Study of Pembrolizumab (MK-3475) as Monotherapy in Participants With Advanced Hepatocellular Carcinoma (MK-3475-224/KEYNOTE-224)

Inclusion Criteria:

- For Cohort 1: has histologically or cytologically confirmed diagnosis of HCC
(fibrolamellar and mixed hepatocellular/cholangiocarcinoma subtypes are not eligible)
based on pathology report

- For Cohort 2: has an HCC diagnosis confirmed by radiology, histology, or cytology
(fibrolamellar and mixed hepatocellular/cholangiocarcinoma subtypes are not eligible)

- Has Barcelona Clinic Liver Cancer (BCLC) Stage C disease or BCLC Stage B disease not
amenable to locoregional therapy or refractory to locoregional therapy, and not
amenable to a curative treatment approach

- Has a Child-Pugh Class A liver score within 7 days of first dose of study drug

- Has a predicted life expectancy >3 months

- Has measurable disease based on Response Evaluation Criteria in Solid Tumors (RECIST)
1.1 as confirmed by the blinded central imaging vendor

- Has a performance status of 0 or 1 using the Eastern Cooperative Oncology Group (ECOG)
Performance Scale within 7 days of first dose of study drug

- For Cohort 1: has documented objective radiographic progression after stopping
treatment with sorafenib or else intolerance to sorafenib

- Is willing to use an adequate method of contraception for the course of the study
through 120 days after the last dose of study drug (male and female participants of
childbearing potential)

- Demonstrates adequate organ function

Exclusion Criteria:

- Is currently participating and receiving study therapy or has participated in a study
of an investigational agent and received study therapy, herbal/complementary oral or
IV medicine, or used an investigational device within 4 weeks of the first dose of
study drug. Participant must also have recovered from associated therapy (i.e., to
Grade ≤1 or baseline) and from adverse events due to any prior therapy

- For Cohort 1: has received sorafenib within 14 days of first dose of study drug

- Has had esophageal or gastric variceal bleeding within the last 6 months

- Has clinically apparent ascites on physical examination

- Has portal vein invasion at the main portal (Vp4), inferior vena cava, or cardiac
involvement of HCC based on imaging

- Has had encephalopathy in the last 6 months. Participants on rifaximin or lactulose to
control their encephalopathy are not allowed

- Had a solid organ or hematologic transplant

- For Cohort 1: had prior systemic therapy for HCC other than sorafenib, or intercurrent
local therapy to the liver tumor between sorafenib and study drug

- For Cohort 2: had prior systemic therapy in the advanced disease setting

- Has active autoimmune disease that has required systemic treatment in past 2 years
(i.e., with use of disease-modifying agents, corticosteroids, or immunosuppressive
drugs)

- Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any
other form of immunosuppressive therapy within 7 days prior to the first dose of study
drug

- Has a diagnosed additional malignancy within 5 years for Cohort 1 and 3 years for
Cohort 2 prior to first dose of study treatment with the exception of curatively
treated basal cell carcinoma of the skin, squamous cell carcinoma of the skin and/or
curatively resected in situ cervical and/or breast cancers

- Has radiographically detectable central nervous system (CNS) metastases and/or
carcinomatous meningitis

- Has evidence or history of interstitial lung disease or active noninfectious
pneumonitis

- Has an active infection requiring systemic therapy

- Has a known severe hypersensitivity to pembrolizumab, its active substance and/or any
of its excipients

- Has known psychiatric or substance abuse disorders that would interfere with
cooperation with the requirements of the study

- Is pregnant or breastfeeding, or expecting to conceive or father children within the
projected duration of the trial, starting with the screening visit through 120 days
after the last dose of trial treatment

- Has received prior immunotherapy including anti-programmed death-1 (anti-PD-1),
anti-PD-ligand-1 (anti-PD-L1), or anti-PD-L2 agents, or if the participant has
previously participated in clinical studies with pembrolizumab (MK-3475)

- Has a known history of human immunodeficiency virus (HIV)

- Has untreated active Hepatitis B virus (HBV)

- For Cohort 1: has dual infection with HBV/Hepatitis C virus (HCV) or other hepatitis
combinations at study entry

- For Cohort 2: has dual active HBV infection (Hepatitis B surface antigen positive
and/or detectable HBV deoxyribonucleic acid [DNA]) and HCV infection (detectable HCV
ribonucleic acid [RNA]) at study entry

- Has received a live vaccine within 30 days of planned start of study drug (Cycle 1,
Day 1)