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NCT03734029

Trastuzumab Deruxtecan (DS-8201a) Versus Investigator's Choice for HER2-low Breast Cancer That Has Spread or Cannot be Surgically Removed [DESTINY-Breast04]

Version 29 to 30 · Daiichi Sankyo

Patch inspector

Version 29 to 30

30 operations 5 path groups ctgov_internal_history
ClinicalTrials.gov
Severity is deterministic uncalibrated triage metadata, not validated review priority. Operation-level severity is inferred from deterministic path rules. Rule matches shown per operation are approximate previews (they skip the pipeline's suppression passes); the authoritative classification is the stored event record.
Plain-language summary

Manual review pending.

Rules fired
adverse_event_group_change
Value signals
[
  {
    "path": "/protocolSection/statusModule/completionDateStruct/date",
    "signal": "timeline_major_slip",
    "category": "timeline_major_slip",
    "new_type": "ESTIMATED",
    "old_type": "ESTIMATED",
    "severity": "high",
    "direction": "later",
    "new_value": "2024-03",
    "old_value": "2023-03",
    "delta_days": 366,
    "date_struct": "completionDateStruct",
    "new_precision": "month",
    "old_precision": "month"
  },
  {
    "paths": [
      "/protocolSection/outcomesModule/secondaryOutcomes/1",
      "/protocolSection/outcomesModule/secondaryOutcomes/3",
      "/protocolSection/outcomesModule/secondaryOutcomes/4",
      "/protocolSection/outcomesModule/secondaryOutcomes/5"
    ],
    "signal": "results_reconciliation_outcome_suppression",
    "category": "results_reconciliation",
    "severity": "low"
  }
]
Provenance
Source
ctgov_internal_history
Fetched
2026-06-18 19:12:50+00
Raw hash
108f01e9d79868cd8cf19eddd9e7f2c465e593e5840905e6d1fdbcabcef1822a
Payload
Source URL
Adverse events and safety Posted serious or other adverse event data. Triage: High 8 ops
replace /resultsSection/adverseEventsModule/timeFrame
Triage: Uncategorized
Uncategorized Operation 21
Before
Treatment-emergent adverse events (TEAEs) were collected from the time of signing the main informed consent form up to 40 days (+7 days) after the last treatment, whether observed by the investigator or reported by the participant, up to approximately 3 years in the Safety Analysis Set.
After
Adverse events (AEs) were collected from the time of signing the main informed consent form up to 40 days (+7 days) after the last treatment, whether observed by the investigator or reported by the participant, up to approximately 3 years in the Safety Analysis Set.
replace /resultsSection/adverseEventsModule/description
Triage: Uncategorized
Uncategorized Operation 22
Before
Safety events were assessed in the Safety Analysis Set, participants who received ≥1 dose of treatment.
An adverse event (AE) was any untoward medical occurrence in a participant administered a pharmaceutical product that does not necessarily have a causal relationship with that product.
The treatment of Physician's Choice arm was based on the label approved in the country of drug administration.
The Physician's Choice group was combined for an appropriate sample size for the comparator group.
After
All-cause mortality was assessed in all participants who were randomized (Full Analysis Set).
Please refer to the other prespecified outcome measure that also reports all-cause mortality from the Safety Analysis Set.
Other AEs and SAEs were assessed in the Safety Analysis Set.
The Physician's Choice (PC) treatment was based on the label approved in each country.
As prespecified in the protocol for safety analysis, the PC group was combined for an appropriate sample size for the comparator group.
replace /resultsSection/adverseEventsModule/eventGroups/0/deathsNumAffected
Triage: High
Adverse Event Group Change Operation 23
Matched rules
  • adverse_event_group_change Changes to adverse event group-level denominators or affected counts are high review priority.
Before
148
After
149
replace /resultsSection/adverseEventsModule/eventGroups/0/deathsNumAtRisk
Triage: High
Adverse Event Group Change Operation 24
Matched rules
  • adverse_event_group_change Changes to adverse event group-level denominators or affected counts are high review priority.
Before
371
After
373
replace /resultsSection/adverseEventsModule/eventGroups/1/deathsNumAffected
Triage: High
Adverse Event Group Change Operation 25
Matched rules
  • adverse_event_group_change Changes to adverse event group-level denominators or affected counts are high review priority.
