Keytruda, also known as pembrolizumab, is an immunotherapy drug that has shown promise in extending the lifespan of mesothelioma patients.
Table of Contents
- Keytruda is an immunomodulatory drug.
- Keytruda and immunotherapy have become more standard in the treatment of mesothelioma.
- Immunotherapy may be an option for patients who have not responded to standard treatments.
- Keytruda has shown improved survival in mesothelioma patients in clinical trials.
Keytruda is an immunotherapy drug designed to boost the immune system, induce an anti-cancer effect that can help the body destroy cancer cells and ultimately treat cancers. such as malignant mesothelioma. The drug developed by Merck has shown promise in improving the quality of life and overall survival of mesothelioma patients inclinical trials and has recently become a treatment option. Following the success of these numerous research, there will be a higher standard for mesothelioma. The US Food and Drug Administration (FDA) has authorized Keytruda as a first-line treatment for non-small cell lung cancer (NSCLC). melanoma, Merkel cell carcinoma (MCC) and other cancers, and the researchers hope it will gain FDA approval for mesothelioma.
Pembrolizumab and Immunotherapy
Keytruda is an immunotherapy medicine that helps the immune system in identifying and attacking cancer cells. Foreign intruders in the body are identified and attacked by the immune system. Immune system cells recognize certain pathogens through receptors called antigens on their surface.
On the surfaces of healthy cells in the body, receptors signal immune cells to leave them alone. Some cancer cells express the same receptor, the PD-1 protein. This causes immune cells to mistake cancer cells for healthy cells and allows them to grow and develop on their own.
Pembrolizumab acts on these cancer cell receptors and helps the immune system recognize them as foreign and attack them. This strategy is sometimes referred to as an immune system blockage.
How Does Keytruda Treat Mesothelioma?
Keytruda works with the body’s immune system to treat cancer. Keytruda, as an immune checkpoint inhibitor, inhibits immune cells from attacking and killing cancer cells. T cells, which are used by the body to detect and fight infections, are sometimes fooled by the protein PD-L1 (programmable ligand-1) found on normal and cancer cells. Keytruda inhibits the PD-1 immune checkpoint that identifies cancer cells as normal cells to help the immune system recognize and fight them.
Keytruda is given by infusion every three weeks over a period of 30 minutes. Patients may receivechemotherapy with Keytruda, which can be given on the same day, but Keytruda must be given first. Keytruda and other immunotherapy medications were previously only available through clinical trials. However, the National Cancer Comprehensive Network (NCCN) recently added Keytruda and Opdivo, another checkpoint inhibitor, to its recommendation as a treatment for patients with pleural mesothelioma. had previously undergone chemotherapy. As a result, Keytruda and immunotherapy are increasingly used in mesothelioma treatment plans.
What Is Keytruda’s Success Rate?
Successful Patients With Keytruda
Keytruda has shown promise in clinical trials as a treatment for mesothelioma patients who have failed to respond to standard treatments, contributing to our recommendation. NCCN. Although drugs and other immunotherapies are now more widely available, researchers continue to test their effectiveness and different combinations in clinical trials to find out what results. best results and hopefully get FDA approval for mesothelioma.
The KEYNOTE-028 clinical trial included 25 people with malignant pleural mesothelioma from 13 locations in six countries. Patients were given the drug every two weeks for two years, until tumor progression or drug toxicity was not tolerated. Every eight weeks, participants’ solid tumor development and overall health were examined. The researchers concluded that 5 patients had a partial response to the drug, and 14 of the 25 participants saw a reduction in their tumors. The overall disease control rate of this study was 76%, with a median progression-free survival of 6.2 months and a median survival of 18 months.
A Phase II clinical trial is expected to be completed in 2020, which will better determine survival rates for mesothelioma patients and may eventually lead to FDA approval of the drug. treatment of mesothelioma.
