Pembrolizumab

Pembrolizumab, also known by its brand name Keytruda, is an immunotherapy drug being studied in various clinical trials for different types of cancer. This article explores recent clinical trials investigating the use of pembrolizumab in treating conditions such as melanoma, non-small cell lung cancer, biliary tract cancer, and other solid tumors. We’ll look at how the drug works, its potential benefits, and what researchers hope to learn from these studies.

Table of Contents

What is Pembrolizumab?

Pembrolizumab is a type of cancer treatment known as immunotherapy. It’s also referred to by its brand name Keytruda[1]. This medication is designed to help your body’s own immune system fight cancer cells. Pembrolizumab is a monoclonal antibody, which is a type of protein made in a laboratory that can bind to specific targets in the body, such as cancer cells[2].

How Does Pembrolizumab Work?

Pembrolizumab works by targeting a protein called PD-1 (programmed death 1) that is found on certain immune cells called T cells. Normally, PD-1 acts as a type of “off switch” that helps prevent T cells from attacking other cells in the body. Some cancer cells can take advantage of this by expressing PD-L1, which binds to PD-1 and turns off the T cells, allowing the cancer to hide from the immune system.

Pembrolizumab blocks the interaction between PD-1 and its ligands (PD-L1 and PD-L2). By doing this, it allows the T cells to remain active and detect and attack cancer cells[1]. In simpler terms, pembrolizumab helps “unmask” the cancer cells so that your immune system can recognize and destroy them.

What Types of Cancers Does Pembrolizumab Treat?

Pembrolizumab has shown effectiveness in treating various types of cancers. Based on the clinical trials information provided, it is being studied or used to treat:

  • Melanoma: A type of skin cancer[1]
  • Non-small cell lung cancer (NSCLC)[3]
  • Head and neck squamous cell carcinoma: Cancers that start in the mouth, nose, or throat[4]
  • Ovarian clear cell carcinoma: A rare type of ovarian cancer[5]
  • Breast cancer: Specifically, hormone receptor-positive, HER2-negative breast cancer[2]
  • Thymic carcinoma: A rare cancer of the thymus gland[6]

It’s important to note that research is ongoing, and pembrolizumab may be effective for other types of cancers as well.

How is Pembrolizumab Administered?

Pembrolizumab is typically given as an intravenous (IV) infusion. This means it’s administered directly into your bloodstream through a vein. The usual dose is 200 mg, given once every three weeks[1]. Each treatment cycle is generally 21 days long. The infusion usually takes about 30 minutes to complete.

The duration of treatment can vary depending on how well the cancer responds and how well you tolerate the medication. In some cases, treatment may continue for up to two years if the cancer is responding well and side effects are manageable[3].

Pembrolizumab in Combination Therapies

Researchers are exploring the use of pembrolizumab in combination with other cancer treatments to potentially enhance its effectiveness. Some combinations being studied include:

  • Pembrolizumab with lenvatinib: This combination is being studied for various cancers, including ovarian clear cell carcinoma and thymic carcinoma[5].
  • Pembrolizumab with radiation therapy: This combination is being investigated for breast cancer[2].
  • Pembrolizumab with chemotherapy: This combination is being studied for lung cancer[3].
  • Pembrolizumab with other targeted therapies: For example, combination with crizotinib for certain types of lung cancer[7].

Potential Side Effects

Like all medications, pembrolizumab can cause side effects. Because it works by stimulating your immune system, many of the side effects are related to an overactive immune response. Some potential side effects include:

  • Fatigue
  • Skin rash or itching
  • Nausea or diarrhea
  • Joint pain
  • Decreased appetite
  • Fever

More serious side effects can occur, though they are less common. These may include inflammation in various parts of the body, such as the lungs (pneumonitis), intestines (colitis), or hormone-producing glands (endocrinopathies)[7]. It’s important to report any new symptoms to your healthcare team promptly.

Ongoing Research and Future Directions

Research on pembrolizumab is ongoing, with many clinical trials exploring its use in different types of cancers and in combination with other treatments. Some areas of current research include:

  • Identifying biomarkers to predict which patients will respond best to pembrolizumab. For example, some studies are looking at the levels of a protein called PD-L1 in tumor cells[7].
  • Investigating the effectiveness of pembrolizumab in cancers that have spread to the brain or spinal cord (leptomeningeal metastases)[8].
  • Exploring the use of pembrolizumab earlier in the course of cancer treatment, including as a first-line therapy for some cancers[1].
  • Studying how pembrolizumab might be used to treat cancers that have become resistant to other forms of treatment[4].

These ongoing studies aim to improve our understanding of how pembrolizumab works and how it can be used most effectively to help patients with various types of cancer.