Before
88
After
90
replace /resultsSection/adverseEventsModule/eventGroups/1/deathsNumAtRisk
Triage: High
Adverse Event Group Change Operation 26
Matched rules
  • adverse_event_group_change Changes to adverse event group-level denominators or affected counts are high review priority.
Before
172
After
184
remove /resultsSection/adverseEventsModule/armsReviewUnit
Triage: Uncategorized
Uncategorized Operation 27
Before
{
  "resetReasons": [
    "The arms/groups appear inconsistent with information in other parts of the record. Each arm/group should be described separately, or a valid explanation provided."
  ]
}
remove /resultsSection/adverseEventsModule/allCauseMortalityReviewUnit
Triage: Uncategorized
Uncategorized Operation 28
Before
{
  "resetReasons": [
    "The number of participants at risk appears inconsistent with data here or in other parts of the record."
  ]
}
Secondary outcomes Additional endpoints and outcome descriptions. Triage: High 5 ops
remove /protocolSection/outcomesModule/secondaryOutcomes/1
Triage: High
Secondary Outcome Change Operation 7
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
{
  "measure": "Overall Survival (OS) in the Hormone Receptor-Positive Cohort in Participants With HER2-low Breast Cancer",
  "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
  "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive."
}
remove /protocolSection/outcomesModule/secondaryOutcomes/1
Triage: High
Secondary Outcome Change Operation 8
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
Before
{
  "measure": "Overall Survival (OS) in Participants With HER2-low Breast Cancer (All Patients)",
  "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
  "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive."
}
add /protocolSection/outcomesModule/secondaryOutcomes/3
Triage: High
Secondary Outcome Change Operation 9
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
After
{
  "measure": "Overall Survival (OS) in the Hormone Receptor-Positive Cohort in Participants With HER2-low Breast Cancer",
  "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
  "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive."
}
add /protocolSection/outcomesModule/secondaryOutcomes/4
Triage: High
Secondary Outcome Change Operation 10
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
After
{
  "measure": "Number of Overall Survival Events (Deaths)",
  "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years"
}
add /protocolSection/outcomesModule/secondaryOutcomes/5
Triage: High
Secondary Outcome Change Operation 11
Matched rules
  • secondary_outcome_any_change Any add/remove/replace under secondary outcome measures is high review priority.
After
{
  "measure": "Overall Survival (OS) in All Patients",
  "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
  "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive."
}
Timeline Start, primary completion, and completion date movement. Triage: Medium 1 ops
replace /protocolSection/statusModule/completionDateStruct/date
Triage: Medium
Timeline Shift Operation 2
Matched rules
  • completion_timeline_change Completion date changes are operational timeline signals.
Before
2023-03
After
2024-03
Other registry fields Changes outside the current high-signal rule families. Triage: Uncategorized 10 ops
replace /protocolSection/statusModule/statusVerifiedDate
Triage: Uncategorized
Uncategorized Operation 1
Before
2023-02
After
2023-05
replace /protocolSection/statusModule/lastUpdateSubmitDate
Triage: Uncategorized
Uncategorized Operation 3
Before
2023-02-15
After
2023-05-25
replace /protocolSection/statusModule/lastUpdatePostDateStruct/date
Triage: Uncategorized
Uncategorized Operation 4
Before
2023-03-14
After
2023-06-15
add /protocolSection/statusModule/resultsFirstSubmitQcDate
Triage: Uncategorized
Uncategorized Operation 5
After
2023-05-25
add /protocolSection/statusModule/resultsFirstPostDateStruct
Triage: Uncategorized
Uncategorized Operation 6
After
{
  "date": "2023-06-15",
  "type": "ACTUAL"
}
add /protocolSection/outcomesModule/otherOutcomes
Triage: Uncategorized
Uncategorized Operation 12
After
[
  {
    "measure": "All-Cause Mortality",
    "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
    "description": "All-cause mortality is defined as all anticipated and unanticipated deaths due to any cause, with the number and frequency of such events by arm or comparison group of the clinical study."
