Breast CancerPhase 3NCT03725059
Study of Pembrolizumab (MK-3475) Versus Placebo in Combination With Neoadjuvant Chemotherapy & Adjuvant Endocrine Therapy in the Treatment of Early-Stage Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative (ER+/HER2-) Breast Cancer (MK-3475-756/KEYNOTE-756)
A Phase 3 study testing Pembrolizumab (K), Paclitaxel (X) and Doxorubicin (A) in people with Breast Cancer, run by Merck Sharp & Dohme LLC at 244 sites in 24 countries.
Trial summary
The purpose of this study is to assess the efficacy and safety of pembrolizumab (MK-3475) versus placebo in combination with neoadjuvant (pre-surgery) chemotherapy and adjuvant (post-surgery) endocrine therapy in the treatment of adults who have high-risk early-stage estrogen receptor-positive, human epidermal growth… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Breast Cancer
- What is being tested?
- Pembrolizumab (K), Paclitaxel (X) and Doxorubicin (A)
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 1,240 participants
- Where
- 244 sitesin 24 countries
- Study dates
- 27 Dec 2018to 24 Jan 2031
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Has a localized invasive breast ductal adenocarcinoma, confirmed by the local pathologist, that includes either T1c-T2 (tumor size ≥2 cm), clinical node stage (cN)1-cN2, or T3-T4, cN0-cN2. Note: Inflammatory breast cancer is allowed.
- Has centrally confirmed ER+/HER2-, Grade 3 breast cancer of ductal histology, according to the most recent American Society of Clinical Oncology/College of American Pathologist guidelines.
- Provides a new or recently obtained core needle biopsy, consisting of multiple cores, taken from the primary breast tumor(s) for central determination of HR status (ER and progesterone receptor), HER2, grade, and PD-L1 status.
- Note: Sponsor agreement is required for formalin-fixed paraffin-embedded (FFPE) tumor tissue sample or slides that were obtained greater than 60 days prior to the date that the documented informed consent was obtained.
- Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, as assessed within 10 days prior to initiation of study treatment.
- Male participants must agree to use contraception during the treatment period and for at least 12 months (for participants who received cyclophosphamide) or 6 months (for participants who did not receive cyclophosphamide) after the last dose of study treatment and refrain from donating sperm during this period.
- Female participants must agree to use effective contraception during the treatment period and for at least 12 months (for participants who received cyclophosphamide) or 6 months (for participants who did not receive cyclophosphamide) after the last dose of study treatment with pembrolizumab or placebo.
- Has adequate organ function.
Who cannot join
- Has a history of non-infectious pneumonitis that required treatment with steroids or has current pneumonitis.
- Has breast cancer with lobular histology.
- Has bilateral invasive breast cancer.
- Has metastatic (Stage IV) breast cancer.
- Has multi-centric breast cancer (presence of more than 1 tumor in different quadrants of the breast).
- Has any of the following clinical lymph node staging per current American Joint Committee on Cancer (AJCC) staging criteria for breast cancer staging based on radiological and/or clinical assessment: cN3, cN3a, cN3b, or cN3c.
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- Has ER-, progesterone receptor positive breast cancer.
- Has undergone excisional biopsy of the primary tumor and/or axillary lymph nodes or has undergone sentinel lymph node biopsy prior to study treatment.
- Has a known additional, invasive, malignancy that is progressing or required active treatment in the last 5 years.
- Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, ductal breast carcinoma in situ, or cervical carcinoma in situ that has undergone potentially curative therapy are not excluded.
- Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (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 treatment.
- Has an active autoimmune disease that has required systemic treatment in the past 2 years (i.e., with use of disease modifying agents, corticosteroids, or immunosuppressive drugs) Note: Replacement therapy (e.g. thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment.
- Has a known history of active tuberculosis (Bacillus tuberculosis).
- Has an active infection requiring systemic therapy.
- Has left ventricular ejection fraction (LVEF) of <50% or below the institution limit of normal, as assessed by echocardiogram (ECHO) or multigated acquisition (MUGA) scan performed at screening.
- Has other significant cardiac disease, such as: 1) History of myocardial infarction, acute coronary syndrome, or coronary angioplasty/stenting/bypass within the last 6 months. or 2) Congestive heart failure (CHF) New York Heart Association (NYHA) Class II-IV or history of CHF NYHA Class III or IV.
- Has a known history of human immunodeficiency virus (HIV) infection.
- Has a known history of hepatitis B or known active hepatitis C virus infection.
- Has received prior treatment for breast cancer.
- Has received prior therapy with an anti-programmed cell death protein 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 protein 4 [CTLA-4], OX 40, CD137).
- Has received a live vaccine within 30 days prior to the first dose of study treatment.
- Has severe hypersensitivity (≥Grade 3) to any of the components or excipients used in the study treatments.
- Is/was enrolled in a study of an investigational agent and received study therapy, or used an investigational device within 4 weeks (12 months for an investigational agent or device with anticancer or antiproliferative properties) prior to the first dose of study treatment.
- Is pregnant, breastfeeding, or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 12 months (for participants who received cyclophosphamide) or 6 months (for participants who did not receive cyclophosphamide) after the last dose of study treatment.
Trial locations and contacts
244 sites in 24 countries.
