Efficacy and Safety Study of Stereotactic Body Radiotherapy (SBRT) With or Without Pembrolizumab (MK-3475) in Adults With Unresected Stage I or II Non-Small Cell Lung Cancer (NSCLC) (MK-3475-867/KEYNOTE-867)
Non-Small Cell Lung Cancer
About this trial
This is an interventional treatment trial for Non-Small Cell Lung Cancer focused on measuring Programmed Cell Death-1 (PD1, PD-1), Programmed Death-Ligand 1 (PDL1, PD-L1)
Eligibility Criteria
Inclusion Criteria:
- Has previously untreated non-small cell lung cancer (NSCLC) diagnosed by histology or cytology and confirmed as Stage I or II (T1 to limited T3, N0, M0) NSCLC (American Joint Committee on Cancer, AJCC) by chest computed tomography (CT) and positron emission tomography (PET) scan. Participants with pericardium invasion, >2 nodules or 2 nodules that cannot be treated in one field (>2 cm apart and/or total planned target volume [PTV] >163 cc) and diaphragm elevation suggestive of phrenic nerve invasion are excluded
- Cannot undergo thoracic surgery due to existing medical illness(es) as determined by the site's multi-disciplinary tumor board. Medically operable participants who decide to treat with stereotactic body radiotherapy (SBRT) as definitive therapy rather than surgery are also eligible, if patient's unwillingness to undergo surgical resection is clearly documented
- Has a Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2
- Is able to receive SBRT and does not have an ultra-centrally located tumor
- Has adequate organ function within 7 days prior to the start of study treatment
- A female is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: a) not a women of childbearing potential (WOCBP) OR b) A WOCBP and uses contraceptive method that is highly effective (with a failure rate of <1% per year), or be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis), during the intervention period and for at least 120 days after the last dose of pembrolizumab/placebo and 180 days after the last radiotherapy dose
- Male participants are eligible to participate if they agree to the following during the intervention period and for at least 90 days after the last dose of radiotherapy: refrain from donating sperm plus either be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis) and agree to remain abstinent or must agree to use contraception per study protocol, unless confirmed to be azoospermic
- Has a radiation therapy plan approved by the central radiation therapy quality assurance vendor
Exclusion Criteria:
- Has received prior therapy with an anti-programmed cell death-1 (anti-PD-1), anti-programmed cell death-ligand 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 antigen 4 [CTLA-4], tumor necrosis factor receptor superfamily member 4 [OX-40], tumor necrosis factor receptor superfamily member 9 [CD137])
- Has received prior radiotherapy to the thorax, including radiotherapy to the esophagus, mediastinum, or breast
- Has received a live vaccine within 30 days prior to the first dose of study intervention
- Has received an investigational agent or has used an investigational device within 4 weeks prior to the first dose of study intervention administration
- Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study treatment
- Has a known additional malignancy that is progressing or has required active treatment within the past 3 years. A prior NSCLC that occurred and was treated curatively at least 2 years prior to the date of the current diagnosis would be considered a separate primary lung cancer, and therefore an additional malignancy. Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (e.g. breast c carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded.
