Quick Facts About: Pembrolizumab
Alternative names
Keytruda
FDA approved?
Yes, in 2014.
Used to treat
Pembrolizumab is used to treat metastatic microsatellite instability (MSI) -high colorectal cancer and unresectable MSI-high colorectal cancer.
It is also used to treat advanced endometrial carcinoma, metastatic gastric adenocarcinoma, metastatic/recurrent cervical cancer and metastatic non-squamous non-small cell lung carcinoma.
Administration and dosage
*All dosages indicated here are specific to colorectal cancer treatment.
Pembrolizumab is administered intravenously.
Pembrolizumab may be used as first line treatment or as monotherapy in patients whose disease has progressed following treatment with fluoropyrimidine, oxaliplatin, and irinotecan. Pembrolizumab may be administered in 200 mg doses once every 3 weeks or 400 mg doses once every 6 weeks via an infusion over 30 minutes. Treatment can continue until disease progression or unacceptable toxicity levels are reached, or for up to 24 months in patients without disease progression.
Dosing may be interrupted or discontinued depending on individual tolerability and safety.
Contraindications and precautions
Special precautions are required for patients with:
- Autoimmune disorder
- Chronic infection, history of recurring infections, or underlying condition predisposing to development of infection
- Allogeneic haematopoietic stem cell transplant (HSCT) or solid organ transplant
- Ongoing pregnancy and lactation
Side effects
Common pembrolizumab side effects include:
- Nausea, vomiting, stomach pain, loss of appetite, diarrhea, constipation, weight loss
- Low blood sodium levels, abnormal thyroid, liver and kidney function tests
- Low blood cell counts
- Tingling or numbness in your hands or feet, loss of movement in the arms and legs
- Bleeding
- Pain and burning when you urinate
- Fever, headache, feeling weak or tired, dizziness, trouble sleeping
- Cough, hoarse voice, feeling short of breath
- Changes in your sense of taste, dry skin and dry eyes
- Itching, hair loss, rash or blisters on your hands or feet
- Increased blood pressure
- Pain in your muscles, bones, or joints
- Mouth sores or swelling around your mouth, nose, eyes, throat, intestines or vagina
Serious side effects to pembrolizumab will require immediate medical attention. Patients should contact their healthcare provider if they experience:
- Severe allergic reactions to pembrolizumab
- New or worsening cough, chest pain, shortness of breath
- Pale skin, easy bruising or bleeding
- Severe muscle pain, cramps, weakness, neck stiffness
- Double or blurry vision
- Confusion, sleep or memory problems, changes in mood or behavior, balance problems
- Numbness, tingling, burning pain, redness, rash, or blisters on your hands or feet
- Fever or flu-like symptoms
- Diarrhea, severe stomach pain or tenderness, bloody or tarry stools
- Feeling sick or uneasy
- High blood sugar
- Symptoms of kidney problems
- Symptoms of liver problems
- Symptoms of hormonal problems
- Anemia
Type of treatment
Pembrolizumab is a monoclonal antibody used in immunotherapy.
Treatment mechanism
Pembrolizumab is an IgG4 monoclonal antibody that binds to the cell surface receptor programmed death-1 (PD-1), a negative immunoregulatory protein. It prevents interaction with ligands PD-L1 and PD-L2, and the blockade of the PD-1 pathway results in the reactivation of tumor specific cytotoxic T-lymphocytes and induction of immune response to tumor cells.