Esophageal NeoplasmsPhase 3NCT03189719
First-line Esophageal Carcinoma Study With Pembrolizumab Plus Chemo vs. Chemo (MK-3475-590/KEYNOTE-590)
A Phase 3 study testing Pembrolizumab, Cisplatin and 5-FU in people with Esophageal Neoplasms, run by Merck Sharp & Dohme LLC at 189 sites in 26 countries.
Trial summary
The purpose of this trial is to evaluate efficacy and safety of pembrolizumab plus standard of care (SOC) chemotherapy with cisplatin and 5-fluorouracil (5-FU) versus placebo plus SOC chemotherapy with cisplatin and 5-FU as first-line treatment in participants with locally advanced or metastatic esophageal carcinoma. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Esophageal Neoplasms
- What is being tested?
- Pembrolizumab, Cisplatin and 5-FU
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 749 participants
- Where
- 189 sitesin 26 countries
- Study dates
- 25 Jul 2017to 10 Jul 2023
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Has histologically- or cytologically-confirmed diagnosis of locally advanced unresectable or metastatic adenocarcinoma or squamous cell carcinoma of the esophagus or advanced/metastatic Siewert type 1 adenocarcinoma of the esophagogastric junction (EGJ)
- Has measurable disease per RECIST 1.1 as determined by the local site investigator/radiology assessment
- Eastern Cooperative Group (ECOG) performance status of 0 to 1
- Can provide either a newly obtained or archival tissue sample for PD-L1 by immunohistochemistry analysis
- Female participants of childbearing potential must have a negative urine or serum pregnancy test within 72 hours prior to randomization and be willing to use an adequate method of contraception (e.g. abstinence, intrauterine device, diaphragm with spermicide, etc.) for the course of the study through 120 days after the last dose of study treatment and up to 180 days after last dose of cisplatin
- Male participants of childbearing potential must agree to use an adequate method of contraception (e.g. abstinence, vasectomy, male condom, etc.) starting with the first dose of study treatment through 120 days after the last dose of study treatment and up to 180 days after last dose of cisplatin, and refrain from donating sperm during this period
- Has adequate organ function
Who cannot join
- Has locally advanced esophageal carcinoma that is resectable or potentially curable with radiation therapy (as determined by local investigator)
- Has had previous therapy for advanced/metastatic adenocarcinoma or squamous cell cancer of the esophagus or advanced/metastatic Siewert type 1 adenocarcinoma of the EGJ
- Has had major surgery, open biopsy, or significant traumatic injury within 28 days prior to randomization, or anticipation of the need for major surgery during the course of study treatment
- Has a known additional malignancy that is progressing or requires active treatment. Exceptions include early-stage cancers (carcinoma in situ or Stage 1) treated with curative intent, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, in situ cervical cancer, in situ breast cancer that has undergone potentially curative therapy, and in situ or intramucosal pharyngeal cancer
- Has known active central nervous system metastases and/or carcinomatous meningitis.
- Has an active autoimmune disease that has required systemic treatment in past 2 years
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- Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment, or has a history of organ transplant, including allogeneic stem cell transplant
- Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis, or has an active infection requiring systemic therapy
- 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 medication and up to 180 days after last dose of cisplatin
- Has received prior therapy with an anti-programmed cell death protein-1 (anti-PD-1), anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another co-inhibitory T-cell receptor or has previously participated in a pembrolizumab (MK-3475) clinical trial
- Has severe hypersensitivity (≥ Grade 3) to any study treatment (pembrolizumab, cisplatin, or 5-FU) and/or any of its excipients
- Has a known history of active tuberculosis (TB; Mycobacterium tuberculosis) or human immunodeficiency virus (HIV) infection
- Has known history of or is positive for hepatitis B or hepatitis C
- Has received a live vaccine within 30 days prior to the first dose of study treatment
- Has had radiotherapy within 14 days of randomization. Participants who received radiotherapy >14 days prior to randomization must have completely recovered from any radiotherapy-related AEs/toxicities
Trial locations and contacts
189 sites in 26 countries.
189 sites in 26 countries
Japan31 sites
Hyogo Cancer Center ( Site 0913)
Akashi, Hyōgo, 673-8558
Chiba University Hospital ( Site 0909)
Chiba, 260-8677
Chiba Cancer Center ( Site 0900)
Chiba, 260-8717
National Hospital Organization Kyushu Cancer Center ( Site 0906)
Fukuoka, 811-1395
Kyushu University Hospital ( Site 0922)
Fukuoka, 812-8582
Gifu University Hospital ( Site 0920)
Gifu, 501-1194
Kansai Medical University Hospital ( Site 0931)
Hirakata, Osaka, 573-1191
Ibaraki Prefectural Central Hospital ( Site 0918)
Kasama, Ibaraki, 309-1793
National Cancer Center Hospital East ( Site 0908)
Kashiwa, Chiba, 277-8577
St. Marianna University School of Medicine Hospital ( Site 0903)
Kawasaki, Kanagawa, 216-8511
Kagawa University Hospital ( Site 0915)
Kita-gun, Kagawa-ken, 761-0793
Saitama Cancer Center ( Site 0926)
Kitaadachi-gun, Saitama, 362-0806
Kobe City Medical Center General Hospital ( Site 0929)
Kobe, Hyōgo, 650-0047
Kumamoto University Hospital ( Site 0919)
Kumamoto, 860-8556
National Hospital Organization Shikoku Cancer Center ( Site 0901)
Matsuyama, Ehime, 791-0280
Kyorin University Hospital ( Site 0905)
Mitaka, Tokyo, 181-8611
Aichi Cancer Center Hospital ( Site 0902)
Nagoya, Aichi-ken, 464-8681
Niigata Cancer Center Hospital ( Site 0924)
Niigata, 951-8566
Osaka International Cancer Institute ( Site 0923)
Osaka, 541-8567
Osaka General Medical Center ( Site 0912)
Osaka, 558-8558
Hokkaido University Hospital ( Site 0916)
Sapporo, Hokkaido, 060-8648
Kindai University Hospital ( Site 0917)
Sayama, Osaka, 589-8511
Osaka University Hospital ( Site 0911)
Suita, Osaka, 565-0871
Shizuoka Cancer Center Hospital and Research Institute ( Site 0914)
Sunto-gun, Shizuoka, 411-8777
Osaka Medical College Hospital ( Site 0925)
Takatsuki, Osaka, 569-8686
National Cancer Center Hospital ( Site 0907)
