Keytruda is an immunotherapy drug developed in the early 2000s by Merck & Co. The U.S. Food and Drug Administration (FDA) and the European Commission approved the drug for the treatment of various advanced cancers, including mesothelioma.
Pembrolizumab, marketed under the brand name Keytruda, was first invented by scientists Gregory Carven, Hans van Eenennaam, and John Dulos. While the FDA hasn’t approved Keytruda for legal mesothelioma treatment caused by asbestos exposure, the medication has been approved to treat melanoma, head and neck cancer, metastatic bladder cancer, metastatic non-small cell lung cancer, and colorectal cancer. Researchers are currently testing Keytruda on mesothelioma patients in clinical trials.
In September of 2014, the FDA approved pembrolizumab for legal use as a cancer medication under the Fast Track Development Program, which accelerates the availability of a new or non-approved drug. Doctors administer pembrolizumab as a first or second-line treatment by aiding the body’s immune system to fight cancer cells.
Immunotherapy drugs like Keytruda help the immune system, which is the body’s natural defense against disease. The body uses T-cells, sent by the immune system, to detect and fight cancer cells. Cancer cells may hide from T-cells using the PD-1 pathway, a type of protein found in the body’s immune cells.
Antibodies are proteins produced by plasma cells and used by the immune system to eliminate viruses, bacteria, and cancer cells. The pembrolizumab binds to and blocks PD-1, so the T-cells can continue to eliminate cancer cells.
Malignant mesothelioma (a disease of the lung, heart, or abdomen lining caused by prolonged exposure to asbestos) tumors consist of cells that often contain high levels of PD-L1. Researchers use Keytruda to block the PD-1 and PD-L1 pathway, which would allow the patient’s immune system to recognize and attack mesothelioma cells.
Patients receive Keytruda via intravenous therapy (IV) for 30-minute increments every three weeks. Cancer patients who tolerate Keytruda will typically continue treatment for up to two years, or until the dug continues to be effective.
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Patients who receive pembrolizumab may experience mild-to-severe side effects and should receive medical advice at a facility. Side effects can occur at the site of infusion or immune-related in response to treatment. Common reactions can include:
In rare situations, Keytruda may cause the immune system to attack normal organs and tissues, affecting their ability to function properly. Serious reactions typically affect the lungs, intestinal tract, kidneys, liver, and some hormone glands.
Cancer patients taking Keytruda can receive medications or therapies to eliminate side effects or keep them under control. Nonetheless, less-common side effects may include:
Pembrolizumab has been tested in clinical trials on multiple types of cancer. Some trials have shown success in treating certain cancers, but trails testing the drug on mesothelioma patients and others with asbestos-related illnesses haven’t shown as much success.
Early trials testing Keytruda on advanced or unresectable melanoma (often caused by hazardous exposure to the sun) in 2014 led to the drug’s approval by the FDA as a legal second-line treatment. Some study participants experienced increased survival, tumor reduction, and reduced risk of disease progression.
In 2015, Keyturda was approved as a first-line treatment of melanoma after a successful phase 3 trial. The drug was previously approved by the European Commission earlier that year. Keytruda as a first-line treatment for non-small cell lung cancer (commonly caused by exposure to airborne contaminants like smoke and pollution) was approved by the FDA in 2016, and for metastatic non-squamous non-small cell lung cancer in 2017.
Researchers at the European Thoracic Oncology Platform (ETOP) completed a phase 3 trial clinical trial on pembrolizumab for mesothelioma treatment in 2019. The randomized trial, called PROMISE-meso, compared pembrolizumab with standard chemotherapy in patients with progressive malignant pleural mesothelioma. Researchers hoped that the drug would improve the performance of single-agent immunotherapy as a second-line treatment for patients who successfully completed first-line, standard chemotherapy treatment.
The leading study author, Sanjay Popat, Ph.D., demonstrated in a presentation that the drug had failed to change disease outcomes on study subjects. Although results weren’t successful, the study provided researchers with new hope for combining immunotherapy with chemotherapy as a beneficial first-line treatment for malignant mesothelioma.
While treatment options like chemotherapy, radiation, and surgery continue to be the standard treatment, researchers believe immunotherapy shows promise in treating mesothelioma caused by asbestos. Multiple clinical trials testing immunotherapy drugs like Keytruda. To learn more about treating mesothelioma as well as your legal compensation options, download our free mesothelioma guide.
Rachel Ernst is a content writer at Mesothelioma Hub. She graduated with a Bachelor of Arts degree from the University of Illinois at Chicago, where she majored in communication and minored in sociology. She hopes to create public awareness about cancer through her writing. In her free time, Rachel likes to be outdoors, watch movies, and spend time with her animals.
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