Study to Evaluate the Safety of Pembrolizumab in Participants With Unresectable or Metastatic Melanoma or Non-small Cell Lung Cancer in India (MK-3475-593/KEYNOTE-593)

A Prospective, Open-label, Phase 4 Study to Evaluate the Safety of Pembrolizumab (KEYTRUDA®) in Subjects With Unresectable or Metastatic Melanoma or PD-L1 Positive Non-small Cell Lung Cancer (NSCLC) in India (Keynote-593)

This study has been designed to evaluate the safety of pembrolizumab in participants in India with unresectable or metastatic melanoma and participants with non-small cell lung cancer (NSCLC) who are either untreated (programmed cell death ligand 1 [PD-L1] ≥50%) or have experienced disease progression after a platinum-containing systemic therapy (PD-L1 ≥1%).

Study Overview

• Status: Completed
• Conditions: Melanoma; Carcinoma, Non-Small-Cell Lung
• Intervention / Treatment: Drug: Pembrolizumab

• Study Type: Interventional
• Enrollment (Actual): 150
• Phase: Phase 4

Contacts and Locations

Study Locations

• India
  • Delhi, India, 110085
    • Rajiv Gandhi Cancer Institute and Research Centre ( Site 0003)
  • Andhra Pradesh
    • Hyderabad, Andhra Pradesh, India, 500082
      • Nizam's Institute of Medical Sciences ( Site 0011)
  • Haryana
    • Gurgaon, Haryana, India, 122001
      • Artemis Health Institute ( Site 0007)
  • Maharashtra
    • Mumbai, Maharashtra, India, 400012
      • Tata Memorial Hospital [M] ( Site 0005)
    • Mumbai, Maharashtra, India, 400053
      • Kokilaben Ben Dhirubhai Ambani Hosp & Med Res Inst. ( Site 0001)
    • Pune, Maharashtra, India, 411004
      • Deenanath Mangeshkar Hospital and Research Center ( Site 0009)
  • National Capital Territory of Delhi
    • New Delhi, National Capital Territory of Delhi, India, 110029
      • All India Institute of Medical Sciences ( Site 0012)
    • New Delhi, National Capital Territory of Delhi, India, 110076
      • Indraprastha Apollo Hospitals ( Site 0008)

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Melanoma Participant:

• Has a histologically confirmed diagnosis of unresectable Stage III or metastatic melanoma (Stage IV) not amenable to local therapy
• Has received no more than 1 line of prior systemic therapy for unresectable Stage III or Stage IV melanoma including mitogen activated protein kinase inhibitors
• Has a Lactate Dehydrogenase (LDH) ≤1.5 times ULN

NSCLC Participant-First Line Treatment:

• Has a histologically or cytologically confirmed diagnosis of Stage IV NSCLC
• Has a tumor that demonstrate PD-L1 strong expression (PD-L1 ≥50%)
• Do not have an EGFR sensitizing mutation AND are anaplastic lymphoma kinase (ALK) translocation negative
• Has received no systemic anti-cancer therapy for their metastatic NSCLC

NSCLC Participant-Second Line Treatment and Beyond:

• Has a histologically or cytologically confirmed diagnosis of stage IIIB//IIIC/IV (including any future updates to the American Joint Committee on Cancer [AJCC] guideline) or recurrent NSCLC
• Has a tumor that expresses programmed cell death ligand 1 (PD-L1) ≥1%
• Has received prior treatment with at least two cycles of a platinum-containing doublet for Stage IIIB/IV or recurrent disease
• Has received an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (either erlotinib, gefitinib, or afatinib) if they have an EGFR sensitizing mutation
• Has received crizotinib if they have an ALK translocation

NSCLC participants must also meet the following requirements:

