Urinary Bladder Cancer, Muscle-invasivePhase 3NCT03924895
Perioperative Pembrolizumab (MK-3475) Plus Cystectomy or Perioperative Pembrolizumab Plus Enfortumab Vedotin Plus Cystectomy Versus Cystectomy Alone in Participants Who Are Cisplatin-ineligible or Decline Cisplatin With Muscle-invasive Bladder Cancer (MK-3475-905/KEYNOTE-905/EV-303)
A Phase 3 study testing Pembrolizumab, Surgery (radical cystectomy (RC) plus Pelvic Lymph Node Dissection [PLND]) and Enfortumab Vedotin in people with Urinary Bladder Cancer, Muscle-invasive, run by Merck Sharp & Dohme LLC at 242 sites in 28 countries.
Trial summary
This is a study of perioperative pembrolizumab or enfortumab vedotin in combination with pembrolizumab in participants who are cisplatin-ineligible or decline cisplatin with muscle-invasive bladder cancer (MIBC). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Urinary Bladder Cancer, Muscle-invasive
- What is being tested?
- Pembrolizumab, Surgery (radical cystectomy (RC) plus Pelvic Lymph Node Dissection [PLND]) and Enfortumab Vedotin
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 595 participants
- Where
- 242 sitesin 28 countries
- Study dates
- 24 Jul 2019to 15 Dec 2027
- 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
- Have a histologically confirmed diagnosis of urothelial carcinoma/muscle-invasive bladder cancer [MIBC] (cT2-T4aN0M0 or T1-T4aN1M0) with predominant (≥50%) urothelial histology to be confirmed by Blinded Independent Central Review (BICR) (central pathology and/or imaging).
- Clinically nonmetastatic bladder cancer determined by imaging
- Eligible for radical cystectomy (RC) + pelvic lymph node dissection (PLND), and agreement to undergo curative intent standard RC + PLND (including prostatectomy if applicable)
- Ineligible for treatment with cisplatin, as defined by meeting at least one of the following criteria OR be eligible for treatment with cisplatin but decline treatment with cisplatin-based chemotherapy:
- Impaired renal function with measured or calculated creatinine clearance (CrCl) 30 to 59 mL/min (calculated by Cockcroft-Gault method, Modification of Diet of Renal Disease [MDRD] equations, or measured by 24-hour urine collection)
- Eastern Cooperative Oncology Group (ECOG) Performance Status 2
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- Common Terminology Criteria for Adverse Events (CTCAE) v.4 Grade ≥2 audiometric hearing loss
- New York Heart Association (NYHA) Class III heart failure
- Transurethral resection (TUR) of a bladder tumor that is submitted for central pathology assessment and adequate to determine urothelial histology and PD-L1 expression assessment
- ECOG performance status of 0, 1, or 2
- Adequate organ function
- A male participant is eligible to participate if he agrees to use contraception and refrain from donating sperm during the intervention period and for at least 180 days after the last dose of enfortumab vedotin. If the male participants are receiving pembrolizumab only or undergoing surgery only, there are no contraception requirements
- A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least 1 of the following conditions applies: Not a (woman of childbearing potential) WOCBP or a WOCBP who agrees to use a highly effective contraceptive method or be abstinent from heterosexual intercourse (as their preferred and usual lifestyle) during the intervention period and for at least 120 days after the last dose of pembrolizumab and at least 180 days after the last dose of enfortumab vedotin; whichever comes last. A female participant must agree not to donate eggs during this period as well
- A WOCBP must have a negative highly sensitive pregnancy test within 24 hours before the first dose of study intervention
Who cannot join
- Known additional nonurothelial malignancy that is progressing or has required active anticancer treatment ≤3 years of study randomization, with certain exceptions
- Has ≥ N2 or metastatic disease (M1) as identified by imaging
- Received any prior systemic treatment, chemoradiation, and/or radiation therapy for muscle-invasive bladder cancer (MIBC) or non-muscle invasive bladder cancer (NMIBC)
- Received prior therapy with an anti-programmed cell death protein 1 (PD-1), anti-programmed death-ligand 1 (PD-L1), or anti-programmed cell death 1 ligand 2 (PD-L2), or with an agent directed to another stimulatory or coinhibitory T-cell receptor
- Received prior systemic anticancer therapy including investigational agents within 3 years prior to randomization
- Received any prior radiotherapy to the bladder
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- Received a partial cystectomy of the bladder to remove any non-muscle-invasive bladder cancer (NMIBC) or MIBC
- Received a live or live-attenuated vaccine within 30 days before the first dose of study intervention
- Current participation in or participation in a study of an investigational agent or use of an investigational device within 4 weeks prior to the first dose of study intervention
- Ongoing sensory or motor neuropathy Grade 2 or higher
- Diagnosis of immunodeficiency or receipt of chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior the first dose of study drug. Physiologic replacement doses of corticosteroids are permitted for participants with adrenal insufficiency.
- Hypersensitivity to monoclonal antibodies (including pembrolizumab) and/or any of their excipients
- Severe hypersensitivity (≥ Grade 3) to enfortumab vedotin or any excipient contained in the drug formulation of enfortumab vedotin
- Active keratitis or corneal ulcerations. Participants with superficial punctate keratitis are allowed if the disorder is being adequately treated in the opinion of the investigator
- Active autoimmune disease that has required systemic therapy in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic therapy and is allowed
- Has uncontrolled diabetes
- History of (noninfectious) pneumonitis that required steroids, or current pneumonitis
- Active infection requiring systemic therapy
- Has had an allogeneic tissue/solid organ transplant
Trial locations and contacts
242 sites in 28 countries.