- Has a known hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its excipients
- Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis
- Has a known history of Hepatitis B or known active Hepatitis C virus infection
- Has an active autoimmune disease that has required systemic treatment in past 2 years, except replacement therapy
- Has an active infection requiring systemic therapy
- Has a known history of human immunodeficiency virus (HIV) infection
- Has a known history of active tuberculosis (TB; Bacillus tuberculosis)
- Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of pembrolizumab/placebo and 180 days after the last radiotherapy dose
- Have not adequately recovered from major surgery or have ongoing surgical complications
- Has had an allogenic tissue/solid organ transplant
Sites / Locations
- University of Alabama ( Site 0099)
- Infirmary Cancer Care ( Site 3044)Recruiting
- Alaska Oncology and Hematology ( Site 3063)Recruiting
- Banner MD Anderson Cancer Center ( Site 3029)
- CARTI Cancer Center ( Site 3045)Recruiting
- USC Norris Comprehensive Cancer Center ( Site 0007)
- Veterans Affairs Palo Alto Health Care System ( Site 3039)Recruiting
- National Jewish Health ( Site 0010)Recruiting
- Yale University ( Site 0011)
- Mid Florida Hematology and Oncology Center ( Site 0067)Recruiting
- H. Lee Moffitt Cancer Center and Research Institute ( Site 0016)
- Goshen Center for Cancer Care ( Site 0022)Recruiting
- Franciscan Health Indianapolis ( Site 0024)Recruiting
- University of Kentucky School of Medicine & Hospitals ( Site 0026)Recruiting
- Sinai Hospital of Baltimore ( Site 3011)
- William E. Kahlert Regional Cancer Center ( Site 3031)
- Massachusetts General Hospital-Cancer Center Protocol Office ( Site 3007)Recruiting
- Mass General / North Shore Center for Outpatient Care ( Site 3040)Recruiting
- University of Massachusetts ( Site 0029)
- Sanford Bemidji ( Site 0080)
- University of Minnesota ( Site 0069)
- University of Missouri Hospital ( Site 3058)Recruiting
- Cox Medical Center North-Cox Medical Center/Hulston Cancer Center/ Radiation Oncology ( Site 3060)Recruiting
- St. Vincent Healthcare Frontier Cancer Center ( Site 3012)Recruiting
- John Theurer Cancer Center at Hackensack University Medical Center ( Site 3036)
- Rutgers Cancer Institute of New Jersey ( Site 0043)
- Hematology-Oncology Associates of CNY ( Site 3055)Recruiting
- Mount Sinai Hospital ( Site 0046)
- Westchester Medical Center ( Site 3057)Recruiting
- White Plains Hospital ( Site 3014)Recruiting
- Sanford Health Roger Maris Cancer Center ( Site 0079)
- Lehigh Valley Hospital- Cedar Crest ( Site 3005)
- St. Luke's University Health Network ( Site 3006)Recruiting
- Penn State University Milton S. Hershey Medical Center ( Site 0064)
- Fox Chase Cancer Center ( Site 0051)
- Allegheny General Hospital ( Site 3028)Recruiting
- Lankenau Medical Center ( Site 3041)Recruiting
- Sanford Cancer Center Oncology Clinic ( Site 0053)Recruiting
- Mountain States Health Alliance ( Site 3054)Recruiting
- University of Tennessee Medical Center Knoxville ( Site 3010)Recruiting
- Vanderbilt University Medical Center ( Site 0075)Recruiting
- Cancer Care Northwest ( Site 0063)
- Hospital Italiano de Buenos Aires-Clinical Oncology ( Site 0206)Recruiting