In another clinical trial, conducted in Australia and Switzerland, 93 patients with malignant pleural mesothelioma were treated with pembrolizumab as palliative treatment.. The patients are given different doses based on their individual case and it is used as a first or second treatment. Of the participants, 68 had mesothelioma, 15 had sarcoma, and 10 had mixed or biphasic mesothelioma. All patients were assessed for performance status by the Eastern Cooperative Oncology Group (ECOG) to assess their quality of life. The ECOG performance status uses a scale of 0 – 5, where 0 represents a fully active patient and able to perform their usual daily tasks, while 5 indicates a successful patient. to live. A score of 1-3 represents patients who are increasingly limited in their mobility and energy to perform their daily tasks.
The Researchers Found A Series Of Scores In Their Ecog Data:
- 11 patients have a score of 0
- 55 patients have a score of 1
- 27 patients with a score of 2 or more
The Researchers Also Noted The Presence Of Pd-L1 In 71% Of The Participants And Found:
- 68% of available samples were negative for PD-L1
- 18% have moderate PD-L1 levels
- 14% is considered a high amount of PD-L1
Overall, the study tested pembrolizumab as a median palliative treatment for three months with a median follow-up of nine months. The researchers have found an overall response rate of 18% with a disease control rate of 48% at the end of treatment, indicating that these patients attained stable disease, partial remission. or complete remission. Stable disease means the mesothelioma does not grow or spread during treatment, while partial or complete remission indicates a decrease in tumor size and growth. Of the subjects tested, those with high PD-L1 expression had a 44% better overall response to the drug than participants with moderate and low PD-L1 expression, with response rates of 42% and 11%, respectively.
The study revealed that the median survival for all patients was 7.2 months, with a progression-free survival rate of 26% at 6 months. The researchers also noted a median survival of 10.2 months for patients with low ECOG scores at the start of the study.
Other checkpoint inhibitors such as Opdivo (nivolumab), which also target the PD-1 protein in vivo, have shown similar promising results in clinical trials. A study with Opdivo concluded that 68% of participants had their disease under control, meaning their cancer did not spread or worsen during treatment. Opdivo and Keytruda have been routinely tested together in clinical trials and show promise for improving quality of life and life expectancy in patients with mesothelioma.
Side Effects and Risks of Keytruda
Side effects of Keytruda are usually mild, but the drug can also cause health problems that can be dangerous for patients. Researchers have seen a wide variety of common symptoms in clinical trials. In a recent clinical study, more than half of the participants experienced side effects, with 24% of patients experiencingfatigue and nausea, while 20% experienced joint pain.Other common side effects include difficulty breathing, loss of appetite, itching, fever, cough and constipation. Some patients may experience side effects associated with chemotherapy in combination with Keytruda, such as hair loss, shortness of breath and neuritis.
Common Side Effects
- Reduce cravings
- A fever
- shortness of breath
Potentially Serious Side Effects
- Inflammation of the large intestine
- Hepatitis and Liver Problems
- hormonal problems
- Infusion (IV) response
- kidney disease
- Pneumonia and other lung problems
- Stevens-Johnson syndrome (SJS)
- Toxic Epidermal Necrolysis (TEN)
Taking immunotherapy drugs can also cause other side effects that can be more serious. Because immunotherapy drugs use the body’s immune system to attack cancer cells, the body can also attack healthy cells and organs, which can lead to complications. Although less common, immune-mediated rashes such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) can occur.
Problems with other organs can also occur with the use of immunotherapy drugs, such as changes in vision, joint pain, muscle weakness, irregular heartbeat and chest pain. It is important that patients evaluate the risks of Keytruda and see a doctor if they develop any symptoms while taking the medicine.
Keytruda for Mesothelioma
Currently, most patients with mesothelioma do not include most patients with mesothelioma indications for Keytruda, but research is underway to determine whether it could be an effective and safe treatment for this cancer. this letter or not.