• Have a life expectancy of at ≥3 months
• Provide a formalin fixed tumor tissue sample for PD-L1 biomarker analysis from a recent biopsy of a tumor lesion not previously irradiated; For first line, biopsies obtained PRIOR to the administration of any systemic therapy administered for the treatment of a tumor (such as neoadjuvant/adjuvant/definitive therapy) will not be permitted for analysis. For second line treatment and beyond, no systemic antineoplastic therapy may be administered between the PD-L1 biopsy and initiating study medication
• Have documented evidence of the EGFR mutation status or ALK translocation status. If unable to provide documentation of these molecular changes, formalin-fixed paraffin-embedded tumor tissue of any age should be submitted for testing
• Have measurable disease per Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1) as assessed by the local site investigator/radiologist
• Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1
• Women of childbearing potential (WOCP) must have a negative urine or serum pregnancy test within 72 hours prior to receiving the first dose of trial treatment. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required
• WOCP must be willing to use an adequate method of contraception for the course of the study through 120 days after the last dose of trial treatment
• Men of childbearing potential must agree to use an adequate method of contraception starting with the first dose of study therapy through 120 days after the last dose of study therapy

Exclusion Criteria:

• For NSCLC Participant only: Has a tumor specimen that is not evaluable for PD-L1 expression by the laboratory
• Is currently participating in or has participated in a trial of an investigational agent or has used an investigational device within 4 weeks prior to the first dose of trial treatment
• Has received prior therapy with an anti- programmed cell death 1 (PD-1), anti-PD-L1, or anti- programmed cell death ligand 2 (PD-L2) agent or with an agent directed to another T-cell receptor (i.e., cytotoxic T-lymphocyte antigen-4 [CTLA-4], OX-40, CD137) or has previously participated in a clinical trial for pembrolizumab (MK-3475)
• Has received prior anti-cancer therapy including investigational agent or device within 4 weeks, or completed palliative radiotherapy within 7 days, prior to enrollment
• Has recovered from all AEs due to previous therapies to ≤ Grade 1 or baseline
• Has recovered adequately from the toxicity and/or complications from major surgery prior to starting trial treatment
• Is expected to require any other form of antineoplastic therapy while participating in the trial
• Is on systemic corticosteroid therapy within 7 days before the planned date for first dose of treatment or any other form of immunosuppressive medication
• Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (exceeding 10 mg daily dose of prednisone or equivalent) or any other form of immunosuppressive therapy within 7 days before the first dose of trial treatment
• Has an active autoimmune disease that has required systemic treatment in the past 2 years
• Has a known additional malignancy that is progressing or requires active treatment with the exception of basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (e.g., cervical cancer in situ, breast carcinoma) that have undergone potentially curative therapy
• Has had an allogeneic tissue/solid organ transplant
• Has a history of or current radiographically detectable central nervous system metastases and/or carcinomatous meningitis
• Has a severe hypersensitivity (≥ Grade 3) to any excipients in pembrolizumab
• Has a history of (noninfectious) pneumonitis/interstitial lung disease that required steroids or current pneumonitis/interstitial lung disease
• Has an active infection requiring systemic therapy including known history of active tuberculosis (Bacillus tuberculosis)
• Has a known history of human immunodeficiency virus (HIV) infection
• Has a known history of or is positive for hepatitis B (hepatitis B surface antigen [HbsAg] reactive) or hepatitis C (HCV) ribonucleic acid (RNA) [qualitative] is detected
• Has a known psychiatric or substance abuse disorder that would interfere with cooperation with the requirements of the trial
• If participant received prior radiation therapy to a symptomatic metastatic lesion, has recovered to Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0 Grade 1 or Grade 0 AEs due to radiation therapy
• Is a regular user of any illicit drug or has a recent history (within the last 3 months) of substance abuse including alcohol
• 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 trial treatment
• Has received a live vaccine within 30 days before the first dose of trial treatment
• Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Pembrolizumab 200 mg IV Q3W; Participants with melanoma or NSCLC receive 200 mg of pembrolizumab as an intravenous (IV) infusion every 3 weeks (Q3W) for up to 35 cycles.	Drug: Pembrolizumab; Administered as an intravenous (IV) infusion every 3 weeks (Q3W); Other Names: MK-3475; KEYTRUDA®

