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NCT06731907PHASE2Recruiting

A Study of Pembrolizumab With or Without Chemotherapy in Combination With Additional Treatments for Advanced Non-Small Cell Lung Cancer (NSCLC) (MK-3475-01G/KEYMAKER U01)

Merck Sharp & Dohme LLC

Start Date

3/30/2025

Completion Date

3/12/2032

Summary

Researchers are investigating new treatments for untreated advanced non-small cell lung cancer (NSCLC), which is the most common form of lung cancer and lung cancer that has spread beyond surgical removal. Standard treatments include immunotherapy, such as pembrolizumab, and chemotherapy. This study aims to determine the effectiveness of adding other treatments, including the human epidermal growth factor receptor 3-directed antibody-drug conjugate (HER3-DXd) patritumab deruxtecan, to pembrolizumab, with or without chemotherapy. The primary goals are to assess safety and efficacy of the treatments.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: The main inclusion criteria include but are not limited to the following: * Histologically or cytologically confirmed diagnosis of Stage IV squamous or non-squamous non-small cell lung cancer (NSCLC) per American Joint Committee on Cancer (AJCC) Staging Manual Version 8. * Has an Eastern Cooperative Oncology Group (ECOG) performance status of either 0 or 1 as assessed within 7 days before randomization. * Has archival tumor tissue sample or newly obtained core, incisional, or excisional biopsy of a tumor lesion not previously irradiated has been provided. * Human immunodeficiency virus (HIV)-infected participants must have well controlled HIV on ART. * Participants who are hepatitis B surface antigen (HBsAg) positive are eligible if they have received hepatitis B virus (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV viral load prior to treatment randomization. Exclusion Criteria: The main exclusion criteria include but are not limited to the following: * Has a diagnosis of small cell lung cancer or, for mixed tumors, presence of small cell elements. * Participants with squamous histology are excluded if there is a known tumor-activating epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) or c ros oncogene 1 (ROS1) gene rearrangement. * Is HIV-infected with a history of Kaposi's sarcoma and/or Multicentric Castleman's Disease * Clinically severe pulmonary compromise resulting from intercurrent pulmonary illnesses including, but not limited to, any underlying pulmonary disorder, or any autoimmune, connective tissue, or inflammatory disorders with pulmonary involvement. * Has evidence of any leptomeningeal disease. * Has known history of, or active, neurologic paraneoplastic syndrome. * Has clinically significant corneal disease. * Has myocardial infarction within 6 months. * Has New York Heart Association (NYHA) Classes 3 or 4 congestive heart failure. * Has uncontrolled angina pectoris within 6 months. * Has cardiac arrhythmia requiring ongoing antiarrhythmic treatment. * Has history of clinically relevant ventricular arrhythmias, such as ventricular tachycardia, ventricular fibrillation, or Torsade de Pointes. * Has bradycardia of less than 50 beats per minute (bpm) unless the participant has a pacemaker. * Has history of second- or third-degree heart block. Candidates with a history of heart block may be eligible if they currently have pacemakers and have no history of fainting or clinically relevant arrhythmia with pacemakers. * Has coronary/peripheral artery bypass graft within 6 months. * Has complete left bundle branch block. * Has inadequate washout period from prior concomitant therapy as specified in protocol before randomization. * Has received prior treatment with a topoisomerase I inhibitor or an anti-HER3 antibody and/or ADC that consists of an exatecan derivative that is a topoisomerase I inhibitor. * Has received prior systemic anticancer therapy for their metastatic NSCLC. * Has received prior therapy with an anti- programmed cell death 1 protein (anti-PD-1), anti- programmed cell death ligand 1 protein (anti-PD-L1), or anti- programmed cell death ligand 2 protein (anti-PD-L2) agent, or with an agent directed to another stimulatory or coinhibitory T-cell receptor. * Has received prior radiotherapy within 2 weeks of randomization, has radiation related toxicity requiring corticosteroids, or has had radiation pneumonitis. * Has received radiation therapy to the lung that is \>30 gray within 6 months of start of study intervention. * Has received a live or live-attenuated vaccine within 30 days before the first dose of study intervention. * Has 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 intervention. * Has known additional malignancy that is progressing or has required active treatment within the past 3 years. * Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. * Has severe hypersensitivity to any of the study interventions and/or any of their excipients. * Has active autoimmune disease that has required systemic treatment in the past 2 years. * Has active infection requiring systemic therapy. * Has concurrent active Hepatitis B and Hepatitis C virus infection. * Have not adequately recovered from major surgery or have ongoing surgical complications.