244 sites in 24 countries
United States45 sites
University of Colorado, Anschutz Cancer Pavilion ( Site 0008)
Aurora, Colorado, 80045
Texas Oncology-Austin Central ( Site 8004)
Austin, Texas, 78731
Maryland Oncology Hematology, P.A. ( Site 8007)
Bethesda, Maryland, 20817
St. Vincent Frontier Cancer Center ( Site 0033)
Billings, Montana, 59102
Massachusetts General Hospital ( Site 0024)
Boston, Massachusetts, 02114
Medical University of South Carolina ( Site 0053)
Charleston, South Carolina, 29425
The University of Chicago Medical Center ( Site 0080)
Chicago, Illinois, 60637
Texas Oncology-Dallas Presbyterian Hospital ( Site 8002)
Dallas, Texas, 75231
Texas Oncology-Baylor Charles A. Sammons Cancer Center ( Site 8009)
Dallas, Texas, 75246
MGH - North Shore Cancer Center ( Site 0081)
Danvers, Massachusetts, 01923
Geisinger Medical Center ( Site 0052)
Danville, Pennsylvania, 17822
Southern Cancer Center, PC ( Site 8003)
Daphne, Alabama, 36526
Henry Ford Health System ( Site 0028)
Detroit, Michigan, 48202
Cancer Treatment Centers of America at Western Regional Medical Center ( Site 0001)
Goodyear, Arizona, 85338
Goshen Center for Cancer Care ( Site 0021)
Goshen, Indiana, 46526
Texas Oncology-Memorial City ( Site 8012)
Houston, Texas, 77024
University of Texas-MD Anderson Cancer Center ( Site 0083)
Houston, Texas, 77030
Baptist MD Anderson Cancer Center ( Site 0014)
Jacksonville, Florida, 32207
Kadlec Clinic Hematology and Oncology ( Site 0070)
Kennewick, Washington, 99336
Cedars Sinai Medical Center Samuel Oschin Comp. Cancer Institute ( Site 0079)
Los Angeles, California, 90048
James Graham Brown Cancer Center ( Site 0022)
Louisville, Kentucky, 40202
Bon Secours St. Francis Medical Center Oncology Research ( Site 0064)
Midlothian, Virginia, 23114
El Camino Hospital Cancer Center ( Site 0004)
Mountain View, California, 94040
Tennessee Oncology, PLLC/The Sarah Cannon Research Institute ( Site 7000)
Nashville, Tennessee, 37203
Weill Cornell Medical College ( Site 0043)
New York, New York, 10065
Southeastern Regional Medical Center, Inc. ( Site 0075)
Newnan, Georgia, 30265
MGH Newton-Wellesley Hospital's Vernon Cancer Center ( Site 0082)
Newton, Massachusetts, 02462
Virginia Oncology Associates ( Site 8001)
Norfolk, Virginia, 23502
Oncology Hematology West, PC dba Nebraska Cancer Specialists ( Site 0039)
Omaha, Nebraska, 68130
Stanford Cancer Center ( Site 0072)
Palo Alto, California, 94304
Fox Chase Cancer Center ( Site 0078)
Philadelphia, Pennsylvania, 19111
Cancer Treatment Centers of America-Eastern Regional Medical Center ( Site 0076)
Philadelphia, Pennsylvania, 19124
Texas Oncology- Plano East ( Site 8010)
Plano, Texas, 75075
OHSU Knight Cancer Institute ( Site 0051)
Portland, Oregon, 97239
Mayo Clinic and Medical School (Rochester) ( Site 0029)
Rochester, Minnesota, 55905
UC Davis Comprehensive Cancer Center ( Site 0073)
Sacramento, California, 95817
Orchard Healthcare Research Inc. ( Site 0020)
Skokie, Illinois, 60077
Medical Oncology Associates (Summit Cancer Centers) ( Site 0066)
Spokane, Washington, 99208
Holy Name Medical Center ( Site 0041)
Teaneck, New Jersey, 07666
Northwest Cancer Specialists, P.C. ( Site 8000)
Tigard, Oregon, 97223
Arizona Oncology Associates PC- HOPE ( Site 8008)
Tucson, Arizona, 85704
CTCA Southwestern ( Site 0074)
Tulsa, Oklahoma, 74133
Texas Oncology - Northeast Texas ( Site 8006)
Tyler, Texas, 75702
MercyOne Waterloo Cancer Center ( Site 0016)
Waterloo, Iowa, 50702
Midwestern Regional Medical Center, Inc. ( Site 0077)
Zion, Illinois, 60099
China18 sites
Cancer Hospital Chinese Academy of Medical Sciences ( Site 3208)
Beijing, Beijing Municipality, 100021
The First Hospital of Jilin University ( Site 3201)
Changchun, Jilin, 130021
Hunan Cancer Hospital ( Site 3214)
Changsha, Hunan, 410013
Fujian Medical University Union Hospital-1 Bingfanglou-Oncology ( Site 3207)
Fuzhou Fujian, Fujian, 350001
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University ( Site 3213)
Guangzhou, Guangdong, 510289
The First Affiliated Hospital of Zhejiang University ( Site 3203)
Hangzhou, Jiangsu, 310003
Zhejiang Provincial People's Hospital ( Site 3225)
Hangzhou, Zhejiang, 310014
Zhejiang Cancer Hospital ( Site 3210)
Hangzhou, Zhejiang, 310022
Harbin Medical University Cancer Hospital ( Site 3200)
Harbin, Heilongjiang, 150081
Anhui Provincial Hospital ( Site 3224)
Heifei, Anhui, 230001
Ruijin Hosp,Shanghai Jiao Tong University School of Medicine ( Site 3215)
Shanghai, Anhui, 200025
Fudan University Shanghai Cancer Center ( Site 3205)
Shanghai, Shanghai Municipality, 200032
Fourth Hospital Of Hebei Medical University ( Site 3216)
Shijiazhuang, Hebei, 050019
Tianjin Medical University Cancer Institute & Hospital ( Site 3209)
Tianjin, Tianjin Municipality, 300060
The Affiliated Cancer Hospital of Xinjiang Medical ( Site 3219)
Ürümqi, Xinjiang, 830000
Hubei Cancer Hospital ( Site 3211)
Wuhan, Hubei, 430079
The First Affiliated Hospital of Xi an Jiaotong University ( Site 3220)
Xi’an, Shanxi, 710061
Henan Cancer Hospital ( Site 3212)
Zhengzhou, Henan, 450008
Japan16 sites
Chiba Cancer Center ( Site 2605)
Chiba, 260-8717
Fukushima Medical University Hospital ( Site 2610)
Fukushima, 960-1295
Saitama Medical University International Medical Center ( Site 2606)
Hidaka, Saitama, 350-1298
Hiroshima City Hiroshima Citizens Hospital ( Site 2603)
Hiroshima, 730-8518
National Cancer Center Hospital East ( Site 2613)
Kashiwa, Chiba, 2778577
Saitama Prefectural Cancer Center ( Site 2612)
Kitaadachi-gun, Saitama, 362-0806
Kumamoto University Hospital ( Site 2602)
Kumamoto, Kumamoto, 860-8556
Aichi Cancer Center ( Site 2601)
Nagoya, Aichi-ken, 464-8681
Hyogo Medical University Hospital ( Site 2600)
Nishinomiya, Hyōgo, 663-8501
National Hospital Organization Osaka National Hospital ( Site 2614)
Osaka, 540-0006
Kitasato University Hospital ( Site 2616)
Sagamihara, Kanagawa, 252-0375
National Hospital Organization Hokkaido Cancer Center ( Site 2607)
Sapporo, Hokkaido, 003-0804
Shizuoka Cancer Center ( Site 2611)
Suntogun, Shizuoka, 411-8777
Toranomon Hospital ( Site 2608)
Tokyo, 105-8470
Cancer Institute Hospital of JFCR ( Site 2604)
Tokyo, 135-8550
Showa Medical University Hospital ( Site 2615)
Tokyo, 142-8666