242 sites in 28 countries
United States39 sites
UNM Comprehensive Cancer Center-Clinical Research Office ( Site 0045)
Albuquerque, New Mexico, 87106
Emory School of Medicine ( Site 0006)
Atlanta, Georgia, 30322
University of Colorado Hospital ( Site 0098)
Aurora, Colorado, 80045
MidLantic Urology ( Site 0089)
Bala-Cynwyd, Pennsylvania, 19004
Greater Baltimore Medical Center ( Site 0014)
Baltimore, Maryland, 21204
Dana-Farber Cancer Institute ( Site 1596)
Boston, Massachusetts, 02215
M Health Fairview Ridges Hospital ( Site 1555)
Burnsville, Minnesota, 55337
Charleston Area Medical Center ( Site 0023)
Charleston, West Virginia, 25304
John H. Stroger Jr. Hospital of Cook County ( Site 1551)
Chicago, Illinois, 60612
University of Chicago ( Site 0068)
Chicago, Illinois, 60637
Cleveland Clinic Main ( Site 1576)
Cleveland, Ohio, 44195
Texas Oncology-Baylor Sammons Cancer Center ( Site 1552)
Dallas, Texas, 75246
Inova Schar Cancer Institute ( Site 0007)
Fairfax, Virginia, 22031
Parkview Cancer Institute ( Site 0077)
Fort Wayne, Indiana, 46845
St. Joseph Heritage Healthcare ( Site 0046)
Fullerton, California, 92835
Bon Secours St. Francis Health System ( Site 1572)
Greenville, South Carolina, 29607
Indiana University Melvin and Bren Simon Comprehensive Cancer Center ( Site 0004)
Indianapolis, Indiana, 46202
Scripps MD Anderson ( Site 0010)
La Jolla, California, 92037
Northwell Health - Monter Cancer Center ( Site 0083)
Lake Success, New York, 11042
CARTI Cancer Center ( Site 1577)
Little Rock, Arkansas, 72205
University of South Alabama, Mitchell Cancer Institute ( Site 1582)
Mobile, Alabama, 36604
Morristown Medical Center ( Site 0015)
Morristown, New Jersey, 07960
Carolina Urologic Research Center ( Site 0062)
Myrtle Beach, South Carolina, 29572
Urology Associates [Nashville, TN] ( Site 0053)
Nashville, Tennessee, 37209
Vanderbilt University Medical Center ( Site 0017)
Nashville, Tennessee, 37232
Tulane University School of Medicine ( Site 0088)
New Orleans, Louisiana, 70112
New York University Perlmutter Cancer Center ( Site 0008)
New York, New York, 10016
Icahn School of Medicine at Mount Sinai ( Site 0031)
New York, New York, 10029
Hoag Memorial Hospital Presbyterian ( Site 1595)
Newport Beach, California, 92663
Abramson Cancer Center of the University of Pennsylvania ( Site 0074)
Philadelphia, Pennsylvania, 19104
Thomas Jefferson University ( Site 1579)
Philadelphia, Pennsylvania, 19107
Fox Chase Cancer Center ( Site 0055)
Philadelphia, Pennsylvania, 19111
Allegheny General Hospital ( Site 0048)
Pittsburgh, Pennsylvania, 15212
Providence Portland Medical Center [Portland, OR] ( Site 0095)
Portland, Oregon, 97213
John Wayne Cancer Institute ( Site 0075)
Santa Monica, California, 90404
Oklahoma Cancer Specialists and Research Institute, LLC ( Site 0021)
Tulsa, Oklahoma, 74146
Georgetown University Medical Center ( Site 0022)
Washington D.C., District of Columbia, 20007
New England Cancer Specialists ( Site 0070)
Westbrook, Maine, 04092
Wichita Urology Group ( Site 0059)
Wichita, Kansas, 67226
Japan18 sites
Institute of Science Tokyo Hospital ( Site 2303)
Bunkyō, Tokyo, 113-8519
Gifu University Hospital ( Site 2310)
Gifu, 501-1112
Hamamatsu University Hospital ( Site 2311)
Hamamatsu, Shizuoka, 431-3192
Saitama Prefectural Cancer Center ( Site 2319)
Ina-machi, Saitama, 362-0806
Kagoshima University Hospital ( Site 2317)
Kagoshima, 890-8520
Nara Medical University Hospital ( Site 2312)
Kashihara, Nara, 634-0813
National Cancer Center Hospital East ( Site 2305)
Kashiwa, Chiba, 277-8577
St. Marianna University Hospital ( Site 2321)
Kawasaki, Kanagawa, 216-8511
Dokkyo Medical University Saitama Medical Center ( Site 2304)
Koshigaya, Saitama, 3438555
Toranomon Hospital ( Site 2322)
Minato-ku, Tokyo, 105-8470
Nagasaki University Hospital ( Site 2315)
Nagasaki, 852-8501
Kitasato University Hospital ( Site 2306)
Sagamihara, Kanagawa, 252-0375
Osaka Rosai Hospital ( Site 2320)
Sakai, Osaka, 591-8025
Tohoku University Hospital ( Site 2301)
Sendai, Miyagi, 980-8574
Nagano Municipal Hospital ( Site 2309)
Tomitake, Nagano, 381-8551
Toyama University Hospital ( Site 2308)
Toyoma, Toyama, 930-0194
University of Tsukuba Hospital ( Site 2302)
Tsukuba, Ibaraki, 305-8576
Yokosuka Kyosai Hospital ( Site 2307)
Yokosuka, Kanagawa, 238-8558
Russia17 sites
Ivanovo Regional Oncology Dispensary ( Site 0852)
Ivanovo, Ivanovo Oblast, 153040
Krasnoyarsk Regional Clinical Oncological Dispensary ( Site 0861)
Krasnoyarsk, Krasnoyarsk Krai, 660133
Kursk Regional Clinical Oncology Dispensary ( Site 0854)
Kursk, Kursk Oblast, 305524
Russian Oncological Research Center n.a. N.N.Blokhin of MoH ( Site 0878)
Moscow, Moscow, 115478
First Moscow State Medical University n.a. I.M.Sechenov ( Site 0884)
Moscow, Moscow, 119991
Central Clinical Hospital with outpatient Clinic ( Site 0856)
Moscow, Moscow, 121359
Bayandin Murmansk Regional Clinical Hospital ( Site 0859)
Murmansk, Murmansk Oblast, 183057