Tokyo, 104-0045
The Cancer Institute Hospital of JFCR ( Site 0904)
Tokyo, 135-8550
Keio University Hospital ( Site 0927)
Tokyo, 160-8582
University of Tsukuba Hospital ( Site 0910)
Tsukuba, Ibaraki, 305-8576
Kanagawa Cancer Center ( Site 0921)
Yokohama, Kanagawa, 241-8515
Oita University Hospital ( Site 0930)
Yufu, Oita Prefecture, 879-5593
China19 sites
Peking Union Medical College Hospital ( Site 0123)
Beijing, Beijing Municipality, 100032
Beijing Cancer Hospital ( Site 0100)
Beijing, 100142
Jilin Cancer Hospital ( Site 0101)
Changchun, Jilin, 130012
Hunan Cancer Hospital ( Site 0105)
Changsha, Hunan, 410013
Fujian Provincial Cancer Hospital ( Site 0104)
Fuzhou, 350014
Guangdong General Hospital ( Site 0103)
Guangzhou, Guangdong, 510120
Zhejiang Cancer Hospital ( Site 0116)
Hangzhou, Zhejiang, 310022
The Affiliated Tumour Hospital of Harbin Medical University ( Site 0102)
Harbin, Heilongjiang, 150081
Anhui Provincial Hospital ( Site 0106)
Hefei, Anhui, 230036
The First Affiliated Hospital of Anhui Medical University ( Site 0112)
Hefei, Anhui, 230088
PLA Cancer Centre of Nanjing Bayi Hospital ( Site 0110)
Nanjing, Jiangsu, 210002
Zhongda Hospital Southeast University ( Site 0125)
Nanjing, Jiangsu, 210009
Shanghai Chest Hospital ( Site 0111)
Shanghai, 200030
Fudan University Shanghai Cancer Center ( Site 0108)
Shanghai, 200032
Renji Hospital Shanghai Jiaotong University School of Medicine ( Site 0114)
Shanghai, 200127
Tongji Medical College Huazhong University of Science and Technology ( Site 0109)
Wuhan, Hubei, 430030
The First Affiliated Hospital of Xi an Jiaotong University ( Site 0120)
Xi'an, Shannxi, 710061
The First Affiliated Hospital of Xiamen University ( Site 0119)
Xiamen, Fujian, 361000
Henan Cancer Hospital ( Site 0107)
Zhengzhou, 450008
United States12 sites
University of Maryland Medical Center ( Site 0013)
Baltimore, Maryland, 21201
Dana Farber Cancer Center ( Site 0009)
Boston, Massachusetts, 02215
Roswell Park Cancer Institute ( Site 0004)
Buffalo, New York, 14263
The University of Chicago Medical Center ( Site 0001)
Chicago, Illinois, 60637
University Hospitals Cleveland Medical Center ( Site 0002)
Cleveland, Ohio, 44106
Henry Ford Cancer Center ( Site 0018)
Detroit, Michigan, 48202
University of Tennessee Medical Center Knoxville ( Site 0017)
Knoxville, Tennessee, 37920
Weill Cornell Medical College ( Site 0024)
New York, New York, 10065
UPMC Cancer Center/Hillman Cancer Center ( Site 0015)
Pittsburgh, Pennsylvania, 15232
Washington University School of Medicine ( Site 0031)
St Louis, Missouri, 63110
Kaiser Permanente Southern California ( Site 0003)
West Los Angeles, California, 90034
University of Kansas ( Site 0029)
Westwood, Kansas, 66205
Brazil10 sites
CETUS Hospital Dia Oncologia ( Site 0208)
Belo Horizonte, Minas Gerais, 30110-022
Hospital Sao Vicente de Paulo ( Site 0204)
Passo Fundo, Rio Grande do Sul, 99010-080
Uniao Brasileira de Educacao e Assistencia Hospital Sao Lucas da Pucrs ( Site 0201)
Porto Alegre, Rio Grande do Sul, 90610-000
Hospital de Clinicas de Porto Alegre ( Site 0200)
Porto Alegre, 90035-903
Inst de Medicina Integral Professor Fernando Figueira- IMIP ( Site 0210)
Recife, Pernambuco, 50070-550
Instituto Nacional do Cancer Jose Alencar Gomes da Silva INCA ( Site 0209)
Rio de Janeiro, Rio de Janeiro, 20231-050
Clinica de Hematologia e Oncologia Viver Ltda ( Site 0211)
Santa Maria, Rio Grande do Sul, 97015-513
Fundacao Faculdade Regional de Medicina de Sao Jose do Rio Preto. ( Site 0203)
São José do Rio Preto, São Paulo, 15090-000
Hospital Alemao Oswaldo Cruz ( Site 0207)
São Paulo, São Paulo, 01323-903
Instituto do Cancer de Sao Paulo - ICESP ( Site 0206)
São Paulo, 01246-000
Taiwan9 sites
Chang Gung Med Foundation. Kaohsiung Branch ( Site 1906)
Kaohsiung City, 833
Taipei Medical University Shuang Ho Hospital ( Site 1908)
New Taipei City, 235
China Medical University Hospital ( Site 1904)
Taichung, 404
Kuang Tien General Hospital ( Site 1909)
Taichung, 43303
National Cheng Kung University Hospital ( Site 1905)
Tainan, 704
Chi Mei Medical Center Liuying ( Site 1907)
Tainan, 736
National Taiwan University Hospital ( Site 1900)
Taipei, 10002
Koo Foundation Sun Yat-Sen Cancer Center ( Site 1902)
Taipei, 11259
Chang Gung Medical Foundation. Linkou ( Site 1903)
Taoyuan, 333
Canada8 sites
Tom Baker Cancer Centre ( Site 0503)
Calgary, Alberta, T2N 4N2
Cross Cancer Institute ( Site 0502)
Edmonton, Alberta, T6G 1Z2
CISSS de la Monteregie-Centre ( Site 0504)
Greenfield Park, Quebec, J4V 2H1
Juravinski Cancer Center ( Site 0508)
Hamilton, Ontario, L8V 5C2
Jewish General Hospital ( Site 0507)
Montreal, Quebec, H3T 1E2
The Ottawa Hospital - Cancer Care ( Site 0501)
Ottawa, Ontario, K1H 8L6
Princess Margaret Cancer Centre ( Site 0505)
Toronto, Ontario, M5G 2M9
CancerCare Manitoba ( Site 0500)
Winnipeg, Manitoba, R3E 0V9
France8 sites
CHU Brest - Institut de Cancerologie et d Hematologie ( Site 0305)
Brest, 29200
Centre Francois Baclesse ( Site 0310)
Caen, 14076
Centre Oscar Lambret ( Site 0304)
Lille, 59020
Centre Leon Berard ( Site 0307)
Lyon, Cedex 8, 69373
Institut du Cancer de Montpellier ( Site 0306)
Montpellier, 34298
CHU de Nantes - Hotel Dieu ( Site 0303)
Nantes, 44093
Institut Mutualiste Montsouris ( Site 0300)
Paris, 75014
CHU de Saint Etienne Hopital Nord ( Site 0309)
Saint-Etienne, 42055
Germany7 sites
Staedtisches Klinikum Dresden ( Site 1507)
Dresden, 01067
Haematologisch-Onkologische Praxis Eppendorf Facharztzentrum Eppendorf - Hope ( Site 1502)
Hamburg, 20249
Universitaetsklinikum Leipzig ( Site 1501)
Leipzig, 04103
Klinikum Ludwigsburg ( Site 1509)
Ludwigsburg, 71640
Universitatsklinikum Mannheim GmbH ( Site 1504)
Mannheim, 68167
Klinik fuer Haematologie. Onkologie und Gastroenterologie ( Site 1508)
Mönchengladbach, 41063
III. Medizinische Klinik Klinikum rechts der Isar ( Site 1506)
München, 81675
Romania7 sites
S.C.Focus Lab Plus S.R.L ( Site 2401)
Bucharest, Sector 2, 021389
S.C.Gral Medical S.R.L ( Site 2406)
Bucharest, 031422
S.C. Radiotherapy Center Cluj S.R.L ( Site 2407)
Comuna Floresti, Cluj, 407280
Spitalul Clinic Judetean De Urgenta Constanta ( Site 2402)
Constanța, 900591
S.C. Centrul de Oncologie Sf. Nectarie SRL ( Site 2404)
Craiova, Dolj, 200347
S C Pelican Impex SRL ( Site 2403)
Oradea, Bihor County, 410469
S C Oncocenter Oncologie Medicala S R L ( Site 2405)
Timișoara, Timiș County, 300166
Russia7 sites
National Medical and Surgical Center n.a. N.I.Pirogov ( Site 0402)
Moscow, 105203
N.N. Blokhin NMRCO ( Site 0401)
Moscow, 115478
