OS Study of Pembrolizumab (MK-3475) vs. SOC in Treatment Naïve Subjects with PD-L1 Positive Advanced or Metastatic NSCLC (Keynote 042)

• Register: EUCTR
• Last refreshed on: 4 January 2022
• Main ID: EUCTR2014-001473-14-LT
• Date of registration: 06/08/2014
• Prospective Registration: Yes
• Primary sponsor: Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
• Public title: OS Study of Pembrolizumab (MK-3475) vs. SOC in Treatment Naïve Subjects with PD-L1 Positive Advanced or Metastatic NSCLC (Keynote 042)
• Scientific title: A Randomized, Open Label, Phase III Study of Overall Survival Comparing Pembrolizumab (MK-3475) versus Platinum Based Chemotherapy in Treatment Naïve Subjects with PD-L1 Positive Advanced or Metastatic Non-Small Cell Lung Cancer (Keynote 042) - OS study of Pembrolizumab vs. SOC in 1L subjects with PD-L1 Positive Advanced or Metastatic NSCLC
• Date of first enrolment: 30/09/2014
• Target sample size: 1250
• Recruitment status: Not Recruiting
• URL: https://www.clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2014-001473-14
• Study type: Interventional clinical trial of medicinal product
• Study design: Controlled: yes; Randomised: yes; Open: yes; Single blind: no; Double blind: no; Parallel group: no; Cross over: no; Other: no; If controlled, specify comparator, Other Medicinial Product: yes; Placebo: no; Other: no; Number of treatment arms in the trial: 2
• Phase: Human pharmacology (Phase I): no Therapeutic exploratory (Phase II): no Therapeutic confirmatory - (Phase III): yes Therapeutic use (Phase IV): no

Countries of recruitment

Argentina, Brazil, Bulgaria, Canada, Chile, China, Colombia, Czech Republic, Czechia, Estonia, Guatemala, Hong Kong, Hungary, Japan, Korea, Republic of, Latvia, Lithuania, Malaysia, Mexico, Peru, Philippines, Poland, Portugal, Romania, Russian Federation, South Africa, Sweden, Switzerland, Taiwan, Thailand, Turkey, Ukraine, Vietnam

Contacts

• Name: Department of Clinical Trials
• Affiliation: JSC "Merck Sharp & Dohme"

• Name: Department of Clinical Trials
• Affiliation: JSC "Merck Sharp & Dohme"

Key inclusion & exclusion criteria

Inclusion criteria:
•Have measurable disease based on RECIST 1.1. as determined by the site.
•Be =18 years of age on the day of signing informed consent.
•Have a life expectancy of at least 3 months.
•Have not received prior systemic chemotherapy treatment for their advanced/metastatic NSCLC. Treatment with chemotherapy and/or radiation as part of neoadjuvant/adjuvant therapy is allowed as long as therapy was completed at least 6 months prior to the diagnosis of advanced or metastatic disease.
•Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Status
•Have adequate organ function.
•Have no history of prior malignancy, with the exception of basal cell carcinoma of the skin, superficial bladder cancer, squamous cell carcinoma of the skin, or in situ cervical cancer, or have undergone potentially curative therapy with no evidence of that disease recurrence for 5 years since initiation of that therapy.
•Have provided formalin fixed tumor tissue sample from a biopsy of a tumor lesion either at the time of or after the diagnosis of advanced or metastatic disease has been made AND from a site not previously irradiated to assess for PD-L1 status. Biopsies obtained PRIOR to the administration of any systemic therapy administered for the treatment of a subject’s tumor (such as adjuvant therapy) will not permitted for analysis. The tissue sample must be received by the central vendor prior to randomization. Fine needle aspirates are not acceptable. Core needle or excisional biopsies, or resected tissue is required.
•Have a histologically or cytologically confirmed diagnosis of advanced or metastatic, NSCLC and not have an EGFR sensitizing (activating) mutation or an ALK translocation. EGFR sensitizing mutations are those mutations that are amenable to treatment with TKIs including erlotinib, gefitinib or afatanib. Investigators must be able to produce the source documentation of the EGFR mutation and ALK translocation in all subjects with non-squamous histologies AND for subjects in whom testing is clinically recommended. If either an EGFR sensitizing mutation or ALK translocation is detected, additional information regarding the mutation status of the other molecule is not required. If documentation is unavailable or the site is unable to test for these molecular changes, formalin fixed paraffin embedded tumor tissue of any age should be submitted to a central laboratory designated by the Sponsor for such testing. Subjects with non-squamous histologies will not be randomized until EGFR mutation status and/or ALK translocation status is available in source documentation at the site.
Have a PD-L1 positive tumor (TPS=1%) as determined by IHC at a central laboratory; only PD-L1 positive (TPS=1%)subjects will be randomized. If the tumor specimen is not evaluable for PD-L1 expression by the central laboratory, the subject is not eligible to participate in the study.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 625
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 625

