What are the side effects of pembrolizumab?

Keytruda (Pembrolizumab) is an immune checkpoint inhibitor that works by blocking the PD-1 receptor, helping the immune system to recognize and fight cancer cells. While it can be highly effective, it can also cause side effects, some of which can be severe. Here are some common and serious side effects associated with pembrolizumab:

Common Side Effects:

1. Fatigue
2. Skin reactions (rash, itching, or redness)
3. Diarrhea
4. Nausea
5. Loss of appetite
6. Joint pain (arthralgia)
7. Cough
8. Shortness of breath

Serious Side Effects:

Pembrolizumab can cause immune-related side effects, as it enhances immune activity, which can lead the body’s immune system to attack healthy tissues. These can include:

1. Immune-related inflammation in organs (e.g., lungs, liver, intestines, kidneys, and endocrine glands):
   • Pneumonitis (inflammation of the lungs)
   • Hepatitis (liver inflammation)
   • Colitis (inflammation of the intestines)
   • Nephritis (kidney inflammation)
   • Hypophysitis (inflammation of the pituitary gland)
   • Thyroid problems (e.g., hyperthyroidism or hypothyroidism)
2. Severe allergic reactions (anaphylaxis, which can include difficulty breathing, swelling of the face or throat, and dizziness)
3. Autoimmune disorders (where the body’s immune system attacks its own tissues)
   • Can include conditions like rheumatoid arthritis, lupus, or Guillain-Barré syndrome.
4. Infusion-related reactions (fever, chills, difficulty breathing, or rash during or shortly after the infusion)
5. Endocrine problems:
   • Adrenal insufficiency (low levels of adrenal hormones)
   • Diabetes or blood sugar issues
6. Nervous system problems:
   • Neuropathy (nerve damage leading to tingling or weakness)
   • Myasthenia gravis (muscle weakness)

Rare but Serious Effects:

• Cardiovascular issues (e.g., inflammation of the heart)
• Severe infections (due to immune system changes)

It’s important to contact a healthcare provider immediately if any of the following occur:

• Persistent or worsening side effects
• New symptoms like difficulty breathing, chest pain, or severe abdominal pain
• Swelling or pain in the joints, yellowing of the skin or eyes, or changes in urination.

Healthcare providers monitor patients receiving pembrolizumab closely to manage side effects, adjusting doses or discontinuing treatment if necessary.

Would you like more details about any specific side effects or how they are managed?

How does KEYTRUDA work?

KEYTRUDA (pembrolizumab) works by targeting a protein called PD-1 (Programmed Death-1) on immune cells, which plays a crucial role in regulating the immune system. Here’s how it works in more detail:

1. Immune System and PD-1:

• Under normal circumstances, the immune system uses the PD-1 protein on T cells (a type of white blood cell) to prevent autoimmunity—this means the immune system doesn’t attack healthy cells in the body.
• PD-1 acts as a “brake” on immune activity, preventing T cells from becoming overactive and attacking normal tissues.

2. Cancer Cells and PD-L1:

• Many cancer cells take advantage of this immune checkpoint system by expressing a protein called PD-L1 (Programmed Death-Ligand 1) on their surface.
• When PD-L1 binds to the PD-1 receptor on T cells, it “turns off” the immune response, allowing the cancer cells to evade detection and destruction by the immune system.

3. How KEYTRUDA Works:

• KEYTRUDA is an antibody that binds to PD-1.
• By binding to the PD-1 receptor, KEYTRUDA blocks the interaction between PD-1 and PD-L1, effectively removing the “brake” on the immune system.
• This action restores the immune system’s ability to detect and attack cancer cells.

4. Activation of the Immune Response:

• With the PD-1 receptor blocked, T cells become activated and are able to recognize and destroy cancer cells more effectively.
• This can help the body fight certain types of cancer, as it essentially “unmasks” the cancer cells, making them visible to the immune system.

