Pembrolizumab
Pembrolizumab (Keytruda®) is an anti-programmed death receptor-1 (PD-1) monoclonal antibody that binds to PD-1, a checkpoint inhibitor control. PD-1 is a negative regulator of Tcell activation and proliferation, meaning PD-1 engagement will turn the immune response off, essentially acting as a brake. For this reason, PD-1 and other regulators acting in this manner are known as immune checkpoints.
This type of inhibitory role is necessary for a normal system to prevent an excessive immune reaction and potentially lethal autoimmune response. Unfortunately, some tumors can exploit the PD-1 pathway, enabling them to evade an immune response by engaging the shut-off actions of PD-1. Pembrolizumab selectively binds to PD-1, thus physically blocking the engagement of PD-1 and preventing the immune system from being shut off by tumor cells. This allows the immune response to recognize the tumor cells and take action.
Pembrolizumab has over 41 indications in 21 tumor types. It is approved for the treatment of:
- Stage IIB, IIC, and III melanoma
- Advanced melanoma
- Advanced non-small cell lung cancer
- Advanced malignant pleural mesothelioma
- Head and neck squamous cell cancer
- Relapsed or refractory classical Hodgkin lymphoma
- Refractory primary mediastinal large B-cell lymphoma
- Advanced Merkel cell carcinoma
- Metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) solid tumors
- Advanced renal cell carcinoma
- MSI-H, dMMR or advanced endometrial carcinoma
- Advanced tumor mutational burden-high solid tumors
- Advanced cutaneous squamous cell carcinoma
- Triple-negative breast cancer
- Urothelial cancer
- MSI-H or dMMR colorectal cancer
- Gastric or gastroesophageal junction adenocarcinoma
- Advanced esophageal cancer
- Advanced cervical cancer
- Hepatocellular carcinoma
- Advanced biliary tract cancer
- Advanced ovarian cancer
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