- Hospital Britanico de Buenos Aires ( Site 0204)Recruiting
- Sanatorio Parque ( Site 0207)Recruiting
- Hospital Provincial del Centenario ( Site 0205)
- IDIM Instituto de Diagnostico e Investigaciones Metabolicas ( Site 0208)Recruiting
- Hospital Aleman ( Site 0200)Recruiting
- Instituto Medico Especializado Alexander Fleming ( Site 0203)Recruiting
- CEMIC ( Site 0201)Recruiting
- Port Macquarie Base Hospital ( Site 2500)
- GenesisCare North Shore ( Site 2508)Recruiting
- Royal Brisbane and Women s Hospital ( Site 2502)Recruiting
- Icon Cancer Centre Hobart ( Site 2507)Recruiting
- Austin Health ( Site 2501)
- Keppler Universitatsklinikum ( Site 0806)Recruiting
- Landeskrankenhaus - Universitatsklinikum Graz ( Site 0804)
- Universitatsklinik LKH Innsbruck ( Site 0802)Recruiting
- Social Medical Center - Otto Wagner Hospital ( Site 0801)Recruiting
- Irmandade da Santa Casa de Misericordia de Porto Alegre ( Site 0318)Recruiting
- Uniao Brasileira de Educacao e Assistencia Hospital Sao Lucas da Pucrs ( Site 0301)Recruiting
- Clínica de Oncologia Reichow ( Site 0319)Recruiting
- Hospital e Maternidade Celso Pierro ( Site 0313)
- Instituto Nacional Do Cancer Jose Alencar Gomes Da Silva ( Site 0305)Recruiting
- Instituto do Cancer do Estado de Sao Paulo - ICESP ( Site 0300)Recruiting
- Hospital Paulistano - Amil Clinical Research ( Site 0316)Recruiting
- A.C. Camargo Cancer Center ( Site 0312)Recruiting
- Moncton Hospital - Horizon Health Network ( Site 0105)Recruiting
- Kingston Health Sciences Centre ( Site 0100)Recruiting
- Trillium Health Partners - Credit Valley Hospital ( Site 0102)Recruiting
- The Ottawa Hospital ( Site 0104)Recruiting
- Sault Area Hospital ( Site 0101)Recruiting
- Health Sciences North Research Institute ( Site 0107)
- CIUSSS de l Est de L Ile de Montreal - Hopital Maisonneuve-Rosemont ( Site 0110)Recruiting
- McGill University Health Centre ( Site 0113)Recruiting
- CHUS - Hopital Fleurimont ( Site 0111)Recruiting
- CHU Poitiers ( Site 1109)Recruiting
- CHU de Brest -Site Hopital Morvan ( Site 1100)Recruiting
- Institut Bergonie ( Site 1102)Recruiting
- Institut Regional du Cancer de Montpellier - ICM ( Site 1108)Recruiting
- CHU de Rouen ( Site 1113)Recruiting
- Hopital Sud du Amiens ( Site 1115)Recruiting
- Institut Curie ( Site 1112)Recruiting
- Hopital Cochin ( Site 1107)Recruiting
- A.P.H. Paris. Hopital Bichat Claude Bernard ( Site 1114)
- Klinikum Esslingen-Klinik für Kardiologie und Pneumologie ( Site 1208)Recruiting
- Universitaetsklinikum Heidelberg. ( Site 1204)Recruiting
- Pius Hospital Oldenburg ( Site 1202)Recruiting
- Universitaetsklinikum Erlangen ( Site 1209)Recruiting
- UKGM Gießen/Marburg-Medical Clinic V ( Site 1210)Recruiting
- Universitaetsklinikum Essen ( Site 1201)
- Evangelisches Krankenhaus Hamm gGmbH ( Site 1205)
- Charite Universitaetsmedizin Berlin ( Site 1207)Recruiting
- Bacs-Kiskun Varmegyei Oktatokorhaz-Onkoradiologiai Kozpont ( Site 2311)Recruiting
- Pécsi Tudományegyetem Klinikai Központ-Onkoterápiás Intézet ( Site 2314)Recruiting
- CRU Hungary KFT ( Site 2309)
- Fejer Megyei Szent Gyorgy Egyetemi Oktato Korhaz ( Site 2312)Recruiting
- Petz Aladar Megyei Oktato Korhaz ( Site 2305)Recruiting
- Debreceni Egyetem Klinikai Kozpont ( Site 2301)Recruiting