  }
]
add /resultsSection/participantFlowModule/periods/0/milestones/1
Triage: Uncategorized
Uncategorized Operation 13
After
{
  "type": "Full Analysis Set (All Randomized Patients)",
  "achievements": [
    {
      "groupId": "FG000",
      "numSubjects": "373"
    },
    {
      "groupId": "FG001",
      "numSubjects": "184"
    }
  ]
}
add /resultsSection/participantFlowModule/periods/0/milestones/2
Triage: Uncategorized
Uncategorized Operation 14
After
{
  "type": "Safety Analysis Set (All Randomized Patients Who Received at Least 1 Dose of Study Treatment)",
  "achievements": [
    {
      "groupId": "FG000",
      "numSubjects": "371"
    },
    {
      "groupId": "FG001",
      "numSubjects": "172"
    }
  ]
}
remove /annotationSection
Triage: Uncategorized
Uncategorized Operation 29
Before
{
  "annotationModule": {
    "unpostedAnnotation": {
      "unpostedEvents": [
        {
          "date": "2023-03-13",
          "type": "RESET"
        },
        {
          "date": "2023-03-16",
          "type": "RELEASE"
        },
        {
          "date": "2023-04-10",
          "type": "RESET"
        }
      ],
      "unpostedResponsibleParty": "Daiichi Sankyo, Inc."
    }
  }
}
remove /reviewUnit
Triage: Uncategorized
Uncategorized Operation 30
Before
{
  "resetReasons": [
    "Issues noted on a previous submission of this record do not appear to have been addressed."
  ]
}
Results outcome measures Posted result outcome measures and result-level endpoint data. Triage: Uncategorized 6 ops
remove /resultsSection/outcomeMeasuresModule/outcomeMeasures/2
Triage: Uncategorized
Uncategorized Operation 15
Before
{
  "type": "SECONDARY",
  "title": "Overall Survival (OS) in the Hormone Receptor-Positive Cohort in Participants With HER2-low Breast Cancer",
  "denoms": [
    {
      "units": "Participants",
      "counts": [
        {
          "value": "331",
          "groupId": "OG000"
        },
        {
          "value": "163",
          "groupId": "OG001"
        }
      ]
    }
  ],
  "groups": [
    {
      "id": "OG000",
      "title": "Trastuzumab Deruxtecan (T-DXd)",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy were randomized to receive an intravenous infusion of DS8201a (initial dose of 5.4 mg/kg) over approximately 90 minutes.\nIf there was no infusion-related reaction (IRR), T-DXd doses after the initial dose of 5.4 mg/kg were infused over a minimum of 30 minutes."
    },
    {
      "id": "OG001",
      "title": "Physician's Choice",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy and randomized to a physician's choice (capecitabine, eribulin, gemcitabine, paclitaxel, and nab-paclitaxel) in which the dose, regimen, administration, and dose modification followed the label approved in the country of drug administration or the National Comprehensive Cancer Network guidelines."
    }
  ],
  "classes": [
    {
      "categories": [
        {
          "measurements": [
            {
              "value": "23.9",
              "groupId": "OG000",
              "lowerLimit": "20.8",
              "upperLimit": "24.8"
            },
            {
              "value": "17.5",
              "groupId": "OG001",
              "lowerLimit": "15.2",
              "upperLimit": "22.4"
            }
          ]
        }
      ]
    }
  ],
  "paramType": "MEDIAN",
  "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
  "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive.",
  "unitOfMeasure": "months",
  "dispersionType": "95% Confidence Interval",
  "reportingStatus": "POSTED",
  "populationDescription": "Overall survival (OS) was assessed in the Hormone Receptor-Positive cohort of Full Analysis Set."
}
remove /resultsSection/outcomeMeasuresModule/outcomeMeasures/2
Triage: Uncategorized
Uncategorized Operation 16
Before
{
  "type": "SECONDARY",
  "title": "Overall Survival (OS) in Participants With HER2-low Breast Cancer (All Patients)",
  "denoms": [
    {
      "units": "Participants",
      "counts": [
        {
          "value": "373",
          "groupId": "OG000"
        },
        {
          "value": "184",
          "groupId": "OG001"
        }
      ]
    }
  ],
  "groups": [
    {
      "id": "OG000",
      "title": "Trastuzumab Deruxtecan (T-DXd)",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy were randomized to receive an intravenous infusion of DS8201a (initial dose of 5.4 mg/kg) over approximately 90 minutes.\nIf there was no infusion-related reaction (IRR), T-DXd doses after the initial dose of 5.4 mg/kg were infused over a minimum of 30 minutes."