Aspect Details
Drug Name Pembrolizumab (Keytruda)
Drug Type Immunotherapy (PD-1 inhibitor)
Administration Intravenous infusion, typically every 3 weeks
Common Dose 200 mg for adults (may vary in some trials)
Cancer Types Studied Melanoma, Non-small cell lung cancer, Biliary tract cancer, Ovarian squamous cell carcinoma, Urothelial bladder carcinoma, Merkel cell carcinoma, Other advanced solid tumors
Key Outcomes Measured Objective response rate, Progression-free survival, Overall survival, Safety and tolerability
Trial Phases Phase 1, 2, and 3 studies represented
Combination Therapies Some trials studying pembrolizumab alone, others in combination with other drugs
Special Considerations Biosimilar studies, neoadjuvant use, pharmacokinetic assessments

Ongoing Clinical Trials on Pembrolizumab

  • Study on the Effectiveness of Optune with Temozolomide and Pembrolizumab in Patients with Newly Diagnosed Glioblastoma

    Recruiting

    3 1 1
    Investigated diseases:
    Czechia France Germany Italy Poland Spain
  • Study on Pembrolizumab for Patients with Early Triple-Negative Breast Cancer Responding Well to Initial Treatment

    Recruiting

    3 1 1 1
    Investigated diseases:
    Investigated drugs:
    Belgium France
  • Study of Roginolisib for Patients with Advanced Uveal Melanoma

    Recruiting

    2 1 1 1
    Investigated diseases:
    Italy Spain
  • Study comparing Rilvegostomig plus chemotherapy versus Pembrolizumab plus chemotherapy for first-line treatment in patients with metastatic non-squamous lung cancer with PD-L1 expression

    Recruiting

    3 1 1 1
    Investigated diseases:
    Belgium France Germany Hungary Italy The Netherlands +2
  • Study on Pembrolizumab for Patients with High-Risk Melanoma Without Signs of Metastasis

    Recruiting

    2 1 1 1
    Investigated drugs:
    Belgium
  • Study of Pembrolizumab and Lenvatinib for Patients with Advanced Vulvar Cancer Not Suitable for Surgery or Radiotherapy

    Recruiting

    2 1 1 1
    Investigated diseases:
    Investigated drugs:
    Germany
  • Study on Stopping Nivolumab or Pembrolizumab in Advanced Melanoma Patients After Achieving a Response

    Recruiting

    3 1 1 1
    Investigated drugs:
    The Netherlands
  • Study on the Effects of Tumor Removal in Patients with Metastatic Kidney Cancer Treated with Nivolumab and Ipilimumab Combination

    Recruiting

    3 1 1 1
    Investigated diseases:
    Italy
  • Study of trastuzumab with chemotherapy and immunotherapy combination for first-line treatment in patients with HER2-positive esophageal squamous cell cancer

    Recruiting

    2 1 1 1
    Denmark
  • Study Comparing Effects and Safety of CT-P51 and Pembrolizumab with Drug Combination in Patients with Untreated Metastatic Non-Small Cell Lung Cancer

    Recruiting

    3 1 1 1
    Investigated diseases:
    Croatia Greece Lithuania Poland Romania Spain

Glossary

  • Pembrolizumab: An immunotherapy drug that works by blocking the PD-1 protein, helping the immune system to better recognize and attack cancer cells.
  • Immunotherapy: A type of cancer treatment that helps the body's immune system fight cancer.
  • PD-1: A protein on T cells that normally helps prevent them from attacking other cells in the body. Some cancer cells can use PD-1 to avoid being attacked by the immune system.
  • Intravenous (IV): A method of administering medication directly into a vein.
  • Pharmacokinetics (PK): The study of how a drug moves through the body, including how it's absorbed, distributed, metabolized, and excreted.
  • Objective Response Rate (ORR): The proportion of patients whose cancer shrinks or disappears after treatment.
  • Progression-Free Survival (PFS): The length of time during and after treatment that a patient lives with cancer without it getting worse.
  • Overall Survival (OS): The length of time from the start of treatment that patients are still alive.
  • Adverse Event (AE): Any unfavorable and unintended sign, symptom, or disease associated with the use of a medical treatment.
  • Biosimilar: A biological product that is highly similar to and has no clinically meaningful differences from an existing approved reference product.

References

  1. https://clinicaltrials.eu/trial/study-of-encorafenib-binimetinib-and-pembrolizumab-for-patients-with-advanced-melanoma-with-braf-v600e-k-mutation/
  2. https://clinicaltrials.gov/study/NCT03051672
  3. https://clinicaltrials.gov/study/NCT04166487
  4. https://clinicaltrials.gov/study/NCT04150900
  5. https://clinicaltrials.gov/study/NCT05296512
  6. https://clinicaltrials.eu/trial/study-on-pembrolizumab-and-lenvatinib-for-patients-with-pre-treated-thymic-carcinoma-and-b3-thymoma/
  7. https://clinicaltrials.gov/study/NCT02511184
  8. https://clinicaltrials.gov/study/NCT04729348