Study of Pembrolizumab (MK-3475) Plus Chemotherapy vs Placebo Plus Chemotherapy as Neoadjuvant Therapy and Pembrolizumab vs Placebo as Adjuvant Therapy in Participants With Triple Negative Breast Cancer (TNBC) (MK-3475-522/KEYNOTE-522)
Triple Negative Breast Neoplasms
About this trial
This is an interventional treatment trial for Triple Negative Breast Neoplasms focused on measuring PD1, PD-1, PDL1, PD-L1
Eligibility Criteria
Inclusion Criteria:
- Has newly diagnosed, locally advanced, centrally confirmed TNBC, as defined by the most recent American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines.
Has previously untreated locally advanced non-metastatic (M0) TNBC defined as the following combined primary tumor (T) and regional lymph node (N) staging per current American Joint Committee of Cancer (AJCC) staging criteria for breast cancer as assessed by the investigator based on radiological and/or clinical assessment:
- T1c, N1-N2
- T2, N0-N2
- T3, N0-N2
- T4a-d, N0-N2
- Provides a core needle biopsy consisting of at least 2 separate tumor cores from the primary tumor at screening to the central laboratory.
- Has Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 performed within 10 days of treatment initiation.
- Demonstrates adequate organ function.
- Males and female participants of childbearing potential must be willing to use an adequate method of contraception for the course of the study through 12 months after the last dose of study treatment for participants who have received cyclophosphamide, and 6 months after the last dose of study treatment for participants who did not.
Exclusion Criteria:
- Has a history of invasive malignancy ≤5 years prior to signing informed consent except for adequately treated basal cell or squamous cell skin cancer or in situ cervical cancer.
- Has received prior chemotherapy, targeted therapy, and radiation therapy within the past 12 months.
- Has received prior therapy with an anti-programmed cell death protein 1 (anti-PD-1), anti-programmed death - ligand 1 (anti-PD-L1), or anti-PD-L2 agent or with an agent directed to another co-inhibitory T-cell receptor (e.g., cytotoxic T-lymphocyte-associated antigen-4 [CTLA-4], OX-40, CD137 [tumor necrosis factor receptor superfamily member 9 (TNFRSF9)]) or has previously participated in a pembrolizumab (MK-3475) clinical study.
- Is currently participating in or has participated in an interventional clinical study with an investigational compound or device within 4 weeks of the first dose of treatment in this current study.
- Has received a live vaccine within 30 days of the first dose of study treatment.
- Has an active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs).
- Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy (i.e., dosing exceeding 10 mg daily of prednisone or equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment.
- Has a known history of Human Immunodeficiency Virus (HIV).
- Has known active Hepatitis B or Hepatitis C.
- Has a history of (non-infectious) pneumonitis that required steroids or current pneumonitis.
- Has an active infection requiring systemic therapy.
- Has significant cardiovascular disease, such as: history of myocardial infarction, acute coronary syndrome or coronary angioplasty/stenting/bypass grafting within the last 6 months OR congestive heart failure (CHF) New York Heart Association (NYHA) Class II-IV or history of CHF NYHA Class III or IV.
- Is pregnant or breastfeeding, or expecting to conceive children within the projected duration of the study, starting with the screening visit through 12 months after the last dose of study treatment for participants who have received cyclophosphamide, and for 6 months after the last dose of study treatment for participants who have not.
- Has a known hypersensitivity to the components of the study treatment or its analogs.
- Has a known history of active tuberculosis (TB, Bacillus Tuberculosis).