    },
    {
      "id": "OG001",
      "title": "Physician's Choice",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy and randomized to a physician's choice (capecitabine, eribulin, gemcitabine, paclitaxel, and nab-paclitaxel) in which the dose, regimen, administration, and dose modification followed the label approved in the country of drug administration or the National Comprehensive Cancer Network guidelines."
    }
  ],
  "classes": [
    {
      "categories": [
        {
          "measurements": [
            {
              "value": "23.4",
              "groupId": "OG000",
              "lowerLimit": "20.0",
              "upperLimit": "24.8"
            },
            {
              "value": "16.8",
              "groupId": "OG001",
              "lowerLimit": "14.5",
              "upperLimit": "20.0"
            }
          ]
        }
      ]
    }
  ],
  "paramType": "MEDIAN",
  "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
  "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive.",
  "unitOfMeasure": "months",
  "dispersionType": "95% Confidence Interval",
  "reportingStatus": "POSTED",
  "populationDescription": "Overall survival (OS) was assessed in the Full Analysis Set."
}
add /resultsSection/outcomeMeasuresModule/outcomeMeasures/4
Triage: Uncategorized
Uncategorized Operation 17
After
{
  "type": "SECONDARY",
  "title": "Overall Survival (OS) in the Hormone Receptor-Positive Cohort in Participants With HER2-low Breast Cancer",
  "denoms": [
    {
      "units": "Participants",
      "counts": [
        {
          "value": "331",
          "groupId": "OG000"
        },
        {
          "value": "163",
          "groupId": "OG001"
        }
      ]
    }
  ],
  "groups": [
    {
      "id": "OG000",
      "title": "Trastuzumab Deruxtecan (T-DXd)",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy were randomized to receive an intravenous infusion of DS8201a (initial dose of 5.4 mg/kg) over approximately 90 minutes.\nIf there was no infusion-related reaction (IRR), T-DXd doses after the initial dose of 5.4 mg/kg were infused over a minimum of 30 minutes."
    },
    {
      "id": "OG001",
      "title": "Physician's Choice",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy and randomized to a physician's choice (capecitabine, eribulin, gemcitabine, paclitaxel, and nab-paclitaxel) in which the dose, regimen, administration, and dose modification followed the label approved in the country of drug administration or the National Comprehensive Cancer Network guidelines."
    }
  ],
  "classes": [
    {
      "categories": [
        {
          "measurements": [
            {
              "value": "23.9",
              "groupId": "OG000",
              "lowerLimit": "20.8",
              "upperLimit": "24.8"
            },
            {
              "value": "17.5",
              "groupId": "OG001",
              "lowerLimit": "15.2",
              "upperLimit": "22.4"
            }
          ]
        }
      ]
    }
  ],
  "paramType": "MEDIAN",
  "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
  "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive.",
  "unitOfMeasure": "months",
  "dispersionType": "95% Confidence Interval",
  "reportingStatus": "POSTED",
  "populationDescription": "Overall survival (OS) was assessed in the Hormone Receptor-Positive cohort of Full Analysis Set."
}
add /resultsSection/outcomeMeasuresModule/outcomeMeasures/5
Triage: Uncategorized
Uncategorized Operation 18
After
{
  "type": "SECONDARY",
  "title": "Number of Overall Survival Events (Deaths)",
  "denoms": [
    {
      "units": "Participants",
      "counts": [
        {
          "value": "373",
          "groupId": "OG000"
        },
        {
          "value": "184",
          "groupId": "OG001"
        }
      ]
    }
  ],
  "groups": [
    {
      "id": "OG000",
      "title": "Trastuzumab Deruxtecan (T-DXd)",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy were randomized to receive an intravenous infusion of DS8201a (initial dose of 5.4 mg/kg) over approximately 90 minutes.\nIf there was no infusion-related reaction (IRR), T-DXd doses after the initial dose of 5.4 mg/kg were infused over a minimum of 30 minutes."
    },
    {
      "id": "OG001",
      "title": "Physician's Choice",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy and randomized to a physician's choice (capecitabine, eribulin, gemcitabine, paclitaxel, and nab-paclitaxel) in which the dose, regimen, administration, and dose modification followed the label approved in the country of drug administration or the National Comprehensive Cancer Network guidelines."
