Substudy 06E: Umbrella Study of Combination Therapies in Esophageal Cancer (MK-3475-06E/KEYMAKER-U06)

NCT ID: NCT06780111

Last Updated: 2025-11-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

228 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-30

Study Completion Date

2032-01-04

Brief Summary

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Researchers are looking for new ways to treat esophageal squamous cell carcinoma (ESCC). ESCC is a type of cancer that starts in certain cells that line the esophagus. The esophagus is the tube that connects the throat to the stomach. This study will look at ESCC that is either locally advanced unresectable, which means it has spread into tissue near where it started and cannot be completely removed by surgery, or metastatic, which means it has spread to other body parts.

Available treatments for these types of ESCC include pembrolizumab and chemotherapy. Pembrolizumab is an immunotherapy, which is a treatment that helps the immune system fight cancer. Chemotherapy is medicine that destroys cancer cells or stops them from growing.

Researchers want to learn about giving pembrolizumab and ifinatamab deruxtecan (I-DXd), a study medicine, with or without chemotherapy to treat ESCC. I-DXd is an antibody-drug conjugate (ADC). An ADC attaches to a protein on cancer cells and delivers treatment to destroy those cells.

The main goal of this study is to learn about the safety of I-DXd and pembrolizumab with or without chemotherapy and if people tolerate them. Researchers also want to learn how cancer responds (gets smaller or goes away) to the study treatments.

Detailed Description

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The master protocol is MK-3475-U06.

Conditions

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Esophageal Squamous Cell Carcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Pembrolizumab + Chemotherapy

Participants will receive 200 mg of pembrolizumab via intravenous (IV) infusion every three weeks (Q3W) on Day 1 of each 21 day cycle up to 35 cycles (up to approximately 2 years), and mFOLFOX6 chemotherapy: oxaliplatin 85 mg/m\^2 via IV infusion every 2 weeks (Q2W) until progressive disease (PD) or toxicity; leucovorin 400 mg/m2 OR levoleucovorin 200 mg/m\^2 via IV infusion Q2W until PD or toxicity; 5-fluorouracil (5-FU) 400 mg/m\^2 bolus IV infusion followed by 2400 mg/m\^2 continuous 46-48 hour IV infusion Q2W until PD or toxicity.

Group Type ACTIVE_COMPARATOR

Pembrolizumab

Intervention Type BIOLOGICAL

IV infusion

Leucovorin

Intervention Type DRUG

IV infusion

Levoleucovorin

Intervention Type DRUG

IV infusion

5-Fluorouracil (5-FU)

Intervention Type DRUG

IV Infusion

Oxaliplatin

Intervention Type DRUG

IV infusion

Pembrolizumab + I-DXd

Participants will receive 200 mg of pembrolizumab via IV infusion Q3W on Day 1 of each 21 day cycle for up to 35 cycles (up to approximately 2 years). Participants will also receive up to 12 mg/kg I-XDd Q3W via IV infusion until PD or toxicity.

Group Type EXPERIMENTAL

Pembrolizumab

Intervention Type BIOLOGICAL

IV infusion

I-DXd

Intervention Type BIOLOGICAL

IV infusion

Pembrolizumab + I-DXd + 5-FU IV + Leucovorin or Levoleucovorin

Participants will receive 200 mg pembrolizumab via IV infusion Q3W on Day 1 of each 21 day cycle up to 35 cycles (up to approximately 2 years). Participants will also receive I-DXd up to 12 mg/kg via IV infusion Q3W until PD or toxicity, 5-FU 400 mg/m\^2 bolus IV infusion followed by 2400 mg/m\^2 continuous 46-48 hour IV infusion Q2W until PD or toxicity, and leucovorin 400 mg/m\^2 OR levoleucovorin 200 mg/m\^2 via IV infusion Q2W until PD or toxicity.

Group Type EXPERIMENTAL

Pembrolizumab

Intervention Type BIOLOGICAL

IV infusion

I-DXd

Intervention Type BIOLOGICAL

IV infusion

Leucovorin

Intervention Type DRUG

IV infusion

Levoleucovorin

Intervention Type DRUG

IV infusion

5-Fluorouracil (5-FU)

Intervention Type DRUG

IV Infusion

Pembrolizumab + I-DXd + 5-FU IV + Leucovorin or Levoleucovorin + Oxaliplatin

Participants will receive 200 mg of pembrolizumab via IV infusion Q3W on Day 1 of each 21 day cycle up to 35 cycles (up to approximately 2 years). Participants will also receive up to 12 mg/kg I-DXd via IV infusion q3w until PD or toxicity, 5-FU 2400 mg/m\^2 continuous 46-48 hour IV infusion Q2W until PD or toxicity, 60mg/m\^2 oxaliplatin via IV infusion Q2W until PD or toxicity, and leucovorin 400 mg/m\^2 OR levoleucovorin 200 mg/m\^2 via IV infusion Q2W until PD or toxicity.