Sites / Locations
- Virginia G. Piper Cancer Center Pharmacy - Scottsdale Healthcare ( Site 0089)
- Arizona Oncology Associates PC- HOPE ( Site 8001)
- Cedars Sinai Medical Center ( Site 0091)
- Pacific Cancer Care ( Site 0069)
- ICRI ( Site 0072)
- University of Colorado Cancer Center ( Site 0021)
- Yale University School of Medicine ( Site 0054)
- Christiana Hospital ( Site 0029)
- Univ of Miami-Sylvester Comprehensive Cancer Center- Kendall satellite ( Site 0079)
- The University of Chicago Medical Center ( Site 0047)
- North Shore University Health System ( Site 0081)
- Orchard Healthcare Research Inc. ( Site 0049)
- Goshen Center for Cancer Care ( Site 0010)
- University of Iowa Hospital and Clinics ( Site 0038)
- New England Cancer Specialists ( Site 0005)
- Henry Ford Hospital ( Site 0003)
- Minnesota Oncology Hematology, PA ( Site 8013)
- Rutgers Cancer Institute of New Jersey ( Site 0073)
- Broome Oncology, LLC ( Site 8002)
- Nyack Hospital Infusion Center ( Site 0059)
- TriHealth Cancer Institute-Good Samaritan Hospital ( Site 0044)
- Oncology Hematology Care, Inc. ( Site 8011)
- Providence Portland Medical Center ( Site 0052)
- Northwest Cancer Specialists, P.C. ( Site 8008)
- Magee - Women's Hospital ( Site 0011)
- Rhode Island Hospital ( Site 0060)
- The West Clinic, P.C. ( Site 0078)
- Texas Oncology-Austin Central ( Site 8005)
- Parkland Health and Hospital System ( Site 0093)
- Texas Oncology-Baylor Charles A. Sammons Cancer Center ( Site 8006)
- Simmons Cancer Center ( Site 0094)
- UT Southwestern Medical Center ( Site 0030)
- Moncrief Cancer Institute ( Site 0092)
- Texas Oncology-Memorial City ( Site 8003)
- Houston Methodist Cancer Center ( Site 0013)
- Texas Oncology- Plano East ( Site 8010)
- Texas Oncology-San Antonio Northeast ( Site 8012)
- Texas Oncology-Tyler ( Site 8007)
- University of Virginia ( Site 0022)
- Virginia Cancer Specialists, PC ( Site 8009)
- Bon Secours Cancer Institute Medical Oncology at St. Mary's ( Site 0033)
- Peninsula Cancer Institute, LLC ( Site 0041)
- Virginia Oncology Associates ( Site 8000)
- Kadlec Clinic Hematology and Oncology ( Site 0087)
- Seattle Cancer Care Alliance ( Site 0068)
- Medical Oncology Associates (Summit Cancer Centers) ( Site 0014)
- YVMH dba Vrigina Mason Memorial/North Star Lodge Cancer Center ( Site 8004)
- Royal North Shore Hospital ( Site 2000)
- Westmead Hospital ( Site 2002)
- Royal Adelaide Hospital ( Site 2008)
- Cabrini Health ( Site 2009)
- Frankston Hospital ( Site 2010)
- Royal Brisbane and Women s Hospital ( Site 2003)
- St John of God Subiaco Hospital ( Site 2006)
- Hospital Nossa Senhora da Conceicao ( Site 0203)
- UOPECCAN - Uniao Oeste Paranaense de Estudos e Combate ao Cancer ( Site 0206)
- Universidade de Caxias do Sul ( Site 0201)
- Hospital Erasto Gaertner ( Site 0207)
- Instituto do Cancer do Ceara ( Site 0205)
- Hospital Araujo Jorge ( Site 0204)
- Hospital Sao Lucas da PUCRS ( Site 0200)
- Fundacao Faculdade Regional de Medicina de Sao Jose do Rio Preto ( Site 0208)
- Instituto do Cancer de Sao Paulo - ICESP ( Site 0211)
- Tom Baker Cancer Centre ( Site 0105)
- The Ottawa Hospital - Cancer Care ( Site 0100)
- Princess Margaret Cancer Centre ( Site 0103)
- Centre Hospitalier de l Universite de Montreal - CHUM ( Site 0106)
- Jewish General Hospital ( Site 0101)
- CIUSSS de l'Estrie-CHUS ( Site 0102)
- CHU de Quebec Universite Laval - Hopital du Saint-Sacrement ( Site 0104)
- Oncomedica S.A. ( Site 0404)
- Oncologos del Occidente S.A. ( Site 0405)
- Hospital Universitario San Ignacio ( Site 0401)
