Combination therapies for esophageal squamous cell carcinoma (KEYMAKER-U06 Substudy 06E)
Official title: A Phase 1/2 Open-Label, Umbrella Platform Design Study of Investigational Agents in Combination With Pembrolizumab (MK-3475) With or Without Chemotherapy in Participants With 1L Locally Advanced Unresectable/Metastatic Esophageal Cancer: KEYMAKER-U06 Substudy 06E
Run by Merck Sharp & Dohme LLC · NCT06780111 · Data updated 2026-11-12
This trial will test pembrolizumab together with an investigational antibody-drug conjugate (I-DXd), with or without chemotherapy, as a first-line treatment for people with locally advanced unresectable or metastatic esophageal squamous cell carcinoma.
Quick facts
| Phase | Phase1; Phase2 |
|---|---|
| Study type | Interventional |
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 298 (estimated) |
| Sponsor | Merck Sharp & Dohme LLC Industry-sponsored |
| Drugs / interventions | radiation, prednisone, pembrolizumab, Ifinatamab, chemotherapy, immunotherapy |
| Locations | 52 sites (Pittsburgh, Pennsylvania and 51 other locations) |
| Status | Recruiting |
| Started | July 30, 2025 |
| Main results expected | January 4, 2032 |
| Study ends | January 4, 2032 |
| Registry record updated | October 27, 2026 |
| Trial ID | NCT06780111 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates are people with treatment-naïve, locally advanced unresectable or metastatic esophageal squamous cell carcinoma who have measurable disease, ECOG performance status 0–1, and adequate organ function.
✕Probably not a fit
People with resectable disease, prior systemic therapy for advanced ESCC, poor performance status (ECOG >1), or significant uncontrolled medical problems are unlikely to qualify or benefit from this protocol.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This Phase 1/2 substudy within the MK-3475-U06 master protocol tests pembrolizumab in combination with investigational agents including the ADC ifinatamab deruxtecan (I-DXd), with or without standard chemotherapy. The trial enrolls patients with measurable, locally advanced unresectable or metastatic esophageal squamous cell carcinoma in the first-line setting and uses RECIST 1.1 with central radiology review for response. Early phases focus on safety, tolerability, and dosing while expansion cohorts will collect preliminary anti-tumor activity and response rate data. The protocol is sponsored by Merck with collaborating partner Daiichi Sankyo and includes sites in the United States and Brazil.
Why it matters
Potential benefit: If successful, the combinations could produce higher tumor response rates, longer disease control, and potentially improved survival compared with current first-line options.
How similar studies have gone: Anti-PD-1 therapy plus chemotherapy has shown benefit in ESCC, while ADCs like I-DXd are investigational and have shown encouraging activity in other tumors, making this combination a promising but not yet proven approach.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria The main inclusion criteria include but are not limited to the following: * 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 or designee/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 had AEs due to previous anticancer therapies that have recovered to ≤Grade 1 or baseline. Endocrine-related AEs that are adequately treated with hormone replacement are elegible. * Human immunodeficiency virus (HIV)-infected participants must have well controlled HIV on antiretroviral therapy (ART). * Has Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1. * Has adequate organ function. Exclusion Criteria The main exclusion criteria include but are not limited to the following: * 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, history of documented severe dry eye syndrome, severe Meibomian gland disease and/or blepharitis, or severe corneal disease that prevents/delays corneal healing. * 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 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 by a 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 a history of interstitial lung disease (ILD)/pneumonitis irrespective of steroid use (except for a history of radiation pneumonitis that did not require steroids), has a current diagnosis of ILD, or has clinical or radiographic suspicion of ILD for which the diagnosis of ILD cannot be ruled out. * 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.