    }
  ],
  "classes": [
    {
      "categories": [
        {
          "measurements": [
            {
              "value": "149",
              "groupId": "OG000"
            },
            {
              "value": "90",
              "groupId": "OG001"
            }
          ]
        }
      ]
    }
  ],
  "paramType": "NUMBER",
  "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
  "unitOfMeasure": "events (deaths)",
  "reportingStatus": "POSTED",
  "populationDescription": "Overall survival events (deaths) were analyzed in the Full Analysis Set (defined as all randomized participants)."
}
add /resultsSection/outcomeMeasuresModule/outcomeMeasures/6
Triage: Uncategorized
Uncategorized Operation 19
After
{
  "type": "SECONDARY",
  "title": "Overall Survival (OS) in All Patients",
  "denoms": [
    {
      "units": "Participants",
      "counts": [
        {
          "value": "373",
          "groupId": "OG000"
        },
        {
          "value": "184",
          "groupId": "OG001"
        }
      ]
    }
  ],
  "groups": [
    {
      "id": "OG000",
      "title": "Trastuzumab Deruxtecan (T-DXd)",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy were randomized to receive an intravenous infusion of DS8201a (initial dose of 5.4 mg/kg) over approximately 90 minutes.\nIf there was no infusion-related reaction (IRR), T-DXd doses after the initial dose of 5.4 mg/kg were infused over a minimum of 30 minutes."
    },
    {
      "id": "OG001",
      "title": "Physician's Choice",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy and randomized to a physician's choice (capecitabine, eribulin, gemcitabine, paclitaxel, and nab-paclitaxel) in which the dose, regimen, administration, and dose modification followed the label approved in the country of drug administration or the National Comprehensive Cancer Network guidelines."
    }
  ],
  "classes": [
    {
      "categories": [
        {
          "measurements": [
            {
              "value": "23.4",
              "groupId": "OG000",
              "lowerLimit": "20.0",
              "upperLimit": "24.8"
            },
            {
              "value": "16.8",
              "groupId": "OG001",
              "lowerLimit": "14.5",
              "upperLimit": "20.0"
            }
          ]
        }
      ]
    }
  ],
  "paramType": "MEDIAN",
  "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
  "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive.",
  "unitOfMeasure": "months",
  "dispersionType": "95% Confidence Interval",
  "reportingStatus": "POSTED",
  "populationDescription": "Overall survival (OS) was assessed in the Full Analysis Set (defined as all randomized participants)."
}
add /resultsSection/outcomeMeasuresModule/outcomeMeasures/11
Triage: Uncategorized
Uncategorized Operation 20
After
{
  "type": "OTHER_PRE_SPECIFIED",
  "title": "All-Cause Mortality",
  "denoms": [
    {
      "units": "Participants",
      "counts": [
        {
          "value": "371",
          "groupId": "OG000"
        },
        {
          "value": "172",
          "groupId": "OG001"
        }
      ]
    }
  ],
  "groups": [
    {
      "id": "OG000",
      "title": "Trastuzumab Deruxtecan (T-DXd)",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy were randomized to receive an intravenous infusion of DS8201a (initial dose of 5.4 mg/kg) over approximately 90 minutes.\nIf there was no infusion-related reaction (IRR), T-DXd doses after the initial dose of 5.4 mg/kg were infused over a minimum of 30 minutes."
    },
    {
      "id": "OG001",
      "title": "Physician's Choice",
      "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy and randomized to a physician's choice (capecitabine, eribulin, gemcitabine, paclitaxel, and nab-paclitaxel) in which the dose, regimen, administration, and dose modification followed the label approved in the country of drug administration or the National Comprehensive Cancer Network guidelines."
    }
  ],
  "classes": [
    {
      "categories": [
        {
          "measurements": [
            {
              "value": "148",
              "groupId": "OG000"
            },
            {
              "value": "88",
              "groupId": "OG001"
            }
          ]
        }
      ]
    }
  ],
  "paramType": "COUNT_OF_PARTICIPANTS",
  "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
  "description": "All-cause mortality is defined as all anticipated and unanticipated deaths due to any cause, with the number and frequency of such events by arm or comparison group of the clinical study.",
  "unitOfMeasure": "Participants",
  "reportingStatus": "POSTED",
  "populationDescription": "All-cause mortality was assessed in the Safety Analysis Set."