- Instituto Nacional de Cancerologia [Bogota-Colombia] ( Site 0403)
- Hemato Oncologos S.A. ( Site 0400)
- Instituto De Cancerologia S.A. ( Site 0406)
- CHU Jean Minjoz ( Site 0917)
- Polyclinique Bordeaux Nord Aquitaine ( Site 0911)
- Centre Francois Baclesse ( Site 0907)
- Centre Jean Perrin ( Site 0903)
- Clinique Victor Hugo ( Site 0901)
- Hopital prive du Confluent ( Site 0902)
- Institut Curie ( Site 0909)
- Hopital Saint Louis ( Site 0908)
- Hopital Diaconesses Croix Saint Simon ( Site 0905)
- CHU de la Miletrie Poitiers ( Site 0913)
- Institut Claudius Regaud IUCT Oncopole ( Site 0914)
- HELIOS Klinikum Berlin-Buch ( Site 1005)
- Gynaekologisches Zentrum ( Site 1004)
- Universitaetsklinikum Erlangen ( Site 1001)
- Kliniken Essen Mitte ( Site 1012)
- Universitaetsklinik und Poliklinik Halle/Saale ( Site 1008)
- Universitaetsklinikum Hamburg-Eppendorf ( Site 1007)
- Klinikum der Universit. Muenchen ( Site 1002)
- Caritasklinik St. Theresia ( Site 1011)
- Universitaets-Frauenklinik Tuebingen ( Site 1003)
- Bon Secours Hospital ( Site 1551)
- St Vincents University Hospital ( Site 1550)
- Oncology institute ( Site 1601)
- Assaf Harofeh MC ( Site 1605)
- Hadassah Ein Karem - Sharett Institute of Oncology ( Site 1600)
- Rabin-Medical Center ( Site 1604)
- Sheba Medical Center ( Site 1602)
- Sourasky Medical Center ( Site 1603)
- Istituto Scientifico Romagnolo per Studio e Cura Tumori IRST ( Site 1101)
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia ( Site 1103)
- Ospedale San Luca, AZIENDA USL2 TOSCANA NORD OVEST ( Site 1105)
- Ospedale Civile di Macerata ( Site 1104)
- Istituto Europeo di Oncologia ( Site 1106)
- Istituto Nazionale Tumori IRCCS Fondazione Pascale ( Site 1102)
- Aichi Cancer Center Hospital ( Site 2502)
- National Cancer Center Hospital East ( Site 2518)
- National Hospital Organization Hokkaido Cancer Center ( Site 2512)
- Hyogo College of Medicine Hospital ( Site 2506)
- Tokai University Hospital ( Site 2517)
- St. Marianna University School of Medicine Hospital ( Site 2516)
- Kindai University Hospital ( Site 2507)
- Saitama Medical University International Medical Center ( Site 2513)
- Saitama Cancer Center ( Site 2510)
- Shizuoka Cancer Center Hospital and Research Institute ( Site 2514)
- Chiba Cancer Center ( Site 2519)
- Hiroshima City Hiroshima Citizens Hospital ( Site 2501)
- Social medical corporation Hakuaikai Sagara Hospital ( Site 2508)
- Kumamoto University Hospital ( Site 2515)
- National Hospital Organization Osaka National Hospital ( Site 2505)
- National Cancer Center Hospital ( Site 2500)
- St.Luke's International Hospital ( Site 2511)
- Toranomon Hospital ( Site 2503)
- The Cancer Institute Hospital of JFCR ( Site 2509)
- Seoul National University Hospital ( Site 2101)
- Severance Hospital Yonsei University Health System ( Site 2100)
- Asan Medical Center ( Site 2102)
- Samsung Medical Center ( Site 2103)
- Mazowiecki Szpital Onkologiczny ( Site 1713)
- Centrum Onkologii Instytut im. Marii Skłodowskiej Curie ( Site 1717)
- Centrum Onkologii im. Prof. Franciszka Lukaszczyka ( Site 1708)
- Centrum Onkologii im. Prof. Franciszka Lukaszczyka ( Site 1712)
- Szpital Morski im. PCK. Szpitale Pomorskie Sp. Z o.o ( Site 1701)
- Centrum Onkologii Instytut im. Marii Sklodowskiej Curie ( Site 1719)
- Centrum Onkologii Ziemi Lubelskiej im. sw. Jana z Dukli ( Site 1700)
- Dolnoslaskie Centrum Onkologii. ( Site 1702)
- Fundacao Champalimaud ( Site 2444)
- Hospital de Santa Maria, E.P.E. ( Site 2445)
