 months (discontinued upon disease progression/secondary malignancy)
Number of Participants With Progression Free Survival (PFS)
Event
9 Participants
19 Participants
Number of Participants With Progression Free Survival (PFS)
Censor
6 Participants
10 Participants

SECONDARY outcome

Timeframe: Baseline, Month 1, 2, 4, 6, 9 and 18

Population: All Enrolled Patients population, which included all enrolled patients regardless of whether they received study drug. "n" in each category represents the number of patients with non-missing CTC values.

Circulating tumor cells (CTCs) have been associated with poor patient prognosis and outcomes in patients receiving treatment for MBC. CTCs have been evaluated as a potential biomarker for predicting treatment effects and overall survival. Baseline was defined as the last predose measurement for patients who received any study drug and as the later of the screening visit or Visit 2 value for patients who did not receive the study drug. Percentage was calculated as the number of patients with CTC ≥5/7.5 mL against the number of patients with nonmissing CTC values (represented as 'n' in the categories).

Outcome measures

Outcome measures
Measure
Patients Without Bone Metastases
n=15 Participants
Patients with no bone metastasis were randomized into a 1:1 ratio to standard therapy plus zoledronic acid 4mg IV Zoledronic acid administration monthly during Months 1-18.
Patients With Bone Metastases
n=29 Participants
Patients with bone metastasis received standard therapy + zoledronic acid for 18 months (discontinued upon disease progression/secondary malignancy)
Percentage of Patients With Circulating Tumor Cell Levels of at Least 5 Per 7.5 mL of Peripheral Blood by Month
Baseline (n=15,28)
26.7 Percentage of Participants
Interval 7.8 to 55.1
57.1 Percentage of Participants
Interval 37.2 to 75.5
Percentage of Patients With Circulating Tumor Cell Levels of at Least 5 Per 7.5 mL of Peripheral Blood by Month
Month 1 (n=8,0)
12.5 Percentage of Participants
Interval 0.3 to 52.7
NA Percentage of Participants
No patient analyzed in this arm for month 1.
Percentage of Patients With Circulating Tumor Cell Levels of at Least 5 Per 7.5 mL of Peripheral Blood by Month
Month 2 (n=12,24)
8.3 Percentage of Participants
Interval 0.2 to 38.5
25.0 Percentage of Participants
Interval 9.8 to 46.7
Percentage of Patients With Circulating Tumor Cell Levels of at Least 5 Per 7.5 mL of Peripheral Blood by Month
Month 4 (n=8,20)
0 Percentage of Participants
Interval 0.0 to 0.0
15.0 Percentage of Participants
Interval 3.2 to 37.9
Percentage of Patients With Circulating Tumor Cell Levels of at Least 5 Per 7.5 mL of Peripheral Blood by Month
Month 6 (n=7,19)
0 Percentage of Participants
Interval 0.0 to 0.0
15.8 Percentage of Participants
Interval 3.4 to 39.6
Percentage of Patients With Circulating Tumor Cell Levels of at Least 5 Per 7.5 mL of Peripheral Blood by Month
Month 9 (n=2,14)
0 Percentage of Participants
Interval 0.0 to 0.0
35.7 Percentage of Participants
Interval 12.8 to 64.9
Percentage of Patients With Circulating Tumor Cell Levels of at Least 5 Per 7.5 mL of Peripheral Blood by Month
Month 18 (n=2,1)
0 Percentage of Participants
Interval 0.0 to 0.0
100.0 Percentage of Participants
Interval 0.0 to 100.0

SECONDARY outcome

Timeframe: up to 18 months

Population: All Enrolled Patients population, which included all enrolled patients regardless of whether they received study drug.

Time to progression is defined as the time from the date of enrollment to the date of first documented disease progression or death due to metastatic breast cancer.