France14 sites
Institut Sainte Catherine ( Site 0916)
Avignon, Provence-Alpes-Côte d'Azur Region, 84918
Centre Francois Baclesse ( Site 0927)
Caen, Calvados, 14076
Centre Jean Perrin ( Site 0909)
Clermont-Ferrand, Puy-de-Dome, 63011
Centre Georges Francois Leclerc ( Site 0920)
Dijon, Cote-d Or, 21079
Clinique Victor Hugo Le Mans ( Site 0906)
Le Mans, Sarthe, 72000
Centre Oscar Lambret ( Site 0911)
Lille, Hauts-de-France, 59000
CHR-METZ-THIONVILLE - Hopital de Mercy ( Site 0919)
Metz, Moselle, 57085
Centre de Cancerologie du Grand Montpellier ( Site 0925)
Montpellier, Herault, 34070
Institut Curie ( Site 0900)
Paris, 75005
Hopital Saint-Louis ( Site 0908)
Paris, 75010
Hopital Tenon ( Site 0914)
Paris, 75020
Institut Curie - Centre Rene Huguenin ( Site 0917)
Saint-Cloud, Hauts-de-Seine, 92210
Institut Claudius Regaud IUCT Oncopole ( Site 0903)
Toulouse, Haute-Garonne, 31059
Institut Gustave Roussy ( Site 0926)
Villejuif, Val-de-Marne, 94800
Spain14 sites
Hospital Teresa Herrera - Chuac ( Site 1358)
A Coruña, La Coruna, 15006
Instituto Oncologico Baselga.Hospital Quiron. ( Site 1352)
Barcelona, 08023
Hospital Vall D Hebron ( Site 1357)
Barcelona, 08035
Hospital Clinic I Provincial de Barcelona ( Site 1353)
Barcelona, 08036
Complejo Hospitalario de Jaen ( Site 1364)
Jaén, 23007
Instituto Catalan de Oncologia ICO - Hospital Duran i Reynals ( Site 1363)
L'Hospitalet de Llobregat, Barcelona, 08908
Hospital General Universitario Gregorio Maranon ( Site 1367)
Madrid, Madrid, Comunidad de, 28007
Hospital Beata María Ana-oncology ( Site 1370)
Madrid, 28007
Hospital Clinico San Carlos ( Site 1354)
Madrid, 28040
Hospital Universitario 12 de Octubre ( Site 1356)
Madrid, 28041
Hospital Quiron de Madrid ( Site 1351)
Pozuelo de Alarcón, Madrid, 28223
Hospital Universitario Virgen del Rocio ( Site 1360)
Seville, 41013
Hospital Clinico Universitario de Valencia ( Site 1355)
Valencia, Valenciana, Comunitat, 46011
Hospital General Arnau de Vilanova de Valencia ( Site 1369)
Valencia, 46015
Israel13 sites
HaEmek Medical Center ( Site 1712)
Afula, 1834111
Assuta Ashdod Public ( Site 1704)
Ashdod, 7747629
Soroka Medical Center ( Site 1701)
Beersheba, 8410101
Rambam Health Care Campus-Oncology Division ( Site 1705)
Haifa, 3109601
Shaare Zedek Medical Center ( Site 1708)
Jerusalem, 9103102
Hadassah Ein Karem - Sharett Institute of Oncology ( Site 1700)
Jerusalem, 9112001
Meir Medical Center ( Site 1710)
Kfar Saba, 4428164
Holy Family Hospital ( Site 1711)
Nazareth, 1641101
Rabin Medical Center ( Site 1702)
Petah Tikva, 4941 492
Chaim Sheba Medical Center. ( Site 1707)
Ramat Gan, 5262000
Kaplan Medical Center ( Site 1703)
Rehovot, 76100
Sourasky Medical Center ( Site 1706)
Tel Aviv, 6423906
Assuta Medical Center ( Site 1709)
Tel Aviv, 6789140
Germany12 sites
Gynaekologisches Zentrum ( Site 1003)
Bonn, North Rhine-Westphalia, 53111
Universitaetsklinikum Carl Gustav Carus ( Site 1008)
Dresden, Saxony, 01307
Universitaetsklinikum Erlangen ( Site 1001)
Erlangen, Bavaria, 91054
Kliniken Essen Mitte Gmbh Evang. Huyssens Stiftung ( Site 1006)
Essen, North Rhine-Westphalia, 45136
Medizinische Management GmbH ( Site 1012)
Friedrichshafen, Baden-Wurttemberg, 88045
MVZ Onko Medical GmbH Hannover ( Site 1013)
Hanover, Lower Saxony, 30177
Klinikum der Universitaet Muenchen - Grosshadern ( Site 1000)
Munich, Bavaria, 80336
MVZ Nordhausen gGmbH - Praxis Dr. Grafe ( Site 1005)
Nordhausen, Thuringia, 99734
Sana Klinikum Offenbach GmbH ( Site 1002)
Offenbach, Hesse, 63069
Frauenklinik St. Louise ( Site 1014)
Paderborn, North Rhine-Westphalia, 33098
Caritas Klinikum Saarbruecken St. Theresia ( Site 1009)
Saarbrücken, Saarland, 66113
HELIOS Dr. Horst Schmidt Kliniken Wiesbaden ( Site 1004)
Wiesbaden, Hesse, 65199
Poland12 sites
Bialostockie Centrum Onkologii ( Site 1819)
Bialystok, Podlaskie Voivodeship, 15-027
Beskidzkie Centrum Onkologii im. Jana Pawla II ( Site 1810)
Bielsko-Biala, Silesian Voivodeship, 43-300
Centrum Onkologii im. Prof. Franciszka Lukaszczyka ( Site 1800)
Bydgoszcz, Kuyavian-Pomeranian Voivodeship, 85-796
Wojewodzki Szpital Specjalistyczny nr 4 w Bytomiu ( Site 1807)
Bytom, Silesian Voivodeship, 41-900
Wojewodzkie Centrum Onkologii Copernicus ( Site 1817)
Gdansk, Pomeranian Voivodeship, 80-219
Szpitale Pomorskie Sp. z o.o. ( Site 1818)
Gdynia, Pomeranian Voivodeship, 81-519
Narodowy Instytut Onkologii - Oddzial w Gliwicach ( Site 1801)
Gliwice, Silesian Voivodeship, 44-101
Instytut Centrum Zdrowia Matki Polki ( Site 1821)
Lodz, Łódź Voivodeship, 93-338
Mazowiecki Szpital Specjalistyczny im. dr Jozefa Psarskiego ( Site 1814)
Ostrołęka, Masovian Voivodeship, 07-410
Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - Panstwowy Instytut Badawczy w Warszawie ( Site 1899)
Warsaw, Masovian Voivodeship, 02-781
Mazowiecki Szpital Onkologiczny ( Site 1803)
Wieliszew, Masovian Voivodeship, 05-135
Dolnoslaskie Centrum Onkologii. ( Site 1820)
Wroclaw, Lower Silesian Voivodeship, 53-413
Ukraine11 sites
Communal nonprofit enterprise "Kherson Regional Oncology Dispensary" of Kherson Regional Council ( Site 2713)
Antonivka Village, Kherson Oblast, 73000
MNPE City Clinical Hospital #4 of Dnipro Regional Council ( Site 2702)
Dnipro, Dnipropetrovsk Oblast, 49102
MI Precarpathian Clinical Oncology Center ( Site 2707)
Ivano-Frankivsk, Ivano-Frankivsk Oblast, 76018
Communal non profit enterprise Regional Clinical Oncology Center ( Site 2721)
Kharkiv, Kharkiv Oblast, 61070
Khmelnitskiy Regional Onkology Dispensary ( Site 2704)
Khmelnitskiy, Khmelnytskyi Oblast, 29000
MI Kryviy Rih Center of Dnipropetrovsk Regional Council ( Site 2700)
Kryviy Rih, Dnipropetrovsk Oblast, 50048
SNPE National Cancer Institute ( Site 2719)
Kyiv, Kyivska Oblast, 03022
Kyiv City Clinical Oncology Centre ( Site 2716)
Kyiv, 03115
MI Odesa Regional Clinical Hospital ( Site 2701)
Odesa, Odesa Oblast, 65025
MI Odessa Regional Oncological Centre ( Site 2714)
Odesa, Odesa Oblast, 65055
Medical center of the Limited Liability Company Yulis ( Site 2720)
Zaporizhzhya, Zaporizhzhia Oblast, 69035
Belgium10 sites
Institut Jules Bordet ( Site 0710)
Anderlecht, Bruxelles-Capitale, Region de, 1070
Imelda Ziekenhuis Bonheiden ( Site 0703)
Bonheiden, Antwerpen, 2820
Cliniques Universitaires Saint-Luc ( Site 0701)