Volga District Medical Center Federal Medical and Biological Agency ( Site 0857)
Nizhny Novgorod, Nizhny Novgorod Oblast, 603074
Omsk Clinical Oncology Dispensary ( Site 0865)
Omsk, Omsk Oblast, 644013
Leningrad Regional Oncology Center ( Site 0868)
Saint Petersburg, Sankt-Peterburg, 188663
Clinical Hospital Saint Luka ( Site 0867)
Saint Petersburg, Sankt-Peterburg, 194044
First St. Petersburg State Medical University n.a. acad. I.P. Pavlov ( Site 0872)
Saint Petersburg, Sankt-Peterburg, 197022
National Medical Research Center of Oncology N.A. N.N. Petrov ( Site 0860)
Saint Petersburg, Sankt-Peterburg, 197758
Saratov State Medical University n.a. V.I.Razumovskiy ( Site 0866)
Saratov, Saratov Oblast, 410012
Medical Sanitary Unit Neftyannik ( Site 0888)
Tyumen, Tyumen Oblast, 625000
Clinic of Bashkortostan State Medical University ( Site 0873)
Ufa, Baskortostan, Respublika, 450081
Sverdlovsk Regional Oncology Hospital ( Site 0874)
Yekaterinburg, Sverdlovsk Oblast, 620036
France16 sites
CHU Jean Minjoz ( Site 0455)
Besançon, Doubs, 25000
CHU de Bordeaux- Hopital Saint Andre ( Site 0456)
Bordeaux, Gironde, 33000
Centre Francois Baclesse ( Site 0459)
Caen, Calvados, 14075
Centre Georges Francois Leclerc ( Site 0488)
Dijon, Bourgogne-Franche-Comté, 21000
Hopital de la Timone ( Site 0489)
Marseille, Bouches-du-Rhone, 13005
CHU de Montpellier - Hopital Saint-Eloi ( Site 0469)
Montpellier, Herault, 34295
CHU Hotel Dieu Nantes ( Site 0458)
Nantes, Loire-Atlantique, 44093
Institut de Cancerologie du Gard - CHU Caremeau ( Site 0490)
Nîmes, Gard, 30029
CHU Cochin ( Site 0475)
Paris, 75014
Hopital Europeen Georges Pompidou ( Site 0476)
Paris, 75015
Hopital Bichat du Paris ( Site 0462)
Paris, 75018
C.H.U. Lyon Sud ( Site 0466)
Pierre-Bénite, Rhone, 69310
C.H.R.U. de Rennes. Hopital de Pontchaillou ( Site 0492)
Rennes, Ille-et-Vilaine, 35033
Institut Claudius Regaud IUCT Oncopole ( Site 0486)
Toulouse, Haute-Garonne, 31059
Hopital Belle Isle ( Site 0452)
Vantoux, Moselle, 57070
Institut Gustave Roussy ( Site 0487)
Villejuif, Val-de-Marne, 94800
Ukraine12 sites
MNE "Clinical Center of Oncology, Hematology, Transplantology and Palliative Care of CRC" ( Site 0959)
Cherkasy, Cherkasy Oblast, 18009
MNPE City Clinical Hospital #4 of Dnipro Regional Council ( Site 0951)
Dnipro, Dnipropetrovsk Oblast, 49102
ME І.І. Mechnykov Dnipro Regional Clinical Hospital ( Site 0963)
Dnipropetrovsk, Dnipropetrovsk Oblast, 49005
Regional Oncology Center of Kharkiv ( Site 0958)
Kharkiv, Kharkiv Oblast, 61000
MNPE V.I. Shapoval Regional Medical Clinical Urology and Nephrology Center of KharkivRegCouncil ( Site 0969)
Kharkiv, Kharkiv Oblast, 61037
Municipal Non-profit Enterprise of Kharkiv Regional Council RCSDRPP ( Site 0973)
Kharkiv, Kharkiv Oblast, 61166
Communal nonprofit enterprise "Kherson Regional Oncology Dispensary" of Kherson Regional Council ( Site 0976)
Kherson, Kherson Oblast, 73034
SNPE National Cancer Institute ( Site 0962)
Kyiv, Kyivska Oblast, 03022
Kyiv City Clinical Oncology Center ( Site 0960)
Kyiv, 03115
MNPE Lviv Regional Clinical Hospital of Lviv Regional Council ( Site 0955)
Lviv, Lviv Oblast, 79010
Lviv State Regional Oncological Center ( Site 0967)
Lviv, Lviv Oblast, 79031
Zhytomyr Regional Oncology Center ( Site 0971)
Zhytomyr, Zhytomyr Oblast, 10002
Canada11 sites
Arthur J.E. Child Comprehensive Cancer Centre ( Site 0100)
Calgary, Alberta, T2N 5G2
CIUSSS du Saguenay-Lac-St-Jean ( Site 0116)
Chicoutimi, Quebec, G7H 5H6
Moncton Hospital - Horizon Health Network ( Site 0112)
Moncton, New Brunswick, E1C 6Z8
CIUSSS de l Est de L Ile de Montreal - Hopital Maisonneuve-Rosemont ( Site 0105)
Montreal, Quebec, H1T 2M4
Jewish General Hospital ( Site 0120)
Montreal, Quebec, H3T 1E2
McGill University Health Centre ( Site 0123)
Montreal, Quebec, H4A 3J1
CIUSSS de l'Estrie-CHUS ( Site 0106)
Sherbrooke, Quebec, J1H 5N4
Sunnybrook Research Institute ( Site 0110)
Toronto, Ontario, M4N 3M5
Princess Margaret Cancer Centre ( Site 0107)
Toronto, Ontario, M5G 2M9
BC Cancer Vancouver-Clinical Trials Unit ( Site 0121)
Vancouver, British Columbia, V5Z 4E6
Silverado Resarch Inc. ( Site 0111)
Victoria, British Columbia, V8T 2C1
Germany11 sites
Vivantes Klinikum am Urban ( Site 0529)
Berlin, 10967
Universitaetsklinikum Bonn ( Site 0550)
Bonn, North Rhine-Westphalia, 53127
Universitaetsklinikum Carl Gustav Carus ( Site 0532)
Dresden, Saxony, 01307
Universitaetsklinikum Erlangen ( Site 0546)
Erlangen, Bavaria, 91058
SRH Wald-Klinikum Gera-Zentrum für klinische Studien ( Site 0533)
Gera, Thuringia, 07548
Universitaetsklinikum Hamburg-Eppendorf-Onkologisches Zentrum ( Site 0528)
Hamburg, 20246
Universitaetsklinikum Magdeburg A.o.R. ( Site 0535)
Magdeburg, Saxony-Anhalt, 39120
Klinikum der Universitaet Muenchen - Grosshadern ( Site 0548)
Munich, Bavaria, 81377
Klinikum Stuttgart - Katharinenhospital ( Site 0520)
Stuttgart, Baden-Wurttemberg, 70174
