Evidence map›Paper›PMID 41757470›Full record

Trial reportCancer research communications2026

Impact of Hepatitis B Virus Infection on the Efficacy and Safety of Pembrolizumab plus Chemotherapy for Advanced Biliary Tract Cancer in the KEYNOTE-966 Study.

Stephen L Chan, Thomas Yau, Robin K Kelley, Richard S Finn, Changhoon Yoo, Junji Furuse, Zhenggang Ren, Heinz-Josef Klümpen, Masato Ozaka, Uwe Pelzer and 10 more

Abstract readRandomized Controlled TrialClinical Trial, Phase IIIMulticenter Study
In one paragraph

Trial report in Cancer research communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Stephen L Chan *State Key Laboratory of Translational Oncology, Department of Clinical Oncology, Sir Y.K. Pao Centre for Cancer, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.ORCID 0000-0001-8998-5480
Thomas Yau *The University of Hong Kong , Hong Kong, Hong Kong SAR, China.ORCID 0000-0002-7114-0305
Robin K KelleyUniversity of California, San Francisco , San Francisco, California.ORCID 0000-0002-1984-2430
Richard S FinnUniversity of California, Los Angeles , Los Angeles, California.ORCID 0000-0003-2494-2126
Changhoon YooAsan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.ORCID 0000-0002-1451-8455
Junji FuruseKyorin University Hospital, Tokyo, Japan.ORCID 0000-0003-0663-6117
Zhenggang RenZhongshan Hospital Fudan University, Shanghai, China.ORCID 0000-0001-5085-6761
Heinz-Josef KlümpenUniversity Medical Center, Groningen, the Netherlands.ORCID 0000-0002-7290-1823
Masato OzakaThe Cancer Institute Hospital of the Japanese Foundation for Cancer Research (JFCR) , Tokyo, Japan.ORCID 0000-0002-5666-1970
Uwe PelzerDepartment of Hematology, Oncology and Cancer Immunology, Charite Campus Mitte, Freie Universität Berlin, Humboldt Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.ORCID 0000-0001-9213-2737
Cagatay ArslanIzmir Economy University Medical Point Hospital, Karsiyaka, Turkey.ORCID 0000-0002-3783-7432
Joon Oh ParkSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.ORCID 0000-0001-6502-2612
Julien EdelineCentre Eugène Marquis , Rennes, France.ORCID 0000-0002-8289-7741
Juan W ValleCholangiocarcinoma Foundation , Salt Lake City, Utah.ORCID 0000-0002-1999-0863
Makoto UenoKanagawa Cancer Center , Yokohama, Japan.ORCID 0000-0003-4480-0029
Arndt VogelDivision of Gastroenterology and Hepatology, Medical Oncology, Toronto General Hospital, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada.ORCID 0000-0003-0560-5538
Liis StarkopfMerck & Co., Inc. , Rahway, New Jersey.ORCID 0009-0003-1664-381X
Usha MalhotraMerck & Co., Inc. , Rahway, New Jersey.ORCID 0009-0003-3184-9605
Abby B SiegelMerck & Co., Inc. , Rahway, New Jersey.ORCID 0009-0005-5523-2807
Shukui QinNanjing Tianyinshan Hospital of China Pharmaceutical University, Nanjing, China.ORCID 0000-0003-2289-1521

Funding

Merck (Merck & Co.)
6 · The paper itself

Abstract

purposeIn the randomized phase 3 KEYNOTE-966 trial, first-line pembrolizumab plus chemotherapy significantly improved overall survival (OS) versus placebo plus chemotherapy for participants with advanced biliary tract cancer (BTC). This post hoc analysis investigated whether hepatitis B virus (HBV) infection affected the efficacy and safety of pembrolizumab plus chemotherapy. PATIENTS AND

methodsEligible participants had histologically confirmed extrahepatic or intrahepatic cholangiocarcinoma or gallbladder cancer, unresectable locally advanced or metastatic disease measurable per RECIST v1.1, known HBV and HCV status (including active HBV), and Eastern Cooperative Oncology Group performance status 0 or 1. Participants were randomly assigned 1:1 to intravenous pembrolizumab 200 mg or placebo every 3 weeks for ≤35 cycles plus gemcitabine and cisplatin. HBV-positive participants were monitored for HBV reactivation, and antiviral therapy was required for chronic HBV infection. The primary end point was OS.

resultsThe intention-to-treat population comprised 1,069 participants (533, pembrolizumab group; 536, placebo group). The median time from randomization to data cutoff (November 14, 2023) was 36.6 months (range, 29.2-49.4). Among 329 HBV-positive participants (30.8%), 30 had chronic and 299 had clinically resolved HBV. The OS HR was 0.87 [95% confidence interval (CI), 0.69-1.10] with pembrolizumab versus placebo for the HBV-positive subgroup and 0.85 (95% CI, 0.73-0.99) for the HBV-negative subgroup. Safety was consistent between the subgroups. Eight participants had HBV reactivation (5, pembrolizumab group; 3, placebo group), and no cases of HBV-associated hepatitis occurred in either group.

conclusionsEfficacy and safety outcomes were consistent between HBV-positive and HBV-negative participants receiving first-line pembrolizumab compared with placebo plus gemcitabine and cisplatin. SIGNIFICANCE: Chronic HBV infection is a risk factor for BTC, potentially affecting the effectiveness of BTC treatment. In this study, treatment outcomes in participants who received first-line pembrolizumab plus gemcitabine and cisplatin for advanced BTC treatment were consistent regardless of HBV infection status.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsBiliary Tract NeoplasmsHepatitis BAdultAgedCisplatinDeoxycytidineFemaleGemcitabineHepatitis B virusHumansMaleMiddle AgedTreatment OutcomeAntibodies, Monoclonal, HumanizedCisplatinDeoxycytidineGemcitabinepembrolizumab

Identifiers

PMID41757470
PMCPMC13012029

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.