Study of Pembrolizumab (MK-3475) Versus Chemotherapy in Chinese Participants With Stage IV Colorectal Cancer (MK-3475-C66)
Colorectal Neoplasms
About this trial
This is an interventional treatment trial for Colorectal Neoplasms focused on measuring Programmed Cell Death-1 (PD1, PD-1), Programmed Cell Death 1 Ligand 1 (PDL1, PD-L1), Programmed Cell Death 1 Ligand 2 (PDL2, PD-L2)
Eligibility Criteria
The main inclusion and exclusion criteria include but are not limited to the following:
Inclusion Criteria:
- Has a histologically confirmed diagnosis of colorectal adenocarcinoma that is at stage IV (as defined by American Joint Committee on Cancer eighth edition) [National Comprehensive Cancer Network 2018]
- Has centrally confirmed MSI-H/dMMR status
- Has centrally confirmed RAS and BRAF mutation status
- A woman of child-bearing potential (WOCBP) must have a negative highly sensitive pregnancy test (urine or serum as required by local regulations) within 24 hours for urine or within 72 hours for serum before the first dose of study intervention
- Has measurable disease per RECIST 1.1 as assessed by the local site investigator/radiology
- Must provide an archival tumor tissue sample or newly obtained core or excisional biopsy of a tumor lesion not previously irradiated
- Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 within 3 days before randomization
- Has a life expectancy of at least 3 months
Exclusion Criteria:
- Has received prior systemic therapy for stage IV colorectal cancer (CRC). Participants may have received prior adjuvant/neoadjuvant chemotherapy for CRC as long as it was completed at least 6 months prior to randomization
- Has undergone major operation within 4 weeks of randomization or has not adequately recovered from major surgery or has ongoing surgical complications
- Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti PD-L2 agent or with an agent directed to another stimulatory or coinhibitory T-cell receptor (eg, cytotoxic T-lymphocyte-associated protein 4 [CTLA-4], tumor necrosis factor receptor superfamily, member 4 [OX 40], tumor necrosis factor receptor superfamily member 9 [CD137])
- Has received prior radiotherapy within 2 weeks of start of study intervention or has radiation-related toxicities, requiring corticosteroids
- Has received a live or live-attenuated vaccine within 30 days before the first dose of study intervention
- Has received an investigational agent or has used an investigational device within 4 weeks prior to 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 to the first dose of study medication
- Has a known additional malignancy that is progressing or has required active treatment within the past 5 years, with the exception of basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (eg, breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded
- Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis
- Has severe hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its excipients
- Has an active autoimmune disease that has required systemic treatment in past 2 years
- Has a history of (noninfectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease
- Has an active infection requiring systemic therapy (eg, tuberculosis, known viral or bacterial infection)
- Has a known history of human immunodeficiency virus (HIV) infection
- Has a known history of Hepatitis B or known Hepatitis C virus infection
- Has had an allogenic tissue/solid organ transplant
Sites / Locations
- Beijing Cancer hospital-Digestive Oncology ( Site 0001)Recruiting
- Beijing Peking Union Medical College Hospital-Medical Oncology ( Site 0011)Recruiting
- Chongqing University Cancer Hospital-Medical Oncology ( Site 0012)Recruiting
- Fujian Provincial Cancer Hospital-oncology department ( Site 0009)Recruiting
- Guangdong Provincial People's Hospital ( Site 0035)Recruiting
- The First Affiliated Hospital, Sun Yat-sen University ( Site 0014)Recruiting
- Cancer Hospital of Shantou University Medical College ( Site 0036)Recruiting
- Guangxi Medical University Affiliated Tumor Hospital ( Site 0039)Recruiting
- Harbin Medical University Cancer Hospital-Harbin Medical University Cancer Hospital ( Site 0007)Recruiting
- Henan Cancer Hospital-henan cancer hospital ( Site 0015)Recruiting
- Wuhan Union Hospital Cancer Center-Cancer Center ( Site 0008)Recruiting
- Tongji Hospital Tongji Medical,Science & Technology-oncology ( Site 0018)Recruiting
- The Third Xiangya Hospital of Central South University ( Site 0031)Recruiting
- The Affiliated Jiangyin Hospital of Southeast University Medical College ( Site 0037)Recruiting
- Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School-Oncology (Recruiting
- The first affiliated hospital of China medical university ( Site 0043)Recruiting
- Tangdu Hospital of Fourth Military Medical University of Chi-General Surgery ( Site 0045)Recruiting
- Jinan Central Hospital-oncology department ( Site 0021)Recruiting
- Shandong Cancer Hospital ( Site 0041)Recruiting
- Shanghai East Hospital ( Site 0022)Recruiting
- Shanghai Changhai Hospital ( Site 0024)Recruiting
- Shanxi Cancer Hospital ( Site 0032)Recruiting
- West China Hospital of Sichuan University ( Site 0044)Recruiting
- Tianjin Medical University Cancer Institute and Hospital-Gastric oncology ( Site 0019)Recruiting
- Yunnan Province Cancer Hospital-Colorectal surgery ( Site 0006)Recruiting
- Zhejiang Cancer Hospital-oncology-abdominal neoplasms ( Site 0028)Recruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Pembrolizumab
Standard of Care Chemotherapy
Participants receive pembrolizumab 200 mg intravenously (IV) on Day 1 of each 21-day cycle (Q3W) for up to 35 treatments (approximately 2 years).
Participants receive 1 of 6 possible standard chemotherapy regimens at the discretion of the investigator: (1) mFOLFOX6; (2) mFOLFOX6+bevacizumab 5 mg/kg IV on Day 1 of each 14-day cycle (Q2W); (3) mFOLFOX6+cetuximab 400 mg/m^2 IV over 2 hours then 250 mg/m^2 over 1 hour weekly Q2W; (4) FOLFIRI; (5) FOLFIRI+bevacizumab 5 mg/kg IV on Day 1 Q2W; OR (6) FOLFIRI+cetuximab 400 mg/m^2 IV over 2 hours then 250 mg/m^2 over 1 hour weekly Q2W. Participants with documented disease progression following chemotherapy can receive pembrolizumab 200 mg intravenously (IV) on Day 1 of each 21-day cycle (Q3W) for up to 35 treatments (approximately 2 years).