Exclusion criteria:
Has an EGFR sensitizing mutation and/or ALK translocation. For patients enrolled who are known to have a tumor of predominantly squamous histology, molecular testing for EGFR mutation and ALK translocation will not be required as this is not standard of care and is not part of current diagnostic guidelines.
•Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of trial treatment.
•Tumor specimen is not evaluable for PD-L1 expression by the central laboratory. If an additional tumor specimen is submitted AND evaluable for PD-L1 expression, the subject will be eligible to participate if PD-L1 expression is assessed as positive (TPS=1%) by the central laboratory.
•Subjects with squamous histology who received carboplatin in combination with paclitaxel in the adjuvant setting.
•Is receiving systemic steroid therapy < 3 days prior to the first dose of trial treatment or receiving any other form of immunosuppressive medication.
a. Corticosteroid use on study after Cycle 1 for management of AEs, SAEs and ECIs, as a pre-medication for the control chemotherapies, as a pre-medication for IV contrast allergies/reactions or if considered necessary for a subject’s welfare is allowed.
b. Subjects who receive daily steroid replacement therapy serve as an exception to this rule. Daily prednisone at doses of 5-7.5 mg is an example of replacement therapy.
c. Equivalent hydrocortisone doses are also permitted if administered as a replacement therapy.
•The subject’s NSCLC can be treated with curative intent with either surgical resection and/or chemoradiation
•Is expected to require any other form of systemic or localized antineoplastic therapy while on trial (including maintenance therapy with another agent for NSCLC, radiation therapy, and/or surgical resection).
•Has received any prior systemic cytotoxic chemotherapy, biological therapy OR had major surgery within 3 weeks of the first dose of trial treatment; received lung radiation therapy of > 30 Gy within 6 months of the first dose of trial treatment.
•Has received prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody (including ipilimumab or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways).
•Has known central nervous system metastases and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate provided they are clinically stable (neurologically asymptomatic) and have no evidence of new or enlarging brain metastasis by imaging at least 4 weeks after treatment of the brain metastases (e.g. surgery, RT) and are off steroids for at least 3 days prior to the first dose of study medication.
•Has active autoimmune disease, that has required systemic treatment in past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (i.e., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. Subjects that require inhaled corticosteroids would not be excluded from the study. Subjects with vitiligo or resolved childhood asthma/atopy would not be excluded from the study. Subjects that require local steroid in

Age minimum:
Age maximum:
Gender:
Female: yes
Male: yes

Health Condition(s) or Problem(s) studied

Therapeutic area: Diseases [C] - Cancer [C04]

Non-Small Cell Lung Carcinoma
MedDRA version: 21.1 Level: PT Classification code 10061873 Term: Non-small cell lung cancer System Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)

Intervention(s)

Product Name: MK-3475; SCH900475; pembrolizumab
Product Code: MK-3475; SCH900475
Pharmaceutical Form: Solution for infusion
INN or Proposed INN: pembrolizumab
CAS Number: 1374853-91-4
Current Sponsor code: MK-3475
Other descriptive name: Anti-PD-1 monoclonal antibody
Concentration unit: mg/ml milligram(s)/millilitre
Concentration type: equal
Concentration number: 25-