Leningrad Regional Oncology Center ( Site 0405)
Saint Petersburg, Vsevolzhsk District, 188663
Scientific Research Oncology Institute n.a. N.N.Petrov ( Site 0406)
Saint Petersburg, 197758
St Petersburg City Clinical Oncology Dispensary ( Site 0409)
Saint Petersburg, 198255
Tomsk Scientific Research Institute of Oncology ( Site 0403)
Tomsk, 634028
SBHCI RCOD of MHC RB ( Site 0407)
Ufa, Bashkortostan Republic, 450054
South Africa7 sites
Clinton Oncology Centre ( Site 2505)
Alberton, 1448
Cape Town Oncology Trials Pty Ltd ( Site 2508)
Cape Town, Western Cape, 7570
The Oncology Centre ( Site 2502)
Durban, KwaZulu-Natal, 4091
Outeniqua Cancercare Oncology Unit ( Site 2504)
George, Western Cape, 6530
The Medical Oncology Centre of Rosebank ( Site 2506)
Johannesburg, Gauteng, 2196
WITS Clinical Research CMJAH Clinical Trial Site ( Site 2500)
Parktown, Gauteng, 2193
Cancer Care Langenhoven Drive Oncology Centre ( Site 2501)
Port Elizabeth, Eastern Cape, 6045
Spain7 sites
Hosp. Gral. Universitari Germans Trias i Pujol ( Site 0701)
Badalona, Barcelona, 08916
Hospital Universitari Vall d Hebron ( Site 0702)
Barcelona, 08035
Hospital Universitario Reina Sofia ( Site 0706)
Córdoba, 14004
Hospital Ramon y Cajal ( Site 0703)
Madrid, 28034
Hospital Universitario La Paz ( Site 0700)
Madrid, 28046
Complejo Hospitalario Virgen De La Victoria ( Site 0705)
Málaga, 29010
Hospital Universitario Central de Asturias ( Site 0708)
Oviedo, Principality of Asturias, 33011
Turkey (Türkiye)7 sites
Adana Sehir Hastanesi ( Site 0802)
Adana, 01370
Ankara Sehir Hastanesi ( Site 0808)
Ankara, 06800
Istanbul Medeniyet Universitesi Goztepe EAH ( Site 0807)
Istanbul, 34093
Istanbul Universitesi Cerrahpasa Tip Fakultesi ( Site 0804)
Istanbul, 34098
Marmara Universitesi Pendik Egitim ve Arastirma Hastanesi ( Site 0801)
Istanbul, 34899
Medical Park Izmir Hastanesi ( Site 0800)
Izmir, 35575
Inonu Universitesi Turgut Ozal Tip Merkezi ( Site 0803)
Malatya, 44280
South Korea6 sites
National Cancer Center ( Site 1304)
Goyang-si, Gyeonggi-do, 10408
Chonnam National University Hwasun Hospital ( Site 1305)
Hwasun Gun, Jeollanam-do, 58128
Seoul National University Cancer Hospital ( Site 1301)
Seoul, 03080
Severance Hospital Yonsei University Health System ( Site 1302)
Seoul, 03722
Asan Medical Center ( Site 1303)
Seoul, 05505
Samsung Medical Center ( Site 1300)
Seoul, 06351
Argentina5 sites
Hospital Aleman ( Site 0605)
Buenos Aires, C1118AAT
Hospital Municipal de Gastroenterologia Dr. Bonorino Udaondo ( Site 0602)
Buenos Aires, C1264AAA
Sanatorio Allende - Cordoba ( Site 0604)
Córdoba, X5000JHQ
Hospital Privado Centro Medico Cordoba ( Site 0601)
Córdoba, X5016KEH
Centro de Investigaciones Clinicas - Clinica Viedma ( Site 0603)
Viedma, Río Negro Province, R8500ACE
Australia5 sites
Blacktown Hospital ( Site 2000)
Blacktown, New South Wales, 2148
Eastern Health ( Site 2002)
Box Hill, Victoria, 3128
Liverpool Hospital. ( Site 2001)
Liverpool, New South Wales, 2170
Peter MacCallum Cancer Centre ( Site 2003)
Melbourne, Victoria, 3000
Princess Alexandra Hospital ( Site 2005)
Woolloongabba, Queensland, 4102
Guatemala5 sites
Centro de Investigacion Oncologica ( Site 1402)
Guatemala City, 01010
Oncomedica ( Site 1400)
Guatemala City, 01010
Grupo Medico Angeles ( Site 1401)
Guatemala City, 01015
Medi-K Cayala ( Site 1404)
Guatemala City, 01016
Centro Regional de Sub Especialidades Medicas SA ( Site 1403)
Quetzaltenango, 09001
Thailand5 sites
Bumrungrad International Hospital ( Site 2203)
Bangkok, 10110
Chulalongkorn Hospital ( Site 2201)
Bangkok, 10330
Ramathibodi Hospital. ( Site 2202)
Bangkok, 10330
Phramongkutklao Hospital ( Site 2205)
Bangkok, 10400
Songklanagarind Hospital ( Site 2204)
Songkhla, 90110
Chile4 sites
Hospital Regional de Concepcion Dr. Guillermo Grant Benavente ( Site 1003)
Concepción, 4070038
Pontificia Universidad Catolica de Chile ( Site 1001)
Santiago, 7620002
Hospital Clinico Universidad de Chile ( Site 1002)
Santiago, 8380456
Clinica Alemana de Temuco ( Site 1006)
Temuco, 4810297
Hong Kong4 sites
Humanity Health Research Centre ( Site 1603)
Hong Kong
Pamela Youde Nethersole Eastern Hospital ( Site 1601)
Hong Kong
Princess Margaret Hospital. ( Site 1602)
Hong Kong
Queen Mary Hospital ( Site 1600)
Hong Kong
Costa Rica3 sites
CIMCA Centro de Investigacion y Manejo del Cancer ( Site 2600)
San José, 10103
Policlinico San Bosco ( Site 2602)
San José, 10103
ICIMED - Instituto de Investigacion en Ciencias Medicas ( Site 2601)
San José, 10108
Malaysia3 sites
Hospital Kuala Lumpur ( Site 1805)
Kuala Lumpur, 50586
University Malaya Medical Centre ( Site 1802)
Kuala Lumpur, 59100
Beacon International Specialist Centre ( Site 1803)
Petaling Jaya, Selangor, 46050
Peru3 sites
Instituto Regional de Enfermedades Neoplasicas del Sur IRENSUR ( Site 1702)
Arequipa, 04000
Hospital Nacional Guillermo Almenara Irigoyen ( Site 1701)
Lima, 15033
Instituto Nacional de Enfermedades Neoplasicas ( Site 1705)
Lima, 15038
United Kingdom3 sites
Lothian University Hospitals NHS Trust ( Site 1101)
Edinburgh, Mid Lothian, EH4 2XU
St Luke's Cancer Centre ( Site 1102)
Guildford, GU2 7XX
The Christie NHS Foundation Trust ( Site 1100)
Manchester, M20 4BX
Colombia2 sites
Rodrigo Botero SAS ( Site 2703)
Medellín, Antioquia, 050030
Oncomedica S.A. ( Site 2701)
Montería, Departamento de Córdoba, 230018
Denmark2 sites
Rigshospitalet ( Site 2301)
Copenhagen, 2100
Odense Universitetshospital ( Site 2300)
Odense, 5000
About this study
Official title: A Randomized, Double-Blind, Placebo-Controlled Phase III Clinical Trial of Pembrolizumab (MK-3475) in Combination With Cisplatin and 5-Fluorouracil Versus Placebo in Combination With Cisplatin and 5-Fluorouracil as First-Line Treatment in Subjects With Advanced/Metastatic Esophageal Carcinoma (KEYNOTE-590)
The purpose of this trial is to evaluate efficacy and safety of pembrolizumab plus standard of care (SOC) chemotherapy with cisplatin and 5-fluorouracil (5-FU) versus placebo plus SOC chemotherapy with cisplatin and 5-FU as first-line treatment in participants with locally advanced or metastatic esophageal carcinoma.
The overall primary efficacy hypotheses are as follows:
- In participants with esophageal squamous cell carcinoma (ESCC), participants whose tumors are programmed cell death-ligand 1 (PD-L1)-positive (defined as combined positive score [CPS] ≥10), ESCC participants whose tumors are PD-L1 positive (CPS ≥10), and in all participants, overall survival (OS) is superior with pembrolizumab plus SOC chemotherapy compared with placebo plus SOC chemotherapy.
