Study of Pembrolizumab (MK-3475) Versus Placebo in Participants With Esophageal Carcinoma Who Are Receiving Chemotherapy and Radiation Therapy (MK-3475-975/KEYNOTE-975)

Completed · Phase 3 · Has a placebo group

Conditions studied: Esophageal Squamous Cell Carcinoma (ESCC), Gastroesophageal Junction Carcinoma (GEJC), Esophageal Adenocarcinoma (EAC)

In brief

The purpose of this study is to assess the efficacy and safety of treatment with definitive chemoradiotherapy (dCRT) + pembrolizumab (MK-3475) compared to treatment with dCRT + placebo with respect to Event-free Survival (EFS) and Overall Survival (OS) in: * participants whose tumors express Programmed Death-Ligand 1 (PD-L1) Combined Positive Score (CPS) ≥10 * participants whose tumors express PD-L1 CPS ≥1 * all participants The primary study hypotheses are that dCRT+ pembrolizumab is better than dCRT + placebo with respect to: * EFS in participants whose tumors express PD-L1 CPS ≥10 * EFS in participants whose tumors express PD-L1 CPS ≥1 * EFS in all participants * OS in participants whose tumors express PD-L1 CPS ≥10 * OS in participants whose tumors express PD-L1 CPS ≥1 * OS in all participants

Key facts

Study ID

NCT04210115

Run by

Merck Sharp & Dohme LLC

People needed

703

Starts

2020-02-28

Expected to finish

2026-06-23

Last updated by the study team

2026-07-22

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Has histologically or cytologically confirmed diagnosis of CTX N+ M0 or cT2-T4a NX M0 ESCC, GEJC, EAC, or histologically or cytologically confirmed diagnosis of cTX N+ M1 cervical or upper thoracic esophageal carcinoma with supraclavicular lymph node metastases only
• Is deemed suitable for dCRT
• Is ineligible for curative surgery based on the documented opinion of a qualified medical/surgical/radiation oncologist.
• Is not expected to require tumor resection during the course of the study
• Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 within 3 days of the first dose of study treatment
• Has adequate organ function
• Male participants must use adequate contraception (a male condom plus partner use of an additional contraceptive method) unless confirmed to be azoospermic (vasectomized or secondary to medical cause) and refrain from donating sperm during the study treatment period and through 90 days after the last dose of chemotherapy
• Female participants who are a Woman of Childbearing Potential (WOCBP) must use contraception that is highly effective (with a failure rate of <1% per year), with low user dependency, or be abstinent from heterosexual intercourse as their preferred and usual lifestyle, during the study treatment period through 180 days after the last dose of chemotherapy or 120 days after the last dose of pembrolizumab, whichever is greater, and agree not to donate eggs to others or freeze/store for her own use for the purpose of reproduction during this period
• Female participants must not be pregnant or breastfeeding

You may not qualify if…

• Has direct invasion of tumor into adjacent organs such as the aorta or trachea or has radiographic evidence of >90 degree encasement or invasion of a major blood vessel, or of intratumoral cavitation
• Has had major surgery other than for insertion of a feeding tube, open biopsy, or significant traumatic injury within 28 days prior to randomization, or anticipates the need for major surgery during study treatment; participants with gastric or esophageal fistulae are excluded
• Has had weight loss of >20% in the previous 3 months
• Has had prior chemotherapy or radiotherapy for esophageal cancer
• Has had a myocardial infarction within the past 6 months
• Has symptomatic congestive heart failure
• Has received prior therapy with an anti-programmed cell death-1 (anti-PD-1), anti-programmed cell death-ligand 1 (anti-PD-L1), or anti-programmed cell death-ligand 2 (anti-PD-L2) agent or with an agent directed to another stimulatory or coinhibitory T-cell receptor (e.g. cytotoxic T-lymphocyte-associated protein 4 [CTLA-4], OX-40, CD137)
• Has received a live or live-attenuated vaccine within 30 days prior to the first dose of study intervention; administration of killed vaccines is allowed
• Has received any prior systemic anticancer therapy for esophageal cancer including investigational agents
• Has not recovered from all adverse events (AEs) due to previous non-anticancer therapies to ≤Grade 1 or Baseline
• Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior the first dose of study treatment
• Has a known additional malignancy that is progressing or has required active treatment within the past 3 years. Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (e.g. breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded from the study. Participants with localized prostate cancer that has undergone potentially curative treatment can be enrolled in the study.
• Has severe hypersensitivity (≥Grade 3) to pembrolizumab, any of the study chemotherapy agents, or their excipients
• Has an active autoimmune disease that has required systemic treatment in past 2 years
• Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis
• Has an active infection requiring systemic therapy
• Has a known history of human immunodeficiency virus (HIV) infection
• Has a known history of Hepatitis B or known active Hepatitis C virus infection
• Has a known history of active tuberculosis (TB; Bacillus tuberculosis)
• Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of study treatment (180 days for participants receiving cisplatin who are breastfeeding)
• Has had an allogeneic tissue/solid organ transplant

Where it is running

• Columbus Regional Research Institute ( Site 0047) — Columbus, Georgia, United States
• University of Kansas Cancer Center ( Site 0023) — Westwood, Kansas, United States
• Cancer Center of Kansas ( Site 0058) — Wichita, Kansas, United States
• University Medical Center ( Site 0035) — New Orleans, Louisiana, United States
• Greater Baltimore Medical Center ( Site 0031) — Baltimore, Maryland, United States
• Dana Farber Cancer Center ( Site 0034) — Boston, Massachusetts, United States
• Henry Ford Hospital ( Site 0685) — Detroit, Michigan, United States
• University of Missouri ( Site 0688) — Columbia, Missouri, United States
• Renown Regional Medical Center ( Site 0706) — Reno, Nevada, United States
• Rutgers Cancer Institute of New Jersey ( Site 0695) — New Brunswick, New Jersey, United States
• Weill Cornell Medical College ( Site 0053) — New York, New York, United States
• Stephenson Cancer Center ( Site 0044) — Oklahoma City, Oklahoma, United States
• Oregon Health & Science University Center for Health & Healing 2- CHH2 ( Site 0060) — Portland, Oregon, United States
• Allegheny Health Network ( Site 0042) — Pittsburgh, Pennsylvania, United States
• Thompson Cancer Survival Center ( Site 0696) — Knoxville, Tennessee, United States
• Utah Cancer Specialists ( Site 0697) — Salt Lake City, Utah, United States
• Cancer Care Northwest - Spokane Valley ( Site 0036) — Spokane Valley, Washington, United States
• University of Wisconsin Hospital and Clinics ( Site 0033) — Madison, Wisconsin, United States
• Instituto Medico Alexander Fleming ( Site 0063) — Buenos Aires, Buenos Aires F.D., Argentina
• Fundacion Favaloro ( Site 0061) — Ciudad de Buenos Aires, Buenos Aires F.D., Argentina
• Hospital Municipal de Gastroenterologia Dr. Bonorino Udaondo ( Site 0066) — Buenos Aires, Argentina
• CEMIC ( Site 0064) — Buenos Aires, Argentina
• UCL Saint Luc ( Site 0162) — Brussels, Bruxelles-Capitale, Region de, Belgium
• UZ Gent ( Site 0163) — Ghent, Oost-Vlaanderen, Belgium
• MemorialCare Health System - Long Beach Medical Center-Oncology ( Site 0691) — Long Beach, California, United States

Full record on ClinicalTrials.gov

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