Uterine Cervical NeoplasmsPhase 3NCT04221945
Study of Chemoradiotherapy With or Without Pembrolizumab (MK-3475) For The Treatment of Locally Advanced Cervical Cancer (MK-3475-A18/KEYNOTE-A18/ENGOT-cx11/GOG-3047)
A Phase 3 study testing Pembrolizumab, Cisplatin and External Beam Radiotherapy (EBRT) in people with Uterine Cervical Neoplasms, run by Merck Sharp & Dohme LLC at 176 sites in 30 countries.
Trial summary
The purpose of this study is to evaluate the efficacy and safety of pembrolizumab plus concurrent chemoradiotherapy compared to placebo plus concurrent chemoradiotherapy in participants with locally advanced cervical cancer. Read more about this study
- Who is it for?
- Ages 18 years and older, women only
- Conditions the study is for
- Uterine Cervical Neoplasms
- What is being tested?
- Pembrolizumab, Cisplatin and External Beam Radiotherapy (EBRT)
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 1,060 participants
- Where
- 176 sitesin 30 countries
- Study dates
- 12 May 2020to 26 Jan 2026
- 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
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Has high-risk locally advanced cervical cancer (LACC): The International Federation of Gynecology and Obstetrics (FIGO) 2014 Stage IB2-IIB (with node-positive disease) or FIGO 2014 Stages III-IVA
- Has histologically-confirmed squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma of the cervix
- Has not previously received any definitive surgical, radiation, or systemic therapy for cervical cancer, including investigational agents, and is immunotherapy-naïve
- Female participants must not be pregnant or breastfeeding and agree to use highly effective contraception during the treatment period and for at least 120 days after the last dose of pembrolizumab or placebo and 180 days following the end of chemoradiotherapy and agrees not to donate eggs (ova, oocytes) to others or freeze/store for her own use for the purpose of reproduction during this period.
- Female participants must abstain from breastfeeding during the study intervention period and for at least 120 days after the last dose of pembrolizumab or placebo and 180 days following the end of chemoradiotherapy
- Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 within 7 days prior to the first dose of study treatment
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- Has provided a tissue sample from a core incisional or excisional biopsy of a tumor lesion
- Has radiographically evaluable disease, either measurable or non-measurable per RECIST 1.1, as assessed by the local site investigator/radiology
- Has adequate organ function within 7 days prior to the start of study treatment.
Who cannot join
- Has excluded subtypes of LACC
- Has FIGO 2014 Stage IVB disease
- Has undergone a previous hysterectomy defined as removal of the entire uterus or will have a hysterectomy as part of their initial cervical cancer therapy
- Has bilateral hydronephrosis, unless at least one side has been stented or resolved by positioning of nephrostomy or considered mild and not clinically significant in the opinion of the investigator
- Has anatomy or tumor geometry or any other reason or contraindication that cannot be treated with intracavitary brachytherapy or a combination of intracavitary and interstitial brachytherapy
- Has received a live vaccine within 30 days prior to the first dose of study treatment
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- Has received treatment with systemic immunostimulatory agents, colony stimulating factors, interferons, interleukins and vaccine combinations within 6 weeks or 5 half-lives of the drug, whichever is shorter, prior to Cycle 1, Day 1
- Has received prior therapy with an anti-programmed cell death receptor 1 (PD-1), anti-programmed cell death receptor ligand 1 (PD-L1), or anti-programmed cell death receptor ligand 2 (PD-L2) agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), OX-40, CD137)
- Has received prior systemic anticancer therapy including investigational agents within 4 weeks prior to randomization
- Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to randomization
- Has any contraindication to the use of cisplatin
- 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
- Has a known additional malignancy that is progressing or has required active treatment within the past 3 years
- Has severe hypersensitivity to pembrolizumab and/or any of its excipients
- Has an active autoimmune disease that has required systemic treatment in past 2 years
- Has a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease
- Has an active infection requiring systemic therapy
- Has a known history of Human Immunodeficiency Virus (HIV) infection
- Has a known history of Hepatitis B or known active Hepatitis C virus infection
- Has a history or current evidence of any condition, therapy, lab abnormality, or other circumstance that may increase the risk associated with study participation or study treatment administration or may interfere with the interpretation of study results, and in the judgment of the investigator or Sponsor, would make the participant inappropriate for entry into this study
- Has a known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study
- Has had an allogenic tissue/solid organ transplant
- Has evidence of metastatic disease per RECIST 1.1 including lymph nodes above the first lumbar vertebra (L1) cephalad body, in the inguinal region
Trial locations and contacts
176 sites in 30 countries.
