The most common grade 3-4 adverse events were skin rash ( 21 [ 27 % ] of 77 patients vs 20 [ 22 % ] of 92 patients ) , neutropenia ( 22 [ 29 % ] vs 30 [ 33 % ] ) , diarrhoea ( 14 [ 18 % ] vs 23 [ 25 % ] ) , and lethargy ( 20 [ 26 % ] vs 19 [ 21 % ] ) .