Klinikum der Eberhard-Karls-Universitaet Tuebingen ( Site 0549)
Tübingen, Baden-Wurttemberg, 72076
Universitaetsklinikum Wuerzburg ( Site 0547)
Würzburg, Bavaria, 97080
Spain11 sites
Hosp. Gral. Universitari Germans Trias i Pujol ( Site 0675)
Badalona, Barcelona, 08916
Hospital Clinic i Provincial ( Site 0674)
Barcelona, Catalonia, 08036
Hospital del Mar ( Site 0698)
Barcelona, 08003
Hospital San Pedro de Alcantara ( Site 0697)
Cáceres, Extremadura, 10003
Institut Català d'Oncologia (ICO) - Girona ( Site 0700)
Girona, Gerona, 17007
Hospital Universitario Ramon y Cajal ( Site 0691)
Madrid, 28034
Hospital Universitario San Carlos ( Site 0678)
Madrid, 28040
Hospital Universitario la Paz ( Site 0690)
Madrid, 28046
Hospital Universitario Quiron Madrid ( Site 0694)
Pozuelo de Alarcón, Madrid, Comunidad de, 28223
Hospital de Nuestra Senora de Valme ( Site 0693)
Seville, 41014
Instituto Valenciano de Oncologia - IVO ( Site 0679)
Valencia, Valenciana, Comunitat, 46009
Israel10 sites
Ha Emek Medical Center ( Site 0843)
Afula, 1834111
Soroka Medical Center ( Site 0849)
Beersheba, 8410101
Rambam Health Care Campus-Oncology Division ( Site 0845)
Haifa, 3109601
Shaare Zedek Medical Center ( Site 0842)
Jerusalem, 9103102
Hadassah Ein Kerem Medical Center ( Site 0841)
Jerusalem, 9112001
Meir Medical Center ( Site 0846)
Kfar Saba, 4428164
Rabin Medical Center ( Site 0847)
Petah Tikva, 4941492
Sheba Medical Center ( Site 0844)
Ramat Gan, 5265601
Sourasky Medical Center ( Site 0850)
Tel Aviv, 6423906
Yitzhak Shamir Medical Center. ( Site 0848)
Tsrifin, 7033001
Italy10 sites
Azienda USL 8 di Arezzo-Medical Oncology ( Site 0565)
Arezzo, 52100
A.O.U. Policlinico Vittorio Emanuele - Presidio Gaspare Rodolico ( Site 0559)
Catania, 95123
Ospedale San Raffaele-Oncologia Medica ( Site 0561)
Milan, 20132
Istituto Nazionale Studio e Cura dei Tumori ( Site 0551)
Milan, 20133
Istituto Nazionale Per Lo Studio E La Cura Dei Tumori ( Site 0552)
Naples, 80131
Azienda Sanitaria Ospedaliera S Luigi Gonzaga-SCDU Oncologia Medica ( Site 0563)
Orbassano, Piedmont, 10043
Fondazione Salvatore Maugeri IRCCS ( Site 0554)
Pavia, 27100
Policlinico Gemelli di Roma ( Site 0558)
Roma, Abruzzo, 00168
Azienda Ospedaliera Santa Maria Terni-S.C. Oncologia Medica e Traslazionale ( Site 0564)
Terni, 05100
AULSS8 Berica-Ospedale S.Bortolo-ONCOLOGIA CLINICA ( Site 0562)
Vicenza, Veneto, 36100
United Kingdom10 sites
Kent and Canterbury Hospital ( Site 0733)
Canterbury, England, CT1 3NG
Western General Hospital ( Site 0749)
Edinburgh, Midlothian, EH4 2XU
Imperial College Healthcare NHS Trust ( Site 0745)
London, Hammersmith and Fulham, W6 8RF
Barts Health NHS Trust - St Bartholomew s Hospital ( Site 0725)
London, London, City of, EC1A 7BE
The Royal Marsden Foundation Trust ( Site 0726)
London, London, City of, SW3 6JJ
Clatterbridge Oncology Centre ( Site 0731)
Metropolitan Borough of Wirral, CH63 4JY
The James Cook University Hospital ( Site 0730)
Middlesbrough, England, TS4 3BW
Lister Hospital ( Site 0739)
Stevenage, Hertfordshire, SG1 4AB
Royal Cornwall Hospital ( Site 0727)
Truro, TR1 3LJ
Walsall Manor Hospital-Oncology ( Site 0743)
Walsall, Devon, WS2 9PS
Poland9 sites
Bialostockie Centrum Onkologii ( Site 1072)
Bialystok, Podlaskie Voivodeship, 15-027
Beskidzkie Centrum Onkologii im. Jana Pawla II ( Site 1061)
Bielsko-Biala, Silesian Voivodeship, 43-300
Centrum Onkologii im.prof. F. Lukaszczyka w Bydgoszczy ( Site 1068)
Bydgoszcz, Kuyavian-Pomeranian Voivodeship, 85-796
Europejskie Centrum Zdrowia Otwock ( Site 1058)
Otwock, Masovian Voivodeship, 05-400
Clinical Research Center Medic-R ( Site 1073)
Poznan, Greater Poland Voivodeship, 60-848
Wojewodzki Szpital Specjalistyczny im. Janusza Korczaka w Slupsku ( Site 1057)
Słupsk, Pomeranian Voivodeship, 76-200
Szpital Wojewodzki ( Site 1062)
Tarnów, Lesser Poland Voivodeship, 33-100
Luxmed Onkologia sp. z o. o. ( Site 1051)
Warsaw, Masovian Voivodeship, 01-748
Uniwersytecki Szpital Kliniczny im. Jana Mikulicza-Radeckiego ( Site 1063)
Wroclaw, Lower Silesian Voivodeship, 50-556
South Korea7 sites
Kyungpook National University Chilgok Hospital-Urology ( Site 1357)
Deagu, Taegu-Kwangyokshi, 41404
National Cancer Center ( Site 1354)
Goyang-si, Kyonggi-do, 10408
Seoul National University Bundang Hospital ( Site 1356)
Seongnam-si, Kyonggi-do, 13620
Korea University Anam Hospital ( Site 1351)
Seoul, 02841
Seoul National University Hospital ( Site 1352)
Seoul, 03080
Samsung Medical Center ( Site 1353)
Seoul, 06351
Asan Medical Center ( Site 1355)
Songpagu, Seoul, 05505
Turkey (Türkiye)7 sites
Hacettepe Universitesi Tıp Fakultesi ( Site 0931)
Ankara, 06100
Istanbul Universitesi Cerrahpasa Tip Fakultesi ( Site 0930)
Istanbul, 34096
TC Saglik Bakanligi Goztepe Prof. Dr. Suleyman Yalcin Sehir Hastanesi-oncology ( Site 0926)
Istanbul, 34722
Marmara Universitesi Pendik Egitim ve Arastirma Hastanesi ( Site 0921)
Istanbul, 34899
Necmettin Erbakan Universitesi Meram Tip Fakultesi Hastanesi ( Site 0929)
