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NCT03875092

A Study of Carboplatin-Paclitaxel/Nab-Paclitaxel Chemotherapy With or Without Pembrolizumab (MK-3475) in Adults With First Line Metastatic Squamous Non-small Cell Lung Cancer (MK-3475-407/KEYNOTE-407)-China Extension Study

Completed Phase 3 Results posted Last updated 1 October 2024
What this trial tests

Phase 3 trial testing Pembrolizumab in Non-small Cell Lung Cancer in 125 participants. Completed in 14 September 2023.

Timeline
21 April 2017
Primary endpoint
30 September 2020
14 September 2023

Quick facts

Lead sponsorMerck Sharp & Dohme LLC
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingtriple
Primary purposetreatment
Enrollment125
Start date21 April 2017
Primary completion30 September 2020
Estimated completion14 September 2023
Sites1 location across China

Drugs / interventions tested

Conditions studied

Sponsor

Merck Sharp & Dohme LLC — full company profile →

Who can join

18 and older, any sex, with Non-small Cell Lung Cancer. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Progression-free Survival (PFS) as Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) Primary · Up to approximately 33 months

PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first. Per Response Criteria in Solid Tumors version 1.1 (RECIST 1.1), PD was defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also have demonstrated an absolute increase of ≥5 mm. Note: The appearance of ≥1 new lesions was also considered PD. PFS as assessed by blinded independent central review per RECIST 1.1 is presented. Data are from the product-limit (Kaplan-Meier) method

GroupValue95% CI
Pembrolizumab + Chemotherapy8.36.2 – 10.5
Chemotherapy4.24.0 – 5.4
Overall Survival (OS) Primary · Up to approximately 39 months

OS was defined as the time from randomization to death due to any cause. OS is presented. Data are from the product-limit (Kaplan-Meier) method for censored data.

GroupValue95% CI
Pembrolizumab + Chemotherapy30.118.2 – NA
Chemotherapy12.79.4 – 17.3
Objective Response Rate (ORR) as Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) Secondary · Up to approximately 33 months

ORR was defined as the percentage of participants in the analysis population who had a Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) as assessed by RECIST 1.1. ORR as assessed by blinded independent central review per RECIST 1.1 is presented.

GroupValue95% CI
Pembrolizumab + Chemotherapy80.068.2 – 88.9
Chemotherapy43.330.6 – 56.8
Duration of Response (DOR) as Assessed by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) Secondary · Up to approximately 30 months

For participants who demonstrated a confirmed response (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) per RECIST 1.1, DOR was defined as the time from first documented evidence of CR or PR until disease progression as assessed by RECIST 1.1 or death. DOR as assessed by blinded independent central review per RECIST 1.1 is presented.

GroupValue95% CI
Pembrolizumab + Chemotherapy7.14.9 – 14.4
Chemotherapy3.52.8 – 4.9
Number of Participants Who Experienced an Adverse Event (AE) Secondary · Up to approximately 31 months

An AE was defined as any untoward medical occurrence in a participant administered study treatment and which did not necessarily have to have a causal relationship with this treatment. The number of participants who experienced an AE is presented. Data are from the product-limit (Kaplan-Meier) method for censored data.

GroupValue95% CI
Pembrolizumab + Chemotherapy65
Chemotherapy60
Number of Participants Who Discontinued Study Treatment Due to an Adverse Event (AE) Secondary · Up to approximately 29 months

The number of participants who discontinued study treatment due to an AE is presented.

GroupValue95% CI
Pembrolizumab + Chemotherapy8
Chemotherapy4

Adverse events — posted to ClinicalTrials.gov

Time frame: All-Cause mortality: Up to 1948 days Adverse events: Up to 1625 days. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Pembrolizumab + Chemotherapy
Serious: 35/65 (54%)
Deaths: 41/65
Chemotherapy
Serious: 22/60 (37%)
Deaths: 22/60
Chemotherapy > Pembrolizumab Switch Over
Serious: 10/38 (26%)
Deaths: 34/38
Pembrolizumab > Pembrolizumab Second Course
Serious: 0/6 (0%)
Deaths: 5/6

Serious adverse events (56 terms)

ReactionSystemPembrolizumab + ChemotherapyChemotherapyChemotherapy > Pembrolizum…Pembrolizumab > Pembrolizu…
PneumoniaInfections and infestations
NeutropeniaBlood and lymphatic system disorders
ThrombocytopeniaBlood and lymphatic system disorders
Febrile neutropeniaBlood and lymphatic system disorders
LeukopeniaBlood and lymphatic system disorders
PyrexiaGeneral disorders
Upper respiratory tract infectionInfections and infestations
Neutrophil count decreasedInvestigations
Diabetic ketoacidosisMetabolism and nutrition disorders
HaemoptysisRespiratory, thoracic and mediastinal disorders
Angina unstableCardiac disorders
Coronary artery diseaseCardiac disorders
Myocardial infarctionCardiac disorders
Tracheo-oesophageal fistulaCongenital, familial and genetic disorders
HypothyroidismEndocrine disorders
ColitisGastrointestinal disorders
DiarrhoeaGastrointestinal disorders
GastritisGastrointestinal disorders
Gastrointestinal perforationGastrointestinal disorders
Intestinal obstructionGastrointestinal disorders
Lower gastrointestinal haemorrhageGastrointestinal disorders
Chest painGeneral disorders
MalaiseGeneral disorders
Autoimmune hepatitisHepatobiliary disorders
Bile duct stoneHepatobiliary disorders
Other adverse events (78 terms — click to expand)