- In participants with ESCC, participants whose tumors are PD-L1 positive (CPS ≥10), and in all participants, progression-free survival (PFS) according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 as assessed by investigator is superior with pembrolizumab plus SOC chemotherapy compared with placebo plus SOC chemotherapy.
- Conditions
- Esophageal Neoplasms
- Being tested
- Pembrolizumab, Placebo, Cisplatin, 5-FU
- Keywords
- Programmed Cell Death-1 (PD1, PD-1),, Programmed Cell Death Receptor Ligand 1 (PDL1, PD-L1), Programmed Cell Death Receptor Ligand 2 (PDL2, PD-L2)
- Medical subject headings
- Esophageal Neoplasms, Parkinson Disease 4, Autosomal Dominant Lewy Body
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PembrolizumabBiological
Also called MK-3475
200 mg administered IV Q3W on Day 1 of each 3-week cycle, up to 35 administrations.
PlaceboDrug
Placebo to pembrolizumab (saline) administered IV Q3W on Day 1 of each 3-week cycle, up to 35 administrations.
CisplatinDrug
80 mg/m^2 administered IV Q3W on Day 1 of each 3-week cycle. Duration of cisplatin treatment will be capped at 6 doses.
5-FUDrug
800 mg/m^2/day (4000 mg/m^2 total per cycle) administered as continuous IV infusion on Days 1 to 5 (120 hours) of each 3-week cycle, or per local standard for 5-FU administration, up to 35 administrations.
| Study group | Role | What they receive |
|---|---|---|
| Pembrolizumab + SOC | Experimental | Participants receive pembrolizumab 200 mg intravenously (IV) every 3 weeks (Q3W) plus standard of care (SOC) chemotherapy with cisplatin 80 mg/m^2 IV Q3W and 5-FU 800 mg/m^2/day continuous IV infusion on Days 1 to 5 (120 hours) Q3W. All treatments will be administered on an outpatient basis beginning on Day 1 of each 3-week dosing cycle. Receives: Biological: Pembrolizumab; Drug: Cisplatin; Drug: 5-FU |
| Placebo + SOC | Placebo comparator | Participants receive placebo to pembrolizumab (saline) IV Q3W plus SOC chemotherapy with cisplatin 80 mg/m^2 IV Q3W and 5-FU 800 mg/m^2/day continuous IV infusion on Days 1 to 5 (120 hours) Q3W. All treatments will be administered on an outpatient basis beginning on Day 1 of each 3-week dosing cycle. Receives: Drug: Placebo; Drug: Cisplatin; Drug: 5-FU |
What is being measured
The primary outcome is the main question the study is designed to answer.
Overall Survival (OS) in Participants With Esophageal Squamous Cell Carcinoma (ESCC) Whose Tumors Are Programmed Cell Death-Ligand 1 (PD-L1) Biomarker-Positive (Combined Positive Score [CPS] ≥10)
Overall survival was defined as the time from randomization to death due to any cause. Participants without documented death at the time of the final analysis were censored at the date of the last follow-up. Per protocol, OS is reported here for all participants of the Intent-To-Treat (ITT) population (all randomized) who had ESCC and who were PD-L1 CPS ≥10.
Measured: Up to approximately 34 months
OS in Participants With ESCC
Overall survival was defined as the time from randomization to death due to any cause. Participants without documented death at the time of the final analysis were censored at the date of the last follow-up. Per protocol, OS is reported here for all participants of the ITT population (all randomized) who had ESCC.
Measured: Up to approximately 34 months
OS in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
Overall survival was defined as the time from randomization to death due to any cause. Participants without documented death at the time of the final analysis were censored at the date of the last follow-up. Per protocol, OS is reported here for all participants of the ITT population (all randomized) who were PD-L1 CPS ≥10.
Measured: Up to approximately 34 months
OS in All Participants
Overall survival was defined as the time from randomization to death due to any cause. Participants without documented death at the time of the final analysis were censored at the date of the last follow-up. Per protocol, OS is reported here for all participants of the ITT population (all randomized).
Measured: Up to approximately 34 months
Progression-free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed By Investigator in Participants With ESCC
PFS was defined as the time from randomization to the first documented progressive disease (PD) per RECIST 1.1 as assessed by the investigator, or death due to any cause, whichever occurred first. Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum had to demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. The sponsor allowed a maximum of 10 target lesions in total and 5 per organ on this study. Per protocol, PFS is reported here for all participants of the ITT population (all randomized) who had ESCC.
Measured: Up to approximately 34 months
PFS Per RECIST 1.1 As Assessed By Investigator in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
PFS was defined as the time from randomization to the first documented progressive disease (PD) per RECIST 1.1 as assessed by the investigator, or death due to any cause, whichever occurred first. Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum had to demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. The sponsor allowed a maximum of 10 target lesions in total and 5 per organ on this study. Per protocol, PFS is reported here for all participants of the ITT population (all randomized) who were PD-L1 CPS ≥10.
Measured: Up to approximately 34 months
PFS Per RECIST 1.1 As Assessed By Investigator in All Participants
PFS was defined as the time from randomization to the first documented progressive disease (PD) per RECIST 1.1 as assessed by the investigator, or death due to any cause, whichever occurred first. Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum had to demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. The sponsor allowed a maximum of 10 target lesions in total and 5 per organ on this study. Per protocol, PFS is reported here for all participants of the ITT population (all randomized).
Measured: Up to approximately 34 months
Secondary outcomes (18)
Objective Response Rate (ORR) Per RECIST 1.1 As Assessed By Investigator in All Participants
ORR was defined as the percentage of participants in the analysis population who had a Complete Response (CR: disappearance of all target lesions) or a Partial Response (PR: ≥30% decrease in the sum of diameters of target lesions) per RECIST 1.1. as assessed by the investigator. The sponsor allowed a maximum of 10 target lesions in total and 5 per organ on this study. Per protocol, the percentage of participants who experienced CR or PR is reported here as the ORR for all participants of the ITT population (all randomized).
Measured: Up to approximately 34 months
ORR Per RECIST 1.1 As Assessed By Investigator in Participants With ESCC Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
ORR was defined as the percentage of participants in the analysis population who had a Complete Response (CR: disappearance of all target lesions) or a Partial Response (PR: ≥30% decrease in the sum of diameters of target lesions) per RECIST 1.1. as assessed by the investigator. The sponsor allowed a maximum of 10 target lesions in total and 5 per organ on this study. Per protocol, the percentage of participants who experienced CR or PR is reported here as the ORR for all participants of the ITT population (all randomized) who had ESCC and who were PD-L1 CPS ≥10.
Measured: Up to approximately 34 months
ORR Per RECIST 1.1 As Assessed By Investigator in Participants With ESCC
ORR was defined as the percentage of participants in the analysis population who had a Complete Response (CR: disappearance of all target lesions) or a Partial Response (PR: ≥30% decrease in the sum of diameters of target lesions) per RECIST 1.1. as assessed by the investigator. The sponsor allowed a maximum of 10 target lesions in total and 5 per organ on this study. Per protocol, the percentage of participants who experienced CR or PR is reported here as the ORR for all participants of the ITT population (all randomized) who had ESCC.
Measured: Up to approximately 34 months
ORR Per RECIST 1.1 As Assessed By Investigator in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
ORR was defined as the percentage of participants in the analysis population who had a Complete Response (CR: disappearance of all target lesions) or a Partial Response (PR: ≥30% decrease in the sum of diameters of target lesions) per RECIST 1.1. as assessed by the investigator. The sponsor allowed a maximum of 10 target lesions in total and 5 per organ on this study. Per protocol, the percentage of participants who experienced CR or PR is reported here as the ORR for all participants of the ITT population (all randomized) who were PD-L1 CPS ≥10.