Konya, 42080
Sakarya Universitesi Tip Fakultesi ( Site 0933)
Sakarya, 54290
Karadeniz Teknik Universitesi Tip Fakultesi Farabi Hastanesi ( Site 0924)
Trabzon, 61080
Australia6 sites
Western Sydney Local Health District ( Site 1259)
Blacktown, New South Wales, 2148
Eastern Health ( Site 1255)
Box Hill, Victoria, 3128
Cairns Base Hospital ( Site 1257)
Cairns, Queensland, 4870
Monash Health ( Site 1260)
Clayton, Victoria, 3168
Macquarie University ( Site 1251)
Macquarie Park, New South Wales, 2109
Mater Misericordiae Ltd ( Site 1258)
South Brisbane, Queensland, 4101
Belgium6 sites
AZ Sint-Jan Brugge ( Site 0352)
Bruges, West-Vlaanderen, 8000
AZ Maria Middelares Gent ( Site 0353)
Ghent, Oost-Vlaanderen, 9000
UZ Leuven ( Site 0361)
Leuven, Vlaams-Brabant, 3000
AZ Delta vzw-Oncology ( Site 0362)
Roeselare, West-Vlaanderen, 8800
UCL Saint-Luc - Oncologie Medicale ( Site 0357)
St-Lambrechts-Woluwe, Bruxelles-Capitale, Region de, 1200
CHU UCL Namur Site de Godinne ( Site 0354)
Yvoir, Namur, 5530
Mexico6 sites
Investigacion Biomedica para el Desarrollo de Farmacos S.A. de C.V. ( Site 0300)
Aguascalientes, 20010
Centro Estatal de Cancerologia de Chihuahua ( Site 0254)
Chihuahua City, 31000
Centro de Tratamiento de Cancer ( Site 0266)
Metepec, 52140
Hospital Angeles Roma ( Site 0262)
Mexico City, 06700
Instituto Nacional de Cancerologia. ( Site 0256)
Mexico City, 14080
Centro de Urologia Avanzada del Noreste S.A. de C.V. ( Site 0253)
Monterrey, Nuevo León, 66269
Colombia5 sites
Clinica Colsanitas S.A, Sede Clínica Universitaria Colombia-Center Investigator ( Site 2002)
Bogotá, Bogota D.C., 111321
Fundacion Valle del Lili- CIC-Fundacion Valle del Lili ( Site 2005)
Cali, Valle del Cauca Department, 760032
Fundacion Colombiana de Cancerología Clinica Vida ( Site 2003)
Medellín, Antioquia, 050030
IMAT S.A.S ( Site 2001)
Montería, Departamento de Córdoba, 230002
Fundación Cardiovascular de Colombia ( Site 2004)
Piedecuesta, Santander Department, 681017
Hungary5 sites
Bajcsy Zsilinszki Korhaz es Rendelointezet ( Site 1001)
Budapest, 1106
Debreceni Egyetem Klinikai Kozpont ( Site 1006)
Debrecen, Hajdú-Bihar, 4032
Petz Aladar Megyei Oktato Korhaz ( Site 1012)
Győr, 9023
Somogy Megyei Kaposi Mor Oktato Korhaz ( Site 1007)
Kaposvár, 7400
SZTE Szent-Gyorgyi Albert Klinikai Kozpont ( Site 1010)
Szeged, Csongrád megye, 6720
Sweden5 sites
Onkologiska kliniken ( Site 1217)
Gothenburg, Västra Götaland County, 413 45
Laenssjukhuset Ryhov ( Site 1215)
Jönköping, Jönköping County, 551 85
Karolinska Universitetssjukhuset Solna ( Site 1212)
Stockholm, Stockholm County, 171 76
Cancercentrum ( Site 1214)
Umeå, Västerbotten County, 901 85
Akademiska Sjukhuset ( Site 1211)
Uppsala, Uppsala County, 751 85
Denmark4 sites
Aarhus University Hospital Skejby ( Site 0418)
Aarhus, Central Jutland, 8200
Rigshospitalet University Hospital ( Site 0411)
Copenhagen, Capital Region, 2100
Herlev og Gentofte Hospital. ( Site 0412)
Herlev, Capital Region, 2730
Odense Universitetshospital ( Site 0413)
Odense, Region Syddanmark, 5000
Thailand4 sites
Ramathibodi Hospital. ( Site 1451)
Bangkok, Bangkok, 10400
Faculty of Medicine Siriraj Hospital ( Site 1452)
Bangkok, Bangkok, 10700
Maharaj Nakorn Chiangmai Hospital ( Site 1453)
Chiang Mai, 50200
Srinagarind Hospital ( Site 1454)
Khon Kaen, 40002
Malaysia3 sites
Hospital Pulau Pinang ( Site 1703)
George Town, Pulau Pinang, 10990
Sarawak General Hospital ( Site 1701)
Kuching, Sarawak, 93586
University Malaya Medical Centre ( Site 1702)
Lembah Pantai, Kuala Lumpur, 59100
Philippines3 sites
THE MEDICAL CITY ILOILO ( Site 1756)
Iloilo City, Iloilo, 5000
The Medical City ( Site 1752)
Pasig, National Capital Region, 1605
St. Luke s Medical Center ( Site 1751)
Quezon City, National Capital Region, 1112
Ireland2 sites
Tallaght University Hospital ( Site 0734)
Dublin, D24 NR0A
University Hospital Waterford ( Site 0747)
Waterford, X91ER8E
Singapore2 sites
National University Hospital ( Site 1802)
Singapore, Central Singapore, 119074
Tan Tock Seng Hospital ( Site 1804)
Singapore, Central Singapore, 398442
South Africa2 sites
Groote Schuur Hospital ( Site 1602)
Cape Town, Western Cape, 7925
Steve Biko Academic Hospital-Medical Oncology ( Site 1601)
Pretoria, Gauteng, 0001
Argentina1 site
Asociación de Beneficencia Hospital Sirio Libanés ( Site 2102)
Buenos Aires, Buenos Aires F.D., C1419AHN
About this study
Official title: A Randomized Phase 3 Study Evaluating Cystectomy With Perioperative Pembrolizumab and Cystectomy With Perioperative Enfortumab Vedotin and Pembrolizumab Versus Cystectomy Alone in Participants Who Are Cisplatin-Ineligible or Decline Cisplatin With Muscle-Invasive Bladder Cancer (KEYNOTE-905/EV-303)
This is a study of perioperative pembrolizumab or enfortumab vedotin in combination with pembrolizumab in participants who are cisplatin-ineligible or decline cisplatin with muscle-invasive bladder cancer (MIBC).