Where it's running
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UPMC Hillman Cancer Center ( Site 1904)
Pittsburgh, Pennsylvania, United States Recruiting -
Liga Norte Riograndense Contra o Cancer ( Site 1301)
Natal, Rio Grande do Norte, Brazil Recruiting -
Hospital Nossa Senhora da Conceicao ( Site 1300)
Porto Alegre, Rio Grande do Sul, Brazil Recruiting -
IBCC - Instituto Brasileiro de Controle do Cancer ( Site 1303)
São Paulo, São Paulo, Brazil Recruiting -
ICESP - INSTITUTO DO CÂNCER DO ESTADO DE SÃO PAULO ( Site 1302)
São Paulo, Brazil Recruiting -
Clínica Puerto Montt ( Site 1406)
Port Montt, Los Lagos Region, Chile Recruiting
Show 44 more locations
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Fundación Arturo López Pérez ( Site 1400)
Santiago, Region M. de Santiago, Chile Recruiting -
Centro de Oncología de Precisión ( Site 1402)
Santiago, Region M. de Santiago, Chile Recruiting -
Clínica UC San Carlos de Apoquindo ( Site 1403)
Santiago, Region M. de Santiago, Chile Recruiting -
Bradfordhill ( Site 1401)
Santiago, Region M. de Santiago, Chile Recruiting -
Bradford Hill Norte ( Site 1405)
Antofagasta, Chile Recruiting -
The Second Affiliated Hospital of Anhui Medical University ( Site 9511)
Hefei, Anhui, China Recruiting -
Beijing Cancer Hospital ( Site 9500)
Beijing, Beijing Municipality, China Recruiting -
The First Affiliated Hospital of Xiamen University ( Site 9503)
Xiamen, Fujian, China Recruiting -
Henan Cancer Hospital ( Site 9509)
Zhengzhou, Henan, China Recruiting -
Xuzhou Central Hospital ( Site 9512)
Xuzhou, Jiangsu, China Recruiting -
The First Affiliated Hospital of Nanchang University ( Site 9505)
Nanchang, Jiangxi, China Recruiting -
Masarykuv onkologicky ustav-Klinika komplexni onkologicke pece ( Site 9000)
Brno, Brno-mesto, Czechia Recruiting -
C.H.R.U. de Brest - Hopital Cavale Blanche ( Site 9104)
Brest, Finistere, France Recruiting -
CHU Lille - Institut Coeur Poumon ( Site 9100)
Lille, Nord, France Recruiting -
Pitie Salpetriere University Hospital ( Site 9102)
Paris, France Recruiting -
NCT-Department of Medical Oncology ( Site 1809)
Heidelberg, Baden-Wurttemberg, Germany Recruiting -
HOPE Hamburg/Norddeutsches Studienzentrum fuer Innovative Onkologie ( Site 1807)
Erdgeschoss, Free and Hanseatic City of Hamburg, Germany Recruiting -
Universitaetsklinikum Duesseldorf ( Site 1808)
Düsseldorf, North Rhine-Westphalia, Germany Recruiting -
Universitätsklinikum Carl Gustav Carus - Medical Oncology ( Site 1806)
Dresden, Saxony, Germany Recruiting -
Ospedale San Raffaele-Oncologia Medica ( Site 9201)
Milan, Lombardy, Italy Recruiting -
Istituto Oncologico Veneto IRCCS ( Site 9202)
Padova, Veneto, Italy Recruiting -
Aichi Cancer Center ( Site 9702)
Nagoya, Aichi-ken, Japan Recruiting -
National Cancer Center Hospital East ( Site 9701)
Kashiwa, Chiba, Japan Recruiting -
National Cancer Center Hospital ( Site 9700)
Chūō, Tokyo, Japan Recruiting -
Oslo Universitetssykehus Radiumhospitalet ( Site 1501)
Oslo, Norway Recruiting -
National University Hospital ( Site 9800)
Singapore, Central Singapore, Singapore Recruiting -
National Cancer Center ( Site 9902)
Goyang-si, Kyonggi-do, South Korea Recruiting -
Asan Medical Center ( Site 9901)
Seoul, South Korea Recruiting -
Samsung Medical Center ( Site 9900)
Seoul, South Korea Recruiting -
Kantonsspital Graubuenden ( Site 1700)
Chur, Kanton Graubünden, Switzerland Recruiting -
Hopitaux Universitaires de Geneve HUG. ( Site 1701)
Geneva, Switzerland Recruiting -
Kaohsiung Medical University Chung-Ho Memorial Hospital ( Site 1009)
Kaoshiung, Kaohsiung, Taiwan Recruiting -
Kaohsiung Chang Gung Memorial Hospital ( Site 1003)
Kaohsiung City, Taiwan Recruiting -
China Medical University Hospital ( Site 1007)
Taichung, Taiwan Recruiting -
National Cheng Kung University Hospital ( Site 1001)
Tainan, Taiwan Recruiting -
National Taiwan University Hospital ( Site 1000)
Taipei, Taiwan Recruiting -
National Taiwan University Cancer Center ( Site 1010)
Taipei, Taiwan Recruiting -
Taipei Veterans General Hospital ( Site 1005)
Taipei, Taiwan Recruiting -
Chang Gung Memorial Hospital - Linkou Branch ( Site 1006)
Taoyuan, Taiwan Recruiting -
Ramathibodi Hospital ( Site 1103)
Ratchathewi, Bangkok, Thailand Recruiting -
Songklanagarind hospital ( Site 1101)
Hat Yai, Changwat Songkhla, Thailand Recruiting -
Adana Medical Park Seyhan Hastanesi ( Site 9404)
Adana, Turkey (Türkiye) Recruiting -
Hacettepe Universite Hastaneleri ( Site 9401)
Ankara, Turkey (Türkiye) Recruiting -
Memorial Ankara Hastanesi ( Site 9406)
Ankara, Turkey (Türkiye) Recruiting
+2 more sites. See ClinicalTrials.gov for the full list.
Study contacts
- Study coordinator: Toll Free Number
- Email: Trialsites@msd.com
- Phone: 1-888-577-8839
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.