Pembrolizumab + Chemotherapy for Stomach Cancer

No longer recruiting at 269 trial locations
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether adding pembrolizumab, a type of immunotherapy, to standard chemotherapy can extend the lives of people with advanced stomach cancer. It compares pembrolizumab plus chemotherapy to a placebo plus chemotherapy to determine which is more effective against HER2-negative gastric or gastroesophageal junction cancer. The trial seeks participants diagnosed with this type of cancer who have not yet received treatment for their advanced condition. As a Phase 3 trial, this study represents the final step before FDA approval, offering participants a chance to contribute to potentially groundbreaking treatment advancements.

Do I need to stop my current medications to join the trial?

The trial information does not specify if you need to stop taking your current medications. It's best to discuss your specific medications with the study team to get a clear answer.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Previous studies have shown that combining pembrolizumab with chemotherapy is safe for people with advanced stomach cancer. Research indicates that pembrolizumab can improve survival and response rates and is generally well-tolerated. Some participants experienced side effects, but these are often manageable.

The chemotherapy drugs used in this trial, such as cisplatin and oxaliplatin, have undergone extensive study. They can cause side effects like nausea or tiredness, but these are common with many cancer treatments and can usually be controlled with other medications.

Overall, pembrolizumab combined with chemotherapy has proven safe for people with stomach cancer. Evidence suggests that while side effects can occur, they are usually not severe and can be managed.12345

Why do researchers think this study treatment might be promising for stomach cancer?

Most treatments for stomach cancer involve chemotherapy drugs like cisplatin, 5-fluorouracil, oxaliplatin, and capecitabine. Pembrolizumab, however, is exciting because it works as an immunotherapy, boosting the body's immune system to better recognize and fight cancer cells. This is different from traditional chemotherapy, which directly attacks the cancer cells but can also harm healthy cells. Researchers are particularly interested in pembrolizumab's potential to enhance the effects of chemotherapy, potentially leading to improved outcomes for patients. By combining pembrolizumab with chemotherapy, this approach could offer a more powerful treatment option for stomach cancer.

What evidence suggests that pembrolizumab plus chemotherapy could be an effective treatment for stomach cancer?

In this trial, participants will receive either pembrolizumab combined with chemotherapy or a placebo combined with chemotherapy. Research has shown that combining pembrolizumab with chemotherapy can extend the lives of people with advanced stomach and gastroesophageal junction cancers. One study found that this combination significantly increased survival time compared to chemotherapy alone, with patients living for a median of 12.9 months. This approach also improved response rates, with more patients experiencing a reduction or disappearance of their cancer. The side effects are considered manageable, making this a promising option for those battling this type of cancer.24678

Who Is on the Research Team?

MD

Medical Director

Principal Investigator

Merck Sharp & Dohme LLC

Are You a Good Fit for This Trial?

Adults with HER2-negative advanced gastric or GEJ adenocarcinoma, who have not had previous treatments for advanced cancer, can join. They must be in good physical condition (ECOG 0-1), agree to use contraception, and have adequate organ function. People with active brain metastases, severe allergies to trial drugs, recent major surgery or other conditions that could affect participation are excluded.

Inclusion Criteria

My recent tests show my organs are functioning well.
My cancer is advanced stomach or GEJ cancer, and I know my PD-L1 status.
My cancer is HER2 negative.
See 7 more

Exclusion Criteria

I have been treated for an autoimmune disease in the last 2 years.
My cancer is a type of stomach cancer called squamous cell or undifferentiated.
I've had treatment for advanced stomach cancer more than 6 months ago.
See 26 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive pembrolizumab plus chemotherapy or placebo plus chemotherapy for up to 35 cycles (approximately 2 years)

104 weeks
1 visit every 3 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

Up to 49.5 months

Second Course Treatment (optional)

Participants who complete the initial treatment or achieve a complete response but experience progression can initiate a second course of pembrolizumab for up to 17 cycles