176 sites in 30 countries
United States28 sites
University of New Mexico Comprehensive Cancer Center-Clinical Research Office ( Site 0019)
Albuquerque, New Mexico, 87106
Texas Oncology-Austin Central ( Site 8006)
Austin, Texas, 78731
Our Lady of the Lake Regional Medical Center. ( Site 0031)
Baton Rouge, Louisiana, 70817
Sanford Bismarck Medical Center ( Site 0046)
Bismarck, North Dakota, 58501
University of North Carolina at Chapel Hill ( Site 0025)
Chapel Hill, North Carolina, 27514
Hollings Cancer Center ( Site 0007)
Charleston, South Carolina, 29425
UVA Health System ( Site 0005)
Charlottesville, Virginia, 22908
The James Cancer Hospital and Solove Research Institute at The Ohio State University Comprehensive C
Columbus, Ohio, 43210
Women's Cancer Care ( Site 0039)
Covington, Louisiana, 70433
University of Colorado Health Sciences Center and Hospital ( Site 0028)
Denver, Colorado, 80262
Karmanos Cancer Institute ( Site 0018)
Detroit, Michigan, 48201
Willamette Valley Cancer Institute and Research Center ( Site 8000)
Eugene, Oregon, 97401
Parkview Research Center at Parkview Regional Medical Center ( Site 0026)
Fort Wayne, Indiana, 46845
Texas Oncology-Fort Worth Cancer Center ( Site 8001)
Fort Worth, Texas, 76104
University of Kentucky Markey Cancer Center ( Site 0015)
Lexington, Kentucky, 40536
UCLA Hematology/Oncology - Westwood (Building 200 Suite 120) ( Site 0027)
Los Angeles, California, 90095
Minnesota Oncology Hematology, PA ( Site 8007)
Minneapolis, Minnesota, 55404
Smilow Cancer Center at Yale-New Haven ( Site 0023)
New Haven, Connecticut, 06510
Hoag Memorial Hospital Presbyterian ( Site 0038)
Newport Beach, California, 92663
AdventHealth Orlando-AdventHealth Medical Group Gynecological Oncology ( Site 0009)
Orlando, Florida, 32804
HonorHealth Research Institute - Biltmore ( Site 8009)
Phoenix, Arizona, 85016
Allegheny Health Network West Penn Hospital-Gynecologic Oncology ( Site 0030)
Pittsburgh, Pennsylvania, 15244
Legacy Good Samaritan Medical Center ( Site 0013)
Portland, Oregon, 97210
Virginia Commonwealth University ( Site 0024)
Richmond, Virginia, 23219
UC Davis Comprehensive Cancer Center ( Site 0017)
Sacramento, California, 95817
Texas Oncology-San Antonio Medical Center ( Site 8002)
San Antonio, Texas, 78240
Sanford Gynecology Oncology ( Site 0003)
Sioux Falls, South Dakota, 57104
Texas Oncology-The Woodlands ( Site 8003)
The Woodlands, Texas, 77380
Japan17 sites
National Hospital Organization Kyushu Cancer Center ( Site 1167)
Fukuoka, 811-1395
Saitama Medical University International Medical Center ( Site 1168)
Hidaka, Saitama, 350-1298
Kagoshima City Hospital ( Site 1166)
Kagoshima, 890-8760
National Cancer Center Hospital East ( Site 1159)
Kashiwa, Chiba, 2778577
Saitama Cancer Center ( Site 1169)
Kitaadachi-gun, Saitama, 362-0806
Kurume University Hospital ( Site 1164)
Kurume, Fukuoka, 830-0011
National Hospital Organization Shikoku Cancer Center ( Site 1162)
Matsuyama, Ehime, 791-0280
Kyorin University Hospital ( Site 1158)
Mitaka, Tokyo, 181-8611
Aichi Cancer Center Hospital ( Site 1155)
Nagoya, Aichi-ken, 464-8681
University of the Ryukyus Hospital ( Site 1156)
Nakagami-gun, Okinawa, 903-0215
Osaka International Cancer Institute ( Site 1161)
Osaka, 541-8567
Hokkaido University Hospital ( Site 1163)
Sapporo, Hokkaido, 060-8648
Iwate Medical University Hospital ( Site 1165)
Shiwa-gun, Iwate, 028-3695
National Cancer Center Hospital ( Site 1172)
Tokyo, 104-0045
Japanese Foundation for Cancer Research-Gynecologic Oncology ( Site 1171)
Tokyo, 135-8550
Keio University Hospital ( Site 1170)
Tokyo, 160-8582
Ehime University Hospital ( Site 1157)
Tōon, Ehime, 790-0295
China16 sites
Peking Union Medical College Hospital ( Site 1001)
Beijing, Beijing Municipality, 100730
Hunan Cancer Hospital ( Site 1015)
Changsha, Hunan, 233004
Xiangya Hospital Central-South University ( Site 1009)
Changsha, Hunan, 410008
Sichuan Cancer Hospital ( Site 1018)
Chengdu, Sichuan, 610041
Chongqing Cancer Hospital ( Site 1030)
Chongqing, Chongqing Municipality, 400030
The First Affiliated Hospital.Sun Yat-sen University ( Site 1005)
Guangzhou, Guangdong, 510080
Zhejiang Provincial People's Hospital ( Site 1021)
Hangzhou, Zhejiang, 310014
Zhejiang Cancer Hospital ( Site 1004)
Hangzhou, Zhejiang, 310022
Harbin Medical University Cancer Hospital ( Site 1013)
Harbin, Heilongjiang, 150081
Anhui Provincial Hospital ( Site 1029)
Hefei, Anhui, 230001
Anhui Provincial Cancer Hospital ( Site 1007)
Hefei, Anhui, 230031
Affiliated Cancer Hospital of Guangxi Medical University ( Site 1036)
Nanning, Guangxi, 530021
Shanghai Cancer Hospital ( Site 1000)
Shanghai, Shanghai Municipality, 200032
Shanghai First Maternity and Infant Hospital-Gynecology department ( Site 1039)
Shanghai, Shanghai Municipality, 201204
The First Affiliated Hospital of Xinjiang Medical University ( Site 1012)
Ürümqi, Xinjiang, 830054