Outcome measures

Outcome measures
Measure
Patients Without Bone Metastases
n=15 Participants
Patients with no bone metastasis were randomized into a 1:1 ratio to standard therapy plus zoledronic acid 4mg IV Zoledronic acid administration monthly during Months 1-18.
Patients With Bone Metastases
n=29 Participants
Patients with bone metastasis received standard therapy + zoledronic acid for 18 months (discontinued upon disease progression/secondary malignancy)
Time to Progression (TTP)
190 Days
Interval 118.0 to 478.0
297 Days
Interval 221.0 to 373.0

SECONDARY outcome

Timeframe: Baseline, Month 2, Month 4

Population: All Enrolled Patients population, which included all enrolled patients regardless of whether they received study drug.

NTX= N-telopeptide of type 1 collagen (nmol bce/mmol \[nanomoles of bone collagen equivalents per millimole of creatinine\]). Baseline was defined as the last predose measurement for patients who received any study drug and as the later of the screening visit or visit 2 value for patients who did not receive study drug.

Outcome measures

Outcome measures
Measure
Patients Without Bone Metastases
n=15 Participants
Patients with no bone metastasis were randomized into a 1:1 ratio to standard therapy plus zoledronic acid 4mg IV Zoledronic acid administration monthly during Months 1-18.
Patients With Bone Metastases
n=29 Participants
Patients with bone metastasis received standard therapy + zoledronic acid for 18 months (discontinued upon disease progression/secondary malignancy)
Change From Baseline in Urine NTX by Month
Change from baseline at Month 4
-4.750 nmol bce/mmol
Standard Deviation 18.7521
-23.476 nmol bce/mmol
Standard Deviation 26.3526
Change From Baseline in Urine NTX by Month
Change from baseline at Month 2
-5.25 nmol bce/mmol
Standard Deviation 22.5555
-27.619 nmol bce/mmol
Standard Deviation 23.3955

Adverse Events

Patients Without Bone Metastases

Serious events: 2 serious events
Other events: 13 other events
Deaths: 0 deaths

Patients With Bone Metastases

Serious events: 7 serious events
Other events: 28 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Patients Without Bone Metastases
n=15 participants at risk
Patients with no bone metastasis were randomized into a 1:1 ratio to standard therapy plus zoledronic acid 4mg IV Zoledronic acid administration monthly during Months 1-18.
Patients With Bone Metastases
n=29 participants at risk
Patients with bone metastasis received standard therapy + zoledronic acid for 18 months (discontinued upon disease progression/secondary malignancy)
Blood and lymphatic system disorders
Anaemia
6.7%
1/15
0.00%
0/29
Gastrointestinal disorders
Rectal haemorrhage
6.7%
1/15
0.00%
0/29
General disorders
Chest discomfort
0.00%
0/15
3.4%
1/29
Hepatobiliary disorders
Hepatic failure
0.00%
0/15
3.4%
1/29
Infections and infestations
Extradural abscess
0.00%
0/15
3.4%
1/29
Infections and infestations
Osteomyelitis
0.00%
0/15
3.4%
1/29
Infections and infestations
Pharyngitis
0.00%
0/15
3.4%
1/29
Infections and infestations
Pneumonia
0.00%
0/15
3.4%
1/29
Infections and infestations
Sepsis
0.00%
0/15
3.4%
1/29
Metabolism and nutrition disorders
Diabetes mellitus
0.00%
0/15
3.4%
1/29
Metabolism and nutrition disorders
Hyperkalaemia
0.00%
0/15
3.4%
1/29
Metabolism and nutrition disorders
Hyponatraemia
6.7%
1/15
0.00%
0/29
Musculoskeletal and connective tissue disorders
Arthralgia
0.00%
0/15
3.4%
1/29
Musculoskeletal and connective tissue disorders
Pain in extremity
0.00%
0/15
3.4%
1/29
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Metastases to meninges
0.00%
0/15
3.4%
1/29
Nervous system disorders
Altered state of consciousness
0.00%
0/15
3.4%
1/29
Nervous system disorders
Convulsion
0.00%
0/15
3.4%
1/29
Nervous system disorders
Loss of consciousness
0.00%
0/15
3.4%
1/29
Psychiatric disorders
Mental status changes
0.00%
0/15
3.4%
1/29
Renal and urinary disorders
Renal failure
0.00%
0/15
3.4%
1/29
Respiratory, thoracic and mediastinal disorders
Acute respiratory distress syndrome
0.00%
0/15
3.4%
1/29
Respiratory, thoracic and mediastinal disorders
Hypoxia
0.00%
0/15
3.4%
1/29
Respiratory, thoracic and mediastinal disorders
Pleural effusion
0.00%
0/15
3.4%
1/29
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
0.00%
0/15
6.9%
2/29