A study published in The Lancet Oncology has shown promising results. This study suggests that while other chemotherapy drugs fail in mesothelioma patients, immune control drugs may be a better alternative.
The clinical trial is called KEYNOTE-028 and involved thirteen research groups in six different countries. The trial included 25 patients with pleural mesothelioma who had received at least one chemotherapy regimen prior to the trial.
The patient received a larger dose of pembrolizumab than usual every two weeks. As a result, 20% of patients saw a reduction in tumor size and another 52% of patients were stable. Respondents had an average of 12 months to respond.
In 2020, the FDA approved Keytruda for certain patients with mesothelioma. Adoption depends on genetic factors. This includes patients with solid tumors with a high tumor mutation burden. Mesothelioma is one of the most common cancers for this indication.
A large clinical trial with Keytruda in mesothelioma patients announced results in 2020. The researchers describe the response time of the treatment as impressive. The patients in the study received Keytruda as a second treatment after the others stopped responding or got stuck.
Keytruda For Asbestos Lung Cancer
Pembrolizumab shows promise for patients with mesothelioma; however, the drug is approved for non-small cell lung cancer (NSCLC), another type of cancer that can be caused by asbestos exposure. The approval to treat this type of cancer came after clinical trial results showed it to be safe and effective. More recent studies suggest it may be more effective than standard chemotherapy drugs such as cisplatin and carboplatin.
KEYNOTE-024 was a clinical trial of pembrolizumab in patients with non-small cell lung cancer whose tumors expressed PD-L1 at 50% or greater. The data suggest that pembrolizumab has several advantages over traditional chemotherapy.
Patients receiving this drug have better overall survival rates, fewer severe side effects, and an improved quality of life. While some side effects are worse with pembrolizumab, the side effects are generally lower and less severe. The benefits of pembrolizumab have been observed when used as a first-line treatment.
This study means that patients with lung cancer could be given pembrolizumab instead of cisplatin or carboplatin, avoiding the side effects of chemotherapy and potentially getting better results.
The promise of immunotherapy cancer drugs is very positive. Keytruda paves the way for a new strategy to better treat mesothelioma. There are already more than 90 clinical studies using Keytruda to treat different types of cancer.
Keytruda Approval Expands, Hope For Mesothelioma Patients
In June 2019, the FDA announced a new indication for Keytruda. It is currently approved for the first-line treatment of metastatic, unresectable, or recurrent squamous cell carcinoma of the head and neck (HNSCC).
The FDA has approved the immunotherapy drug as a combination treatment with chemotherapy and as a standalone treatment for HNSCC patients expressing PD-L1 on tumor cells.
This is important news not only for HNSCC patients who could benefit from Keytruda, but also for mesothelioma patients. HNSCC is a rare, difficult-to-treat, mesothelioma-like cancer. The approval of pembrolizumab is an important step in giving patients with mesothelioma hope for improved survival.
It is also a step towards obtaining approved drugs for other rare cancers. The approval comes after the clinical trial of KEYNOTE-048 showed that the drug can significantly extend patient survival.
Two new mesothelioma trials are expected to begin shortly. If you are struggling with mesothelioma, pembrolizumab is not currently approved for treatment; however, you can participate in a clinical trial. Talk to your doctor about entering if you qualify for this revolutionary treatment for this difficult-to-treat cancer.
Eligible for Keytruda
Keytruda is available in clinical trials for patients with mesothelioma, but the National Comprehensive Cancer Network (NCCN) has also recommended immunotherapy as a first-line treatment for patients with mesothelioma. malignant pleural mesothelioma. This means that patients can now only access clinical trial treatments with the recommendation of a medical professional. Cancer patients should consult a medical professional to see if they are eligible to add Keytruda to their treatment plan or to participate in a clinical trial involving Keytruda, as the trials Trials through the National Cancer Institute (NCI) have specific qualifications for participants, such as having undergone chemotherapy before seeking alternative treatments.