The First Affiliated Hospital of Xiamen University ( Site 1025)
Xiamen, Fujian, 361003
Italy10 sites
A.O. Universitaria Policlinico S. Orsola-Malpighi ( Site 0541)
Bologna, 40138
Istituto di Candiolo - IRCCS ( Site 0546)
Candiolo, Piedmont, 10060
Ospedale Vito Fazzi ( Site 0547)
Lecce, 73100
Istituto Europeo di Oncologia ( Site 0536)
Milan, Milano, 20141
IRCCS Ospedale San Raffaele ( Site 0539)
Milan, 20132
Fondazione IRCCS Istituto Nazionale dei Tumori di Milano ( Site 0542)
Milan, 20133
Fondazione Giovanni Pascale Di Napoli ( Site 0544)
Naples, 80131
Policlinico Universitario Gemelli ( Site 0538)
Roma, 00168
Istituto Nazionale Tumori Regina Elena ( Site 0540)
Rome, Roma, 00144
A.O.U. Citta della Salute e della Scienza di Torino ( Site 0535)
Torino, 10126
Germany8 sites
Charite Universitaetsmedizin Berlin ( Site 0442)
Berlin, 13353
Universitaetsklinikum Carl Gustav Carus der Technischen Univ ( Site 0452)
Dresden, Saxony, 01307
Universitaetsklinikum Freiburg ( Site 0454)
Freiburg im Breisgau, Baden-Wurttemberg, 79106
Universitaetsklinikum Hamburg-Eppendorf ( Site 0445)
Hamburg, 20246
Universitaetsklinik Leipzig ( Site 0456)
Leipzig, Saxony, 04103
Universitätsmedizin Mannheim-Department of Obstetrics and Gynecology ( Site 0443)
Mannheim, Baden-Wurttemberg, 68167
Klinikum der Universitaet in Muenchen ( Site 0446)
Munich, Bavaria, 80336
Klinikum Rechts der Isar. Technischen Universitaet Muenchen ( Site 0453)
Munich, Bavaria, 81675
Peru7 sites
Centro Medico Monte Carmelo ( Site 0289)
Arequipa, Ariqipa, 04001
Hospital Nacional Daniel Alcides Carrion ( Site 0293)
Callao, Lima, 07021
Instituto de Oncologia y Radioterapia Clinica Ricardo Palma ( Site 0290)
Lima, 15036
Hospital Nacional Arzobispo Loayza ( Site 0292)
Lima, 15082
Hospital Nacional Guillermo Almenara Irigoyen ( Site 0291)
Lima, 15082
Clinica San Gabriel ( Site 0296)
San Miguel, Lima region, 15087
Hospital de Alta Complejidad de La Libertad Virgen de La Puerta ( Site 0287)
Trujillo, La Libertad, 13013
Belgium6 sites
OLV Ziekenhuis ( Site 0352)
Aalst, Oost-Vlaanderen, 9300
UZA University Hospital Antwerp ( Site 0351)
Edegem, Antwerpen, 2650
AZ St Lucas ( Site 0349)
Ghent, Oost-Vlaanderen, 9000
UZ Leuven ( Site 0354)
Leuven, Vlaams-Brabant, 3000
C.I.U. Hopital Ambroise Pare ( Site 0353)
Mons, Hainaut, 7000
GZA Sint Augustinus ( Site 0356)
Wilrijk, Antwerpen, 2610
Guatemala6 sites
Centro de Investigaciones Clinicas de Latinoamerica S.A. - CELAN ( Site 0321)
Guatemala City, 01010
Oncologika S.A. ( Site 0323)
Guatemala City, 01010
Oncomedica ( Site 0320)
Guatemala City, 01010
Grupo Angeles SA ( Site 0319)
Guatemala City, 01015
Medi-K Cayala ( Site 0318)
Guatemala City, 01016
Centro Medico Integral De Cancerología (CEMIC) ( Site 0322)
Quetzaltenango, 09002
Russia6 sites
Chelyabinsk Regional Clinical Center Oncology and Nuclear Medicine ( Site 0741)
Chelyabinsk, Chelyabinsk Oblast, 454087
Krasnoyarsk Regional Clinical Oncological Dispensary ( Site 0729)
Krasnoyarsk, Krasnoyarsk Krai, 660133
MSROI named after P.A. Hertsen branch of FSBI NMRC Radiology ( Site 0722)
Moscow, Moscow, 125284
GBUZ SPb CRPCstmc(o) ( Site 0746)
Saint Petersburg, Sankt-Peterburg, 197758
National Medical Research Center of Oncology N.A. N.N. Petrov ( Site 0725)
Saint Petersburg, Sankt-Peterburg, 197758
Yaroslavl Regional SBIH Clinical Oncology Hospital ( Site 0734)
Yaroslavl, Yaroslavl Oblast, 150054
Spain6 sites
Hospital Germans Trias i Pujol-Instituto Catalán de Oncología de Badalona ( Site 0637)
Badalona, Barcelona, 08916
Hospital Universitari Vall d Hebron ( Site 0634)
Barcelona, 08035
Complejo Hospitalario de Jaen ( Site 0632)
Jaén, 23007
HOSPITAL UNIVERSITARIO QUIRONSALUD MADRID-ONCOLOGIA MEDICA ( Site 0638)
Pozuelo de Alarcón, Madrid, 28223
Hosp Clin Univ de Santiago ( Site 0629)
Santiago de Compostela, La Coruna, 15706
Hospital Clinico Universitario Lozano Blesa ( Site 0630)
Zaragoza, 50009
Australia5 sites
Monash Health-Monash Medical Centre ( Site 0970)
Clayton, Victoria, 3168
Royal Brisbane and Women s Hospital ( Site 0972)
Herston, Queensland, 4029
Peter MacCallum Cancer Centre ( Site 0971)
Melbourne, Victoria, 3000
St John of God Subiaco Hospital ( Site 0969)
Subiaco, Western Australia, 6008
Westmead Hospital ( Site 0973)
Westmead, New South Wales, 2145
Brazil5 sites
Hospital das Clinicas da UFMG ( Site 0172)
Belo Horizonte, Minas Gerais, 30130-100
Liga Norte Riograndense Contra o Cancer ( Site 0170)
Natal, Rio Grande do Norte, 59075-740
Hospital de Clínicas de Ribeirão Preto ( Site 0171)
Ribeirão Preto, São Paulo, 14048900
Instituto Nacional Do Cancer II ( Site 0173)
Rio de Janeiro, 20220-410
Núcleo de Pesquisa Clínica da Rede São Camilo ( Site 0166)
São Paulo, São Paulo, 04014-002
South Korea5 sites
Keimyung University Dongsan Medical Center ( Site 1066)
Daegu, Taegu-Kwangyokshi, 42601
National Cancer Center ( Site 1065)
Goyang-si, Kyonggi-do, 10408
Asan Medical Center ( Site 1062)
