Evidence map›Paper›PMID 42047965›Full record

Trial reportEsophagus : official journal of the Japan Esophageal Society2026

First-line pembrolizumab plus chemotherapy versus chemotherapy alone for advanced esophageal cancer: 5-year extended follow-up in the Japanese subgroup of KEYNOTE-590.

Ken Kato, Takashi Kojima, Hiroki Hara, Akihito Tsuji, Hisateru Yasui, Kei Muro, Taroh Satoh, Naoyoshi Yatsuzuka, Tomoko Sakata, Shirong Han and 1 more

Erratum issued Registry-linked trialAbstract readRandomized Controlled TrialClinical Trial, Phase IIIMulticenter Study
In one paragraph

Trial report in Esophagus : official journal of the Japan Esophageal Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03189719 (A Randomized, Double-Blind, Placebo-Controlled Phase III Clinical Trial of Pembrolizumab), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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.

NCT03189719 phase3completednot on this map

A Randomized, Double-Blind, Placebo-Controlled Phase III Clinical Trial of Pembrolizumab (MK-3475) in Combination With Cisplatin and 5-Fluorouracil Versus Placebo in Combination With Cisplatin and 5-Fluorouracil as First-Line Treatment in Subjects With Advanced/Metastatic Esophageal Carcinoma (KEYNOTE-590)

TypeinterventionalSponsorMerck Sharp & Dohme LLCRan2017 to 2023Enrolled749ConditionsEsophageal NeoplasmsArmsPembrolizumab, Placebo, Cisplatin, 5-FU
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Ken KatoDepartment of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan. kenkato@ncc.go.jp.ORCID http://orcid.org/0000-0002-1733-5072
Takashi KojimaDepartment of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
Hiroki HaraDepartment of Gastroenterology, Saitama Cancer Center, Saitama, Japan.
Akihito TsujiDepartment of Medical Oncology, Kagawa University Hospital, Kagawa, Japan.
Hisateru YasuiKobe City Medical Center General Hospital, Kobe, Japan.
Kei MuroAichi Cancer Center Hospital, Nagoya, Japan.
Taroh SatohThe University of Osaka Hospital, Osaka, Japan.
Naoyoshi YatsuzukaMSD K.K., Tokyo, Japan.
Tomoko SakataMSD K.K., Tokyo, Japan.
Shirong HanMSD K.K., Tokyo, Japan.
Toshihiko DoiExperimental Therapeutics, National Cancer Center Hospital East, Kashiwa, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAfter a median study follow-up of 36.6 months, first-line pembrolizumab plus chemotherapy numerically improved overall survival (OS) and progression-free survival (PFS) versus placebo plus chemotherapy in Japanese participants with advanced esophageal cancer in the phase 3 KEYNOTE-590 study. The 5-year follow-up is presented.

methodsParticipants with previously untreated advanced esophageal cancer were randomly assigned 1:1 to pembrolizumab 200 mg or placebo every 3 weeks up to 35 cycles plus chemotherapy (cisplatin 80 mg/m

resultsIn total, 141 of 794... participants were enrolled in Japan. Median study follow-up was 60.6 months (range, 53.8-69.7). Median OS was 17.7 months (95% CI, 13.9-28.5) with pembrolizumab plus chemotherapy versus 11.7 months (95% CI, 9.5-19.0) with placebo plus chemotherapy (HR, 0.65; 95% CI, 0.45-0.94); 60-month rates were 24.0% and 8.5%. Median PFS was 6.3 months (95% CI, 6.0-8.2) versus 6.0 months (95% CI, 4.2-6.2) (HR, 0.57; 95% CI, 0.39-0.83); 60-month rates were 16.9% and 0%. ORRs were 56.8% (95% CI, 44.7-68.2) and 38.8% (95% CI, 27.1-51.5). The median DOR was 8.3 months for pembrolizumab plus chemotherapy and 6.1 months for placebo plus chemotherapy. No new treatment-related adverse events occurred since the prior analysis.

conclusionsAfter a median follow-up of 5 years, pembrolizumab plus chemotherapy continues to provide long-term survival outcomes among Japanese participants with advanced esophageal cancer. No new safety signals were observed. Clinical trial registration ClinicalTrials.gov, NCT03189719.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsEsophageal NeoplasmsAgedCisplatinEast Asian PeopleFemaleFluorouracilFollow-Up StudiesHumansJapanMaleMiddle AgedProgression-Free SurvivalAntibodies, Monoclonal, HumanizedCisplatinFluorouracilpembrolizumabEsophageal neoplasmsImmunotherapyJapanPD-1 inhibitor

Identifiers

PMID42047965
PMCPMC13319894

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Registered trials

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.