The primary hypothesis is that perioperative pembrolizumab plus radical cystectomy (RC) plus pelvic lymph node dissection (PLND) and perioperative enfortumab vedotin in combination with pembrolizumab plus RC+PLND will achieve superior event-free survival (EFS) compared with RC+PLND alone.
Read more
With Amendment 5, outcome measures for programmed cell death ligand 1 (PD-L1) combined positive score (CPS) were removed.
With Amendment 8, the primary outcome measure of pathologic complete response (pCR) rates was changed to a secondary outcome measure.
- Conditions
- Urinary Bladder Cancer, Muscle-invasive
- Being tested
- Pembrolizumab, Surgery (radical cystectomy (RC) plus Pelvic Lymph Node Dissection [PLND]), Enfortumab Vedotin
- Keywords
- Muscle-Invasive Bladder Cancer (MIBC), Enfortumab vedotin (EV), Pembrolizumab (MK-3475)
- Medical subject headings
- Urinary Bladder Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PembrolizumabDrug
Also called KEYTRUDA®, MK-3475
Pembrolizumab 200 mg by intravenous (IV) infusion, given on Day 1 of each 21-day cycle.
Surgery (radical cystectomy (RC) plus Pelvic Lymph Node Dissection [PLND])Procedure or surgery
Surgical RC+PLND will be done in accordance with the American Urological Association (AUA)/American Society of Clinical Oncology (ASCO)/American Society for Radiation Oncology (ASTRO)/Society of Urologic Oncology (SUO) guidelines.
Enfortumab VedotinDrug
Also called Padcev, ASG-22CE, ASG-22ME
Enfortumab vedotin 1.25 mg/kg by intravenous (IV) infusion, given on Days 1 and 8 of each 21-day cycle.
| Study group | Role | What they receive |
|---|---|---|
| Arm A: Pembrolizumab + Surgery | Experimental | Participants receive 3 preoperative cycles of pembrolizumab, followed by standard of care surgery, followed by 14 cycles of postoperative pembrolizumab. Each cycle is 21 days. Receives: Drug: Pembrolizumab; Procedure: Surgery (radical cystectomy (RC) plus Pelvic Lymph Node Dissection [PLND]) |
| Arm B: Surgery alone | Active comparator | Participants receive standard of care surgery alone. Receives: Procedure: Surgery (radical cystectomy (RC) plus Pelvic Lymph Node Dissection [PLND]) |
| Arm C: Enfortumab Vedotin + Pembrolizumab + Surgery | Experimental | Participants receive 3 preoperative cycles of enfortumab vedotin + pembrolizumab, followed by standard of care surgery, followed by 6 cycles of postoperative enfortumab vedotin + pembrolizumab, followed by 8 cycles of pembrolizumab alone. Each cycle is 21 days. Receives: Drug: Enfortumab Vedotin |
What is being measured
The primary outcome is the main question the study is designed to answer.
Event-Free Survival (EFS) Between Arm C: Enfortumab Vedotin + Pembrolizumab + Surgery and Arm B: Surgery Alone
EFS is defined as the time from randomization to the first occurrence of any of the following events: progression of disease that precludes radical cystectomy + pelvic lymph node dissection (RC + PLND) surgery, failure to undergo RC + PLND surgery in participants with residual disease and any radiographic disease present (biopsy-proven muscle-invasive bladder cancer [MIBC] will be considered an event regardless of radiographic findings), gross residual disease left behind at the time of surgery, local or distant recurrence as assessed by imaging and/or biopsy, or death due to any cause.
Measured: Up to approximately 53 months
Secondary outcomes (11)
EFS Between Arm A and Arm B
EFS is defined as the time from randomization to the first occurrence of any of the following events: progression of disease that precludes RC surgery or failure to undergo RC surgery in participants with residual disease (biopsy-proven muscle-invasive bladder cancer [MIBC] will be considered an event regardless of radiographic findings), gross residual disease left behind at the time of surgery, local or distant recurrence as assessed by imaging and/or biopsy, or death due to any cause.
Measured: Up to approximately 6.75 years
Overall Survival (OS) Between Arm C and Arm B
OS is defined as the time from randomization to death due to any cause.
Measured: Up to approximately 7.6 years
OS Between Arm A and Arm B
OS is defined as the time from randomization to death due to any cause.
Measured: Up to approximately 7.6 years
Pathologic Complete Response (pCR) Rate Between Arm C and Arm B
Pathologic complete response rate is defined as the percentage of participants having pCR. pCR is defined as absence of viable tumor (pT0N0) in examined tissue from RC and PLND, as assessed by blind independent central review (BICR).
Measured: Up to approximately 53 monhts
pCR Rate Between Arm A and Arm B
Pathologic complete response rate is defined as the percentage of participants having pCR. pCR is defined as absence of viable tumor (pT0N0) in examined tissue from RC and PLND, as determined centrally.
Measured: Up to approximately 5.7 years
Disease-Free Survival (DFS)
DFS is defined as the time from first post-surgery baseline scan until:
- local or distant recurrence as assessed by imaging and/or biopsy
- Death due to any cause
Measured: Up to approximately 6.75 years
Pathologic Downstaging (pDS) Rate Between Arm A and Arm B
Pathologic downstaging rate is defined as the percentage of participants having pDS. pDS is defined as participants with a tumor classification of <pT2 (includes pT0, pTis, pTa, pT1) and N0 in examined tissue from RC and PLND.
Measured: Up to approximately 5.7 years
Pathologic Downstaging {pDS) Rate Between Arm C and Arm B
Pathologic downstaging (pDS) is defined as participants with a tumor classification of <pT2. The pathologic stage <pT2 includes pT0 (No residual primary tumor found in the tissue examined), pTis (carcinoma in situ; a flat, non-invasive cancer confined to the epithelial lining), pTa (Non-invasive papillary carcinoma limited to the urothelium) pT1 (tumor has invaded the connective tissue beneath the urothelium, but not the muscle layer) and N0 (No cancer found in the examined lymph nodes) in examined tissue from RC and PLND. The <pT2 category represents a better outcome than participants with residual muscle-invasive disease (pT2 or higher) and/or any nodal involvement (N1/N2). The percentage of participants with pDS is presented.