}
Raw JSON Patch
[
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/statusVerifiedDate",
    "value": "2023-05"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/completionDateStruct/date",
    "value": "2024-03"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/lastUpdateSubmitDate",
    "value": "2023-05-25"
  },
  {
    "op": "replace",
    "path": "/protocolSection/statusModule/lastUpdatePostDateStruct/date",
    "value": "2023-06-15"
  },
  {
    "op": "add",
    "path": "/protocolSection/statusModule/resultsFirstSubmitQcDate",
    "value": "2023-05-25"
  },
  {
    "op": "add",
    "path": "/protocolSection/statusModule/resultsFirstPostDateStruct",
    "value": {
      "date": "2023-06-15",
      "type": "ACTUAL"
    }
  },
  {
    "op": "remove",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/1"
  },
  {
    "op": "remove",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/1"
  },
  {
    "op": "add",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/3",
    "value": {
      "measure": "Overall Survival (OS) in the Hormone Receptor-Positive Cohort in Participants With HER2-low Breast Cancer",
      "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
      "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive."
    }
  },
  {
    "op": "add",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/4",
    "value": {
      "measure": "Number of Overall Survival Events (Deaths)",
      "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years"
    }
  },
  {
    "op": "add",
    "path": "/protocolSection/outcomesModule/secondaryOutcomes/5",
    "value": {
      "measure": "Overall Survival (OS) in All Patients",
      "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
      "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive."
    }
  },
  {
    "op": "add",
    "path": "/protocolSection/outcomesModule/otherOutcomes",
    "value": [
      {
        "measure": "All-Cause Mortality",
        "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
        "description": "All-cause mortality is defined as all anticipated and unanticipated deaths due to any cause, with the number and frequency of such events by arm or comparison group of the clinical study."
      }
    ]
  },
  {
    "op": "add",
    "path": "/resultsSection/participantFlowModule/periods/0/milestones/1",
    "value": {
      "type": "Full Analysis Set (All Randomized Patients)",
      "achievements": [
        {
          "groupId": "FG000",
          "numSubjects": "373"
        },
        {
          "groupId": "FG001",
          "numSubjects": "184"
        }
      ]
    }
  },
  {
    "op": "add",
    "path": "/resultsSection/participantFlowModule/periods/0/milestones/2",
    "value": {
      "type": "Safety Analysis Set (All Randomized Patients Who Received at Least 1 Dose of Study Treatment)",
      "achievements": [
        {
          "groupId": "FG000",
          "numSubjects": "371"
        },
        {
          "groupId": "FG001",
          "numSubjects": "172"
        }
      ]
    }
  },
  {
    "op": "remove",
    "path": "/resultsSection/outcomeMeasuresModule/outcomeMeasures/2"
  },
  {
    "op": "remove",
    "path": "/resultsSection/outcomeMeasuresModule/outcomeMeasures/2"
  },
  {
    "op": "add",
    "path": "/resultsSection/outcomeMeasuresModule/outcomeMeasures/4",
    "value": {
      "type": "SECONDARY",
      "title": "Overall Survival (OS) in the Hormone Receptor-Positive Cohort in Participants With HER2-low Breast Cancer",
      "denoms": [
        {
          "units": "Participants",
          "counts": [
            {
              "value": "331",
              "groupId": "OG000"
            },
            {
              "value": "163",
              "groupId": "OG001"
            }
          ]
        }
      ],
      "groups": [
        {
          "id": "OG000",
          "title": "Trastuzumab Deruxtecan (T-DXd)",
          "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy were randomized to receive an intravenous infusion of DS8201a (initial dose of 5.4 mg/kg) over approximately 90 minutes.\nIf there was no infusion-related reaction (IRR), T-DXd doses after the initial dose of 5.4 mg/kg were infused over a minimum of 30 minutes."
        },
        {
          "id": "OG001",
          "title": "Physician's Choice",
          "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy and randomized to a physician's choice (capecitabine, eribulin, gemcitabine, paclitaxel, and nab-paclitaxel) in which the dose, regimen, administration, and dose modification followed the label approved in the country of drug administration or the National Comprehensive Cancer Network guidelines."
