Study of Pemetrexed+Platinum Chemotherapy With or Without Pembrolizumab (MK-3475) in Participants With First Line Metastatic Nonsquamous Non-small Cell Lung Cancer (MK-3475-189/KEYNOTE-189)-Japan Extension Study
Non-Small-Cell Lung Carcinoma

About this trial
This is an interventional treatment trial for Non-Small-Cell Lung Carcinoma focused on measuring Programmed Cell Death-1 (PD1, PD-1), Programmed Death-Ligand 1 (PDL1, PD-L1), Non-Small-Cell Lung Cancer (NSCLC), PD1, PD-1, PDL1, PD-L1, Non-Small-Cell Lung Cancer
Eligibility Criteria
Inclusion Criteria:
- Has a histologically-confirmed or cytologically confirmed diagnosis of stage IV nonsquamous NSCLC.
- Has confirmation that epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK)-directed therapy is not indicated.
- Has measurable disease.
- Has not received prior systemic treatment for their advanced/metastatic NSCLC.
- Can provide tumor tissue.
- Has a life expectancy of at least 3 months.
- Has a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Status.
- Has adequate organ function
- If female of childbearing potential, is willing to use adequate contraception for the course of the study through 120 days after the last dose of study medication or through 180 days after last dose of chemotherapeutic agents.
- If male with a female partner(s) of child-bearing potential, must agree to use adequate contraception starting with the first dose of study medication through 120 days after the last dose of study medication or through 180 days after last dose of chemotherapeutic agents.
Exclusion Criteria:
- Has predominantly squamous cell histology NSCLC.
- Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks prior to administration of pembrolizumab.
- Before the first dose of study medication: a) Has received prior systemic cytotoxic chemotherapy for metastatic disease, b) Has received antineoplastic biological therapy (e.g. erlotinib, crizotinib, cetuximab), c) Had major surgery (<3 weeks prior to first dose)
- Received radiation therapy to the lung that is >30 Gray (Gy) within 6 months of the first dose of study medication.
- Completed palliative radiotherapy within 7 days of the first dose of study medication.
- Is expected to require any other form of antineoplastic therapy while on study.
- Received a live-virus vaccination within 30 days of planned start of study medication.
- Has clinically active diverticulitis, intra-abdominal abscess, gastrointestinal obstruction, peritoneal carcinomatosis.
- Known history of prior malignancy except if participant has undergone potentially curative therapy with no evidence of that disease recurrence for 5 years since initiation of that therapy, except for successful definitive resection of basal cell carcinoma of the skin, superficial bladder cancer, squamous cell carcinoma of the skin, in situ cervical cancer, or other in situ cancers.
- Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
- Previously had a severe hypersensitivity reaction to treatment with another monoclonal antibody (mAb).
- Known sensitivity to any component of cisplatin, carboplatin or pemetrexed.
- Has active autoimmune disease that has required systemic treatment in past 2 years.
- Is on chronic systemic steroids.
- Is unable to interrupt aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), other than an aspirin dose ≤1.3 g per day, for a 5-day period (8-day period for long-acting agents, such as piroxicam).
- Is unable or unwilling to take folic acid or vitamin B12 supplementation.
- Had prior treatment with any other anti-programmed cell death-1 (PD-1), or PD-ligand 1 (PD-L1) or PD-L2 agent or an antibody targeting other immuno-regulatory receptors or mechanisms. Has participated in any other pembrolizumab study and has been treated with pembrolizumab.
- Has an active infection requiring therapy.
- Has known history of Human Immunodeficiency Virus (HIV).
- Has known active Hepatitis B or C.
- Has known psychiatric or substance abuse disorder that would interfere with cooperation with the requirements of the trial.
- Is a regular user (including "recreational use") of any illicit drugs or had a recent history (within the last year) of substance abuse (including alcohol).
- Has symptomatic ascites or pleural effusion.
- Has a history of (non-infectious) pneumonitis that required steroids or current pneumonitis.
- Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the study.
Sites / Locations
- National Hospital Organization Nagoya Medical Center ( Site 0324)
- Kurume University Hospital ( Site 0326)
- Hyogo Cancer Center ( Site 0325)
- Kanazawa University Hospital ( Site 0328)
- Kansai Medical University Hospital ( Site 0313)
- Shizuoka Cancer Center Hospital and Research Institute ( Site 0322)
- National Hospital Organization Shikoku Cancer Center ( Site 0303)
- Okayama University Hospital ( Site 0327)
- National Cancer Center Hospital ( Site 0301)
- The Cancer Institute Hospital of JFCR ( Site 0323)
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Pembrolizumab
Control
Participants receive pembrolizumab 200 mg intravenously (IV) PLUS pemetrexed 500 mg/m^2 IV (with vitamin supplementation) PLUS cisplatin 75 mg/m^2 IV OR carboplatin Area Under the Curve (AUC) 5 IV on Day 1 of every 3-week cycle (Q3W) for 4 cycles followed by pembrolizumab 200 mg IV PLUS pemetrexed 500 mg/m^2 IV Q3W until progression (up to 35 treatment administrations; up to approximately 2 years).
Participants receive saline placebo IV PLUS pemetrexed 500 mg/m^2 IV (with vitamin supplementation) PLUS cisplatin 75 mg/m^2 IV OR carboplatin AUC 5 IV on Day 1 of every 3-week cycle (Q3W) for 4 cycles followed by saline placebo IV PLUS pemetrexed 500 mg/m^2 IV Q3W until progression. If documented progression occurs, participants may be able to receive pembrolizumab Q3W for the remainder of the study or until documented further progression (up to 35 treatment administrations; up to approximately 2 years).