- Jász-Nagykun-Szolnok Vármegyei Hetényi Géza Kórház ( Site 2310)Recruiting
- Törökbálinti Tüdőgyógyintézet ( Site 2302)Recruiting
- Somogy Megyei Kaposi Mor Oktato Korhaz ( Site 2307)Recruiting
- Farkasgyepui Tudogyogyintezet ( Site 2313)Recruiting
- Semmelweis University ( Site 2303)Recruiting
- Orszagos Koranyi Pulmonologiai Intezet ( Site 2304)Recruiting
- Orszagos Koranyi Pulmonologiai Intezet ( Site 2306)Recruiting
- Orszagos Onkologiai Intezet ( Site 2308)Recruiting
- Ospedale Santissima Annunziata ( Site 1303)
- A.O. Universitaria Careggi ( Site 1301)Recruiting
- Policlinico di Modena ( Site 1306)Recruiting
- Policlinico Agostino Gemelli ( Site 1302)Recruiting
- Azienda Ospedaliera S. Giovanni Addolorata-Oncologia Medica ( Site 1309)Recruiting
- Aichi Cancer Center Hospital ( Site 2804)Recruiting
- National Cancer Center Hospital East ( Site 2800)Recruiting
- Kurume University Hospital ( Site 2815)Recruiting
- Kobe Minimally Invasive Cancer Center ( Site 2811)Recruiting
- University of Tsukuba Hospital ( Site 2809)Recruiting
- Sendai Kousei Hospital ( Site 2814)Recruiting
- Kansai Medical University Hospital ( Site 2808)Recruiting
- Osaka Medical and Pharmaceutical University Hospital ( Site 2813)Recruiting
- University of Yamanashi Hospital ( Site 2807)Recruiting
- Chiba University Hospital ( Site 2806)Recruiting
- National Hospital Organization Kyushu Cancer Center ( Site 2816)Recruiting
- Hiroshima University Hospital ( Site 2810)Recruiting
- Niigata Cancer Center Hospital ( Site 2801)Recruiting
- Osaka International Cancer Institute ( Site 2812)Recruiting
- Tokyo Metropolitan Komagome Hospital ( Site 2802)Recruiting
- The Cancer Institute Hospital of JFCR ( Site 2803)Recruiting
- Showa University Hospital ( Site 2805)Recruiting
- Chungbuk National University Hospital ( Site 2605)Recruiting
- National Cancer Center ( Site 2604)Recruiting
- The Catholic University of Korea St. Vincent s Hospital ( Site 2606)Recruiting
- Seoul National University Hospital ( Site 2600)
- Samsung Medical Center ( Site 2603)Recruiting
- Ziekenhuis Rijnstate ( Site 1405)Recruiting
- Tergooiziekenhuizen, locatie Hilversum-Oncology ( Site 1407)Recruiting
- Meander Medisch Centrum-Studie Team Oncologie ( Site 1403)Recruiting
- Auckland City Hospital ( Site 2900)
- St Olavs Hospital ( Site 1504)
- Helse Bergen HF Haukeland Universitetssykehus ( Site 1502)Recruiting
- Oslo Universitetssykehus HF Ulleval Sykehus ( Site 1500)Recruiting
- Centrum Onkologii im. prof. Franciszka ukaszczyka-Ambulatorium Chemioterapii ( Site 2407)Recruiting
- Wojewodzkie Wielospecjalistyczne Centrum Onkologii i Traumatologii ( Site 2402)Recruiting
- Szpital Specjalistyczny im. Ludwika Rydygiera w Krakowie ( Site 2400)
- Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - Panstwowy Instytut Badawczy w Warszawie (Recruiting
- Narodowy Instytut Onkologii - Oddzial w Gliwicach ( Site 2403)Recruiting
- SPZOZ MSWIA z Warminsko-Mazurskim Centrum Onkologii w Olsztynie ( Site 2404)Recruiting
- Amethyst Radiotherapy Center-Oncologie Medicala ( Site 3201)Recruiting
- Chelyabinsk Regional Clinical Oncology Dispensary ( Site 2014)
- GUZ Lipetsk Regional Oncology Dispensary ( Site 2010)
- N.N.Blokhin Russian Cancer Research center ( Site 2013)