ReactionSystemPembrolizumab + ChemotherapyChemotherapyChemotherapy > Pembrolizum…Pembrolizumab > Pembrolizu…
White blood cell count decreasedInvestigations
AlopeciaSkin and subcutaneous tissue disorders
Neutrophil count decreasedInvestigations
AnaemiaBlood and lymphatic system disorders
HypoaesthesiaNervous system disorders
Decreased appetiteMetabolism and nutrition disorders
NauseaGastrointestinal disorders
Alanine aminotransferase increasedInvestigations
ArthralgiaMusculoskeletal and connective tissue disorders
Platelet count decreasedInvestigations
Aspartate aminotransferase increasedInvestigations
ConstipationGastrointestinal disorders
HypokalaemiaMetabolism and nutrition disorders
RashSkin and subcutaneous tissue disorders
VomitingGastrointestinal disorders
Pain in extremityMusculoskeletal and connective tissue disorders
HyperglycaemiaMetabolism and nutrition disorders
HypoalbuminaemiaMetabolism and nutrition disorders
MyalgiaMusculoskeletal and connective tissue disorders
LeukopeniaBlood and lymphatic system disorders
HyperthyroidismEndocrine disorders
PyrexiaGeneral disorders
HaemoptysisRespiratory, thoracic and mediastinal disorders
DiarrhoeaGastrointestinal disorders
Gamma-glutamyltransferase increasedInvestigations
Weight decreasedInvestigations
HiccupsRespiratory, thoracic and mediastinal disorders
AstheniaGeneral disorders
HyperuricaemiaMetabolism and nutrition disorders
HyponatraemiaMetabolism and nutrition disorders
InsomniaPsychiatric disorders
Chest painGeneral disorders
Upper respiratory tract infectionInfections and infestations
CoughRespiratory, thoracic and mediastinal disorders
HypothyroidismEndocrine disorders
MalaiseGeneral disorders
Weight increasedInvestigations
Neuropathy peripheralNervous system disorders
PneumoniaInfections and infestations
Blood alkaline phosphatase increasedInvestigations

Most-reported serious reactions: Pneumonia, Neutropenia, Thrombocytopenia, Febrile neutropenia, Leukopenia, Pyrexia, Upper respiratory tract infection, Neutrophil count decreased.

Data from ClinicalTrials.gov NCT03875092 adverse events section.

Sponsor's own description

In this China extension study, carboplatin and paclitaxel with or without pembrolizumab (MK-3475, KEYTRUDA®) will be administered to Chinese adults with first line metastatic squamous non-small cell lung cancer (NSCLC). The primary hypotheses are that treatment with pembrolizumab prolongs: 1) Progression-free Survival (PFS) by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by a blinded central imaging vendor compared to placebo, and 2) Overall Survival (OS) in Chinese participants. After analysis of interim results was conducted, the protocol was amended (Amendment 5) to allow participants the option to discontinue placebo in the control arm and to switch to pembrolizumab in the event of documented progressive disease as assessed by central review.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Overcoming acquired resistance to cancer immune checkpoint therapy: potential strategies based on molecular mechanisms.
    Wang B, Han Y, Zhang Y, Zhao Q, et al · · 2023 · cited 57× · PMID 37386520 · DOI 10.1186/s13578-023-01073-9
  2. Immunogenicity of cell death and cancer immunotherapy with immune checkpoint inhibitors.
    Catanzaro E, Beltrán-Visiedo M, Galluzzi L, Krysko DV. · · 2025 · cited 53× · PMID 39653769 · DOI 10.1038/s41423-024-01245-8
  3. The evolving immuno-oncology landscape in advanced lung cancer: first-line treatment of non-small cell lung cancer.
    Low JL, Walsh RJ, Ang Y, Chan G, et al · · 2019 · cited 45× · PMID 31497071 · DOI 10.1177/1758835919870360
  4. Nanoparticles advanced from preclinical studies to clinical trials for lung cancer therapy.
    Liu Y, Cheng W, Xin H, Liu R, et al · · 2023 · cited 42× · PMID 37009262 · DOI 10.1186/s12645-023-00174-x
  5. Pembrolizumab Plus Chemotherapy for Metastatic NSCLC With Programmed Cell Death Ligand 1 Tumor Proportion Score Less Than 1%: Pooled Analysis of Outcomes After Five Years of Follow-Up.
    Gadgeel SM, Rodríguez-Abreu D, Halmos B, Garassino MC, et al · · 2024 · cited 35× · PMID 38642841 · DOI 10.1016/j.jtho.2024.04.011
  6. Chemotherapy-induced metastasis: molecular mechanisms and clinical therapies.
    Su JX, Li SJ, Zhou XF, Zhang ZJ, et al · · 2023 · cited 32× · PMID 37169853 · DOI 10.1038/s41401-023-01093-8
  7. Pembrolizumab Plus Chemotherapy for Chinese Patients With Metastatic Squamous NSCLC in KEYNOTE-407.
    Cheng Y, Zhang L, Hu J, Wang D, et al · · 2021 · cited 32× · PMID 34661177 · DOI 10.1016/j.jtocrr.2021.100225
  8. What is the optimal duration of immune checkpoint inhibitors in malignant tumors?
    Yin J, Song Y, Tang J, Zhang B. · · 2022 · cited 27× · PMID 36225926 · DOI 10.3389/fimmu.2022.983581

Verify or expand the search:

Other trials of Pembrolizumab

Trials testing the same drug.

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Currently open trials in the same condition.

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Trials by the same sponsor.

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