5. Specific Types of Cancer:

KEYTRUDA is used to treat several types of cancers, including:

• Non-small cell lung cancer (NSCLC)
• Melanoma
• Head and neck squamous cell carcinoma
• Urothelial carcinoma (bladder cancer)
• Classical Hodgkin lymphoma
• Some types of gastric cancer
• Certain types of microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) cancers

In Summary:

KEYTRUDA works by blocking the PD-1 pathway, which removes an immune “brake” that cancer cells use to avoid detection. This enables the immune system to recognize and attack cancer cells more effectively.

Keytruda (Pembrolizumab)

What types of Keytruda cancer is it treating?

Would you like to know more about how KEYTRUDA is used in specific cancers or its effectiveness in particular situations?

KEYTRUDA (pembrolizumab) is used to treat a variety of cancers by boosting the immune system’s ability to recognize and attack cancer cells. It has been approved for the treatment of the following types of cancer:

1. Non-Small Cell Lung Cancer (NSCLC)

• KEYTRUDA is used to treat advanced or metastatic non-small cell lung cancer, especially in patients whose tumors have high levels of PD-L1 expression, and for those who cannot undergo surgery or other treatments.

2. Melanoma

• KEYTRUDA is approved for the treatment of unresectable or metastatic melanoma, a type of skin cancer that has spread beyond its original site.

3. Head and Neck Squamous Cell Carcinoma (HNSCC)

• It is used to treat certain patients with head and neck squamous cell carcinoma, a type of cancer that affects the mouth, throat, and larynx, especially when the disease has spread or is recurrent.

4. Urothelial Carcinoma (Bladder Cancer)

• KEYTRUDA is approved for advanced or metastatic urothelial carcinoma, including cancers of the bladder and the urinary system, particularly in patients who have previously received chemotherapy.

5. Classical Hodgkin Lymphoma

• Pembrolizumab is used in the treatment of relapsed or refractory classical Hodgkin lymphoma, a type of blood cancer that affects lymphocytes (a kind of white blood cell).

6. Gastric Cancer (Stomach Cancer)

• KEYTRUDA can be used for advanced or metastatic gastric cancer or gastroesophageal junction cancer, particularly when the tumors have high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR).

7. Cervical Cancer

• It is used to treat recurrent or metastatic cervical cancer, particularly when it expresses PD-L1 and has progressed after prior treatment.

8. Esophageal Cancer

• KEYTRUDA is used to treat advanced esophageal cancer, especially for patients with PD-L1 expression or for tumors with high microsatellite instability (MSI-H).

9. Microsatellite Instability-High (MSI-H) or Mismatch Repair-Deficient (dMMR) Cancers

• KEYTRUDA is approved for treating MSI-H or dMMR cancers, regardless of the tumor’s origin. This includes cancers such as colorectal cancer, endometrial cancer, and others that show these genetic markers.

10. Triple-Negative Breast Cancer (TNBC)

• For triple-negative breast cancer that is advanced or metastatic, KEYTRUDA is used in combination with chemotherapy in certain patients, especially when the cancer expresses PD-L1.

11. Lung Cancer with High PD-L1 Expression

• KEYTRUDA is used as a first-line treatment for NSCLC in patients with high PD-L1 expression and no EGFR or ALK mutations.

12. Other Cancers:

• Small Cell Lung Cancer (SCLC): It is used for extensive-stage small cell lung cancer in combination with chemotherapy.
• Renal Cell Carcinoma (Kidney Cancer): KEYTRUDA is used to treat advanced renal cell carcinoma (a form of kidney cancer), particularly in combination with other treatments.

In Summary:

KEYTRUDA has a broad range of uses in treating solid tumors and hematologic cancers. It is primarily used for cancers that express PD-L1 or have high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR). It works by stimulating the immune system to fight cancer more effectively.

Would you like more information on how KEYTRUDA is used for a specific cancer or its effectiveness in those cancers?