- Russian Scientific Center of Roentgenoradiology ( Site 2011)
- Scientific Research Oncology Institute n.a. N.N.Petrov ( Site 2000)
- Medical institute named after Berezin Sergey ( Site 2009)
- Sverdlovsk Regional Oncology Hospital ( Site 2012)
- Republican Clinical Oncology Dispensary of Tatarstan MoH ( Site 2001)
- Hospital Universitario Quiron Madrid ( Site 1601)
- Hospital Universitario La Fe ( Site 1603)
- Hospital General Universitari Vall d Hebron ( Site 1602)Recruiting
- Hospital General Universitario Gregorio Maranon ( Site 1604)Recruiting
- Hopitaux Universitaires de Geneve HUG ( Site 1706)Recruiting
- Universitaetsspital Zuerich ( Site 1700)Recruiting
- Tri-Service General Hospital ( Site 3300)Recruiting
- Kaohsiung Medical University Chung-Ho Memorial Hospital ( Site 3304)Recruiting
- Taipei Medical University Hospital ( Site 3303)Recruiting
- Taipei Veterans General Hospital ( Site 3301)Recruiting
- Baskent Adana Dr Turgut Noyan Uygulama ve Arastirma Merkezi ( Site 2105)Recruiting
- Hacettepe University Medical Faculty ( Site 2100)Recruiting
- Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital ( Site 2101)Recruiting
- Göztepe Prof. Dr. Süleyman Yalçın Şehir Hastanesi-oncology ( Site 2116)Recruiting
- Kartal Training and Research Hospital ( Site 2102)
- I.E.U. Medical Point Hastanesi ( Site 2115)Recruiting
- Erciyes University Medical Faculty ( Site 2109)Recruiting
- Sakarya Universitesi Tip Fakultesi Hastanesi ( Site 2114)Recruiting
- Medical center Medikal Plaza of Ecodnipro LLC ( Site 2207)
- Regional Centre of Oncology-Thoracic organs ( Site 2202)Recruiting
- Ukrainian Center of Tomotherapy ( Site 2206)
- Medical Center of Yuriy Spizhenko LLC.-Clinical Trial ( Site 2205)
- Medical Center Asklepion LLC ( Site 2208)
- Medical and Diagnostic Centre LLC Dobryi Prognoz ( Site 2203)
- Kyiv City Clinical Oncology Centre ( Site 2200)
- University Hospitals Bristol NHS Foundation Trust ( Site 1802)Recruiting
- Royal Free London NHS Foundation Trust ( Site 1813)Recruiting
- Weston Park Hospital ( Site 1801)Recruiting
- Clatterbridge Cancer Center NHS FT ( Site 1800)Recruiting
- Lancashire Teaching Hospitals NHS Foundation Trust ( Site 1809)
- Leicester Royal Infirmary ( Site 1811)
- University College London Hospital NHS Foundation Trust ( Site 1806)Recruiting
- Guy s and St Thomas Hospital NHS Foundation Trust ( Site 1808)Recruiting
- Norfolk and Norwich University Foundation NHS Trust ( Site 1805)
- Oxford University Hospitals NHS Foundation Trust ( Site 1812)Recruiting
- Darlington Memorial Hospital NHS Trust ( Site 1810)
- Mount Vernon Hospital ( Site 1803)Recruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
SBRT+Pembolizumab
SBRT+Placebo
Participants receive SBRT once every 3, 4, 5, or 8 fractions (dependent on tumor type/location; 45-70 Gray [Gy] total) over approximately 2 weeks PLUS pembrolizumab 200 mg via intravenous (IV) infusion once every 3 weeks for up to 17 cycles (up to approximately 1 year). Each cycle is 21 days.
Participants receive SBRT once every 3 days for 3, 4, 5, or 8 fractions (dependent on tumor type/location; 45-70 Gy total) over approximately 2 weeks PLUS placebo (normal saline solution) via IV infusion once every 3 weeks for up to 17 cycles (up to approximately 1 year). Each cycle is 21 days.