Group Type EXPERIMENTAL

Pembrolizumab

Intervention Type BIOLOGICAL

IV infusion

I-DXd

Intervention Type BIOLOGICAL

IV infusion

Leucovorin

Intervention Type DRUG

IV infusion

Levoleucovorin

Intervention Type DRUG

IV infusion

5-Fluorouracil (5-FU)

Intervention Type DRUG

IV Infusion

Oxaliplatin

Intervention Type DRUG

IV infusion

Interventions

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Pembrolizumab

IV infusion

Intervention Type BIOLOGICAL

I-DXd

IV infusion

Intervention Type BIOLOGICAL

Leucovorin

IV infusion

Intervention Type DRUG

Levoleucovorin

IV infusion

Intervention Type DRUG

5-Fluorouracil (5-FU)

IV Infusion

Intervention Type DRUG

Oxaliplatin

IV infusion

Intervention Type DRUG

Other Intervention Names

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MK-3475 KEYTRUDA® Ifinatamab deruxtecan MK-2400 DS-7300a

Eligibility Criteria

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Inclusion Criteria

* Has histologically or cytologically confirmed diagnosis of locally advanced unresectable or metastatic squamous cell carcinoma of the esophagus in first-line (1L) setting.
* Has measurable disease per RECIST 1.1 as assessed by the local site. investigator/radiology assessment and verified by BICR. Lesions situated in a previously irradiated area are considered measurable if progression has been shown in such lesions.
* Has AEs due to previous anticancer therapies of ≤Grade 1 or baseline (except alopecia and vitiligo). Endocrine-related AEs adequately treated with hormone replacement are acceptable.
* Human immunodeficiency virus (HIV)-infected participants must have well controlled HIV on antiretroviral therapy (ART).
* Participants who are hepatitis B surface antigen (HBsAg) positive are eligible if they have received hepatitis B virus (HBV) antiviral therapy for at least 4 weeks, and have undetectable HBV viral load.
* Participants with history of hepatitis C virus (HCV) infection are eligible if HCV viral load is undetectable.
* Has Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.

Exclusion Criteria

* Has had systemic anticancer therapy for locally advanced unresectable or metastatic esophageal cancer.
* Has tumor invasion into organs located adjacent to the esophageal disease site (eg, aorta or respiratory tract) at an increased risk of fistula.
* Has uncontrollable pleural effusion, pericardial effusion, or ascites requiring frequent drainage or medical intervention.
* Has clinically significant corneal disease.
* HIV-infected participants with a history of Kaposi's sarcoma and/or Multicentric Castleman's Disease.
* Has received prior therapy with an anti-programmed cell death 1 protein (PD-1), anti-programmed cell death ligand 1 (PD-L1), or anti-programmed cell death ligand 2 (PD-L2) agent, or with an agent directed to another stimulatory or coinhibitory T-cell receptor
* Has received prior treatment with orlotamab, enoblituzumab, or other humanized anti-B7 homologue 3 (B7-H3)-targeted agents.
* Has received prior treatment with a topoisomerase-I inhibitor, including antibody-drug conjugate (ADC).
* Has received prior systemic anticancer therapy including investigational agents within 4 weeks before the first dose of study intervention.
* 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. Administration of killed vaccines is allowed.
* Has inadequate cardiac function assessed as: - corrected QT interval by Fredericia (QTcF) value \>470 msec.
* Has clinically significant cardiovascular disease within 6 months from first dose of study intervention, including New York Heart Association Class III or IV congestive heart failure, unstable angina, myocardial infarction, cerebral vascular accident, or cardiac arrhythmia associated with hemodynamic instability.
* Has peripheral neuropathy ≥ Grade 2.
* Has 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 intervention.
* Has known additional malignancy that is progressing or has required active treatment within the past 3 years.
* Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
* Has active autoimmune disease that has required systemic treatment in the past 2 years.
* Has had (noninfectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease, and/or suspected interstitial lung disease (ILD)/pneumonitis that cannot be ruled out by imaging at Screening.
* Has active infection requiring systemic therapy.
* Has clinically severe pulmonary compromise resulting from intercurrent pulmonary illnesses, including, but not limited to, any underlying pulmonary disorder.
* Has severe hypersensitivity (≥Grade 3) to treatment with a monoclonal antibody (mAb) or known sensitivity or intolerance to pembrolizumab, I-DXd, study chemotherapy agents and/or to any of their excipients, murine proteins, or platinum containing products.
* Has had allogeneic tissue/solid organ transplant.
* Have not adequately recovered from major surgery or have ongoing surgical complications.
* Are incapacitated.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Daiichi Sankyo