Seoul, Seoul, 05505
Severance Hospital ( Site 1063)
Seoul, 03722
Samsung Medical Center ( Site 1064)
Seoul, 06351
Canada4 sites
Centre Hospitalier de l Universite de Montreal - CHUM ( Site 0101)
Montreal, Quebec, H2X 0A9
McGill University Health Centre ( Site 0105)
Montreal, Quebec, H4A 3J1
Centre intégré de cancérologie du CHU de Québec Université Laval, Hôpital de l'Enfant-Jésus ( Site 0
Québec, Quebec, G1J 1Z4
Princess Margaret Cancer Centre ( Site 0102)
Toronto, Ontario, M5G 2M9
Chile4 sites
Sociedad Oncovida S.A. ( Site 0196)
Santiago, Region M. de Santiago, 7510032
Iram Cancer Research ( Site 0198)
Santiago, Region M. de Santiago, 7630370
Centro Investigación del Cáncer James Lind ( Site 0194)
Temuco, Araucania, 4800827
Oncocentro ( Site 0195)
Viña del Mar, Valparaiso
Colombia4 sites
Instituto Nacional de Cancerologia E.S.E ( Site 0228)
Bogotá, Bogota D.C., 110321
Fundacion Valle del Lili ( Site 0230)
Cali, Valle del Cauca Department, 760032
Centro Medico Imbanaco de Cali S.A ( Site 0227)
Cali, Valle del Cauca Department, 760042
Fundacion Centro de Investigacion Clinica CIC ( Site 0231)
Medellín, Antioquia, 050021
Greece4 sites
Alexandra General Hospital ( Site 0477)
Athens, Attica, 11528
Hospital Hygeia ( Site 0478)
Athens, Attica, 151 23
General Hospital of Patras. St Andrews ( Site 0473)
Pátrai, Achaia, 262 00
Euromedica General Clinic of Thessaloniki ( Site 0474)
Thessaloniki, 546 45
Israel4 sites
Rambam Medical Center ( Site 0815)
Haifa, 3109601
Hadassah Medical Center. Ein Kerem ( Site 0816)
Jerusalem, 9112001
Chaim Sheba Medical Center ( Site 0814)
Ramat Gan, 5262000
Sourasky Medical Center ( Site 0819)
Tel Aviv, 6423906
Thailand4 sites
Maharaj Nakorn Chiang Mai Hospital ( Site 1133)
Chiang Mai, 50200
Songklanagarind Hospital ( Site 1130)
Hat Yai, Changwat Songkhla, 90110
Srinagarind Hospital. Khon Kaen University ( Site 1132)
Mueang, Changwat Khon Kaen, 40002
Ramathibodi Hospital, Mahidol University ( Site 1131)
Rajthevee, Bangkok, 10400
Austria3 sites
Medizinische Universitat Graz ( Site 0569)
Graz, Styria, 8036
Medizinische Universitat Innsbruck ( Site 0566)
Innsbruck, Tyrol, 6020
Medizinische Universität Wien ( Site 0567)
Vienna, State of Vienna, 1090
Czechia3 sites
Fakultni Nemocnice Brno Bohunice ( Site 0912)
Brno, Brno-mesto, 602 00
Fakultni nemocnice Ostrava ( Site 0909)
Ostrava, Moravian-Silesian Region, 708 52
Fakultni nemocnice Kralovske Vinohrady ( Site 0913)
Prague, 100 34
France3 sites
CHU Jean Minjoz ( Site 0411)
Besançon, Doubs, 25000
Centre Hospitalier Lyon Sud ( Site 0413)
Pierre-Bénite, Rhone, 69310
Institut Claudius Regaud ( Site 0417)
Toulouse, Haute-Garonne, 31059
Taiwan3 sites
National Taiwan University Hospital ( Site 1095)
Taipei, 100
Mackay Memorial Hospital ( Site 1094)
Taipei, 104
Linkou Chang Gung Memorial Hospital ( Site 1097)
Taoyuan, 333
Turkey (Türkiye)3 sites
Acibadem Adana Hastanesi ( Site 0756)
Adana, 01130
Baskent Universitesi Ankara Hastanesi ( Site 0754)
Ankara, 06490
I.U. Cerrahpasa Medical Faculty ( Site 0755)
Istanbul, Istanbul, 34093
United Kingdom3 sites
Royal Devon and Exeter Foundation Trust Hospital ( Site 0699)
Exeter, England
ROYAL MARSDEN HOSPITAL (CHELSEA) ( Site 0701)
London, London, City of, SW3 6JJ
Royal Marsden Hospital (Sutton)-Gynaecology Unit ( Site 0696)
London, Surrey, SM3 5PT
Hungary2 sites
Orszagos Onkologiai Intezet ( Site 0846)
Budapest, 1122
Debreceni Egyetem Klinikai Kozpont ( Site 0845)
Debrecen, 4032
Ireland2 sites
Cork University Hospital ( Site 0504)
Cork, T12 DC4A
St James Hospital ( Site 0505)
Dublin, D8
Norway2 sites
Helse Bergen HF Haukeland Universitetssjukehus ( Site 0601)
Bergen, Hordaland, 5021
Oslo Universitetssykehus Radiumhospitalet ( Site 0600)
Oslo, 0379
Ukraine2 sites
Grigoriev Institute for medical Radiology NAMS of Ukraine ( Site 0876)
Kharkiv, Kharkiv Oblast, 61024
Lviv State Oncology Regional Treatment and Diagnostic Center ( Site 0882)
Lviv, Lviv Oblast, 79031
Sweden1 site
Karolinska Universitetssjukhuset ( Site 0784)
Stockholm, Stockholm County, 171 76
About this study
Official title: A Randomized, Phase 3, Double-Blind Study of Chemoradiotherapy With or Without Pembrolizumab for the Treatment of High-risk, Locally Advanced Cervical Cancer (KEYNOTE-A18/ENGOT-cx11/GOG-3047)
The purpose of this study is to evaluate the efficacy and safety of pembrolizumab plus concurrent chemoradiotherapy compared to placebo plus concurrent chemoradiotherapy in participants with locally advanced cervical cancer.
The primary hypotheses are that pembrolizumab plus concurrent chemoradiotherapy is superior to placebo plus concurrent chemoradiotherapy with respect to progression-free survival and overall survival.
Once the study objectives have been met or the study has ended, participants will be discontinued from this study and will be enrolled in an extension study to continue protocol-defined assessments and treatment.