Brussels, Bruxelles-Capitale, Region de, 1200
UZ Antwerpen - Medical Oncology ( Site 0709)
Edegem, Antwerpen, 2650
AZ Maria Middelares Gent ( Site 0700)
Ghent, Oost-Vlaanderen, 9000
Jessa Ziekenhuis Campus Virga Jesse ( Site 0704)
Hasselt, Limburg, 3500
AZ Groeninge ( Site 0705)
Kortrijk, West-Vlaanderen, 8500
UZ Leuven ( Site 0702)
Leuven, Vlaams-Brabant, 3000
CHC MontLegia ( Site 0707)
Liège, Liege, 4000
CHU UCL Namur Site de Godinne ( Site 0706)
Yvoir, Namur, 5530
Brazil10 sites
CEPON - Centro de Pesquisas Oncologicas ( Site 0208)
Florianópolis, Santa Catarina, 88034-000
Hospital Araujo Jorge Associacao de Combate ao Cancer de Goias ( Site 0205)
Goiânia, Goiás, 74605-070
ONCOSITE - Centro de Pesquisa Clinica em Oncologia ( Site 0206)
Ijuí, Rio Grande do Sul, 98700-000
Centro de Novos Tratamentos Itajai - Clinica de Neoplasias Litoral ( Site 0207)
Itajaí, Santa Catarina, 88301-220
Associacao Hospitalar Moinhos de Vento ( Site 0201)
Porto Alegre, Rio Grande do Sul, 90035-001
Uniao Brasileira de Educacao e Assistencia Hospital Sao Lucas da Pucrs ( Site 0202)
Porto Alegre, Rio Grande do Sul, 90610-000
Instituto Nacional de Câncer - INCA-Pesquisa Clinica HC3 ( Site 0200)
Rio de Janeiro, 20560121
Clinica de Pesquisas e Ctro de Estudos Onc. Ginecol. e Mamaria Ltda ( Site 0204)
São Paulo, 01317-001
Núcleo de Pesquisa Clínica da Rede São Camilo ( Site 0210)
São Paulo, 04014-002
Instituto do Cancer do Estado de Sao Paulo - ICESP ( Site 0209)
São Paulo, 12460-000
Russia10 sites
Arkhangelsk Clinical Oncological Dispensary ( Site 1901)
Arkhangelsk, Arkhangelskaya oblast, 163045
Republican Clinical Oncology Dispensary of Tatarstan MoH named after professor M.Z. Sigal ( Site 1903)
Kazan', Tatarstan, Respublika, 420029
N.N. Blokhin NMRCO ( Site 1908)
Moscow, Moscow, 115478
Central Clinical Hospital with outpatient Clinic ( Site 1907)
Moscow, Moscow, 121359
Medical Rehabilitation Center ( Site 1912)
Moscow, Moscow, 125367
Ryazan Regional Clinical Oncology Dispensary ( Site 1910)
Ryazan, Ryazan Oblast, 390046
Railway Hospital of OJSC ( Site 1913)
Saint Petersburg, Sankt-Peterburg, 195271
Scientific Research Oncology Institute n.a. N.N.Petrov ( Site 1900)
Saint Petersburg, Sankt-Peterburg, 197758
Tomsk Scientific Research Institute of Oncology ( Site 1905)
Tomsk, Tomsk Oblast, 634028
Republican Clinical Oncology Dispensary of Republic of Bashkortostan ( Site 1909)
Ufa, Baskortostan, Respublika, 450054
Canada9 sites
Cross Cancer Institute ( Site 0115)
Edmonton, Alberta, T6G 1Z2
CISSS de la Monteregie-Centre ( Site 0108)
Greenfield Park, Quebec, J4V 2H1
Hopital Maisonneuve-Rosemont CIUSSS de l Est de L Ile de Montreal ( Site 0111)
Montreal, Quebec, H1T 2M4
Centre Hospitalier de l Universite de Montreal - CHUM ( Site 0114)
Montreal, Quebec, H2X 3E4
Jewish General Hospital ( Site 0103)
Montreal, Quebec, H3T 1E2
CHU de Quebec Universite Laval - Hopital du Saint-Sacrement ( Site 0101)
Québec, Quebec, G1S 4L8
Princess Margaret Cancer Centre ( Site 0112)
Toronto, Ontario, M5G 2M9
Centre Hospitalier Regional de Trois-Rivieres ( Site 0106)
Trois-Rivières, Quebec, G8Z 3R9
BC Cancer-Vancouver Center ( Site 0116)
Vancouver, British Columbia, V5Z 4E6
Hungary8 sites
Budapesti Szent Margit Korhaz ( Site 2901)
Budapest, 1032
Orszagos Onkologiai Intezet ( Site 2908)
Budapest, 1122
Budapesti Uzsoki Utcai Kórház-Onkoradiológiai Osztály ( Site 2902)
Budapest, 1145
Debreceni Egyetem Klinikai Kozpont ( Site 2907)
Debrecen, 4032
Somogy Megyei Kaposi Mor Oktato Korhaz ( Site 2915)
Kaposvár, 7400
Bacs-Kiskun Varmegyei Oktatokorhaz-Onkoradiologiai Kozpont ( Site 2913)
Kecskemét, Bács-Kiskun county, 6000
Borsod-Abauj-Zemplen Megyei Korhaz es Egyetemi OktatoKorhaz ( Site 2904)
Miskolc, Borsod-Abauj Zemplen county, 3526
Pecsi Tudomanyegyetem Klinikai Kozpont ( Site 2905)
Pécs, Baranya, 7621
United Kingdom8 sites
University Hospitals Bristol NHS Foundation Trust ( Site 1503)
Bristol, Bristol, City of, BS2 8ED
Colchester General Hospital ( Site 1508)
Colchester, Essex, CO4 5JL
Barts Health NHS Trust ( Site 1500)
London, London, City of, EC1A 7BE
Guy's Hospital ( Site 1501)
London, London, City of, SE1 9RY
St. Georges University Hospital NHS Foundation Trust ( Site 1505)
London, London, City of, SW17 0QT
Nottingham University Hospitals NHS Trust ( Site 1504)
Nottingham, England, NG5 1PF
Birmingham & Solihull Heartlands Hospital NHS ( Site 1506)
Solihull, B91 2JL
Royal Cornwall Hospital ( Site 1502)
Truro, TR1 3LJ
Colombia7 sites
Clinica de la Costa S.A.S. ( Site 0400)
Barranquilla, Atlántico, 080020
Centro de Investigacion Clinica del Country ( Site 0402)
Bogotá, Bogota D.C., 110221
Fundacion Universitaria Sanitas ( Site 0403)
Bogotá, Bogota D.C., 111221
Clínica Imbanaco S.A.S ( Site 0406)
Cali, Valle del Cauca Department, 760042
Fundacion Colombiana de Cancerología Clinica Vida ( Site 0405)
Medellín, Antioquia, 050030
Rodrigo Botero SAS ( Site 0407)
Medellín, Antioquia, 50030
IMAT S.A.S ( Site 0401)
Montería, Departamento de Córdoba, 230002
Australia6 sites
Chris OBrien Lifehouse ( Site 2107)
Camperdown, New South Wales, 2050
Frankston Hospital ( Site 2103)
Frankston, Victoria, 3199
Peter MacCallum Cancer Centre ( Site 2102)
Melbourne, Victoria, 3000
Mater Misericordiae Ltd ( Site 2106)
South Brisbane, Queensland, 4101
Royal North Shore Hospital ( Site 2100)
Sydney, New South Wales, 2065
Westmead Hospital ( Site 2101)
Sydney, New South Wales, 2145
South Korea5 sites
National Cancer Center ( Site 2204)
Goyang-si, Kyonggi-do, 10408
Seoul National University Hospital ( Site 2200)
Seoul, 03080
Severance Hospital Yonsei University Health System ( Site 2201)
Seoul, 03722
Asan Medical Center ( Site 2202)
Seoul, 05505
Samsung Medical Center ( Site 2203)
Seoul, 06351
Taiwan5 sites
China Medical University Hospital ( Site 2401)
Taichung, 40447
National Cheng Kung University Hospital ( Site 2400)
Tainan, 70457
National Taiwan University Hospital ( Site 2404)
Taipei, 100225
Koo Foundation Sun Yat-Sen Cancer Center ( Site 2403)
Taipei, 11259
Linkou Chang Gung Memorial Hospital ( Site 2402)
Taoyuan, 333
Portugal4 sites
Fundacao Champalimaud ( Site 2500)
Lisboa, Aveiro District, 1400-038
Unidade Local de Saude de Santa Maria - Hospital de Santa Maria ( Site 2501)