52 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • 5-fluorouracil
  • capecitabine
  • Cisplatin
  • oxaliplatin
  • Pembrolizumab
  • Placebo for Pembrolizumab
Trial Overview The study is testing the effectiveness of pembrolizumab combined with chemotherapy (Cisplatin/5-Fluorouracil or Oxaliplatin/Capecitabine) versus a placebo plus chemotherapy in treating stomach tumors. The main goal is to see if pembrolizumab helps patients live longer compared to the placebo.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Pembrolizumab + Chemotherapy (FP or CAPOX regimen)Experimental Treatment5 Interventions
Group II: Placebo + Chemotherapy (FP or CAPOX regimen)Active Control5 Interventions

5-fluorouracil is already approved in United States, European Union, Canada, Japan for the following indications:

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Approved in United States as 5-FU for:
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Approved in European Union as 5-FU for:
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Approved in Canada as 5-FU for:
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Approved in Japan as 5-FU for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Merck Sharp & Dohme Corp.

Lead Sponsor

Trials
2,287
Recruited
4,582,000+
Chirfi Guindo profile image

Chirfi Guindo

Merck Sharp & Dohme Corp.

Chief Medical Officer

Engineering degree from Ecole Centrale de Paris, MBA from New York University Stern School of Business

Robert M. Davis profile image

Robert M. Davis

Merck Sharp & Dohme Corp.

Chief Executive Officer since 2021

J.D. from Northwestern University Pritzker School of Law, MBA from Northwestern University Kellogg Graduate School of Management, Bachelor's in Finance from Miami University

Merck Sharp & Dohme LLC

Lead Sponsor

Trials
4,096
Recruited
5,232,000+
Chirfi Guindo profile image

Chirfi Guindo

Merck Sharp & Dohme LLC

Chief Marketing Officer since 2022

Degree in Engineering from Ecole Centrale de Paris, MBA from New York University Stern School of Business

Robert M. Davis profile image

Robert M. Davis

Merck Sharp & Dohme LLC

Chief Executive Officer since 2021

JD from Northwestern University Pritzker School of Law, MBA from Northwestern University Kellogg Graduate School of Management, Bachelor's in Finance from Miami University

Citations

Efficacy and safety of pembrolizumab in advanced gastric and ...Pembrolizumab combined with chemotherapy improves survival and response rates with a manageable safety profile in advanced gastric and GEJ cancers.
Merck's KEYTRUDA® (pembrolizumab) Plus ...After a median follow-up of 31.0 months (range, 15.3-46.3 months), KEYTRUDA in combination with chemotherapy significantly improved overall survival (OS), ...
FDA approves pembrolizumabTreatment with pembrolizumab and chemotherapy resulted in a statistically significant improvement in OS, PFS, and ORR. Median OS was 12.9 months ...
Efficacy and Safety of Pembrolizumab or ...In cohort 1 of the phase 2 KEYNOTE-059 study, pembrolizumab provided an objective response rate (ORR) of 15.5% in patients with advanced G/GEJ ...
Safety and Efficacy of Pembrolizumab (MK-3475) in ...The purpose of this study is to estimate objective response rates (ORRs) of pembrolizumab + oxaliplatin + TS-1 and pembrolizumab + cisplatin + TS-1, ...
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/40087572/
Efficacy and safety of pembrolizumab in advanced gastric ...Results: Pembrolizumab combined with chemotherapy significantly improved OS (MD = 1.92 months; 95% CI: 0.94 to 2.91) and ORR (MD = 11.05%; 95% ...
Efficacy and safety of pembrolizumab in advanced gastric and ...Pembrolizumab combined with chemotherapy improves survival and response rates with a manageable safety profile in advanced gastric and GEJ cancers.
KEYNOTE-859: a Phase III study of pembrolizumab plus ...Combining pembrolizumab with chemotherapy has demonstrated efficacy and manageable safety in multiple tumor types, including gastric cancer [13,15–17]. Based on ...
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