Measured: Up to approximately 34 months
Duration of Response (DOR) Per RECIST 1.1 As Assessed By Investigator in All Participants
For participants who demonstrated a confirmed CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by the investigator, DOR was defined as the time from first documented evidence of confirmed CR or PR until PD or death due to any cause, whichever occurred first. DOR for participants who had not progressed or died at the time of analysis was censored at the date of their last tumor assessment. Per RECIST 1.1, PD was defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum had to demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. Per protocol, DOR is reported here for all participants of the ITT population (all randomized) who had CR or PR.
Measured: Up to approximately 34 months
DOR Per RECIST 1.1 As Assessed By Investigator in Participants With ESCC Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
For participants who demonstrated a confirmed CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by the investigator, DOR was defined as the time from first documented evidence of confirmed CR or PR until PD or death due to any cause, whichever occurred first. DOR for participants who had not progressed or died at the time of analysis was censored at the date of their last tumor assessment. Per RECIST 1.1, PD was defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum had to demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. Per protocol, DOR is reported here for all participants of the ITT population (all randomized) who had CR or PR, and who had ESCC and were PD-L1 CPS ≥10.
Measured: Up to approximately 34 months
DOR Per RECIST 1.1 As Assessed By Investigator in Participants With ESCC
For participants who demonstrated a confirmed CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by the investigator, DOR was defined as the time from first documented evidence of confirmed CR or PR until PD or death due to any cause, whichever occurred first. DOR for participants who had not progressed or died at the time of analysis was censored at the date of their last tumor assessment. Per RECIST 1.1, PD was defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum had to demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. Per protocol, DOR is reported here for all participants of the ITT population (all randomized) who had CR or PR, and who had ESCC.
Measured: Up to approximately 34 months
DOR Per RECIST 1.1 As Assessed By Investigator in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
For participants who demonstrated a confirmed CR (disappearance of all target lesions) or PR (at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by the investigator, DOR was defined as the time from first documented evidence of confirmed CR or PR until PD or death due to any cause, whichever occurred first. DOR for participants who had not progressed or died at the time of analysis was censored at the date of their last tumor assessment. Per RECIST 1.1, PD was defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum had to demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. Per protocol, DOR is reported here for all participants of the ITT population (all randomized) who had CR or PR, and were PD-L1 CPS ≥10.
Measured: Up to approximately 34 months
Number of Participants With an Adverse Event (AE)
An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have to have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a pre-existing condition that was temporally associated with the use of the Sponsor's product was also an AE. The number of participants that experienced at least one AE was reported for each treatment arm.
Measured: Up to approximately 28 months
Number of Participants Discontinuing Study Treatment Due to an AE
An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have to have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening of a pre-existing condition that was temporally associated with the use of the Sponsor's product was also an AE. The number of participants that discontinued any study drug due to an AE was reported for each treatment arm.
Measured: Up to approximately 27 months
Change From Baseline To Week 18 in the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) Global Health Status/Quality of Life (GHS/QoL) Combined Score in All Participants
The EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer patients. Participant responses to the Global Health Status (GHS) question "How would you rate your overall health during the past week?" (Item 29) and the Quality of Life (QoL) question "How would you rate your overall quality of life during the past week?" (Item 30) were scored on a 7-point scale (1=Very Poor to 7=Excellent). Using linear transformation, raw scores were standardized so that scores ranged from 0 to 100, with a higher score indicating a better overall outcome. Per protocol, change from baseline to Week 18 in the GHS/QoL combined score was reported by treatment arm as a pre-specified secondary analysis for all participants.
Measured: Baseline, Week 18
Change From Baseline To Week 18 in the EORTC QLQ-C30 GHS/QoL Combined Score in Participants With ESCC Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
The EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer patients. Participant responses to the Global Health Status (GHS) question "How would you rate your overall health during the past week?" (Item 29) and the Quality of Life (QoL) question "How would you rate your overall quality of life during the past week?" (Item 30) were scored on a 7-point scale (1=Very Poor to 7=Excellent). Using linear transformation, raw scores were standardized so that scores ranged from 0 to 100, with a higher score indicating a better overall outcome. Per protocol, change from baseline to Week 18 in the GHS/QoL combined score was reported by treatment arm as a pre-specified secondary analysis for all participants who had ESCC and who were PD-L1 CPS ≥10.
Measured: Baseline, Week 18
Change From Baseline To Week 18 in the EORTC QLQ-C30 GHS/QoL Combined Score in Participants With ESCC
The EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer patients. Participant responses to the Global Health Status (GHS) question "How would you rate your overall health during the past week?" (Item 29) and the Quality of Life (QoL) question "How would you rate your overall quality of life during the past week?" (Item 30) were scored on a 7-point scale (1=Very Poor to 7=Excellent). Using linear transformation, raw scores were standardized so that scores ranged from 0 to 100, with a higher score indicating a better overall outcome. Per protocol, change from baseline to Week 18 in the GHS/QoL combined score was reported by treatment arm as a pre-specified secondary analysis for all participants who had ESCC.
Measured: Baseline, Week 18
Change From Baseline To Week 18 in the EORTC QLQ-C30 GHS/QoL Combined Score in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
The EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer patients. Participant responses to the Global Health Status (GHS) question "How would you rate your overall health during the past week?" (Item 29) and the Quality of Life (QoL) question "How would you rate your overall quality of life during the past week?" (Item 30) were scored on a 7-point scale (1=Very Poor to 7=Excellent). Using linear transformation, raw scores were standardized so that scores ranged from 0 to 100, with a higher score indicating a better overall outcome. Per protocol, change from baseline to Week 18 in the GHS/QoL combined score was reported by treatment arm as a pre-specified secondary analysis for all participants who were PD-L1 CPS ≥10.
Measured: Baseline, Week 18
Change From Baseline in the EORTC Quality Of Life Questionnaire Oesophageal Module (QLQ-OES18) Subscale Scores in All Participants
The EORTC QLQ-OES18 is a disease-specific questionnaire developed and validated to address measurements specific to esophageal cancer and contains 18 items assessing symptoms of dysphagia, pain, reflux symptoms, eating restrictions, anxiety, dry mouth, taste, body image, and hair loss. For the purposes of this study, the Dysphagia subscale (three items), Pain subscale (three items), and Reflux subscale (two items) were evaluated. All subscale items were scored using a four-point Likert scale with the following response choices: 1=not at all, 2=a little, 3=quite a bit, 4=very much. Raw scores for the subscales were standardized into a range of 0 to 100 by linear transformation, with higher symptom scores represent a higher ("worse") level of symptoms. Per protocol, change from baseline to Week 18 in the Dysphagia, Pain, and Reflux subscales was reported for all participants in each treatment arm. Negative changes from baseline indicate a decrease in symptom severity.
Measured: Baseline, Week 18
Change From Baseline in the EORTC QLQ-OES18 Subscale Scores in Participants With ESCC Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
The EORTC QLQ-OES18 is a disease-specific questionnaire developed and validated to address measurements specific to esophageal cancer and contains 18 items assessing symptoms of dysphagia, pain, reflux symptoms, eating restrictions, anxiety, dry mouth, taste, body image, and hair loss. For the purposes of this study, the Dysphagia subscale (three items), Pain subscale (three items), and Reflux subscale (two items) were evaluated. All subscale items were scored using a four-point Likert scale with the following response choices: 1=not at all, 2=a little, 3=quite a bit, 4=very much. Raw scores for the subscales were standardized into a range of 0 to 100 by linear transformation, with higher symptom scores representing a higher ("worse") level of symptoms. Change from baseline to Week 18 in the Dysphagia, Pain, and Reflux subscales was reported for participants with ESCC who were PD-L1 CPS≥10 in each treatment arm. Negative changes from baseline indicate a decrease in symptom severity.
