Pembrolizumab
Indications
Pembrolizumab is an immunotherapy medicine (a monoclonal antibody) used to treat many types of cancer, including advanced melanoma, non-small cell lung cancer, head and neck cancer, Hodgkin lymphoma, bladder and urinary tract cancer, certain stomach, oesophageal, cervical, endometrial, kidney, liver and triple-negative breast cancers, and tumours with specific genetic features (MSI-high or dMMR). It may be used alone or with chemotherapy, depending on the cancer and test results.
How It Works
Pembrolizumab blocks a protein called PD-1 on immune cells (T cells). Some cancer cells use PD-1 as a "brake" to hide from the immune system. By releasing this brake, Pembrolizumab helps the body's own immune system recognise and attack the cancer.
Dosage and Administration
Pembrolizumab is given only in hospital or a cancer centre by a doctor or nurse, as an infusion into a vein over about 30 minutes. It is usually given every 3 or 6 weeks, at a dose and for a length of treatment decided by the cancer specialist, as prescribed. Blood tests and check-ups are done before each dose.
Interactions
Steroids and other medicines that suppress the immune system should ideally be avoided before starting unless the doctor advises, as they may reduce its effect; they are, however, used to treat its immune side effects. Tell the team about all medicines, including herbal products, and about any planned vaccines.
Contraindications
Do not use if you have had a severe allergic reaction to Pembrolizumab or any ingredient. Special caution is needed in people with autoimmune disease, organ transplants, or previous severe immune reactions to similar medicines.
Side Effects
Common effects include tiredness, itching, rash, diarrhoea, nausea, reduced appetite, cough, joint or muscle pain and changes in thyroid function. Because it boosts the immune system, it can cause inflammation in almost any organ (immune-related side effects), such as the lungs (pneumonitis), bowel (colitis), liver (hepatitis), kidneys, hormone glands (thyroid, pituitary, adrenal, pancreas, leading to diabetes), skin, nerves or heart. These can happen during or even months after treatment. Infusion reactions may also occur.
Get urgent medical help if you have new or worse cough or breathlessness, chest pain, severe or frequent diarrhoea or blood in stools, severe stomach pain, yellowing of the skin or eyes, very dark urine, severe tiredness or headache, extreme thirst or passing a lot of urine, confusion, muscle weakness, a severe or blistering rash, or fever and chills during the infusion.
Pregnancy and Lactation
Pembrolizumab may harm an unborn baby. Women who could become pregnant should use effective contraception during treatment and for at least 4 months after the last dose. Do not breastfeed during treatment and for 4 months after the last dose.
Precautions and Warnings
Carry information that you are receiving immunotherapy and tell any doctor you see. Report side effects early, as most can be treated if caught quickly, often with steroids. Thyroid, liver, kidney and blood sugar tests are checked regularly. Tell your doctor about any autoimmune condition, transplant, lung disease or previous radiotherapy to the chest.
Overdose
Overdose is unlikely as it is given by health professionals. If it happens, the person is closely monitored for immune-related side effects and given supportive treatment.
Therapeutic Class
Antineoplastic, immune checkpoint inhibitor (anti-PD-1 monoclonal antibody).
Storage
Stored by the hospital pharmacy in a refrigerator at 2 to 8°C, do not freeze, protected from light, as directed on the pack. Do not shake.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Pembrolizumab