Interventions

BIOLOGICAL

Pembrolizumab

DRUG

Carboplatin

DRUG

Paclitaxel

DRUG

Nab-paclitaxel

DRUG

Pemetrexed

BIOLOGICAL

HER3-DXd

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Conditions

Non-small Cell Lung Cancer

Locations

University of Kentucky ( Site 0019)

Lexington, Kentucky 40536

United States

MedStar Franklin Square Medical Center ( Site 0033)

Baltimore, Maryland 21237

United States

Sanford Fargo Medical Center ( Site 0039)

Fargo, North Dakota 58102

United States

Abramson Cancer Center ( Site 0010)

Philadelphia, Pennsylvania 19104

United States

Sanford Cancer Center ( Site 0038)

Sioux Falls, South Dakota 57104

United States

Centro de Estudios Clínicos SAGA ( Site 0162)

Santiago, Region M. de Santiago 7500653

Chile

FALP ( Site 0161)

Santiago, Region M. de Santiago 7500921

Chile

Bradfordhill ( Site 0160)

Santiago, Region M. de Santiago 8420383

Chile

THORACIC GENERAL HOSPITAL OF ATHENS "I SOTIRIA"-3rd Dept of Internal Medicine and Laboratory, Oncol ( Site 0204)

Athens, Attica 115 27

Greece

European Interbalkan Medical Center-Oncology Department ( Site 0205)

Thessaloniki, 570 01

Greece

Petz Aladar Egyetemi Oktato Korhaz ( Site 0062)

Győr, Győr-Moson-Sopron 9024

Hungary

Jasz-Nagykun-Szolnok Varmegyei Hetenyi Geza Korhaz-Rendelointezet ( Site 0061)

Szolnok, Jász-Nagykun-Szolnok 5000

Hungary

Országos Korányi Pulmonológiai Intézet ( Site 0060)

Budapest, 1121

Hungary

Rambam Health Care Campus ( Site 0076)

Haifa, 3109601

Israel

Shaare Zedek Medical Center ( Site 0075)

Jerusalem, 9103102

Israel

Meir Medical Center ( Site 0071)

Kfar Saba, 4428164

Israel

Rabin Medical Center ( Site 0074)

Petah Tikva, 4941492

Israel

Sheba Medical Center ( Site 0070)

Ramat Gan, 5262000

Israel

Sourasky Medical Center ( Site 0077)

Tel Aviv, 6423906

Israel

Fondazione IRCCS Istituto Nazionale dei Tumori ( Site 0175)

Milan, Lombardy 20133

Italy

IRCCS Ospedale San Raffaele ( Site 0171)

Milan, 20132

Italy

Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Università Cattolica del Sacro Cuore ( Site 0174)

Roma, 00168

Italy

Wielkopolskie Centrum Pulmonologii i Torakochirurgii-Oddzial Onkologii Klinicznej z Pododdzialem Dz ( Site 0153)

Poznan, Greater Poland Voivodeship 60-569

Poland

Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - Panstwowy Instytut Badawczy w Warszawie ( Site 0151)

Warsaw, Masovian Voivodeship 02-781

Poland

Uniwersyteckie Centrum Kliniczne-Early Clinical Trials Unit ( Site 0150)

Gdansk, Pomeranian Voivodeship 80-214

Poland

Szpital Wojewódzki im. Mikoaja Kopernika w Koszalinie-Oddzial Dzienny Chemioterapii ( Site 0152)

Koszalin, West Pomeranian Voivodeship 75-581

Poland

Institut Català d'Oncologia - L'Hospitalet ( Site 0090)

L'Hospitalet de Llobregat, Barcelona 08908

Spain

HOSPITAL CLÍNIC DE BARCELONA ( Site 0092)

Barcelona, 08008

Spain

Hospital Universitario Quiron Madrid ( Site 0091)

Madrid, 28223

Spain

Changhua Christian Hospital ( Site 0181)

Changhua, 50006

Taiwan

Taipei Medical University Hospital ( Site 0180)

Taipei, 110

Taiwan

Chang Gung Medical Foundation-Linkou Branch ( Site 0182)

Taoyuan, 33305

Taiwan

Baskent University Dr. Turgut Noyan Research and Training Center ( Site 0141)

Adana, 01250

Turkey (Türkiye)

Hacettepe Universite Hastaneleri ( Site 0140)

Ankara, 06410

Turkey (Türkiye)

Ankara Bilkent Şehir Hastanesi ( Site 0142)

Ankara, 06530

Turkey (Türkiye)

CNE CC of Oncology Hematol ( Site 0130)

Cherkasy, Cherkasy Oblast 18009

Ukraine

Municipal Enterprise "Bukovinian сlinical oncology сenter" ( Site 0136)

Chernivtsi, Chernivetska Oblast 58013

Ukraine

CNCE Precarpathian Clinical Oncologic Center ( Site 0131)

Ivano-Frankivsk, Ivano-Frankivsk Oblast 76018

Ukraine

VISION PARTNER Medical Centre ( Site 0134)

Kyiv, Kyivska Oblast 03022

Ukraine

Communal Noncommercial Enterprise "Podillia Regional Oncology Center Of Vinnytsia Regional Council" ( Site 0133)

Vinnytsia, Vinnytsia Oblast 21029

Ukraine

Shalimov Institute of Surgery and Transplantation ( Site 0135)

Kyiv, 03126

Ukraine