In late 2017, the FDA approved Keytruda (pembrolizumab) as an immunotherapy treatment for cancer. It’s typically used to treat inoperable metastatic non-small cell lung cancer and melanoma but it has also been approved by the FDA to treat any unresectable or metastatic solid tumor, such as those found in mesothelioma.
Immunotherapy is a type of cancer treatment that is designed to work with the body’s own immune system and fight diseases in a more natural way. Immunotherapy treatments focus on improving the immune system using elements created within the body, but treatments can also be man-made. Typically, immunotherapy works by stopping the spread and growth of cancer cells, all while improving the immune system’s strength. Keytruda works by blocking PD-1 which is a protein that allows cells to not be affected the body’s immune system and its ligands PD-L1 and PD-L2.
At the 17th World Conference on Lung Cancer in 2017, researchers and scientists were excited to report the positive effects Keytruda had not only by itself, but when combined with a listeria-based therapeutic vaccine. Keytruda is currently in clinical trials for a mesothelioma treatment, along with Yervoy and Opdivo, two other checkpoint inhibitor immunotherapy drugs.
While there has been some success associated with Keytruda, Opdivo and Yervoy, a recent journal article published in the JAMA Network clarifies that only patients who are eligible for immune checkpoint inhibitors are able to receive the treatment, of those people, the treatment may or may not be a success. A little less than half – 43.63 percent – of cancer patients are eligible for these therapies. Of that 43 percent, 12.46 percent have benefited. However, it’s important to remember that even though the cancer itself is the same, its effect will be different from person to person. This means that benefit estimates and eligibility will change over time.
Keytruda Clinical Trial
This upcoming clinical trial from the University of Pennsylvania was last verified in April 2019 and should be recruiting soon. The purpose if this trial is to evaluate the safety, feasibility, and preliminary efficacy of the addition of pembrolizumab and image-guided resection to surgical therapy and chemotherapy for malignant pleural mesothelioma.
Keytruda will be administered via IV before surgery, after surgery, and for three weeks during maintenance along with chemotherapy treatments cisplatin and pemetrexed, which will be administered post-surgery.
Daniel Catenacci, “Keeping Checkpoint Inhibitors in Check,” JAMA Network (May 3 2019). [Link]