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants With an Adverse Event (AE)	An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. The number of participants with an AE was reported.	Up to approximately 66.5 months
Number of Participants With a Serious Adverse Event (SAE)	An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. An SAE was any adverse event occurring at any dose or during any use of Sponsor's product that resulted in death; was life threatening; resulted in persistent or significant disability/incapacity; resulted in or prolonged an existing inpatient hospitalization; was a congenital anomaly/birth defect; was another important medical event. The number of participants with an SAE was reported.	Up to approximately 66.5 months
Number of Participants With a Drug-Related AE	An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. A drug-related AE was defined as an AE that was determined by the investigator to be possibly, probably, or definitely related to drug. The number of participants with a drug-related AE was reported.	Up to approximately 66.5 months
Number of Participants With a Drug-Related SAE	An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An SAE was any AE occurring at any dose or during any use of Sponsor's product that resulted in death; was life threatening; resulted in persistent or significant disability/incapacity; resulted in or prolonged an existing inpatient hospitalization; was a congenital anomaly/birth defect; was another important medical event. A drug-related SAE was defined as an SAE that was determined by the investigator to be possibly, probably, or definitely related to drug. The number of participants with a drug-related SAE was reported.	Up to approximately 66.5 months
Number of Participants Who Discontinued Study Drug Due to an AE	An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. The number of participants who discontinued study drug due to an AE was reported	Up to approximately 26 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants With an Adverse Event of Special Interest (AEOSI)	An AEOSI was defined as an AE (serious or non-serious) of scientific and medical concern specific to the sponsor's product or program, for which ongoing monitoring and rapid communication by the investigator to the sponsor was appropriate. Pembrolizumab AEOSIs included immune-mediated events (pneumonitis, colitis, hepatitis, nephritis, adrenal insufficiency, hypophysitis, hyperthyroidism, hypothyroidism, thyroiditis, type 1 diabetes mellitus, severe skin reactions including Stevens-Johnson Syndrome [SJS] and Toxic Epidermal Necrolysis [TEN], uveitis, pancreatitis, myositis, Guillain-Barre Syndrome, myocarditis, encephalitis, sarcoidosis, myasthenic syndrome, myelitis, vasculitis, cholangitis sclerosing, hypoparathyroidism, arthritis, haemophagocytic lymphohistiocytosis, optic neuritis, gastritis, haemolytic anaemia, exocrine pancreatic insufficiency, pericarditis) and infusion reactions. The number of participants with an AEOSI was reported.	Up to approximately 66.5 months

Collaborators and Investigators

• Sponsor: Merck Sharp & Dohme LLC
• Investigators: Study Director: Medical Director, Merck Sharp & Dohme LLC

Publications and helpful links

Helpful Links

• Merck Oncology Clinical Trials Information

Study record dates

Study Major Dates

• Study Start (Actual): January 31, 2019
• Primary Completion (Actual): August 21, 2024
• Study Completion (Actual): August 21, 2024

Study Registration Dates

• First Submitted: October 19, 2018
• First Submitted That Met QC Criteria: October 19, 2018
• First Posted (Actual): October 23, 2018

Study Record Updates

• Last Update Posted (Estimated): August 29, 2025
• Last Update Submitted That Met QC Criteria: August 11, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: programmed cell death 1 (PD-1, PD1); programmed cell death ligand 1 (PD-L1, PDL1); programmed cell death ligand 2 (PD-L2, PDL2)
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Respiratory Tract Diseases; Neoplasms by Histologic Type; Lung Diseases; Respiratory Tract Neoplasms; Thoracic Neoplasms; Lung Neoplasms; Skin Diseases; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms, Nerve Tissue; Carcinoma, Bronchogenic; Bronchial Neoplasms; Neuroendocrine Tumors; Nevi and Melanomas; Skin Neoplasms; Skin and Connective Tissue Diseases; Carcinoma, Non-Small-Cell Lung; Melanoma; Parkinson Disease 4, Autosomal Dominant Lewy Body; Molecular Mechanisms of Pharmacological Action; Antineoplastic Agents; Antineoplastic Agents, Immunological; Immune Checkpoint Inhibitors; pembrolizumab
• Other Study ID Numbers: 3475-593; MK-3475-593 (Other Identifier: MSD); KEYNOTE 593 (Other Identifier: MSD)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No