Measured: Baseline, Week 18
Change From Baseline in the EORTC QLQ-OES18 Subscale Scores in Participants With ESCC
The EORTC QLQ-OES18 is a disease-specific questionnaire developed and validated to address measurements specific to esophageal cancer and contains 18 items assessing symptoms of dysphagia, pain, reflux symptoms, eating restrictions, anxiety, dry mouth, taste, body image, and hair loss. For the purposes of this study, the Dysphagia subscale (three items), Pain subscale (three items), and Reflux subscale (two items) were evaluated. All subscale items were scored using a four-point Likert scale with the following response choices: 1=not at all, 2=a little, 3=quite a bit, 4=very much. Raw scores for the subscales were standardized into a range of 0 to 100 by linear transformation, with higher symptom scores representing a higher ("worse") level of symptoms. Change from baseline to Week 18 in the Dysphagia, Pain, and Reflux subscales was reported for participants with ESCC in each treatment arm. Negative changes from baseline indicate a decrease in symptom severity.
Measured: Baseline, Week 18
Change From Baseline in the EORTC QLQ-OES18 Subscale Scores in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
The EORTC QLQ-OES18 is a disease-specific questionnaire developed and validated to address measurements specific to esophageal cancer and contains 18 items assessing symptoms of dysphagia, pain, reflux symptoms, eating restrictions, anxiety, dry mouth, taste, body image, and hair loss. For the purposes of this study, the Dysphagia subscale (three items), Pain subscale (three items), and Reflux subscale (two items) were evaluated. All subscale items were scored using a four-point Likert scale with the following response choices: 1=not at all, 2=a little, 3=quite a bit, 4=very much. Raw scores for the subscales were standardized into a range of 0 to 100 by linear transformation, with higher symptom scores representing a higher ("worse") level of symptoms. Change from baseline to Week 18 in the Dysphagia, Pain, and Reflux subscales was reported for participants who were PD-L1 CPS≥10 in each treatment arm. Negative changes from baseline indicate a decrease in symptom severity.
Measured: Baseline, Week 18
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Jun 2017
- Study start25 Jul 2017
- Primary completion2 Jul 2020
- Study completion10 Jul 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for Esophageal NeoplasmsStudies of the same condition, open and under way.
- More trials run by Merck Sharp & Dohme LLCThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 749 participants (actual)
Sponsor and investigators
- Lead sponsor
- Merck Sharp & Dohme LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Medical Director, Study director, Merck Sharp & Dohme LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03189719
- Sponsor's protocol ID
- 3475-590
- Other IDs
- 173739, MK-3475-590, KEYNOTE-590, 2017-000958-19, 2017
- Status last verified
- Oct 2024
- First submitted
- 14 Jun 2017
- Last updated
- 15 Oct 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
Publications
Kato K, Kojima T, Hara H, Tsuji A, Yasui H, Muro K, Satoh T, Yatsuzuka N, Sakata T, Han S, Doi T. First-line pembrolizumab plus chemotherapy versus chemotherapy alone for advanced esophageal cancer: 5-year extended follow-up in the Japanese subgroup of KEYNOTE-590. Esophagus. 2026 Jul;23(3):486-500. doi: 10.1007/s10388-026-01200-8. Epub 2026 Apr 28.
PubMed 42047965Zhang Y, Diez Garcia M, Shah S, Joo S, Valderrama A, Zhang S, Enzinger PC. Analysis of quality-adjusted survival time without symptoms or toxicity for pembrolizumab plus chemotherapy as treatment for previously untreated participants with advanced or metastatic esophageal cancer. Qual Life Res. 2026 Feb 1;35(3):58. doi: 10.1007/s11136-025-04109-4.
PubMed 41620988Mansoor W, Joo S, Norquist JM, Kato K, Sun JM, Shah MA, Enzinger P, Adenis A, Doi T, Kojima T, Metges JP, Li Z, Kim SB, Cho BC, Sunpaweravong P, Alsina M, Goekkurt E, Suryawanshi S, Shah S, Shen L. Health-related quality-of-life analysis from KEYNOTE-590: pembrolizumab plus chemotherapy versus chemotherapy for advanced esophageal cancer. Oncologist. 2024 Oct 3;29(10):e1324-e1335. doi: 10.1093/oncolo/oyae087.
PubMed 38815152Kato K, Kojima T, Hara H, Tsuji A, Yasui H, Muro K, Satoh T, Ogata T, Ishihara R, Goto M, Baba H, Nishina T, Han S, Iwakami K, Yatsuzuka N, Doi T. First-line pembrolizumab plus chemotherapy for advanced/metastatic esophageal cancer: 1-year extended follow-up in the Japanese subgroup of the phase 3 KEYNOTE-590 study. Esophagus. 2024 Jul;21(3):306-318. doi: 10.1007/s10388-024-01053-z. Epub 2024 Apr 12.
PubMed 38607538Zhang Y, Li C, Du K, Pengkhun N, Huang Z, Gong M, Li Y, Liu X, Li L, Wang D, Wang C, Chen F, Li J. Comparative analysis of immune checkpoint inhibitors in first-line treatment of esophageal squamous cell carcinoma: a network meta-analysis. Immunotherapy. 2023 Jul;15(10):737-750. doi: 10.2217/imt-2022-0236. Epub 2023 May 4.
PubMed 37139963Kojima T, Hara H, Tsuji A, Yasui H, Muro K, Satoh T, Ogata T, Ishihara R, Goto M, Baba H, Nishina T, Han S, Sakata T, Yatsuzuka N, Doi T, Kato K. First-line pembrolizumab + chemotherapy in Japanese patients with advanced/metastatic esophageal cancer from KEYNOTE-590. Esophagus. 2022 Oct;19(4):683-692. doi: 10.1007/s10388-022-00920-x. Epub 2022 Jun 7.
PubMed 35668304Zhu Y, Liu K, Ding D, Zhou Y, Peng L. Pembrolizumab Plus Chemotherapy as First-Line Treatment for Advanced Esophageal Cancer: A Cost-Effectiveness Analysis. Adv Ther. 2022 Jun;39(6):2614-2629. doi: 10.1007/s12325-022-02101-9. Epub 2022 Apr 8.
PubMed 35394255Sun JM, Shen L, Shah MA, Enzinger P, Adenis A, Doi T, Kojima T, Metges JP, Li Z, Kim SB, Cho BC, Mansoor W, Li SH, Sunpaweravong P, Maqueda MA, Goekkurt E, Hara H, Antunes L, Fountzilas C, Tsuji A, Oliden VC, Liu Q, Shah S, Bhagia P, Kato K; KEYNOTE-590 Investigators. Pembrolizumab plus chemotherapy versus chemotherapy alone for first-line treatment of advanced oesophageal cancer (KEYNOTE-590): a randomised, placebo-controlled, phase 3 study. Lancet. 2021 Aug 28;398(10302):759-771. doi: 10.1016/S0140-6736(21)01234-4.
PubMed 34454674Kato K, Shah MA, Enzinger P, Bennouna J, Shen L, Adenis A, Sun JM, Cho BC, Ozguroglu M, Kojima T, Kostorov V, Hierro C, Zhu Y, McLean LA, Shah S, Doi T. KEYNOTE-590: Phase III study of first-line chemotherapy with or without pembrolizumab for advanced esophageal cancer. Future Oncol. 2019 Apr;15(10):1057-1066. doi: 10.2217/fon-2018-0609. Epub 2019 Feb 8.
PubMed 30735435
Study at a glance
From the registry record, last updated by the sponsor on 15 Oct 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double-Blind, Placebo-Controlled Phase III Clinical Trial of Pembrolizumab (MK-3475) in Combination With Cisplatin and 5-Fluorouracil Versus Placebo in Combination With Cisplatin and 5-Fluorouracil as First-Line Treatment in Subjects With Advanced/Metastatic Esophageal Carcinoma (KEYNOTE-590)
- ClinicalTrials.gov ID
- NCT03189719
- Acronym / sponsor ID
- 3475-590
- Conditions
- Esophageal Neoplasms
- Keywords
- Programmed Cell Death-1 (PD1, PD-1),, Programmed Cell Death Receptor Ligand 1 (PDL1, PD-L1), Programmed Cell Death Receptor Ligand 2 (PDL2, PD-L2)
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 749 participants (actual)
- Lead sponsor
- Merck Sharp & Dohme LLCIndustry (pharma, biotech, devices)
- Study start
- 25 Jul 2017 (actual)
- Primary completion
- 2 Jul 2020 (actual)
- Study completion
- 10 Jul 2023 (actual)
- First posted
- 16 Jun 2017 (actual)
- Results
- Posted 6 Jul 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this trial is to evaluate efficacy and safety of pembrolizumab plus standard of care (SOC) chemotherapy with cisplatin and 5-fluorouracil (5-FU) versus placebo plus SOC chemotherapy with cisplatin and 5-FU as first-line treatment in participants with locally advanced or metastatic esophageal carcinoma.
