Pembrolizumab,or, Keytruda

Pembrolizumab,or, Keytruda

Patient-friendly review of Pembrolizumab, trade name Keytruda, which is used to treat melanoma, non-small cell lung cancer (NSCLC), head and neck squamous cancer (HNSCC), classical Hodgkin lymphoma (cHL), cervical cancer, gastric cancer, bladder cancer, renal cancer and Merkel cell carcinoma (MCC). 

Approved by

the Medical Board. 

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Pembrolizumab was approved by the FDA in September 2014. It is a monoclonal antibody which means it works by targeting a specific type of antigen on cells. Cancer cells which are abnormal can ‘hide’ away from being detected by the T-cells and "for paediatrics up to 24 months etc." and “In paediatric patients” by using what is called the ‘PD-1 (programmed death receptor-1) pathway’. Keytruda is designed to block the PD-1 pathway causing the cancer cells to be exposed to the T-cells and enables the immune system to attack the cancer.  

According to the FDA, the recommended dosage for

  • Melanoma, head and neck cancer is 200 mg IV every 3 weeks over 30 minutes 
  • Hodgkin lymphoma is 200 mg IV every 3 weeks over 30 minutes for adults and 2 mg /kg (maximum of 200 mg) for paediatrics up to 24 months if the disease does not progress.
  • Non-small cell lung cancer, bladder cancer, gastric cancer and cervical cancer is 200 mg IV every 3 weeks over 30 minutes up to 24 months if the disease does not progress. 
  • Renal cancer is 200 mg IV every 3 weeks over 30 minutes with a combination of 5 mg axitinib twice daily.
  • Merkel cell carcinoma is 200 mg IV every 3 weeks over 30 minutes for adults and 2 mg /kg (maximum of 200 mg) for paediatrics up to 24 months if the disease does not progress.

There may be multiple drug interactions with Pembrolizumab but the three major ones are Lenalidomide, Pomalidomide and Thalidomide.

Common side effects of using Pembrolizumab include swelling of arms and face, constipation, headaches, muscle and joint pain, fever, chills, fatigue, decreased appetite, etc. 

Precautions: Because of the mechanism of the drug altering the immune system of the body to attack the cancer cells, there’s a possibility that it could attack the healthy tissues, affecting multiple organs and can become fatal. The potential problems include:

  • Pneumonitis - symptoms are chest pains, severe coughing or shortness of breath.
  • Nephritis - symptoms are changes in colour and amount of urine. 
  • Colitis - symptoms are diarrhea, dark-coloured stools, stools containing blood, pain and tenderness in the abdomen. 
  • Hormonal gland problems- symptoms are increased in heartbeat, dizziness, unusual headaches, often urinating, unusual weight loss and gain, constipation and muscle aches.
  • Hepatitis - symptoms are yellow eyes and skin, nausea, vomiting, pain and tenderness in the abdomen, dark-coloured urine and easily bruised.
  • Others-  other adverse reactions may include a low count of red blood cells (anaemia), seizures (encephalitis), chest pains (myocarditis), and weakness of muscles and joints, etc. 

Other articles that you may find interesting are:

  1. A diet for Chemotherapy
  2. Immunotherapy overview
  3. A to Z Guide to Complementary Therapies

Go to: Return to the CANCERactive drug list

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