        }
      ],
      "classes": [
        {
          "categories": [
            {
              "measurements": [
                {
                  "value": "23.9",
                  "groupId": "OG000",
                  "lowerLimit": "20.8",
                  "upperLimit": "24.8"
                },
                {
                  "value": "17.5",
                  "groupId": "OG001",
                  "lowerLimit": "15.2",
                  "upperLimit": "22.4"
                }
              ]
            }
          ]
        }
      ],
      "paramType": "MEDIAN",
      "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
      "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive.",
      "unitOfMeasure": "months",
      "dispersionType": "95% Confidence Interval",
      "reportingStatus": "POSTED",
      "populationDescription": "Overall survival (OS) was assessed in the Hormone Receptor-Positive cohort of Full Analysis Set."
    }
  },
  {
    "op": "add",
    "path": "/resultsSection/outcomeMeasuresModule/outcomeMeasures/5",
    "value": {
      "type": "SECONDARY",
      "title": "Number of Overall Survival Events (Deaths)",
      "denoms": [
        {
          "units": "Participants",
          "counts": [
            {
              "value": "373",
              "groupId": "OG000"
            },
            {
              "value": "184",
              "groupId": "OG001"
            }
          ]
        }
      ],
      "groups": [
        {
          "id": "OG000",
          "title": "Trastuzumab Deruxtecan (T-DXd)",
          "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy were randomized to receive an intravenous infusion of DS8201a (initial dose of 5.4 mg/kg) over approximately 90 minutes.\nIf there was no infusion-related reaction (IRR), T-DXd doses after the initial dose of 5.4 mg/kg were infused over a minimum of 30 minutes."
        },
        {
          "id": "OG001",
          "title": "Physician's Choice",
          "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy and randomized to a physician's choice (capecitabine, eribulin, gemcitabine, paclitaxel, and nab-paclitaxel) in which the dose, regimen, administration, and dose modification followed the label approved in the country of drug administration or the National Comprehensive Cancer Network guidelines."
        }
      ],
      "classes": [
        {
          "categories": [
            {
              "measurements": [
                {
                  "value": "149",
                  "groupId": "OG000"
                },
                {
                  "value": "90",
                  "groupId": "OG001"
                }
              ]
            }
          ]
        }
      ],
      "paramType": "NUMBER",
      "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
      "unitOfMeasure": "events (deaths)",
      "reportingStatus": "POSTED",
      "populationDescription": "Overall survival events (deaths) were analyzed in the Full Analysis Set (defined as all randomized participants)."
    }
  },
  {
    "op": "add",
    "path": "/resultsSection/outcomeMeasuresModule/outcomeMeasures/6",
    "value": {
      "type": "SECONDARY",
      "title": "Overall Survival (OS) in All Patients",
      "denoms": [
        {
          "units": "Participants",
          "counts": [
            {
              "value": "373",
              "groupId": "OG000"
            },
            {
              "value": "184",
              "groupId": "OG001"
            }
          ]
        }
      ],
      "groups": [
        {
          "id": "OG000",
          "title": "Trastuzumab Deruxtecan (T-DXd)",
          "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy were randomized to receive an intravenous infusion of DS8201a (initial dose of 5.4 mg/kg) over approximately 90 minutes.\nIf there was no infusion-related reaction (IRR), T-DXd doses after the initial dose of 5.4 mg/kg were infused over a minimum of 30 minutes."
        },
        {
          "id": "OG001",
          "title": "Physician's Choice",
          "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy and randomized to a physician's choice (capecitabine, eribulin, gemcitabine, paclitaxel, and nab-paclitaxel) in which the dose, regimen, administration, and dose modification followed the label approved in the country of drug administration or the National Comprehensive Cancer Network guidelines."
        }
      ],
      "classes": [
        {
          "categories": [
            {
              "measurements": [
                {
                  "value": "23.4",
                  "groupId": "OG000",
                  "lowerLimit": "20.0",
                  "upperLimit": "24.8"
                },
                {
                  "value": "16.8",
                  "groupId": "OG001",
                  "lowerLimit": "14.5",
                  "upperLimit": "20.0"
                }
              ]
            }
          ]
        }
      ],
      "paramType": "MEDIAN",
      "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
      "description": "Overall survival (OS) was defined as the time from the date of randomization to the date of death due to any cause.\nIf there was no death reported for a participant before the data cutoff for OS analysis, OS was censored at the last contact date at which the participant was known to be alive.",
      "unitOfMeasure": "months",
      "dispersionType": "95% Confidence Interval",
      "reportingStatus": "POSTED",
      "populationDescription": "Overall survival (OS) was assessed in the Full Analysis Set (defined as all randomized participants)."