Trade Name: ALIMTA
Product Name: pemetrexed
Pharmaceutical Form: Powder for concentrate for solution for infusion
INN or Proposed INN: PEMETREXED
CAS Number: 137281-23-3
Other descriptive name: Alimta
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 500-

Trade Name: Paclitaxel 6mg/ml Concentrate For Solution For Infusion
Product Name: paclitaxel
Pharmaceutical Form: Concentrate for solution for infusion
INN or Proposed INN: PACLITAXEL
CAS Number: 33069-62-4
Other descriptive name: Abraxane, Taxol
Concentration unit: mg/ml milligram(s)/millilitre
Concentration type: equal
Concentration number: 6-

Trade Name: Carboplatin 10mg/mL concentrate for infusion for solution
Product Name: carboplatin
Pharmaceutical Form: Concentrate for solution for infusion
INN or Proposed INN: carboplatin
CAS Number: 41575-94-4
Other descriptive name: cis-Diammine(1,1-cyclobutanedicarboxylato)platinum(II)
Concentration unit: mg/ml milligram(s)/millilitre
Concentration type: equal
Concentration number: 10-

Trade Name: Paclitaxel 6mg/ml Concentrate For Solution For Infusion
Product Name: paclitaxel
Pharmaceutical Form: Concentrate for solution for infusion
INN or Proposed INN: PACLITAXEL
CAS Number: 33069-62-4
Other descriptive name: Abraxane, Taxol
Concentration unit: mg/ml milligram(s)/millilitre
Concentration type: equal
Concentration number: 6-

Trade Name: Carboplatin 10mg/mL concentrate fo

Primary Outcome(s)

Primary end point(s): Overall Survival

Timepoint(s) of evaluation of this end point: - At interim analysis 1, when approximately 250 deaths have ocurred in both arms and at least 6 months after the last patient is enrolled
- At interim analysis 2, which will conducted approximately 38 months after enrollment completion (February 2018)
- final OS analysis will be conducted approximately 45 months (September 2018) after enrollment completion.

Main Objective: 1) To compare the overall survival (OS) in subjects with TPS=50%, 1L
advanced/metastatic NSCLC treated with pembrolizumab compared to standard of care
(SOC) chemotherapies.
2) To compare the OS in subjects with TPS=20%, 1L advanced/metastatic
NSCLC treated with pembrolizumab compared to standard of care (SOC)
chemotherapies.
3) To compare the OS in subjects with TPS=1%, 1L advanced/metastatic
NSCLC treated with pembrolizumab compared to SOC chemotherapies.

Secondary Objective: 1) To compare the progression-free survival (PFS) by RECIST 1.1 as assessed by central independent radiologists’ review in subjects with TPS=50%, 1L advanced / metastatic NSCLC treated with pembrolizumab compared to SOC
chemotherapy.
2) To compare the PFS by RECIST 1.1 as assessed by central independent
radiologists’ review in subjects with TPS=20%, 1L advanced/metastatic NSCLC treated
with pembrolizumab compared to SOC chemotherapy.
3) To compare the PFS as assessed by RECIST 1.1 by central independent
radiologists’ review in subjects with TPS=1%, 1L advanced/metastatic NSCLC treated
with pembrolizumab compared to SOC chemotherapy.
4) To evaluate the ORR by RECIST 1.1 by central independent radiologists’
review in subjects with TPS=50%, 1L advanced/metastatic NSCLC treated with
pembrolizumab compared to SOC chemotherapy

Secondary Outcome(s)

Secondary end point(s): Progression-Free Survival

Timepoint(s) of evaluation of this end point: - At interim analysis 1, when approximately 250 deaths have ocurred in both arms and at least 6 months after the last patient is enrolled
- At interim analysis 2, which will conducted approximately 38 months after enrollment completion (February 2018)
- final OS analysis will be conducted approximately 45 months (September 2018) after enrollment completion.

Secondary ID(s)

2014-001473-14-SE

MK-3475-042

Source(s) of Monetary Support

Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.

Ethics review

Status: Approved
Approval date: 11/09/2014
Contact: