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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/show/NCT03675737




Registration number
NCT03675737
Ethics application status
Date submitted
17/09/2018
Date registered
18/09/2018
Date last updated
7/07/2020

Titles & IDs
Public title
Pembrolizumab (MK-3475) Plus Chemotherapy Versus Placebo Plus Chemotherapy in Participants Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma (MK-3475-859/KEYNOTE-859)
Scientific title
A Phase 3, Randomized, Double-blind Clinical Study of Pembrolizumab (MK-3475) Plus Chemotherapy Versus Placebo Plus Chemotherapy as First-line Treatment in Participants With HER2 Negative, Previously Untreated, Unresectable or Metastatic Gastric Orgastroesophageal Junction Adenocarcinoma (KEYNOTE-859)
Secondary ID [1] 0 0
2018-001757-27
Secondary ID [2] 0 0
3475-859
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Stomach Neoplasms 0 0
Condition category
Condition code
Cancer 0 0 0 0
Stomach

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Pembrolizumab
Treatment: Drugs - Cisplatin
Treatment: Drugs - 5-fluorouracil
Treatment: Drugs - oxaliplatin
Treatment: Drugs - capecitabine
Treatment: Drugs - Placebo for Pembrolizumab

Experimental: Pembrolizumab + FP or CAPOX - Participants receive pembrolizumab 200 mg intravenously (IV) on Day 1 of each 21-day cycle (Q3W) for up to 35 cycles (approximately 2 years) + physicians' choice of either cisplatin 80 mg/m^2 IV on Day 1 Q3W and 5-fluorouracil (5FU) 800 mg/m^2/day via continuous IV infusion on Days 1 to 5 Q3W OR oxaliplatin 130 mg/m^2 IV on Day 1 Q3W + capecitabine 1000 mg/m^2 orally twice a day (BID) on Days 1 to 14 Q3W. Participants who complete 35 administrations or achieve a complete response (CR) but progress after discontinuation can initiate a second course of pembrolizumab for up to 17 cycles (approximately 1 additional year).

Active Comparator: Placebo + FP or CAPOX - Participants receive placebo for pembrolizumab IV on Day 1 Q3W for up to 35 cycles (approximately 2 years) + physicians' choice of either cisplatin 80 mg/m^2 IV on Day 1 Q3W and 5FU 800 mg/m^2/day via continuous IV infusion on Days 1 to 5 Q3W OR oxaliplatin 130 mg/m^2 IV on Day 1 Q3W + capecitabine 1000 mg/m^2 orally BID on Days 1 to 14 Q3W.


Treatment: Drugs: Pembrolizumab
Administered as an IV infusion on Day 1 Q3W

Treatment: Drugs: Cisplatin
Administered as an IV infusion on Day 1 Q3W

Treatment: Drugs: 5-fluorouracil
Administered as a continuous IV infusion on Days 1-5 Q3W

Treatment: Drugs: oxaliplatin
Administered as an IV infusion on Day 1 Q3W

Treatment: Drugs: capecitabine
Administered orally BID on Days 1 to 14 Q3W

Treatment: Drugs: Placebo for Pembrolizumab
Administered as an IV infusion on Day 1 Q3W

Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Overall Survival (OS) - OS is the time from randomization to death due to any cause.
Timepoint [1] 0 0
Up to approximately 54 months
Primary outcome [2] 0 0
Progression-free Survival (PFS) - PFS is defined as the time from randomization to the first documented disease progression or death due to any cause, whichever occurs first. Responses are according to the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by blinded independent central review (BICR).
Timepoint [2] 0 0
Up to approximately 54 months
Secondary outcome [1] 0 0
Objective Response Rate (ORR) - ORR was defined as the percentage of participants who have a confirmed complete response (CR: disappearance of all target lesions) or partial response (PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters) per RECIST 1.1 as assessed by BICR.
Timepoint [1] 0 0
Up to approximately 54 months
Secondary outcome [2] 0 0
Duration of Response (DOR) - DOR is determined by disease assessment and is defined as the time from first response (CR or PR) to disease progression, or death from any cause, whichever occurs first.
Timepoint [2] 0 0
Up to approximately 54 months
Secondary outcome [3] 0 0
Percentage of Participants Experiencing Adverse Events (AEs) - Percentage of participants experiencing an AE defined as any unfavorable and unintended sign, symptom, disease, or worsening of preexisting condition temporally associated with study therapy and irrespective of causality to study treatment
Timepoint [3] 0 0
Up to approximately 54 months
Secondary outcome [4] 0 0
Percentage of Participants Discontinuing Study Drug Due to AEs - Percentage of participants discontinuing study treatment due to an AE
Timepoint [4] 0 0
Up to approximately 54 months

Eligibility
Key inclusion criteria
Inclusion Criteria

- Has histologically or cytologically confirmed diagnosis of locally advanced
unresectable or metastatic gastric or GEJ adenocarcinoma with known programmed cell
death ligand 1 (PD-L1) expression status

- Has HER2 negative cancer

- Male Participants must agree to use contraception during the treatment period and
through 180 days after the last dose of chemotherapy or through 120 days after the
last dose of pembrolizumab, whichever is greater, and must refrain from donating sperm
during this period

- Female Participants who are not pregnant, not breastfeeding, and at least one of the
following conditions applies: not a woman of childbearing potential (WOCBP) OR agrees
to use contraception during the treatment period and through 180 days after the last
dose of chemotherapy or through 120 days after the last dose of pembrolizumab,
whichever is greater

- Has measurable disease per RECIST 1.1 as assessed by investigator assessment

- Has provided archival tumor tissue sample or newly obtained core or excisional biopsy
of a tumor lesion not previously irradiated

- Has provided tumor tissue sample deemed adequate for PD-L1 biomarker analysis

- Has provided tumor tissue sample for microsatellite instability (MSI) biomarker
analysis

- Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 within 3
days prior to the start of study intervention

- Has adequate organ function as demonstrated by laboratory testing within 10 days prior
to the start of study treatment
Minimum age
18 Years
Maximum age
No limit
Gender
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Exclusion Criteria

- Has squamous cell or undifferentiated gastric cancer

- Has had major surgery, open biopsy, or significant traumatic injury within 28 days
prior to randomization, anticipation of the need for major surgery during the course
of study intervention, or has not recovered adequately from the toxicity and/or
complications from previous surgery

- Has pre-existing peripheral neuropathy >Grade 1

- Is a WOCBP who has a positive urine pregnancy test within 72 hours prior to
randomization or treatment allocation

- Has had previous therapy for locally advanced, unresectable or metastatic gastric/GEJ
cancer. Participants may have received prior neoadjuvant and/or adjuvant therapy as
long as it was completed =6 months prior to randomization

- Has received prior therapy with an anti-PD-1, anti-PD-L1 or anti- PD-L2 agent or with
an agent directed to another stimulatory or co-inhibitory T-cell receptor (e.g.,
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 or has not recovered from all AEs due to any previous
therapies to =Grade 1 or baseline

- Has received prior radiotherapy within 2 weeks prior to study start or has not
recovered from all previous radiation-related toxicities, required corticosteroids,
and have not had radiation pneumonitis. A 1-week washout is permitted for palliative
radiation (=2 weeks of radiotherapy) to non-central nervous system (CNS) disease

- Has received a live vaccine within 30 days prior to the first dose of study treatment

- 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 the first dose of
study treatment

- Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy
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 5 years with the exception of basal cell carcinoma of the skin,
squamous cell carcinoma of the skin, or carcinoma in situ (eg, breast carcinoma,
cervical cancer in situ) that have undergone potentially curative therapy

- Has known active CNS metastases and/or carcinomatous meningitis

- Has severe hypersensitivity (=Grade 3) 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 that required steroids or has current
pneumonitis

- Has an active infection requiring systemic therapy

- Has a known history of human immunodeficiency virus (HIV) infection

- Has a known history of Hepatitis B (defined as Hepatitis B surface antigen [HBsAg]
reactive) or known active Hepatitis C virus (defined as Hepatitis C virus [HCV]
ribonucleic acid [RNA] detected qualitatively) infection

- Has a known history of active tuberculosis

- Has hypokalemia (serum potassium less than the lower limit of normal)

- Has hypomagnesemia (serum magnesium less than the lower limit of normal)

- Has hypocalcemia (serum calcium less than the lower limit of normal)

- Has a history or current evidence of any condition (eg, known deficiency of the enzyme
dihydropyrimidine dehydrogenase), therapy, or laboratory abnormality that might
confound the results of the study, interfere with the participant's participation for
the full duration of the study, or is not in the best interest of the participant to
participate, in the opinion of the treating investigator

- Has a known psychiatric or substance abuse disorder that would interfere with the
participant's ability to cooperate with the requirements of the study

- Is pregnant or breastfeeding or expecting to conceive or father children within the
projected duration of the study, starting with the screening visit through 180 days
after the last dose of chemotherapy or through 120 days after the last dose of
pembrolizumab, whichever is greater

- Has had an allogenic tissue/solid organ transplant

- Has a known severe hypersensitivity (= Grade 3) to any of the study chemotherapy
agents (including, but not limited to, infusional 5-fluorouracil or oral capecitabine)
and/or to any of their excipients