Measured: Up to approximately 53 months
Number of Participants Experiencing Adverse Events (AEs)
An AE is defined as any unfavorable and unintended sign, symptom, or disease (new or worsening) temporally associated with the use of study therapy, regardless of whether or not a causal relationship with the study therapy can be determined.
Measured: Up to approximately 7.6 years
Number of Participants Discontinuing Study Drug Due to Adverse Events (AEs)
An AE is defined as any unfavorable and unintended sign, symptom, or disease (new or worsening) temporally associated with the use of study therapy, regardless of whether or not a causal relationship with the study therapy can be determined.
Measured: Up to approximately 1 year
Number of Participants Experiencing Perioperative Complications
The number of participants who experience perioperative complications will be presented.
Measured: Up to approximately 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Apr 2019
- Study start24 Jul 2019
- Primary completion6 Jun 2025
- Study completion15 Dec 2027 (estimated)
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 (2)Papers the sponsor has linked to this study.
- Other trials for Urinary Bladder Cancer, Muscle-invasiveStudies 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
- None (open label)
- Enrolment
- 595 participants (actual)
Sponsor and investigators
- Lead sponsor
- Merck Sharp & Dohme LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Seagen Inc., Astellas Pharma Global Development, Inc.
- Responsible party
- Sponsor
- Investigators
- Medical Director, Study director, Merck Sharp & Dohme LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03924895
- Sponsor's protocol ID
- 3475-905
- Other IDs
- MK-3475-905, KEYNOTE-905, EV-303, PHRR210911-003890, jRCT2031220686, 2023-504932-16, 2031220686, U1111-1290-4057
- Status last verified
- Jun 2026
- First submitted
- 22 Apr 2019
- Last updated
- 30 Jun 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: https://trialstransparency.msdclinicaltrials.com/pdf/ProcedureAccessClinicalTrialData.pdf
Publications
Vulsteke C, Adra N, Danchaivijitr P, Sabadash M, Rodriguez-Vida A, Zhang Z, Atduev V, Goger YE, Rausch S, Kang SH, Loriot Y, Bedke J, Galsky MD, O'Donnell PH, von Amsberg G, Alimohamed N, Sulimka G, Gupta S, Paramonov V, Nakane K, Mihm M, Meng C, Huang CD, Ramamurthy C, Homet Moreno B, Ullen A; KEYNOTE-905/EV-303 Investigators. Perioperative Enfortumab Vedotin and Pembrolizumab in Bladder Cancer. N Engl J Med. 2026 Apr 2;394(13):1257-1269. doi: 10.1056/NEJMoa2511674. Epub 2026 Feb 18.
PubMed 41707170Galsky MD, Hoimes CJ, Necchi A, Shore N, Witjes JA, Steinberg G, Bedke J, Nishiyama H, Fang X, Kataria R, Sbar E, Jia X, Siefker-Radtke A. Perioperative pembrolizumab therapy in muscle-invasive bladder cancer: Phase III KEYNOTE-866 and KEYNOTE-905/EV-303. Future Oncol. 2021 Aug;17(24):3137-3150. doi: 10.2217/fon-2021-0273. Epub 2021 May 19.
PubMed 34008425
Study at a glance
From the registry record, last updated by the sponsor on 30 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Phase 3 Study Evaluating Cystectomy With Perioperative Pembrolizumab and Cystectomy With Perioperative Enfortumab Vedotin and Pembrolizumab Versus Cystectomy Alone in Participants Who Are Cisplatin-Ineligible or Decline Cisplatin With Muscle-Invasive Bladder Cancer (KEYNOTE-905/EV-303)
- ClinicalTrials.gov ID
- NCT03924895
- Acronym / sponsor ID
- 3475-905
- Conditions
- Urinary Bladder Cancer, Muscle-invasive
- Keywords
- Muscle-Invasive Bladder Cancer (MIBC), Enfortumab vedotin (EV), Pembrolizumab (MK-3475)
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 595 participants (actual)
- Lead sponsor
- Merck Sharp & Dohme LLCIndustry (pharma, biotech, devices)
- Collaborators
- Seagen Inc., Astellas Pharma Global Development, Inc.
- Study start
- 24 Jul 2019 (actual)
- Primary completion
- 6 Jun 2025 (actual)
- Study completion
- 15 Dec 2027 (estimated)
- First posted
- 23 Apr 2019 (actual)
- Results
- Posted 30 Jun 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a study of perioperative pembrolizumab or enfortumab vedotin in combination with pembrolizumab in participants who are cisplatin-ineligible or decline cisplatin with muscle-invasive bladder cancer (MIBC).
The primary hypothesis is that perioperative pembrolizumab plus radical cystectomy (RC) plus pelvic lymph node dissection (PLND) and perioperative enfortumab vedotin in combination with pembrolizumab plus RC+PLND will achieve superior event-free survival (EFS) compared with RC+PLND alone.
With Amendment 5, outcome measures for programmed cell death ligand 1 (PD-L1) combined positive score (CPS) were removed.
With Amendment 8, the primary outcome measure of pathologic complete response (pCR) rates was changed to a secondary outcome measure.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Arm A: Pembrolizumab + Surgery | Experimental | Drug: Pembrolizumab, Procedure: Surgery (radical cystectomy (RC) plus Pelvic Lymph Node Dissection [PLND])Participants receive 3 preoperative cycles of pembrolizumab, followed by standard of care surgery, followed by 14 cycles of postoperative pembrolizumab. Each cycle is 21 days. |
| Arm B: Surgery alone | Active comparator | Procedure: Surgery (radical cystectomy (RC) plus Pelvic Lymph Node Dissection [PLND])Participants receive standard of care surgery alone. |
| Arm C: Enfortumab Vedotin + Pembrolizumab + Surgery | Experimental | Drug: Enfortumab VedotinParticipants receive 3 preoperative cycles of enfortumab vedotin + pembrolizumab, followed by standard of care surgery, followed by 6 cycles of postoperative enfortumab vedotin + pembrolizumab, followed by 8 cycles of pembrolizumab alone. Each cycle is 21 days. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (14 listed)
- Have a histologically confirmed diagnosis of urothelial carcinoma/muscle-invasive bladder cancer [MIBC] (cT2-T4aN0M0 or T1-T4aN1M0) with predominant (≥50%) urothelial histology to be confirmed by Blinded Independent Central Review (BICR) (central pathology and/or imaging).
- Clinically nonmetastatic bladder cancer determined by imaging
- Eligible for radical cystectomy (RC) + pelvic lymph node dissection (PLND), and agreement to undergo curative intent standard RC + PLND (including prostatectomy if applicable)
- Ineligible for treatment with cisplatin, as defined by meeting at least one of the following criteria OR be eligible for treatment with cisplatin but decline treatment with cisplatin-based chemotherapy:
- Transurethral resection (TUR) of a bladder tumor that is submitted for central pathology assessment and adequate to determine urothelial histology and PD-L1 expression assessment
Key exclusion criteria (19 listed)
- Known additional nonurothelial malignancy that is progressing or has required active anticancer treatment ≤3 years of study randomization, with certain exceptions
- Has ≥ N2 or metastatic disease (M1) as identified by imaging
- Received any prior systemic treatment, chemoradiation, and/or radiation therapy for muscle-invasive bladder cancer (MIBC) or non-muscle invasive bladder cancer (NMIBC)
- Received prior therapy with an anti-programmed cell death protein 1 (PD-1), anti-programmed death-ligand 1 (PD-L1), or anti-programmed cell death 1 ligand 2 (PD-L2), or with an agent directed to another stimulatory or coinhibitory T-cell receptor
- Received prior systemic anticancer therapy including investigational agents within 3 years prior to randomization
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: KEYTRUDA®, MK-3475Pembrolizumab 200 mg by intravenous (IV) infusion, given on Day 1 of each 21-day cycle. | Drug | Arm A: Pembrolizumab + Surgery |
| Surgery (radical cystectomy (RC) plus Pelvic Lymph Node Dissection [PLND])Surgical RC+PLND will be done in accordance with the American Urological Association (AUA)/American Society of Clinical Oncology (ASCO)/American Society for Radiation Oncology (ASTRO)/Society of Urologic Oncology (SUO) guidelines. | Procedure or surgery | Arm A: Pembrolizumab + Surgery, Arm B: Surgery alone |
| Enfortumab VedotinAlso: Padcev, ASG-22CE, ASG-22MEEnfortumab vedotin 1.25 mg/kg by intravenous (IV) infusion, given on Days 1 and 8 of each 21-day cycle. | Drug | Arm C: Enfortumab Vedotin + Pembrolizumab + Surgery |
Primary outcome
Event-Free Survival (EFS) Between Arm C: Enfortumab Vedotin + Pembrolizumab + Surgery and Arm B: Surgery Alone
Time frame: Up to approximately 53 months
EFS is defined as the time from randomization to the first occurrence of any of the following events: progression of disease that precludes radical cystectomy + pelvic lymph node dissection (RC + PLND) surgery, failure to undergo RC + PLND surgery in participants with residual disease and any radiographic disease present (biopsy-proven muscle-invasive bladder cancer [MIBC] will be considered an event regardless of radiographic findings), gross residual disease left behind at the time of surgery, local or distant recurrence as assessed by imaging and/or biopsy, or death due to any cause.
11 secondary outcomes
EFS Between Arm A and Arm B
Time frame: Up to approximately 6.75 years
Overall Survival (OS) Between Arm C and Arm B
Time frame: Up to approximately 7.6 years
OS Between Arm A and Arm B
Time frame: Up to approximately 7.6 years
Pathologic Complete Response (pCR) Rate Between Arm C and Arm B
Time frame: Up to approximately 53 monhts
pCR Rate Between Arm A and Arm B
Time frame: Up to approximately 5.7 years
Disease-Free Survival (DFS)
Time frame: Up to approximately 6.75 years
Pathologic Downstaging (pDS) Rate Between Arm A and Arm B
Time frame: Up to approximately 5.7 years
Pathologic Downstaging {pDS) Rate Between Arm C and Arm B
Time frame: Up to approximately 53 months
Number of Participants Experiencing Adverse Events (AEs)
Time frame: Up to approximately 7.6 years
Number of Participants Discontinuing Study Drug Due to Adverse Events (AEs)
Time frame: Up to approximately 1 year
Number of Participants Experiencing Perioperative Complications
Time frame: Up to approximately 1 year
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Jun 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 41707170Vulsteke C, Adra N, Danchaivijitr P, Sabadash M, Rodriguez-Vida A, Zhang Z, Atduev V, Goger YE, Rausch S, Kang SH, Loriot Y, Bedke J, Galsky MD, O'Donnell PH, von Amsberg G, Alimohamed N, Sulimka G, Gupta S, Paramonov V, Nakane K, Mihm M, Meng C, Huang CD, Ramamurthy C, Homet Moreno B, Ullen A; KEYNOTE-905/EV-303 Investigators. Perioperative Enfortumab Vedotin and Pembrolizumab in Bladder Cancer. N Engl J Med. 2026 Apr 2;394(13):1257-1269. doi: 10.1056/NEJMoa2511674. Epub 2026 Feb 18.
- Derived from this study: PubMed 34008425Galsky MD, Hoimes CJ, Necchi A, Shore N, Witjes JA, Steinberg G, Bedke J, Nishiyama H, Fang X, Kataria R, Sbar E, Jia X, Siefker-Radtke A. Perioperative pembrolizumab therapy in muscle-invasive bladder cancer: Phase III KEYNOTE-866 and KEYNOTE-905/EV-303. Future Oncol. 2021 Aug;17(24):3137-3150. doi: 10.2217/fon-2021-0273. Epub 2021 May 19.
- Merck Clinical Trials InformationLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. https://trialstransparency.msdclinicaltrials.com/pdf/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
242 sites in 28 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Pembrolizumab, Surgery (radical cystectomy (RC) plus Pelvic Lymph Node Dissection [PLND]) and Enfortumab Vedotin in people with Urinary Bladder Cancer, Muscle-invasive, run by Merck Sharp & Dohme LLC at 242 sites in 28 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 14 inclusion and 19 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: under way, not looking for participants, as of the sponsor's last update on 30 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 242 sites in United States, Japan, Russia, France, Ukraine and 23 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. 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 30 Jun 2026). 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?
Event-Free Survival (EFS) Between Arm C: Enfortumab Vedotin + Pembrolizumab + Surgery and Arm B: Surgery Alone (time frame: Up to approximately 53 months). 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 NCT03924895, which also lists 2 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 30 Jun 2026.