- Instituto Portugues de Oncologia Do Porto Francisco Gentil E.P.E. ( Site 2446)
- Arkhangelsk Clinical Oncological Dispensary ( Site 1810)
- Chelyabinsk Regional Clinical Oncological Dispensary ( Site 1805)
- Republican Clinical Oncology Dispensary of Tatarstan MoH ( Site 1806)
- Russian Oncological Research Center n.a. N.N.Blokhin of MoH ( Site 1801)
- GBU RO Regional Clinical Oncological Dispensary ( Site 1808)
- Scientific Research Oncology Institute n.a. N.N.Petrov ( Site 1803)
- Republican Clinical Oncology Dispensary of Republic of Bashkortostan ( Site 1804)
- National Cancer Centre Singapore ( Site 2600)
- ICO L Hospitalet ( Site 1305)
- Hospital Quiron de Madrid ( Site 1303)
- Hospital del Mar ( Site 1306)
- Instituto Oncologico Baselga.Hospital Quiron. ( Site 1312)
- Hospital General Universitari Vall d Hebron ( Site 1301)
- Hospital Universitario Reina Sofia ( Site 1304)
- Hospital Universitario Ramon y Cajal ( Site 1300)
- Complejo Hospitalario Universitario de Santiago ( Site 1308)
- Hospital Universitario Virgen del Rocio ( Site 1314)
- Hospital Clinico Univ de Valencia ( Site 1313)
- Linkopings Universitetssjukhus ( Site 1402)
- Karolinska Universitetssjukhuset Solna ( Site 1404)
- Norrlands Universitetssjukhus ( Site 1401)
- Akademiska Sjukhuset ( Site 1403)
- Taipei Veterans General Hospital ( Site 2302)
- National Cheng Kung University Hospital ( Site 2305)
- National Taiwan University Hospital ( Site 2301)
- MacKay Memorial Hospital ( Site 2303)
- Koo Foundation Sun Yat-Sen Cancer Center ( Site 2304)
- Linkou Chang Gung Memorial Hospital ( Site 2300)
- Samsun Ondokuz Mayıs Universitesi Tıp Fakultesi Hastanesi ( Site 1910)
- Adana Acıbadem Hospital Department of Medical Oncology ( Site 1906)
- Baskent Unıversity Adana Kısla Hospital ( Site 1903)
- Hacettepe Universitesi Tip Fakultesi Hastanesi ( Site 1912)
- Abdurrahman Yurtaslan Oncology Training and Research Hospital ( Site 1909)
- Ozel Medicana International Ankara Hastanesi ( Site 1915)
- Antalya Memorial Hospital Department of Medical Oncology ( Site 1908)
- Trakya University Medical Faculty Balkan Oncology Hospital ( Site 1901)
- Acibadem Altunizade Hastanesi ( Site 1900)
- İstanbul University Cerrahpaşa Medical Faculty ( Site 1904)
- Amerikan Hospital Medical ( Site 1902)
- Memorial Sisli Hastanesi ( Site 1913)
- Ege University Medical Faculty Tulay Aktas Oncology Hospital ( Site 1905)
- Izmir Medical Park Hospital Department of Medical Oncology ( Site 1907)
- Colchester General Hospital ( Site 1508)
- Barts Cancer Institute ( Site 1500)
- St George s Hospital ( Site 1516)
- Maidstone Hospital ( Site 1511)
- The James Cook University Hospital ( Site 1515)
- Nottingham University Hospitals NHS Trust ( Site 1505)
- Royal Cornwall Hospitals NHS Trust ( Site 1504)
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Pembrolizumab + Chemotherapy
Placebo + Chemotherapy
Participants receive pembrolizumab every 3 weeks (Q3W) + paclitaxel weekly + carboplatin (weekly or Q3W) x 4 cycles, followed by pembrolizumab Q3W + (doxorubicin OR epirubicin) + cyclophosphamide Q3W x 4 cycles as neoadjuvant therapy prior to surgery; followed by 9 cycles of pembrolizumab Q3W as adjuvant therapy post-surgery. Each cycle is 21 days.
Participants receive placebo (normal saline solution) Q3W + paclitaxel weekly + carboplatin (weekly or Q3W) x 4 cycles, followed by placebo + (doxorubicin OR epirubicin) + cyclophosphamide Q3W x 4 cycles as neoadjuvant therapy prior to surgery; followed by 9 cycles of placebo Q3W as adjuvant therapy post-surgery. Each cycle is 21 days.