Other adverse events

Other adverse events
Measure
Patients Without Bone Metastases
n=15 participants at risk
Patients with no bone metastasis were randomized into a 1:1 ratio to standard therapy plus zoledronic acid 4mg IV Zoledronic acid administration monthly during Months 1-18.
Patients With Bone Metastases
n=29 participants at risk
Patients with bone metastasis received standard therapy + zoledronic acid for 18 months (discontinued upon disease progression/secondary malignancy)
Blood and lymphatic system disorders
Anaemia
0.00%
0/15
17.2%
5/29
Blood and lymphatic system disorders
Coagulopathy
6.7%
1/15
0.00%
0/29
Blood and lymphatic system disorders
Leukopenia
6.7%
1/15
3.4%
1/29
Blood and lymphatic system disorders
Neutropenia
33.3%
5/15
17.2%
5/29
Blood and lymphatic system disorders
Thrombocytopenia
13.3%
2/15
6.9%
2/29
Cardiac disorders
Palpitations
6.7%
1/15
0.00%
0/29
Cardiac disorders
Tachycardia
0.00%
0/15
13.8%
4/29
Ear and labyrinth disorders
Deafness
6.7%
1/15
0.00%
0/29
Eye disorders
Erythema of eyelid
6.7%
1/15
0.00%
0/29
Gastrointestinal disorders
Abdominal discomfort
6.7%
1/15
3.4%
1/29
Gastrointestinal disorders
Abdominal distension
6.7%
1/15
3.4%
1/29
Gastrointestinal disorders
Abdominal pain
13.3%
2/15
6.9%
2/29
Gastrointestinal disorders
Abdominal pain upper
6.7%
1/15
10.3%
3/29
Gastrointestinal disorders
Constipation
46.7%
7/15
6.9%
2/29
Gastrointestinal disorders
Diarrhoea
26.7%
4/15
13.8%
4/29
Gastrointestinal disorders
Dry mouth
0.00%
0/15
10.3%
3/29
Gastrointestinal disorders
Dyspepsia
0.00%
0/15
6.9%
2/29
Gastrointestinal disorders
Dysphagia
6.7%
1/15
0.00%
0/29
Gastrointestinal disorders
Lip ulceration
6.7%
1/15
0.00%
0/29
Gastrointestinal disorders
Nausea
33.3%
5/15
27.6%
8/29
Gastrointestinal disorders
Oedema mouth
6.7%
1/15
0.00%
0/29
Gastrointestinal disorders
Stomatitis
6.7%
1/15
3.4%
1/29
Gastrointestinal disorders
Vomiting
26.7%
4/15
17.2%
5/29
General disorders
Asthenia
13.3%
2/15
6.9%
2/29
General disorders
Chest pain
6.7%
1/15
0.00%
0/29
General disorders
Chills
0.00%
0/15
13.8%
4/29
General disorders
Fatigue
26.7%
4/15
62.1%
18/29
General disorders
Generalised oedema
6.7%
1/15
0.00%
0/29
General disorders
Mucosal inflammation
13.3%
2/15
3.4%
1/29
General disorders
Non-cardiac chest pain
0.00%
0/15
6.9%
2/29
General disorders
Oedema peripheral
20.0%
3/15
10.3%
3/29
General disorders
Pain
0.00%
0/15
10.3%
3/29
General disorders
Pyrexia
0.00%
0/15
17.2%
5/29
Hepatobiliary disorders
Jaundice
6.7%
1/15
0.00%
0/29
Immune system disorders
Drug hypersensitivity
6.7%
1/15
3.4%
1/29
Infections and infestations
Acute sinusitis
6.7%
1/15
0.00%
0/29
Infections and infestations
Cellulitis
6.7%
1/15
0.00%
0/29
Infections and infestations
Nasopharyngitis
13.3%
2/15
0.00%
0/29
Infections and infestations
Oral herpes
0.00%
0/15
6.9%
2/29
Infections and infestations
Postoperative wound infection
6.7%
1/15
0.00%
0/29
Infections and infestations