Lisbon, 1649-035
Unidade Local de Saude de Santo António - Hospital Santo António ( Site 2503)
Porto, 4099-001
Inst. Portugues de Oncologia de Porto Francisco Gentil EPE ( Site 2502)
Porto, 4200-072
New Zealand3 sites
Canterbury Regional Cancer & Blood Services ( Site 2303)
Christchurch, Canterbury, 8011
Tauranga Hospital ( Site 2302)
Tauranga, Bay of Plenty, 3112
Capital & Coast District Health Board - Wellington Hospital ( Site 2301)
Wellington, 6021
Ireland2 sites
Bon Secours Hospital ( Site 1554)
Cork, T12 DV56
St. James s Hospital ( Site 1553)
Dublin, Dublin 8
Costa Rica1 site
Hospital Metropolitano - Sede Lindora ( Site 4203)
Santa Ana, Provincia de San José, 10903
Puerto Rico1 site
UPR Comprehensive Cancer Center ( Site 6200)
San Juan, 00935
About this study
Official title: A Randomized, Double-Blind, Phase III Study of Pembrolizumab Versus Placebo in Combination With Neoadjuvant Chemotherapy and Adjuvant Endocrine Therapy for the Treatment of High-Risk Early-Stage Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative (ER+/HER2-) Breast Cancer (KEYNOTE-756)
The purpose of this study is to assess the efficacy and safety of pembrolizumab (MK-3475) versus placebo in combination with neoadjuvant (pre-surgery) chemotherapy and adjuvant (post-surgery) endocrine therapy in the treatment of adults who have high-risk early-stage estrogen receptor-positive, human epidermal growth factor receptor 2-negative (ER+/HER2-) breast cancer.
The primary study hypotheses are: 1) pembrolizumab is superior to placebo, both in combination with the protocol-specified neoadjuvant anticancer therapy, as assessed by pathological Complete Response (pCR) rate defined by the local pathologist, and 2) pembrolizumab is superior to placebo (both in combination with the protocol-specified neoadjuvant and adjuvant anticancer therapies) as assessed by Event-Free Survival (EFS) as determined by the investigator. The study is considered to have met its primary objective if pembrolizumab is superior to placebo with respect to either pCR (ypT0/Tis ypN0) or EFS.
Read the detailed description
Study participants will receive 8 cycles of neoadjuvant study treatment and then will undergo surgery for their breast cancer. After surgery, participants will receive 9 cycles of study treatment and up to 10 years of variable endocrine therapy. Each cycle is 21 days long.
- Conditions
- Breast Cancer
- Being tested
- Pembrolizumab (K), Placebo (P), Paclitaxel (X), Doxorubicin (A), Epirubicin (E)
- Keywords
- PD1, PD-1, PDL1, PD-L1
- Medical subject headings
- Breast Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Pembrolizumab (K)Biological
Also called MK-3475, KEYTRUDA®
IV infusion Q3W
Placebo (P)Drug
Normal saline or dextrose IV infusion Q3W
Paclitaxel (X)Drug
Also called TAXOL®
IV infusion QW
Doxorubicin (A)Drug
Also called ADRIAMYCIN®
IV infusion either in Q2W or Q3W
Epirubicin (E)Drug
Also called ELLENCE®
IV infusion either in Q2W or Q3W
Cyclophosphamide (C)Drug
Also called CYTOXAN®
IV infusion either in Q2W or Q3W
Endocrine therapyDrug
Variable endocrine therapy for up 10 years
Radiation therapyRadiation
Variable radiation therapy per local standard of care
SurgeryProcedure or surgery
Surgery for breast cancer
| Study group | Role | What they receive |
|---|---|---|
| Pembrolizumab+Chemotherapy (KX/KA[E]C) | Experimental | In the neoadjuvant setting, participants receive pembrolizumab (K) 200 mg via intravenous (IV) infusion once every 3 weeks (Q3W) + paclitaxel (X) 80 mg/m^2 via IV infusion once weekly (QW) for 4 cycles (Treatment 1), followed by pembrolizumab 200 mg via IV infusion + doxorubicin or epirubicin (A or E; 60 mg/m^2 or 100 mg/m^2) via IV infusion either in Q2W or Q3W + cyclophosphamide (C) 600 mg/m^2 via IV infusion either in Q2W or Q3W for 4 cycles (Treatment 2). At no more than 6 weeks after last cycle of neoadjuvant treatment, participants will undergo surgery for their breast cancer. After surgery, participants will begin adjuvant study treatment. In the adjuvant setting, participants receive pembrolizumab 200 mg via IV infusion Q3W for 9 cycles + variable endocrine therapy for up to 10 years. Each cycle is 21 days long. Receives: Biological: Pembrolizumab (K); Drug: Paclitaxel (X); Drug: Doxorubicin (A); Drug: Epirubicin (E); Drug: Cyclophosphamide (C); Drug: Endocrine therapy; Radiation: Radiation therapy; Procedure: Surgery |
| Placebo+Chemotherapy (PX/PA[E]C) | Placebo comparator | In the neoadjuvant setting, participants receive placebo (P; normal saline or dextrose) via IV infusion Q3W + paclitaxel (X) 80 mg/m^2 via IV infusion once weekly (QW) for 4 cycles (Treatment 1), followed by placebo via IV infusion + doxorubicin or epirubicin (A or E; 60 mg/m^2 or 100 mg/m^2) via IV infusion either in Q2W or Q3W + cyclophosphamide (C) 600 mg/m^2 via IV infusion either in Q2W or Q3W for 4 cycles (Treatment 2). At no more than 6 weeks after last cycle of neoadjuvant treatment, participants will undergo surgery for their breast cancer. After surgery, participants will begin adjuvant study treatment. In the adjuvant setting, participants receive placebo via IV infusion Q3W for 9 cycles + variable endocrine therapy for up to 10 years. Each cycle is 21 days long. Receives: Drug: Placebo (P); Drug: Paclitaxel (X); Drug: Doxorubicin (A); Drug: Epirubicin (E); Drug: Cyclophosphamide (C); Radiation: Radiation therapy; Procedure: Surgery |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pathological Complete Response (pCR) Rate Using the Definition of ypT0/Tis ypN0
The pCR rate (ypT0/Tis ypN0) is defined as the percentage of participants without residual invasive cancer on hematoxylin and eosin evaluation of the complete resected breast specimen and all sampled regional lymph nodes following completion of neoadjuvant systemic therapy by American Joint Committee on Cancer (AJCC) staging criteria (8th edition) assessed by the local pathologist at the time of surgery. The percentage of participants with a pathological Complete Response (pCR) using the definition of (ypT0/Tis ypN0) will be presented for pembrolizumab versus placebo, both in combination with the protocol-specified neoadjuvant anticancer therapies.