The overall primary efficacy hypotheses are as follows:
- In participants with esophageal squamous cell carcinoma (ESCC), participants whose tumors are programmed cell death-ligand 1 (PD-L1)-positive (defined as combined positive score [CPS] ≥10), ESCC participants whose tumors are PD-L1 positive (CPS ≥10), and in all participants, overall survival (OS) is superior with pembrolizumab plus SOC chemotherapy compared with placebo plus SOC chemotherapy.
- In participants with ESCC, participants whose tumors are PD-L1 positive (CPS ≥10), and in all participants, progression-free survival (PFS) according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 as assessed by investigator is superior with pembrolizumab plus SOC chemotherapy compared with placebo plus SOC chemotherapy.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Pembrolizumab + SOC | Experimental | Biological: Pembrolizumab, Drug: Cisplatin, Drug: 5-FUParticipants receive pembrolizumab 200 mg intravenously (IV) every 3 weeks (Q3W) plus standard of care (SOC) chemotherapy with cisplatin 80 mg/m^2 IV Q3W and 5-FU 800 mg/m^2/day continuous IV infusion on Days 1 to 5 (120 hours) Q3W. All treatments will be administered on an outpatient basis beginning on Day 1 of each 3-week dosing cycle. |
| Placebo + SOC | Placebo comparator | Drug: Placebo, Drug: Cisplatin, Drug: 5-FUParticipants receive placebo to pembrolizumab (saline) IV Q3W plus SOC chemotherapy with cisplatin 80 mg/m^2 IV Q3W and 5-FU 800 mg/m^2/day continuous IV infusion on Days 1 to 5 (120 hours) Q3W. All treatments will be administered on an outpatient basis beginning on Day 1 of each 3-week dosing cycle. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Has histologically- or cytologically-confirmed diagnosis of locally advanced unresectable or metastatic adenocarcinoma or squamous cell carcinoma of the esophagus or advanced/metastatic Siewert type 1 adenocarcinoma of the esophagogastric junction (EGJ)
- Has measurable disease per RECIST 1.1 as determined by the local site investigator/radiology assessment
- Eastern Cooperative Group (ECOG) performance status of 0 to 1
- Can provide either a newly obtained or archival tissue sample for PD-L1 by immunohistochemistry analysis
- Female participants of childbearing potential must have a negative urine or serum pregnancy test within 72 hours prior to randomization and be willing to use an adequate method of contraception (e.g. abstinence, intrauterine device, diaphragm with spermicide, etc.) for the course of the study through 120 days after the last dose of study treatment and up to 180 days after last dose of cisplatin
Key exclusion criteria (15 listed)
- Has locally advanced esophageal carcinoma that is resectable or potentially curable with radiation therapy (as determined by local investigator)
- Has had previous therapy for advanced/metastatic adenocarcinoma or squamous cell cancer of the esophagus or advanced/metastatic Siewert type 1 adenocarcinoma of the EGJ
- Has had major surgery, open biopsy, or significant traumatic injury within 28 days prior to randomization, or anticipation of the need for major surgery during the course of study treatment
- Has a known additional malignancy that is progressing or requires active treatment. Exceptions include early-stage cancers (carcinoma in situ or Stage 1) treated with curative intent, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, in situ cervical cancer, in situ breast cancer that has undergone potentially curative therapy, and in situ or intramucosal pharyngeal cancer
- Has known active central nervous system metastases and/or carcinomatous meningitis.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PembrolizumabAlso: MK-3475200 mg administered IV Q3W on Day 1 of each 3-week cycle, up to 35 administrations. | Biological | Pembrolizumab + SOC |
| PlaceboPlacebo to pembrolizumab (saline) administered IV Q3W on Day 1 of each 3-week cycle, up to 35 administrations. | Drug | Placebo + SOC |
| Cisplatin80 mg/m^2 administered IV Q3W on Day 1 of each 3-week cycle. Duration of cisplatin treatment will be capped at 6 doses. | Drug | Pembrolizumab + SOC, Placebo + SOC |
| 5-FU800 mg/m^2/day (4000 mg/m^2 total per cycle) administered as continuous IV infusion on Days 1 to 5 (120 hours) of each 3-week cycle, or per local standard for 5-FU administration, up to 35 administrations. | Drug | Pembrolizumab + SOC, Placebo + SOC |
Primary outcome
Overall Survival (OS) in Participants With Esophageal Squamous Cell Carcinoma (ESCC) Whose Tumors Are Programmed Cell Death-Ligand 1 (PD-L1) Biomarker-Positive (Combined Positive Score [CPS] ≥10)
Time frame: Up to approximately 34 months
Overall survival was defined as the time from randomization to death due to any cause. Participants without documented death at the time of the final analysis were censored at the date of the last follow-up. Per protocol, OS is reported here for all participants of the Intent-To-Treat (ITT) population (all randomized) who had ESCC and who were PD-L1 CPS ≥10.
OS in Participants With ESCC
Time frame: Up to approximately 34 months
Overall survival was defined as the time from randomization to death due to any cause. Participants without documented death at the time of the final analysis were censored at the date of the last follow-up. Per protocol, OS is reported here for all participants of the ITT population (all randomized) who had ESCC.
OS in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
Time frame: Up to approximately 34 months
Overall survival was defined as the time from randomization to death due to any cause. Participants without documented death at the time of the final analysis were censored at the date of the last follow-up. Per protocol, OS is reported here for all participants of the ITT population (all randomized) who were PD-L1 CPS ≥10.
OS in All Participants
Time frame: Up to approximately 34 months
Overall survival was defined as the time from randomization to death due to any cause. Participants without documented death at the time of the final analysis were censored at the date of the last follow-up. Per protocol, OS is reported here for all participants of the ITT population (all randomized).
Progression-free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) As Assessed By Investigator in Participants With ESCC
Time frame: Up to approximately 34 months
PFS was defined as the time from randomization to the first documented progressive disease (PD) per RECIST 1.1 as assessed by the investigator, or death due to any cause, whichever occurred first. Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum had to demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. The sponsor allowed a maximum of 10 target lesions in total and 5 per organ on this study. Per protocol, PFS is reported here for all participants of the ITT population (all randomized) who had ESCC.
PFS Per RECIST 1.1 As Assessed By Investigator in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
Time frame: Up to approximately 34 months
PFS was defined as the time from randomization to the first documented progressive disease (PD) per RECIST 1.1 as assessed by the investigator, or death due to any cause, whichever occurred first. Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum had to demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. The sponsor allowed a maximum of 10 target lesions in total and 5 per organ on this study. Per protocol, PFS is reported here for all participants of the ITT population (all randomized) who were PD-L1 CPS ≥10.
PFS Per RECIST 1.1 As Assessed By Investigator in All Participants
Time frame: Up to approximately 34 months
PFS was defined as the time from randomization to the first documented progressive disease (PD) per RECIST 1.1 as assessed by the investigator, or death due to any cause, whichever occurred first. Per RECIST 1.1, PD was defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum had to demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions was also considered PD. The sponsor allowed a maximum of 10 target lesions in total and 5 per organ on this study. Per protocol, PFS is reported here for all participants of the ITT population (all randomized).
