Pembrolizumab

Drug Image Pembrolizumab
Brand name: Keytruda®
IUPAC: Anticuerpo humanizado contra la PD-1
FDA approval: Yes
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Usage:

Keytruda® (pembrolizumab) was approved by the FDA in 2014 to treat advanced or unresectable melanoma in patients who are no longer responding to other drugs and in 2015 to treat advanced non-small cell lung cancer. In 2016 pembrolizumab was approved for treatment of patients with metastaticThe term for a cancer that has spread beyond its point of origin. Metastatic disease is responsible for the majority of cancer deaths. non-small cell lung cancer (NSCLC).1 It is also intended for use in melanoma patients who have already taken ipilimumab. In melanoma patients who have a BRAF V600 mutation, Keytruda® is intended for use after treatment with ipilimumab and a BRAF inhibitor. Keytruda® is also intended for use in non-small cell lung cancer patients whose lung cancer has spread, tests positive for PD-L1, has not responded or is no longer responding to platinum-based chemotherapies, and has abnormal EGFR or ALK genes.2

In 2017, the FDA approved Keytruda® for the treatment of ANY solid cancer that has defects in specific kinds of DNAAbbreviation for deoxyribonucleic acid. Composed of very long strings of nucleotides, which are abbreviated as A, C, G and T. DNA is the storage form of our genetic material. All of the instructions for the production of proteins are encoded in our DNA. repair - called microsatellite instability (MSI) or mismatch repair (MMR). This was the first time that the FDA had approved a drug based on a genetic feature of the cancer instead of the type of tissue in which the cancer arises (i.e. lung or breast). Another checkpoint inhibitor drug, nivolumab (Opdivo®) has been approved for colorectal cancer patients whose tumors have one of these defects.3

In June of 2018, the FDA approved Keytruda® for the treatment of advanced cervical cancer and for the treatment of a rare form of lymphomaA cancer arising in the lymphatic system. The white blood cells affected are part of the body's immune system. The lymphatic system is a large network of vessels that carry fluid and cells of the immune system around the body. Lymph nodes are regional collection centers in the lymphatic system. See also, 'lymphatic system'. - primary mediastinal large B-cell lymphoma (PMBCL).4, 5

Mechanism:

Pembrolizumab (Keytruda®) is a type of immunotherapyA treatment for a disease (including cancer) that involves the modulation of the immune system. Treatments include the administration of cytokines (proteins produced by cells of the immune system) and vaccinations. that blocks the PD-1 pathway. Our immune system regulates T cell activity through the PD-1 pathway. Cancer cells can hijack the PD-1 pathway and hide from T cells. The drug works by helping restore proper function to the immune system, so that the immune system and T cells can do what they are supposed to do: detect and kill cancer cells.1

The diagram below shows the 3D crystal structure of Pembrolizumab, a full length IgG4 antibodyAntibody molecules tightly bind to their targets (usually proteins) with great specificity. Antibody binding alerts the immune system to target the bound molecule for destruction. Specific antibodies can be made in the laboratory. .

Side effects:

Most common side effects include: tiredness, cough, nausea, itching, rash, decreased appetite, constipation, join pain, and diarrhea.1

  • 1. Pai-Scherf L, Blumenthal GM, Li H2, Subramaniam S, Mishra-Kalyani PS, He K, Zhao H, Yu J, Paciga M, Goldberg KB, McKee AE, Keegan P, Pazdur R. FDA Approval Summary: Pembrolizumab for Treatment of Metastatic Non-Small Cell Lung Cancer: First-Line Therapy and Beyond. Oncologist. 2017 Nov;22(11):1392-1399. doi: 10.1634/theoncologist.2017-0078. [PUBMED]
  • 2. Keytruda Manufacturer website. Accessed on 8-8-2018 [LINK]
  • 3. FDA approves first cancer treatment for any solid tumor with a specific genetic feature. FDA News Release May 23, 2017 accessed 8-8-2018LINK]
  • 4. FDA approves pembrolizumab for advanced cervical cancer with disease progression during or after chemotherapy. June 12, 2018 Accessed on 08-08-2018 [LINK]
  • 5. FDA approves pembrolizumab for treatment of relapsed or refractory PMBCL. June 13, 2018. Accessed on 8-8-2018 [LINK]
  • 6. Keytruda - Manufacturer's Website Accessed on 8-8-2018 [LINK]
  • 7. Pembrolizumab. MedlinePlus. Accessed 8-8-2018 [LINK]