Measured: Up to approximately 7 months (Time of surgery)
Event-Free Survival (EFS)
EFS is defined as the time from randomization to disease progression that: precludes surgery, results in a local or distant recurrence, results in a second primary malignancy, or death due to any cause whichever occurs first. The EFS following administration of pembrolizumab and placebo, both in combination with the protocol-specified neoadjuvant and adjuvant anticancer therapies, as determined by the investigator will be presented.
Measured: Up to approximately 12 years
Secondary outcomes (12)
Overall Survival (OS)
OS is defined as the time from date of randomization to date of death due to any cause. The OS following administration of pembrolizumab and placebo, both in combination with the protocol-specified neoadjuvant and adjuvant anticancer therapies will be presented.
Measured: Up to approximately 12 years
pCR Rate Using the Definition of ypT0ypN0
pCR rate (ypT0ypN0) is defined as the percentage of participants without residual invasive or in situ cancer on hematoxylin and eosin evaluation of the complete resected breast specimen and all sampled regional lymph nodes after completion of neoadjuvant systemic therapy by AJCC staging criteria (8th edition) assessed by the local pathologist at the time of surgery. The percentage of participants with a pCR using the definition of (ypT0ypN0) will be presented for pembrolizumab versus placebo, both in combination with the protocol-specified neoadjuvant anticancer therapies.
Measured: Up to approximately 7 months (Time of surgery)
pCR Rate Using the Definition of ypT0/Tis
pCR rate (ypT0/Tis) is defined as the percentage of participants without residual invasive cancer on hematoxylin and eosin evaluation of the complete resected breast specimen (independent of lymph node involvement) after completion of neoadjuvant systemic therapy by AJCC staging criteria (8th edition) assessed by the local pathologist at the time of surgery. The percentage of participants with a pCR using the definition of ypT0/Tis will be presented for pembrolizumab versus placebo, both in combination with the protocol-specified neoadjuvant anticancer therapies.
Measured: Up to approximately 7 months (Time of surgery)
pCR Rate Using the Definitions of ypT0/Tis ypN0, ypT0/Tis, and ypT0 ypN0 in Participants With a Combined Positive Score [CPS] ≥1
pCR rates were calculated using the definitions of ypT0/Tis ypN0, ypT0/Tis, and ypT0 ypN0 after completion of neoadjuvant systemic therapy by AJCC staging criteria (8th edition) assessed by the local pathologist at the time of surgery. The percentage of participants with a pCR using the three definitions of ypT0/Tis ypN0, ypT0/Tis, and ypT0 ypN0 in participants with a CPS ≥1 (with a positive Programmed Cell Death-Ligand 1 [PD-L1] tumor status) will be presented for pembrolizumab versus placebo, both in combination with the protocol-specified neoadjuvant anticancer therapies.
Measured: Up to approximately 7 months (Time of surgery)
EFS in Participants With a CPS ≥1
EFS is defined as the time from randomization to disease progression that: precludes surgery, results in a local or distant recurrence, results in a second primary malignancy, or death due to any cause whichever occurs first. The EFS following administration of pembrolizumab and placebo, both in combination with the protocol-specified neoadjuvant and adjuvant anticancer therapies, as determined by the investigator for participants with a CPS ≥1 will be presented.
Measured: Up to approximately 12 years
OS in Participants With a CPS ≥1
OS is defined as the time from date of randomization to date of death due to any cause. The OS following administration of pembrolizumab and placebo, both in combination with the protocol-specified neoadjuvant and adjuvant anticancer therapies for participants with a CPS ≥1 will be presented.
Measured: Up to approximately 12 years
Number of Participants Experiencing an Adverse Event (AE)
An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants who experience an AE while receiving pembrolizumab or placebo (including 1 month of safety follow up) will be presented.
Measured: Up to approximately 15 months
Number of Participants Experiencing a Serious Adverse Event (SAE)
An SAE is defined as any untoward medical occurrence that, at any dose: Results in death, Is life-threatening, Requires inpatient hospitalization or prolongation of existing hospitalization, Results in persistent or significant disability/incapacity or Is a congenital anomaly/birth defect. The number of participants who experience an SAE while receiving pembrolizumab or placebo (including 3 months of safety follow up) will be presented.
Measured: Up to approximately 17 months
Number of Participants Experiencing an Immune-related AE (irAE)
Some AEs that may occur in this study that are known to be related to pembrolizumab immunotherapy treatment and may include: pneumonitis, diarrhea/colitis, aspartate aminotransferase/alanine aminotransferase (AST/ALT) elevation or increased bilirubin, Type 1 diabetes mellitus or hyperglycemia, hypophysitis, hyperthyroidism, hypothyroidism, nephritis and renal dysfunction, and myocarditis. The number of participants who experience an irAE while receiving pembrolizumab or placebo (including 1 month of safety follow up) will be presented.
Measured: Up to approximately 15 months
Number of Participants who Discontinued Study Treatment Due to an AE
An AE is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants who discontinue study treatment (pembrolizumab or placebo) due to an AE will be presented.
Measured: Up to approximately 14 months
Change from Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life (QoL) Questionnaire Core 30 (QLQ-C30) Score
The EORTC QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer patients. Individual responses for each of 28 items are given on a 4-point scale (1=Not at All to 4=Very Much), with a lower score indicating a better outcome, and responses for each of 2 items (overall health and overall quality of life) are given on a 7-point scale (1=Very poor to 7=Excellent), with a higher score indicating a better outcome. The change from Baseline to end of treatment (up to Cycle 4 Day 1) in EORTC-QLQ-C30 scores for participants will be presented.
Measured: Baseline (Cycle 1 Day 1 in Treatment 1) and Cycles 1 and 4 Day 1 in Treatment 2 (Up to approximately 5 months) Each cycle is 21 days.
Change from Baseline in EORTC Breast Cancer-Specific QoL Questionnaire (QLQ-BR23) Score
The EORTC QLQ-BR23 is a 23-item questionnaire developed to assess the quality of life in women with breast cancer. Responses for each item are given on a 4-point scale (1=Not at All to 4=Very Much), with a lower score indicating a better outcome. The change from Baseline to end of treatment (up to Cycle 4 Day 1) in EORTC QLQ-BR23 score for participants will be presented.