18 secondary outcomes
Objective Response Rate (ORR) Per RECIST 1.1 As Assessed By Investigator in All Participants
Time frame: Up to approximately 34 months
ORR Per RECIST 1.1 As Assessed By Investigator in Participants With ESCC Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
Time frame: Up to approximately 34 months
ORR Per RECIST 1.1 As Assessed By Investigator in Participants With ESCC
Time frame: Up to approximately 34 months
ORR Per RECIST 1.1 As Assessed By Investigator in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
Time frame: Up to approximately 34 months
Duration of Response (DOR) Per RECIST 1.1 As Assessed By Investigator in All Participants
Time frame: Up to approximately 34 months
DOR Per RECIST 1.1 As Assessed By Investigator in Participants With ESCC Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
Time frame: Up to approximately 34 months
DOR Per RECIST 1.1 As Assessed By Investigator in Participants With ESCC
Time frame: Up to approximately 34 months
DOR Per RECIST 1.1 As Assessed By Investigator in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
Time frame: Up to approximately 34 months
Number of Participants With an Adverse Event (AE)
Time frame: Up to approximately 28 months
Number of Participants Discontinuing Study Treatment Due to an AE
Time frame: Up to approximately 27 months
Change From Baseline To Week 18 in the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) Global Health Status/Quality of Life (GHS/QoL) Combined Score in All Participants
Time frame: Baseline, Week 18
Change From Baseline To Week 18 in the EORTC QLQ-C30 GHS/QoL Combined Score in Participants With ESCC Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
Time frame: Baseline, Week 18
Change From Baseline To Week 18 in the EORTC QLQ-C30 GHS/QoL Combined Score in Participants With ESCC
Time frame: Baseline, Week 18
Change From Baseline To Week 18 in the EORTC QLQ-C30 GHS/QoL Combined Score in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
Time frame: Baseline, Week 18
Change From Baseline in the EORTC Quality Of Life Questionnaire Oesophageal Module (QLQ-OES18) Subscale Scores in All Participants
Time frame: Baseline, Week 18
Change From Baseline in the EORTC QLQ-OES18 Subscale Scores in Participants With ESCC Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
Time frame: Baseline, Week 18
Change From Baseline in the EORTC QLQ-OES18 Subscale Scores in Participants With ESCC
Time frame: Baseline, Week 18
Change From Baseline in the EORTC QLQ-OES18 Subscale Scores in Participants Whose Tumors Are PD-L1 Biomarker-Positive (CPS ≥10)
Time frame: Baseline, Week 18
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Oct 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 42047965Kato K, Kojima T, Hara H, Tsuji A, Yasui H, Muro K, Satoh T, Yatsuzuka N, Sakata T, Han S, Doi T. First-line pembrolizumab plus chemotherapy versus chemotherapy alone for advanced esophageal cancer: 5-year extended follow-up in the Japanese subgroup of KEYNOTE-590. Esophagus. 2026 Jul;23(3):486-500. doi: 10.1007/s10388-026-01200-8. Epub 2026 Apr 28.
- Derived from this study: PubMed 41620988Zhang Y, Diez Garcia M, Shah S, Joo S, Valderrama A, Zhang S, Enzinger PC. Analysis of quality-adjusted survival time without symptoms or toxicity for pembrolizumab plus chemotherapy as treatment for previously untreated participants with advanced or metastatic esophageal cancer. Qual Life Res. 2026 Feb 1;35(3):58. doi: 10.1007/s11136-025-04109-4.
- Derived from this study: PubMed 38815152Mansoor W, Joo S, Norquist JM, Kato K, Sun JM, Shah MA, Enzinger P, Adenis A, Doi T, Kojima T, Metges JP, Li Z, Kim SB, Cho BC, Sunpaweravong P, Alsina M, Goekkurt E, Suryawanshi S, Shah S, Shen L. Health-related quality-of-life analysis from KEYNOTE-590: pembrolizumab plus chemotherapy versus chemotherapy for advanced esophageal cancer. Oncologist. 2024 Oct 3;29(10):e1324-e1335. doi: 10.1093/oncolo/oyae087.
- Derived from this study: PubMed 38607538Kato K, Kojima T, Hara H, Tsuji A, Yasui H, Muro K, Satoh T, Ogata T, Ishihara R, Goto M, Baba H, Nishina T, Han S, Iwakami K, Yatsuzuka N, Doi T. First-line pembrolizumab plus chemotherapy for advanced/metastatic esophageal cancer: 1-year extended follow-up in the Japanese subgroup of the phase 3 KEYNOTE-590 study. Esophagus. 2024 Jul;21(3):306-318. doi: 10.1007/s10388-024-01053-z. Epub 2024 Apr 12.
- Derived from this study: PubMed 37139963Zhang Y, Li C, Du K, Pengkhun N, Huang Z, Gong M, Li Y, Liu X, Li L, Wang D, Wang C, Chen F, Li J. Comparative analysis of immune checkpoint inhibitors in first-line treatment of esophageal squamous cell carcinoma: a network meta-analysis. Immunotherapy. 2023 Jul;15(10):737-750. doi: 10.2217/imt-2022-0236. Epub 2023 May 4.
- Derived from this study: PubMed 35668304Kojima T, Hara H, Tsuji A, Yasui H, Muro K, Satoh T, Ogata T, Ishihara R, Goto M, Baba H, Nishina T, Han S, Sakata T, Yatsuzuka N, Doi T, Kato K. First-line pembrolizumab + chemotherapy in Japanese patients with advanced/metastatic esophageal cancer from KEYNOTE-590. Esophagus. 2022 Oct;19(4):683-692. doi: 10.1007/s10388-022-00920-x. Epub 2022 Jun 7.
- Derived from this study: PubMed 35394255Zhu Y, Liu K, Ding D, Zhou Y, Peng L. Pembrolizumab Plus Chemotherapy as First-Line Treatment for Advanced Esophageal Cancer: A Cost-Effectiveness Analysis. Adv Ther. 2022 Jun;39(6):2614-2629. doi: 10.1007/s12325-022-02101-9. Epub 2022 Apr 8.
- Derived from this study: PubMed 34454674Sun JM, Shen L, Shah MA, Enzinger P, Adenis A, Doi T, Kojima T, Metges JP, Li Z, Kim SB, Cho BC, Mansoor W, Li SH, Sunpaweravong P, Maqueda MA, Goekkurt E, Hara H, Antunes L, Fountzilas C, Tsuji A, Oliden VC, Liu Q, Shah S, Bhagia P, Kato K; KEYNOTE-590 Investigators. Pembrolizumab plus chemotherapy versus chemotherapy alone for first-line treatment of advanced oesophageal cancer (KEYNOTE-590): a randomised, placebo-controlled, phase 3 study. Lancet. 2021 Aug 28;398(10302):759-771. doi: 10.1016/S0140-6736(21)01234-4.
- Derived from this study: PubMed 30735435Kato K, Shah MA, Enzinger P, Bennouna J, Shen L, Adenis A, Sun JM, Cho BC, Ozguroglu M, Kojima T, Kostorov V, Hierro C, Zhu Y, McLean LA, Shah S, Doi T. KEYNOTE-590: Phase III study of first-line chemotherapy with or without pembrolizumab for advanced esophageal cancer. Future Oncol. 2019 Apr;15(10):1057-1066. doi: 10.2217/fon-2018-0609. Epub 2019 Feb 8.
- Merck Clinical Trials InformationLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Medical Director study director
Merck Sharp & Dohme LLC
189 sites in 26 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Pembrolizumab, Cisplatin and 5-FU in people with Esophageal Neoplasms, run by Merck Sharp & Dohme LLC at 189 sites in 26 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 189 sites in Japan, China, United States, Brazil, Taiwan and 21 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 6 Jul 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Overall Survival (OS) in Participants With Esophageal Squamous Cell Carcinoma (ESCC) Whose Tumors Are Programmed Cell Death-Ligand 1 (PD-L1) Biomarker-Positive (Combined Positive Score [CPS] ≥10) (time frame: Up to approximately 34 months). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03189719, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Oct 2024.