- For participants taking Cisplatin: has Grade =2 audiometric hearing loss

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s


The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint(s)
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW,VIC
Recruitment hospital [1] 0 0
Liverpool Hospital ( Site 2301) - Liverpool
Recruitment hospital [2] 0 0
Southern Medical Day Care Centre ( Site 2303) - Wollongong
Recruitment hospital [3] 0 0
Box Hill Hospital ( Site 2300) - Box Hill
Recruitment postcode(s) [1] 0 0
2170 - Liverpool
Recruitment postcode(s) [2] 0 0
2500 - Wollongong
Recruitment postcode(s) [3] 0 0
3128 - Box Hill
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
California
Country [2] 0 0
United States of America
State/province [2] 0 0
Florida
Country [3] 0 0
United States of America
State/province [3] 0 0
Maryland
Country [4] 0 0
United States of America
State/province [4] 0 0
Minnesota
Country [5] 0 0
United States of America
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New York
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United States of America
State/province [6] 0 0
Pennsylvania
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United States of America
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Virginia
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United States of America
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Washington
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Brazil
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Ceara
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Brazil
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Rio Grande Do Sul
Country [11] 0 0
Brazil
State/province [11] 0 0
Rio de Janeiro
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Brazil
State/province [12] 0 0
Sao Paulo
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Canada
State/province [13] 0 0
British Columbia
Country [14] 0 0
Canada
State/province [14] 0 0
Ontario
Country [15] 0 0
Canada
State/province [15] 0 0
Quebec
Country [16] 0 0
Chile
State/province [16] 0 0
Araucania
Country [17] 0 0
Chile
State/province [17] 0 0
Region Metropolitana De Santiago
Country [18] 0 0
China
State/province [18] 0 0
Beijing
Country [19] 0 0
China
State/province [19] 0 0
Fujian
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China
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Guangdong
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China
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Heilongjiang
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China
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Henan
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China
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Hubei
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China
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Hunan
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China
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Jiangsu
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China
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Jilin
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China
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Shandong
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China
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Shanghai
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China
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Shanxi
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China
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Xinjiang
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China
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Zhejiang
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Colombia
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Cesar
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Colombia
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Cordoba
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Colombia
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Distrito Capital De Bogota
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Colombia
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Valle Del Cauca
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Doubs
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Finistere
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Paris
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HaDarom
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HaMerkaz
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Tell Abib
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Ciudad de Mexico
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Mexico
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Mexico City
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New Zealand
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Auckland
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Peru
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Lima
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Poland
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Dolnoslaskie
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Malopolskie
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Mazowieckie
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Wielkopolskie
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Grudziadz
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Russian Federation
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Chelyabinskaya Oblast
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Russian Federation
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Moskva
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Russian Federation
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Samarskaya Oblast'
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Russian Federation
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Sankt-Peterburg
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South Africa
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Eastern Cape
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South Africa
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Free State
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South Africa
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Gauteng
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South Africa
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Kwazulu-Natal
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South Africa
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Western Cape
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Spain
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Asturias
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Spain
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Barcelona [Barcelona]
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Spain
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Cantabria
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Spain
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Madrid
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Switzerland
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Basel-Stadt
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Switzerland
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Geneve
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Switzerland
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Grisons
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Switzerland
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Sankt Gallen
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Switzerland
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Ticino
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Switzerland
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Zurich
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Switzerland
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Luzern
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Taiwan
State/province [95] 0 0
Kaohsiung
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Taiwan
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Tainan
Country [97] 0 0
Taiwan
State/province [97] 0 0
Taipei
Country [98] 0 0
Turkey
State/province [98] 0 0
Adana
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Turkey
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Ankara
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Turkey
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Edirne
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Turkey
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Erzurum
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Turkey
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Istanbul
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Turkey
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Izmir
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Turkey
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Malatya
Country [105] 0 0
Turkey
State/province [105] 0 0
Sakarya
Country [106] 0 0
Ukraine
State/province [106] 0 0
Dnipropetrovska Oblast
Country [107] 0 0
Ukraine
State/province [107] 0 0
Ivano-Frankivska Oblast
Country [108] 0 0
Ukraine
State/province [108] 0 0
Kharkivska Oblast
Country [109] 0 0
Ukraine
State/province [109] 0 0
Kyivska Oblast
Country [110] 0 0
Ukraine
State/province [110] 0 0
Lvivska Oblast
Country [111] 0 0
Ukraine
State/province [111] 0 0
Odeska Oblast
Country [112] 0 0
Ukraine
State/province [112] 0 0
Zaporizka Oblast
Country [113] 0 0
United Kingdom
State/province [113] 0 0
Devon
Country [114] 0 0
United Kingdom
State/province [114] 0 0
East Riding Of Yorkshire
Country [115] 0 0
United Kingdom
State/province [115] 0 0
London, City Of

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
Merck Sharp & Dohme Corp.
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
The purpose of this study is to evaluate the efficacy of pembrolizumab (MK-3745) in
combination with chemotherapy (Cisplatin combined with 5-Fluorouracil [FP regimen] or
oxaliplatin combined with capecitabine [CAPOX regimen]) versus placebo in combination with
chemotherapy (FP or CAPOX regimens) in the treatment of human epidermal growth factor
receptor 2 (HER2) negative advanced gastric or GEJ adenocarcinoma in adult participants.

The primary hypotheses of this study are that pembrolizumab plus chemotherapy is superior to
placebo plus chemotherapy in terms of overall survival (OS), and progression-free survival
(PFS).
Trial website
https://clinicaltrials.gov/show/NCT03675737
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Medical Director
Address 0 0
Merck Sharp & Dohme Corp.
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Toll Free Number
Address 0 0
Country 0 0
Phone 0 0
1-888-577-8839
Fax 0 0
Email 0 0
Trialsites@merck.com
Contact person for scientific queries

Summary results
For IPD and results data, please see https://clinicaltrials.gov/show/NCT03675737