Measured: Baseline (Cycle 1 Day 1 in Treatment 1) and Cycles 1 and 4 Day 1 in Treatment 2 (Up to approximately 5 months) Each cycle is 21 days.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Oct 2018
- Study start27 Dec 2018
- Primary completion24 Jan 2031 (estimated)
- Study completion24 Jan 2031 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- More trials run by Merck Sharp & Dohme LLCThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 1,240 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Merck Sharp & Dohme LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Medical Director, Study director, Merck Sharp & Dohme LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03725059
- Sponsor's protocol ID
- 3475-756
- Other IDs
- MK-3475-756, 194604, KEYNOTE-756, 2023-506921-12-00, jRCT2080224535, U1111-1294-6352, 2017-004869-27, 2017
- Status last verified
- Jul 2025
- First submitted
- 29 Oct 2018
- Last updated
- 11 Jul 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: https://trialstransparency.msdclinicaltrials.com/pdf/ProcedureAccessClinicalTrialData.pdf
Publications
Cardoso F, O'Shaughnessy J, Liu Z, McArthur H, Schmid P, Cortes J, Harbeck N, Telli ML, Cescon DW, Fasching PA, Shao Z, Loirat D, Park YH, Fernandez MG, Rubovszky G, Spring L, Im SA, Hui R, Takano T, Andre F, Yasojima H, Ding Y, Jia L, Karantza V, Tryfonidis K, Bardia A. Pembrolizumab and chemotherapy in high-risk, early-stage, ER+/HER2- breast cancer: a randomized phase 3 trial. Nat Med. 2025 Feb;31(2):442-448. doi: 10.1038/s41591-024-03415-7. Epub 2025 Jan 21.
PubMed 39838117Schlam I, Corti C, Sammons S, Mittendorf EA, Tolaney SM. Checkpoint inhibition for early-stage hormone receptor-positive breast cancer. Expert Opin Biol Ther. 2024 Jun;24(6):511-520. doi: 10.1080/14712598.2024.2370395. Epub 2024 Jun 24.
PubMed 38913933
Study at a glance
From the registry record, last updated by the sponsor on 11 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double-Blind, Phase III Study of Pembrolizumab Versus Placebo in Combination With Neoadjuvant Chemotherapy and Adjuvant Endocrine Therapy for the Treatment of High-Risk Early-Stage Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative (ER+/HER2-) Breast Cancer (KEYNOTE-756)
- ClinicalTrials.gov ID
- NCT03725059
- Acronym / sponsor ID
- 3475-756
- Conditions
- Breast Cancer
- Keywords
- PD1, PD-1, PDL1, PD-L1
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 1,240 participants (estimated)
- Lead sponsor
- Merck Sharp & Dohme LLCIndustry (pharma, biotech, devices)
- Study start
- 27 Dec 2018 (actual)
- Primary completion
- 24 Jan 2031 (estimated)
- Study completion
- 24 Jan 2031 (estimated)
- First posted
- 30 Oct 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to assess the efficacy and safety of pembrolizumab (MK-3475) versus placebo in combination with neoadjuvant (pre-surgery) chemotherapy and adjuvant (post-surgery) endocrine therapy in the treatment of adults who have high-risk early-stage estrogen receptor-positive, human epidermal growth factor receptor 2-negative (ER+/HER2-) breast cancer.
The primary study hypotheses are: 1) pembrolizumab is superior to placebo, both in combination with the protocol-specified neoadjuvant anticancer therapy, as assessed by pathological Complete Response (pCR) rate defined by the local pathologist, and 2) pembrolizumab is superior to placebo (both in combination with the protocol-specified neoadjuvant and adjuvant anticancer therapies) as assessed by Event-Free Survival (EFS) as determined by the investigator. The study is considered to have met its primary objective if pembrolizumab is superior to placebo with respect to either pCR (ypT0/Tis ypN0) or EFS.
Detailed description
Study participants will receive 8 cycles of neoadjuvant study treatment and then will undergo surgery for their breast cancer. After surgery, participants will receive 9 cycles of study treatment and up to 10 years of variable endocrine therapy. Each cycle is 21 days long.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Pembrolizumab+Chemotherapy (KX/KA[E]C) | Experimental | Biological: Pembrolizumab (K), Drug: Paclitaxel (X), Drug: Doxorubicin (A), Drug: Epirubicin (E), Drug: Cyclophosphamide (C), Drug: Endocrine therapy, Radiation: Radiation therapy, Procedure: SurgeryIn the neoadjuvant setting, participants receive pembrolizumab (K) 200 mg via intravenous (IV) infusion once every 3 weeks (Q3W) + paclitaxel (X) 80 mg/m^2 via IV infusion once weekly (QW) for 4 cycles (Treatment 1), followed by pembrolizumab 200 mg via IV infusion + doxorubicin or epirubicin (A or E; 60 mg/m^2 or 100 mg/m^2) via IV infusion either in Q2W or Q3W + cyclophosphamide (C) 600 mg/m^2 via IV infusion either in Q2W or Q3W for 4 cycles (Treatment 2). At no more than 6 weeks after last cycle of neoadjuvant treatment, participants will undergo surgery for their breast cancer. After surgery, participants will begin adjuvant study treatment. In the adjuvant setting, participants receive pembrolizumab 200 mg via IV infusion Q3W for 9 cycles + variable endocrine therapy for up to 10 years. Each cycle is 21 days long. |
| Placebo+Chemotherapy (PX/PA[E]C) | Placebo comparator | Drug: Placebo (P), Drug: Paclitaxel (X), Drug: Doxorubicin (A), Drug: Epirubicin (E), Drug: Cyclophosphamide (C), Radiation: Radiation therapy, Procedure: SurgeryIn the neoadjuvant setting, participants receive placebo (P; normal saline or dextrose) via IV infusion Q3W + paclitaxel (X) 80 mg/m^2 via IV infusion once weekly (QW) for 4 cycles (Treatment 1), followed by placebo via IV infusion + doxorubicin or epirubicin (A or E; 60 mg/m^2 or 100 mg/m^2) via IV infusion either in Q2W or Q3W + cyclophosphamide (C) 600 mg/m^2 via IV infusion either in Q2W or Q3W for 4 cycles (Treatment 2). At no more than 6 weeks after last cycle of neoadjuvant treatment, participants will undergo surgery for their breast cancer. After surgery, participants will begin adjuvant study treatment. In the adjuvant setting, participants receive placebo via IV infusion Q3W for 9 cycles + variable endocrine therapy for up to 10 years. Each cycle is 21 days long. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Has a localized invasive breast ductal adenocarcinoma, confirmed by the local pathologist, that includes either T1c-T2 (tumor size ≥2 cm), clinical node stage (cN)1-cN2, or T3-T4, cN0-cN2. Note: Inflammatory breast cancer is allowed.
- Has centrally confirmed ER+/HER2-, Grade 3 breast cancer of ductal histology, according to the most recent American Society of Clinical Oncology/College of American Pathologist guidelines.
- Provides a new or recently obtained core needle biopsy, consisting of multiple cores, taken from the primary breast tumor(s) for central determination of HR status (ER and progesterone receptor), HER2, grade, and PD-L1 status.
- Note: Sponsor agreement is required for formalin-fixed paraffin-embedded (FFPE) tumor tissue sample or slides that were obtained greater than 60 days prior to the date that the documented informed consent was obtained.
- Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, as assessed within 10 days prior to initiation of study treatment.
Key exclusion criteria (24 listed)
- Has a history of non-infectious pneumonitis that required treatment with steroids or has current pneumonitis.