- Conditions
- Uterine Cervical Neoplasms
- Being tested
- Pembrolizumab, Placebo for pembrolizumab, Cisplatin, External Beam Radiotherapy (EBRT), Brachytherapy
- Keywords
- Programmed Cell Death Receptor 1 (PD-1, PD1), Programmed Cell Death Receptor Ligand 1 (PD-L1, PDL1), Programmed Cell Death Receptor Ligand 2 (PD-L2, PDL2)
- Medical subject headings
- Uterine Cervical 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 KEYTRUDA®, MK-3475
IV infusion
Placebo for pembrolizumabDrug
IV infusion
CisplatinDrug
Also called Platinol®, Platinol®-AQ
IV infusion
External Beam Radiotherapy (EBRT)Radiation
Given as a total radiotherapy dose of 80 Gy for volume-directed and 75 Gy for point-directed
BrachytherapyRadiation
Given as a total radiotherapy dose of 80 Gy for volume-directed and 75 Gy for point-directed
| Study group | Role | What they receive |
|---|---|---|
| chemoradiotherapy + pembrolizumab | Experimental | Participants receive pembrolizumab 200 mg intravenously (IV) on Day 1 of each 3-week cycle (Q3W) for 5 cycles followed by pembrolizumab 400 mg IV on Day 1 of each 6-week cycle (Q6W) for an additional 15 cycles. During the Q3W dosing period of pembrolizumab, participants receive concurrent chemoradiotherapy. The standard of care chemoradiotherapy regimen includes cisplatin 40 mg/m^2 IV once per week (QW) for 5 or 6 weeks plus external beam radiotherapy (EBRT) followed by brachytherapy with minimum total radiotherapy dose of 80 Gray Units (Gy) for volume-directed and 75 Gy for point-directed given with the total duration of radiation treatment not to exceed 50 days (with an extension to a maximum of 56 days for unforeseen delays). Receives: Biological: Pembrolizumab; Drug: Cisplatin; Radiation: External Beam Radiotherapy (EBRT); Radiation: Brachytherapy |
| chemoradiotherapy + placebo for pembrolizumab | Experimental | Participants receive placebo for pembrolizumab IV on Day 1 of each 3-week cycle (Q3W) for 5 cycles followed by placebo IV on Day 1 of each 6-week cycle (Q6W) for an additional 15 cycles. During the Q3W dosing period of placebo, participants receive concurrent chemoradiotherapy. The standard of care chemoradiotherapy regimen includes cisplatin 40 mg/m^2 IV once per week (QW) for 5 or 6 weeks plus external beam radiotherapy (EBRT) followed by brachytherapy with minimum total radiotherapy dose of 80 Gray Units (Gy) for volume-directed and 75 Gy for point-directed given with the total duration of radiation treatment not to exceed 50 days (with an extension to a maximum of 56 days for unforeseen delays). Receives: Drug: Placebo for pembrolizumab; Drug: Cisplatin; Radiation: External Beam Radiotherapy (EBRT); Radiation: Brachytherapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression-Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by the Investigator
PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, or by histopathologic confirmation of suspected disease progression, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. Unequivocal progression of non-target lesions is also considered PD. The Kaplan-Meier nonparametric product limit method for censored data was used to estimate PFS.
Measured: Up to approximately 55 months
Overall Survival (OS)
OS is the time from randomization to death due to any cause. The Kaplan-Meier nonparametric product limit method for censored data was used to estimate OS.
Measured: Up to approximately 55 months
Secondary outcomes (17)
PFS Per RECIST 1.1 as Assessed by Blinded Independent Central Review (BICR)
PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. Unequivocal progression of non-target lesions is also considered PD. The Kaplan-Meier nonparametric product limit method for censored data was used to estimate PFS.
Measured: Up to approximately 55 months
PFS Per RECIST 1.1 at Month 24 as Assessed by the Investigator
PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, or by histopathologic confirmation of suspected disease progression, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. Unequivocal progression of non-target lesions is also considered PD. The percentage of participants with PFS as assessed by the investigator is presented.
Measured: 24 months
PFS Per RECIST 1.1 at Month 24 as Assessed by BICR
PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. Unequivocal progression of non-target lesions is also considered PD. The percentage of participants with PFS as assessed by BICR is presented.
Measured: 24 months
Overall Survival (OS) at Month 36
OS is the time from randomization to death due to any cause. The analysis was performed via Kaplan-Meier approach to estimate the OS rate at Month 36. The percentage of participants with OS at Month 36 is presented.
Measured: 36 months
Complete Response (CR) Rate Per RECIST 1.1 at Week 12 as Assessed by the Investigator
For participants who demonstrated a confirmed Complete Response (CR: Disappearance of all target and non-target lesions and also includes reduction of all nodal lesions to <10mm) per RECIST 1.1, CR rate is defined as the percentage of participants who experienced a CR. The percentage of participants with CR per RECIST 1.1 as assessed by the investigator at Week 12 is presented.
Measured: 12 weeks
CR Rate Per RECIST 1.1 at Week 12 as Assessed by BICR
For participants who demonstrated a confirmed CR: Disappearance of all target and non-target lesions and also includes reduction of all nodal lesions to <10mm) per RECIST 1.1, CR rate is defined as the percentage of participants who experienced a CR. The percentage of participants with CR per RECIST 1.1 as assessed by BICR at Week 12 is presented.
Measured: 12 weeks
Objective Response Rate (ORR) Per RECIST 1.1 as Assessed by the Investigator
ORR is defined as the percentage of participants who have a Complete Response (CR: Disappearance of all target and non-target lesions and also includes reduction of all nodal lesions to <10mm) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions and includes no unequivocal progression in non-target lesions) per RECIST 1.1.
Measured: Up to approximately 55 months
ORR Per RECIST 1.1 as Assessed by BICR
ORR is defined as the percentage of participants who have a Complete Response (CR: Disappearance of all target and non-target lesions and also includes reduction of all nodal lesions to <10mm) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions and includes no unequivocal progression in non-target lesions) per RECIST 1.1.
Measured: Up to approximately 55 months
PFS Per RECIST 1.1 in Programmed Cell Death 1 Ligand 1 (PD-L1) Positive Participants as Assessed by the Investigator
PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, or by histopathologic confirmation of suspected disease progression, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. Unequivocal progression of non-target lesions is also considered PD. PD-L1 positive participants have a combined positivity score (CPS) equal or greater than 1. The Kaplan-Meier nonparametric product limit method for censored data was used to estimate PFS.
Measured: Up to approximately 55 months
PFS Per RECIST 1.1 in PD-L1 Positive Participants as Assessed by BICR
PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. Unequivocal progression of non-target lesions is also considered PD. PD-L1 positive participants have a CPS equal or greater than 1. The Kaplan-Meier nonparametric product limit method for censored data was used to estimate PFS.
Measured: Up to approximately 55 months
OS in PD-L1 Positive Participants
OS is the time from randomization to death due to any cause. PD-L1 positive participants have a CPS equal or greater than 1. The Kaplan-Meier nonparametric product limit method for censored data was used to estimate OS.
Measured: Up to approximately 55 months
PFS After Next-Line Treatment (PFS 2) Following Discontinuation of Study Treatment
PFS is defined as the time from randomization to the first documented progressive disease (PD) on next-line treatment or death due to any cause, whichever occurs first, as assessed by the investigator. PFS 2 is measured after next-line treatment following discontinuation of study treatment administration.
Measured: Up to approximately 55 months
Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Global Health Status Score
The EORTC QLQ-C30 is a questionnaire that rates the overall quality of life in cancer participants. The first 28 questions use a 4-point scale (1=not at all to 4=very much) for evaluating function (physical, role, social, cognitive, emotional), symptoms (diarrhea, fatigue, dyspnea, appetite loss, insomnia, nausea/vomiting, constipation, and pain) and financial difficulties. The last 2 questions use a 7-point scale (1=very poor to 7=excellent) to evaluate overall health and quality of life. Global scores are converted to a score of 0 to 100, with a higher score indicating improved health status. The change from baseline in EORTC QLQ-C30 score will be presented.
Measured: Baseline and week 36
Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Physical Function Score
The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to 5 questions about their physical functioning are scored on a 4-point scale (1=not at all to 4=very much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better quality of life. The change from baseline in physical function (EORTC QLQ-C30 Items 1-5) score will be presented.
Measured: Baseline and week 36
Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Symptom Specific Scale for Cervical Cancer (EORTC QLQ-CX24) Score
The EORTC QLQ-CX24 is a questionnaire that rates the symptoms common to women with cervical cancer and evaluates the impact of disease and/or treatments. The 24 items use a 4-point scale (1=not at all to 4=very much) and are classified into 3 multi-item scales, 11 items with symptom experience, 3 items with body image, and 4 items with sexual/ vaginal functioning. The other items of the questionnaire are lymphedema, peripheral neuropathy, menopausal symptom, sexual worry, sexual activity, and sexual enjoyment. Total scores are linearly transformed and range from 0 (no symptoms) to 100 (most severe symptoms). The change from baseline in EORTC QLQ-CX24 score is presented, with negative scores representing an improvement from baseline and vice versa.
Measured: Baseline and Week 36
Number of Participants Who Experience One or More Adverse Events (AEs)
An AE is defined as any unfavorable and unintended sign, symptom, disease, or worsening of preexisting condition temporally associated with study treatment and irrespective of causality to study treatment.
Measured: Up to 55 months
Number of Participants Who Discontinue Study Treatment Due to an AE
An AE is defined as any unfavorable and unintended sign, symptom, disease, or worsening of preexisting condition temporally associated with study treatment and irrespective of causality to study treatment.
Measured: Up to 32 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Jan 2020
- Study start12 May 2020
- Primary completion7 Jan 2025
- Study completion26 Jan 2026
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 (3)Papers the sponsor has linked to this study.
- Other trials for Uterine Cervical 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
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 1,060 participants (actual)
Sponsor and investigators
- Lead sponsor
- Merck Sharp & Dohme LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- GOG Foundation, European Network of Gynaecological Oncological Trial Groups (ENGOT)
- Responsible party
- Sponsor
- Investigators
- Medical Director, Study director, Merck Sharp & Dohme LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04221945
- Sponsor's protocol ID
- 3475-A18
- Other IDs
- MK-3475-A18, KEYNOTE-A18, ENGOT-cx11, 205189, GOG-3047, 2022-501972-25-00, U1111-1282-6395, 2019-003152-37
- Status last verified
- Oct 2026
- First submitted
- 23 Dec 2019
- Last updated
- 5 Nov 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
Lorusso D, Xiang Y, Hasegawa K, Scambia G, Leiva M, Ramos-Elias P, Acevedo A, Sukhin V, Cloven N, Pereira de Santana Gomes AJ, Contreras Mejia F, Reiss A, Ayhan A, Lee JY, Saevets V, Zagouri F, Gilbert L, Sehouli J, Tharavichitkul E, Lindemann K, Lazzari R, Chang CL, Lampe R, Zhu H, Oaknin A, Christiaens M, Polterauer S, Usami T, Li K, Yamada K, Toker S, Keefe SM, Pignata S, Duska LR; ENGOT-cx11/GOG-3047/KEYNOTE-A18 investigators. Pembrolizumab or placebo with chemoradiotherapy followed by pembrolizumab or placebo for newly diagnosed, high-risk, locally advanced cervical cancer (ENGOT-cx11/GOG-3047/KEYNOTE-A18): a randomised, double-blind, phase 3 clinical trial. Lancet. 2024 Apr 6;403(10434):1341-1350. doi: 10.1016/S0140-6736(24)00317-9. Epub 2024 Mar 20.
PubMed 38521086Lorusso D, Xiang Y, Hasegawa K, Scambia G, Leiva M, Ramos-Elias P, Acevedo A, Cvek J, Randall L, Pereira de Santana Gomes AJ, Contreras Mejia F, Helpman L, Akilli H, Lee JY, Saevets V, Zagouri F, Gilbert L, Sehouli J, Tharavichitkul E, Lindemann K, Colombo N, Chang CL, Bednarikova M, Zhu H, Oaknin A, Christiaens M, Petru E, Usami T, Liu P, Yamada K, Toker S, Keefe SM, Pignata S, Duska LR; ENGOT-cx11/GOG-3047/KEYNOTE-A18 investigators. Pembrolizumab or placebo with chemoradiotherapy followed by pembrolizumab or placebo for newly diagnosed, high-risk, locally advanced cervical cancer (ENGOT-cx11/GOG-3047/KEYNOTE-A18): overall survival results from a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2024 Oct 5;404(10460):1321-1332. doi: 10.1016/S0140-6736(24)01808-7. Epub 2024 Sep 14.
PubMed 39288779Randall L, Xiang Y, Matsumoto T, Giannarelli D, Milla DP, Lopez KA, Acevedo A, Vizkeleti J, Salani R, Nogueira-Rodrigues A, Mejia FC, Korach J, Akilli H, Lee JY, Saevets VV, Samouelian V, Sehouli J, Tharavichikul E, Sukhin V, Colombo N, Chang CL, Cueva JF, Lalondrelle S, Petru E, Szamreta E, Nguyen AM, Yamada K, Li K, Pignata S, Lorusso D. Patient-reported outcomes from the phase 3, randomized, double-blind, placebo-controlled ENGOT-cx11/GOG-3047/KEYNOTE-A18 study of pembrolizumab plus concurrent chemoradiotherapy in participants with high-risk locally advanced cervical cancer. Gynecol Oncol. 2025 Aug;199:88-95. doi: 10.1016/j.ygyno.2025.06.003. Epub 2025 Jun 30.
PubMed 40592026
Study at a glance
From the registry record, last updated by the sponsor on 5 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Phase 3, Double-Blind Study of Chemoradiotherapy With or Without Pembrolizumab for the Treatment of High-risk, Locally Advanced Cervical Cancer (KEYNOTE-A18/ENGOT-cx11/GOG-3047)
- ClinicalTrials.gov ID
- NCT04221945
- Acronym / sponsor ID
- 3475-A18
- Conditions
- Uterine Cervical Neoplasms
- Keywords
- Programmed Cell Death Receptor 1 (PD-1, PD1), Programmed Cell Death Receptor Ligand 1 (PD-L1, PDL1), Programmed Cell Death Receptor Ligand 2 (PD-L2, PDL2)
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,060 participants (actual)
- Lead sponsor
- Merck Sharp & Dohme LLCIndustry (pharma, biotech, devices)
- Collaborators
- GOG Foundation, European Network of Gynaecological Oncological Trial Groups (ENGOT)
- Study start
- 12 May 2020 (actual)
- Primary completion
- 7 Jan 2025 (actual)
- Study completion
- 26 Jan 2026 (actual)
- First posted
- 9 Jan 2020 (actual)
- Results
- Posted 5 Jan 2026
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 study is to evaluate the efficacy and safety of pembrolizumab plus concurrent chemoradiotherapy compared to placebo plus concurrent chemoradiotherapy in participants with locally advanced cervical cancer.
The primary hypotheses are that pembrolizumab plus concurrent chemoradiotherapy is superior to placebo plus concurrent chemoradiotherapy with respect to progression-free survival and overall survival.
Once the study objectives have been met or the study has ended, participants will be discontinued from this study and will be enrolled in an extension study to continue protocol-defined assessments and treatment.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| chemoradiotherapy + pembrolizumab | Experimental | Biological: Pembrolizumab, Drug: Cisplatin, Radiation: External Beam Radiotherapy (EBRT), Radiation: BrachytherapyParticipants receive pembrolizumab 200 mg intravenously (IV) on Day 1 of each 3-week cycle (Q3W) for 5 cycles followed by pembrolizumab 400 mg IV on Day 1 of each 6-week cycle (Q6W) for an additional 15 cycles. During the Q3W dosing period of pembrolizumab, participants receive concurrent chemoradiotherapy. The standard of care chemoradiotherapy regimen includes cisplatin 40 mg/m^2 IV once per week (QW) for 5 or 6 weeks plus external beam radiotherapy (EBRT) followed by brachytherapy with minimum total radiotherapy dose of 80 Gray Units (Gy) for volume-directed and 75 Gy for point-directed given with the total duration of radiation treatment not to exceed 50 days (with an extension to a maximum of 56 days for unforeseen delays). |
| chemoradiotherapy + placebo for pembrolizumab | Experimental | Drug: Placebo for pembrolizumab, Drug: Cisplatin, Radiation: External Beam Radiotherapy (EBRT), Radiation: BrachytherapyParticipants receive placebo for pembrolizumab IV on Day 1 of each 3-week cycle (Q3W) for 5 cycles followed by placebo IV on Day 1 of each 6-week cycle (Q6W) for an additional 15 cycles. During the Q3W dosing period of placebo, participants receive concurrent chemoradiotherapy. The standard of care chemoradiotherapy regimen includes cisplatin 40 mg/m^2 IV once per week (QW) for 5 or 6 weeks plus external beam radiotherapy (EBRT) followed by brachytherapy with minimum total radiotherapy dose of 80 Gray Units (Gy) for volume-directed and 75 Gy for point-directed given with the total duration of radiation treatment not to exceed 50 days (with an extension to a maximum of 56 days for unforeseen delays). |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (9 listed)
- Has high-risk locally advanced cervical cancer (LACC): The International Federation of Gynecology and Obstetrics (FIGO) 2014 Stage IB2-IIB (with node-positive disease) or FIGO 2014 Stages III-IVA
- Has histologically-confirmed squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma of the cervix
- Has not previously received any definitive surgical, radiation, or systemic therapy for cervical cancer, including investigational agents, and is immunotherapy-naïve
- Female participants must not be pregnant or breastfeeding and agree to use highly effective contraception during the treatment period and for at least 120 days after the last dose of pembrolizumab or placebo and 180 days following the end of chemoradiotherapy and agrees not to donate eggs (ova, oocytes) to others or freeze/store for her own use for the purpose of reproduction during this period.
- Female participants must abstain from breastfeeding during the study intervention period and for at least 120 days after the last dose of pembrolizumab or placebo and 180 days following the end of chemoradiotherapy
Key exclusion criteria (23 listed)
- Has excluded subtypes of LACC
- Has FIGO 2014 Stage IVB disease
- Has undergone a previous hysterectomy defined as removal of the entire uterus or will have a hysterectomy as part of their initial cervical cancer therapy
- Has bilateral hydronephrosis, unless at least one side has been stented or resolved by positioning of nephrostomy or considered mild and not clinically significant in the opinion of the investigator
- Has anatomy or tumor geometry or any other reason or contraindication that cannot be treated with intracavitary brachytherapy or a combination of intracavitary and interstitial brachytherapy
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-3475IV infusion | Biological | chemoradiotherapy + pembrolizumab |
| Placebo for pembrolizumabIV infusion | Drug | chemoradiotherapy + placebo for pembrolizumab |
| CisplatinAlso: Platinol®, Platinol®-AQIV infusion | Drug | chemoradiotherapy + pembrolizumab, chemoradiotherapy + placebo for pembrolizumab |
| External Beam Radiotherapy (EBRT)Given as a total radiotherapy dose of 80 Gy for volume-directed and 75 Gy for point-directed | Radiation | chemoradiotherapy + pembrolizumab, chemoradiotherapy + placebo for pembrolizumab |
| BrachytherapyGiven as a total radiotherapy dose of 80 Gy for volume-directed and 75 Gy for point-directed | Radiation | chemoradiotherapy + pembrolizumab, chemoradiotherapy + placebo for pembrolizumab |
Primary outcome
Progression-Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by the Investigator
Time frame: Up to approximately 55 months
PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per RECIST 1.1, or by histopathologic confirmation of suspected disease progression, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. Unequivocal progression of non-target lesions is also considered PD. The Kaplan-Meier nonparametric product limit method for censored data was used to estimate PFS.
Overall Survival (OS)
Time frame: Up to approximately 55 months
OS is the time from randomization to death due to any cause. The Kaplan-Meier nonparametric product limit method for censored data was used to estimate OS.
17 secondary outcomes
PFS Per RECIST 1.1 as Assessed by Blinded Independent Central Review (BICR)
Time frame: Up to approximately 55 months
PFS Per RECIST 1.1 at Month 24 as Assessed by the Investigator
Time frame: 24 months
PFS Per RECIST 1.1 at Month 24 as Assessed by BICR
Time frame: 24 months
Overall Survival (OS) at Month 36
Time frame: 36 months
Complete Response (CR) Rate Per RECIST 1.1 at Week 12 as Assessed by the Investigator
Time frame: 12 weeks
CR Rate Per RECIST 1.1 at Week 12 as Assessed by BICR
Time frame: 12 weeks
Objective Response Rate (ORR) Per RECIST 1.1 as Assessed by the Investigator
Time frame: Up to approximately 55 months
ORR Per RECIST 1.1 as Assessed by BICR
Time frame: Up to approximately 55 months
PFS Per RECIST 1.1 in Programmed Cell Death 1 Ligand 1 (PD-L1) Positive Participants as Assessed by the Investigator
Time frame: Up to approximately 55 months
PFS Per RECIST 1.1 in PD-L1 Positive Participants as Assessed by BICR
Time frame: Up to approximately 55 months
OS in PD-L1 Positive Participants
Time frame: Up to approximately 55 months
PFS After Next-Line Treatment (PFS 2) Following Discontinuation of Study Treatment
Time frame: Up to approximately 55 months
Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Global Health Status Score
Time frame: Baseline and week 36
Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Physical Function Score
Time frame: Baseline and week 36
Change From Baseline in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Symptom Specific Scale for Cervical Cancer (EORTC QLQ-CX24) Score
Time frame: Baseline and Week 36
Number of Participants Who Experience One or More Adverse Events (AEs)
Time frame: Up to 55 months
Number of Participants Who Discontinue Study Treatment Due to an AE
Time frame: Up to 32 months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Nov 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 38521086Lorusso D, Xiang Y, Hasegawa K, Scambia G, Leiva M, Ramos-Elias P, Acevedo A, Sukhin V, Cloven N, Pereira de Santana Gomes AJ, Contreras Mejia F, Reiss A, Ayhan A, Lee JY, Saevets V, Zagouri F, Gilbert L, Sehouli J, Tharavichitkul E, Lindemann K, Lazzari R, Chang CL, Lampe R, Zhu H, Oaknin A, Christiaens M, Polterauer S, Usami T, Li K, Yamada K, Toker S, Keefe SM, Pignata S, Duska LR; ENGOT-cx11/GOG-3047/KEYNOTE-A18 investigators. Pembrolizumab or placebo with chemoradiotherapy followed by pembrolizumab or placebo for newly diagnosed, high-risk, locally advanced cervical cancer (ENGOT-cx11/GOG-3047/KEYNOTE-A18): a randomised, double-blind, phase 3 clinical trial. Lancet. 2024 Apr 6;403(10434):1341-1350. doi: 10.1016/S0140-6736(24)00317-9. Epub 2024 Mar 20.
- Results publication: PubMed 39288779Lorusso D, Xiang Y, Hasegawa K, Scambia G, Leiva M, Ramos-Elias P, Acevedo A, Cvek J, Randall L, Pereira de Santana Gomes AJ, Contreras Mejia F, Helpman L, Akilli H, Lee JY, Saevets V, Zagouri F, Gilbert L, Sehouli J, Tharavichitkul E, Lindemann K, Colombo N, Chang CL, Bednarikova M, Zhu H, Oaknin A, Christiaens M, Petru E, Usami T, Liu P, Yamada K, Toker S, Keefe SM, Pignata S, Duska LR; ENGOT-cx11/GOG-3047/KEYNOTE-A18 investigators. Pembrolizumab or placebo with chemoradiotherapy followed by pembrolizumab or placebo for newly diagnosed, high-risk, locally advanced cervical cancer (ENGOT-cx11/GOG-3047/KEYNOTE-A18): overall survival results from a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2024 Oct 5;404(10460):1321-1332. doi: 10.1016/S0140-6736(24)01808-7. Epub 2024 Sep 14.
- Derived from this study: PubMed 40592026Randall L, Xiang Y, Matsumoto T, Giannarelli D, Milla DP, Lopez KA, Acevedo A, Vizkeleti J, Salani R, Nogueira-Rodrigues A, Mejia FC, Korach J, Akilli H, Lee JY, Saevets VV, Samouelian V, Sehouli J, Tharavichikul E, Sukhin V, Colombo N, Chang CL, Cueva JF, Lalondrelle S, Petru E, Szamreta E, Nguyen AM, Yamada K, Li K, Pignata S, Lorusso D. Patient-reported outcomes from the phase 3, randomized, double-blind, placebo-controlled ENGOT-cx11/GOG-3047/KEYNOTE-A18 study of pembrolizumab plus concurrent chemoradiotherapy in participants with high-risk locally advanced cervical cancer. Gynecol Oncol. 2025 Aug;199:88-95. doi: 10.1016/j.ygyno.2025.06.003. Epub 2025 Jun 30.
- 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
176 sites in 30 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 External Beam Radiotherapy (EBRT) in people with Uterine Cervical Neoplasms, run by Merck Sharp & Dohme LLC at 176 sites in 30 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 9 inclusion and 23 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 5 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 176 sites in United States, Japan, China, Italy, Germany and 25 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 5 Jan 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?
Progression-Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by the Investigator (time frame: Up to approximately 55 months). The study lists 2 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 NCT04221945, which also lists 3 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 5 Nov 2026.