Upper respiratory tract infection
13.3%
2/15
10.3%
3/29
Infections and infestations
Urinary tract infection
13.3%
2/15
3.4%
1/29
Infections and infestations
Vulvovaginal candidiasis
6.7%
1/15
0.00%
0/29
Injury, poisoning and procedural complications
Radiation skin injury
6.7%
1/15
0.00%
0/29
Investigations
Alanine aminotransferase increased
0.00%
0/15
6.9%
2/29
Investigations
Aspartate aminotransferase increased
0.00%
0/15
6.9%
2/29
Investigations
Blood alkaline phosphatase increased
0.00%
0/15
6.9%
2/29
Investigations
Blood creatinine increased
0.00%
0/15
20.7%
6/29
Investigations
Haemoglobin decreased
6.7%
1/15
10.3%
3/29
Investigations
Neutrophil count decreased
0.00%
0/15
6.9%
2/29
Investigations
Platelet count decreased
6.7%
1/15
0.00%
0/29
Investigations
Urine output decreased
6.7%
1/15
0.00%
0/29
Investigations
Weight decreased
0.00%
0/15
6.9%
2/29
Investigations
Weight increased
6.7%
1/15
0.00%
0/29
Investigations
White blood cell count decreased
0.00%
0/15
6.9%
2/29
Metabolism and nutrition disorders
Decreased appetite
0.00%
0/15
13.8%
4/29
Metabolism and nutrition disorders
Dehydration
6.7%
1/15
17.2%
5/29
Metabolism and nutrition disorders
Hypoalbuminaemia
6.7%
1/15
0.00%
0/29
Metabolism and nutrition disorders
Hypocalcaemia
6.7%
1/15
10.3%
3/29
Metabolism and nutrition disorders
Hypochloraemia
6.7%
1/15
0.00%
0/29
Metabolism and nutrition disorders
Hypokalaemia
13.3%
2/15
6.9%
2/29
Metabolism and nutrition disorders
Hyponatraemia
0.00%
0/15
10.3%
3/29
Musculoskeletal and connective tissue disorders
Arthralgia
20.0%
3/15
24.1%
7/29
Musculoskeletal and connective tissue disorders
Back pain
6.7%
1/15
31.0%
9/29
Musculoskeletal and connective tissue disorders
Bone pain
13.3%
2/15
17.2%
5/29
Musculoskeletal and connective tissue disorders
Joint swelling
6.7%
1/15
3.4%
1/29
Musculoskeletal and connective tissue disorders
Muscular weakness
6.7%
1/15
6.9%
2/29
Musculoskeletal and connective tissue disorders
Musculoskeletal chest pain
6.7%
1/15
3.4%
1/29
Musculoskeletal and connective tissue disorders
Musculoskeletal pain
6.7%
1/15
13.8%
4/29
Musculoskeletal and connective tissue disorders
Myalgia
20.0%
3/15
10.3%
3/29
Musculoskeletal and connective tissue disorders
Neck pain
0.00%
0/15
10.3%
3/29
Musculoskeletal and connective tissue disorders
Pain in extremity
6.7%
1/15
10.3%
3/29
Musculoskeletal and connective tissue disorders
Pain in jaw
6.7%
1/15
0.00%
0/29
Nervous system disorders
Dizziness
6.7%
1/15
10.3%
3/29
Nervous system disorders
Dysgeusia
6.7%
1/15
3.4%
1/29
Nervous system disorders
Headache
6.7%
1/15
10.3%
3/29
Nervous system disorders
Hypoaesthesia
0.00%
0/15
6.9%
2/29
Nervous system disorders
Neuropathy peripheral
20.0%
3/15
6.9%
2/29
Nervous system disorders
Peripheral sensory neuropathy
0.00%
0/15
6.9%
2/29
Nervous system disorders
Sinus headache
6.7%
1/15
0.00%
0/29
Nervous system disorders
Tremor
6.7%
1/15
0.00%
0/29
Psychiatric disorders
Anxiety
0.00%
0/15
10.3%