- Has breast cancer with lobular histology.
- Has bilateral invasive breast cancer.
- Has metastatic (Stage IV) breast cancer.
- Has multi-centric breast cancer (presence of more than 1 tumor in different quadrants of the breast).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Pembrolizumab (K)Also: MK-3475, KEYTRUDA®IV infusion Q3W | Biological | Pembrolizumab+Chemotherapy (KX/KA[E]C) |
| Placebo (P)Normal saline or dextrose IV infusion Q3W | Drug | Placebo+Chemotherapy (PX/PA[E]C) |
| Paclitaxel (X)Also: TAXOL®IV infusion QW | Drug | Pembrolizumab+Chemotherapy (KX/KA[E]C), Placebo+Chemotherapy (PX/PA[E]C) |
| Doxorubicin (A)Also: ADRIAMYCIN®IV infusion either in Q2W or Q3W | Drug | Pembrolizumab+Chemotherapy (KX/KA[E]C), Placebo+Chemotherapy (PX/PA[E]C) |
| Epirubicin (E)Also: ELLENCE®IV infusion either in Q2W or Q3W | Drug | Pembrolizumab+Chemotherapy (KX/KA[E]C), Placebo+Chemotherapy (PX/PA[E]C) |
| Cyclophosphamide (C)Also: CYTOXAN®IV infusion either in Q2W or Q3W | Drug | Pembrolizumab+Chemotherapy (KX/KA[E]C), Placebo+Chemotherapy (PX/PA[E]C) |
| Endocrine therapyVariable endocrine therapy for up 10 years | Drug | Pembrolizumab+Chemotherapy (KX/KA[E]C) |
| Radiation therapyVariable radiation therapy per local standard of care | Radiation | Pembrolizumab+Chemotherapy (KX/KA[E]C), Placebo+Chemotherapy (PX/PA[E]C) |
| SurgerySurgery for breast cancer | Procedure or surgery | Pembrolizumab+Chemotherapy (KX/KA[E]C), Placebo+Chemotherapy (PX/PA[E]C) |
Primary outcome
Pathological Complete Response (pCR) Rate Using the Definition of ypT0/Tis ypN0
Time frame: Up to approximately 7 months (Time of surgery)
The pCR rate (ypT0/Tis ypN0) is defined as the percentage of participants without residual invasive cancer on hematoxylin and eosin evaluation of the complete resected breast specimen and all sampled regional lymph nodes following completion of neoadjuvant systemic therapy by American Joint Committee on Cancer (AJCC) staging criteria (8th edition) assessed by the local pathologist at the time of surgery. The percentage of participants with a pathological Complete Response (pCR) using the definition of (ypT0/Tis ypN0) will be presented for pembrolizumab versus placebo, both in combination with the protocol-specified neoadjuvant anticancer therapies.
Event-Free Survival (EFS)
Time frame: Up to approximately 12 years
EFS is defined as the time from randomization to disease progression that: precludes surgery, results in a local or distant recurrence, results in a second primary malignancy, or death due to any cause whichever occurs first. The EFS following administration of pembrolizumab and placebo, both in combination with the protocol-specified neoadjuvant and adjuvant anticancer therapies, as determined by the investigator will be presented.
12 secondary outcomes
Overall Survival (OS)
Time frame: Up to approximately 12 years
pCR Rate Using the Definition of ypT0ypN0
Time frame: Up to approximately 7 months (Time of surgery)
pCR Rate Using the Definition of ypT0/Tis
Time frame: Up to approximately 7 months (Time of surgery)
pCR Rate Using the Definitions of ypT0/Tis ypN0, ypT0/Tis, and ypT0 ypN0 in Participants With a Combined Positive Score [CPS] ≥1
Time frame: Up to approximately 7 months (Time of surgery)
EFS in Participants With a CPS ≥1
Time frame: Up to approximately 12 years
OS in Participants With a CPS ≥1
Time frame: Up to approximately 12 years
Number of Participants Experiencing an Adverse Event (AE)
Time frame: Up to approximately 15 months
Number of Participants Experiencing a Serious Adverse Event (SAE)
Time frame: Up to approximately 17 months
Number of Participants Experiencing an Immune-related AE (irAE)
Time frame: Up to approximately 15 months
Number of Participants who Discontinued Study Treatment Due to an AE
Time frame: Up to approximately 14 months
Change from Baseline in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life (QoL) Questionnaire Core 30 (QLQ-C30) Score
Time frame: Baseline (Cycle 1 Day 1 in Treatment 1) and Cycles 1 and 4 Day 1 in Treatment 2 (Up to approximately 5 months) Each cycle is 21 days.
Change from Baseline in EORTC Breast Cancer-Specific QoL Questionnaire (QLQ-BR23) Score
Time frame: Baseline (Cycle 1 Day 1 in Treatment 1) and Cycles 1 and 4 Day 1 in Treatment 2 (Up to approximately 5 months) Each cycle is 21 days.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Jul 2025.
- Results publication: PubMed 39838117Cardoso F, O'Shaughnessy J, Liu Z, McArthur H, Schmid P, Cortes J, Harbeck N, Telli ML, Cescon DW, Fasching PA, Shao Z, Loirat D, Park YH, Fernandez MG, Rubovszky G, Spring L, Im SA, Hui R, Takano T, Andre F, Yasojima H, Ding Y, Jia L, Karantza V, Tryfonidis K, Bardia A. Pembrolizumab and chemotherapy in high-risk, early-stage, ER+/HER2- breast cancer: a randomized phase 3 trial. Nat Med. 2025 Feb;31(2):442-448. doi: 10.1038/s41591-024-03415-7. Epub 2025 Jan 21.
- Derived from this study: PubMed 38913933Schlam I, Corti C, Sammons S, Mittendorf EA, Tolaney SM. Checkpoint inhibition for early-stage hormone receptor-positive breast cancer. Expert Opin Biol Ther. 2024 Jun;24(6):511-520. doi: 10.1080/14712598.2024.2370395. Epub 2024 Jun 24.
- Merck Clinical Trials InformationLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. https://trialstransparency.msdclinicaltrials.com/pdf/ProcedureAccessClinicalTrialData.pdf
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A Study of Camrelizumab Plus Chemotherapy in Combination With or Without Famitinib as Neoadjuvant Therapy in Participants With Triple Negative Breast Cancer (BCTOP-T-N01)
TNBC - Triple-Negative Breast Cancer
RecruitingPhase 3
Testing Whether Hormone Therapy With Ribociclib is as Effective as Chemotherapy Followed by Hormone Therapy With Ribociclib for the Treatment of High Anatomic Stage Breast Cancer With Low Recurrence Risk, The RxFINE-Low Trial
Anatomic Stage II Breast Cancer AJCC v8, Anatomic Stage IIIA Breast Cancer AJCC v8
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Medical Director study director
Merck Sharp & Dohme LLC
244 sites in 24 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Pembrolizumab (K), Paclitaxel (X) and Doxorubicin (A) in people with Breast Cancer, run by Merck Sharp & Dohme LLC at 244 sites in 24 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 11 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 244 sites in United States, China, Japan, France, Spain and 19 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pathological Complete Response (pCR) Rate Using the Definition of ypT0/Tis ypN0 (time frame: Up to approximately 7 months (Time of surgery)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03725059, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jul 2025.