INDUSTRY

Sponsor Role collaborator

Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Director

Role: STUDY_DIRECTOR

Merck Sharp & Dohme LLC

Locations

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Liga Norte Riograndense Contra o Cancer ( Site 1301)

Natal, Rio Grande do Norte, Brazil

Site Status RECRUITING

Clínica Puerto Montt ( Site 1406)

Port Montt, Los Lagos Region, Chile

Site Status RECRUITING

FALP ( Site 1400)

Santiago, Region M. de Santiago, Chile

Site Status RECRUITING

Centro de Oncología de Precisión ( Site 1402)

Santiago, Region M. de Santiago, Chile

Site Status RECRUITING

Clínica UC San Carlos de Apoquindo ( Site 1403)

Santiago, Region M. de Santiago, Chile

Site Status RECRUITING

The Second Affiliated Hospital of Anhui Medical University ( Site 9511)

Hefei, Anhui, China

Site Status RECRUITING

Beijing Cancer Hospital ( Site 9500)

Beijing, Beijing Municipality, China

Site Status RECRUITING

The First Affiliated Hospital of Xiamen University ( Site 9503)

Xiamen, Fujian, China

Site Status RECRUITING

Henan Cancer Hospital ( Site 9509)

Zhengzhou, Henan, China

Site Status RECRUITING

Xuzhou Central Hospital ( Site 9512)

Xuzhou, Jiangsu, China

Site Status RECRUITING

The First Affiliated Hospital of Nanchang University ( Site 9505)

Nanchang, Jiangxi, China

Site Status RECRUITING

Masarykuv onkologicky ustav-Klinika komplexni onkologicke pece ( Site 9000)

Brno, Brno-mesto, Czechia

Site Status RECRUITING

CHU Lille - Institut Coeur Poumon ( Site 9100)

Lille, Nord, France

Site Status RECRUITING

Pitie Salpetriere University Hospital ( Site 9102)

Paris, , France

Site Status RECRUITING

Ospedale San Raffaele-Oncologia Medica ( Site 9201)

Milan, Lombardy, Italy

Site Status RECRUITING

Istituto Oncologico Veneto IRCCS ( Site 9202)

Padua, Veneto, Italy

Site Status RECRUITING

Aichi Cancer Center ( Site 9702)

Nagoya, Aichi-ken, Japan

Site Status RECRUITING

National Cancer Center Hospital East ( Site 9701)

Kashiwa, Chiba, Japan

Site Status RECRUITING

National Cancer Center Hospital ( Site 9700)

Chūō, Tokyo, Japan

Site Status RECRUITING

Oslo Universitetssykehus Radiumhospitalet ( Site 1501)

Oslo, , Norway

Site Status RECRUITING

National University Hospital ( Site 9800)

Singapore, Central Singapore, Singapore

Site Status RECRUITING

National Cancer Center ( Site 9902)

Goyang-si, Kyonggi-do, South Korea

Site Status RECRUITING

Asan Medical Center ( Site 9901)

Seoul, , South Korea

Site Status RECRUITING

Kantonsspital Graubuenden ( Site 1700)

Chur, Kanton Graubünden, Switzerland

Site Status RECRUITING

Hopitaux Universitaires de Geneve HUG. ( Site 1701)

Geneva, , Switzerland

Site Status RECRUITING

Kaohsiung Chang Gung Memorial Hospital ( Site 1003)

Kaohsiung City, , Taiwan

Site Status RECRUITING

National Cheng Kung University Hospital ( Site 1001)

Tainan, , Taiwan

Site Status RECRUITING

National Taiwan University Hospital ( Site 1000)

Taipei, , Taiwan

Site Status RECRUITING

Taipei Veterans General Hospital ( Site 1005)

Taipei, , Taiwan

Site Status RECRUITING

Ramathibodi Hospital ( Site 1103)

Ratchathewi, Bangkok, Thailand

Site Status RECRUITING

Countries

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Brazil Chile China Czechia France Italy Japan Norway Singapore South Korea Switzerland Taiwan Thailand

Central Contacts

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Toll Free Number

Role: CONTACT

Phone: 1-888-577-8839

Email: [email protected]

Facility Contacts

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Study Coordinator

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Related Links

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http://www.merckclinicaltrials.com

Merck Clinical Trials Information

Other Identifiers

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MK-3475-06E

Identifier Type: OTHER

Identifier Source: secondary_id

2024-514273-22-00

Identifier Type: REGISTRY

Identifier Source: secondary_id

U1111-1307-6484

Identifier Type: REGISTRY

Identifier Source: secondary_id

jRCT2041240166

Identifier Type: REGISTRY

Identifier Source: secondary_id

3475-06E

Identifier Type: -

Identifier Source: org_study_id