3/29
Psychiatric disorders
Depression
6.7%
1/15
10.3%
3/29
Psychiatric disorders
Insomnia
13.3%
2/15
13.8%
4/29
Psychiatric disorders
Sleep disorder
6.7%
1/15
0.00%
0/29
Renal and urinary disorders
Bladder irritation
6.7%
1/15
0.00%
0/29
Renal and urinary disorders
Dysuria
0.00%
0/15
6.9%
2/29
Respiratory, thoracic and mediastinal disorders
Cough
13.3%
2/15
20.7%
6/29
Respiratory, thoracic and mediastinal disorders
Dysphonia
6.7%
1/15
3.4%
1/29
Respiratory, thoracic and mediastinal disorders
Dyspnoea
26.7%
4/15
13.8%
4/29
Respiratory, thoracic and mediastinal disorders
Dyspnoea paroxysmal nocturnal
6.7%
1/15
0.00%
0/29
Respiratory, thoracic and mediastinal disorders
Epistaxis
0.00%
0/15
6.9%
2/29
Respiratory, thoracic and mediastinal disorders
Nasal congestion
13.3%
2/15
0.00%
0/29
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain
6.7%
1/15
6.9%
2/29
Respiratory, thoracic and mediastinal disorders
Orthopnoea
6.7%
1/15
0.00%
0/29
Respiratory, thoracic and mediastinal disorders
Pleural effusion
0.00%
0/15
6.9%
2/29
Respiratory, thoracic and mediastinal disorders
Productive cough
6.7%
1/15
0.00%
0/29
Respiratory, thoracic and mediastinal disorders
Wheezing
6.7%
1/15
0.00%
0/29
Skin and subcutaneous tissue disorders
Alopecia
6.7%
1/15
6.9%
2/29
Skin and subcutaneous tissue disorders
Dermatitis contact
6.7%
1/15
0.00%
0/29
Skin and subcutaneous tissue disorders
Dry skin
0.00%
0/15
6.9%
2/29
Skin and subcutaneous tissue disorders
Hyperhidrosis
6.7%
1/15
0.00%
0/29
Skin and subcutaneous tissue disorders
Nail disorder
0.00%
0/15
6.9%
2/29
Skin and subcutaneous tissue disorders
Night sweats
13.3%
2/15
13.8%
4/29
Skin and subcutaneous tissue disorders
Palmar-plantar erythrodysaesthesia syndrome
6.7%
1/15
3.4%
1/29
Skin and subcutaneous tissue disorders
Plantar erythema
6.7%
1/15
0.00%
0/29
Skin and subcutaneous tissue disorders
Pruritus
0.00%
0/15
6.9%
2/29
Skin and subcutaneous tissue disorders
Rash
6.7%
1/15
3.4%
1/29
Skin and subcutaneous tissue disorders
Skin exfoliation
6.7%
1/15
6.9%
2/29
Skin and subcutaneous tissue disorders
Skin hyperpigmentation
0.00%
0/15
6.9%
2/29
Vascular disorders
Flushing
6.7%
1/15
0.00%
0/29
Vascular disorders
Hot flush
13.3%
2/15
17.2%
5/29
Vascular disorders
Hypertension
6.7%
1/15
3.4%
1/29
Vascular disorders
Hypotension
0.00%
0/15
10.3%
3/29
Vascular disorders
Lymphoedema
6.7%
1/15
0.00%
0/29

Additional Information

Study Director

Novartis Pharmaceuticals

Phone: 862-778-8300

Results disclosure agreements

  • Principal investigator is a sponsor employee Principal Investigators are NOT employed by the organization sponsoring the study. Other disclosure agreement that restricts the right of the PI to discuss or publish trial results after the trial is completed. The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of pooled data (i.e.,data from all sites) in clinical trial.
  • Publication restrictions are in place

Restriction type: OTHER