    }
  },
  {
    "op": "add",
    "path": "/resultsSection/outcomeMeasuresModule/outcomeMeasures/11",
    "value": {
      "type": "OTHER_PRE_SPECIFIED",
      "title": "All-Cause Mortality",
      "denoms": [
        {
          "units": "Participants",
          "counts": [
            {
              "value": "371",
              "groupId": "OG000"
            },
            {
              "value": "172",
              "groupId": "OG001"
            }
          ]
        }
      ],
      "groups": [
        {
          "id": "OG000",
          "title": "Trastuzumab Deruxtecan (T-DXd)",
          "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy were randomized to receive an intravenous infusion of DS8201a (initial dose of 5.4 mg/kg) over approximately 90 minutes.\nIf there was no infusion-related reaction (IRR), T-DXd doses after the initial dose of 5.4 mg/kg were infused over a minimum of 30 minutes."
        },
        {
          "id": "OG001",
          "title": "Physician's Choice",
          "description": "Participants with HER2-low, unresectable, and/or metastatic breast cancer who were previously treated with chemotherapy and randomized to a physician's choice (capecitabine, eribulin, gemcitabine, paclitaxel, and nab-paclitaxel) in which the dose, regimen, administration, and dose modification followed the label approved in the country of drug administration or the National Comprehensive Cancer Network guidelines."
        }
      ],
      "classes": [
        {
          "categories": [
            {
              "measurements": [
                {
                  "value": "148",
                  "groupId": "OG000"
                },
                {
                  "value": "88",
                  "groupId": "OG001"
                }
              ]
            }
          ]
        }
      ],
      "paramType": "COUNT_OF_PARTICIPANTS",
      "timeFrame": "From the date of randomization up to the date of death due to any cause, up to approximately 3 years",
      "description": "All-cause mortality is defined as all anticipated and unanticipated deaths due to any cause, with the number and frequency of such events by arm or comparison group of the clinical study.",
      "unitOfMeasure": "Participants",
      "reportingStatus": "POSTED",
      "populationDescription": "All-cause mortality was assessed in the Safety Analysis Set."
    }
  },
  {
    "op": "replace",
    "path": "/resultsSection/adverseEventsModule/timeFrame",
    "value": "Adverse events (AEs) were collected from the time of signing the main informed consent form up to 40 days (+7 days) after the last treatment, whether observed by the investigator or reported by the participant, up to approximately 3 years in the Safety Analysis Set."
  },
  {
    "op": "replace",
    "path": "/resultsSection/adverseEventsModule/description",
    "value": "All-cause mortality was assessed in all participants who were randomized (Full Analysis Set).\nPlease refer to the other prespecified outcome measure that also reports all-cause mortality from the Safety Analysis Set.\nOther AEs and SAEs were assessed in the Safety Analysis Set.\nThe Physician's Choice (PC) treatment was based on the label approved in each country.\nAs prespecified in the protocol for safety analysis, the PC group was combined for an appropriate sample size for the comparator group."
  },
  {
    "op": "replace",
    "path": "/resultsSection/adverseEventsModule/eventGroups/0/deathsNumAffected",
    "value": 149
  },
  {
    "op": "replace",
    "path": "/resultsSection/adverseEventsModule/eventGroups/0/deathsNumAtRisk",
    "value": 373
  },
  {
    "op": "replace",
    "path": "/resultsSection/adverseEventsModule/eventGroups/1/deathsNumAffected",
    "value": 90
  },
  {
    "op": "replace",
    "path": "/resultsSection/adverseEventsModule/eventGroups/1/deathsNumAtRisk",
    "value": 184
  },
  {
    "op": "remove",
    "path": "/resultsSection/adverseEventsModule/armsReviewUnit"
  },
  {
    "op": "remove",
    "path": "/resultsSection/adverseEventsModule/allCauseMortalityReviewUnit"
  },
  {
    "op": "remove",
    "path": "/annotationSection"
  },
  {
    "op": "remove",
    "path": "/reviewUnit"
  }
]