Written By: Camryn Keeble
Keytruda for Mesothelioma
Keytruda is a type of mesothelioma immunotherapy approved for the treatment of pleural mesothelioma. Keytruda can improve survival and life expectancy for some patients.
Medically Reviewed By
Karen Ritter, RN BSN
Registered Nurse
Medically Reviewed By
Karen Ritter, RN BSN
Registered Nurse
JUMP TO A TOPIC
Important Facts About Keytruda for Mesothelioma
- The FDA approved Keytruda for the treatment of unresectable, malignant pleural mesothelioma in September 2024.
- Keytruda is the brand name of the checkpoint inhibitor immunotherapy drug pembrolizumab.
- Side effects of Keytruda are usually mild – especially when taken alone. If you take Keytruda in combination with another prescription, side effects can be more severe.
FDA Approval of Keytruda for Mesothelioma
The U.S. Food and Drug Administration (FDA) approved Keytruda in September 2024 as a first-line option to treat unresectable, malignant pleural mesothelioma. This type of mesothelioma forms in the lining of the lungs.
The FDA approval requires patients to use Keytruda in combination with chemotherapy. “Unresectable” means surgery is not an option to treat the cancer.
Keytruda is not yet approved for peritoneal mesothelioma (mesothelioma of the abdominal cavity lining).
How Keytruda Works for Mesothelioma
Keytruda is a type of mesothelioma immunotherapy called a checkpoint inhibitor. These types of immunotherapies boost the immune system’s ability to respond to cancer cells. In more technical terms, Keytruda stops cancerous proteins from preventing the immune system from working to fight the cancer.
PD-1 and PD-L1
The immune system has soldier cells, called T cells, that attack and kill diseases. However, mesothelioma cells have surface proteins that subdue or prevent the T cells from doing their job.
Mesothelioma tumors have a protein called PD-L1, which interacts with the PD-1 protein found on T cells. When PD-L1 and PD-1 bind together, T cells no longer recognize mesothelioma tumors as a threat to the body. This means they cannot actively fight off disease, allowing cancer to spread freely.
Keytruda Blocks PD-L1
Keytruda blocks interactions between the PD-L1 and PD-1 proteins, preventing the binding of the two proteins. By blocking the interaction, T cells remain active and alert, ready to fight off mesothelioma.
This therapy helps the immune system to attack, helping to kill mesothelioma cancer cells and preventing them from growing and spreading throughout the body.
Mesothelioma Survival and Keytruda
Mesothelioma survival after receiving Keytruda is promising. Keytruda in combination with chemotherapy performed better in terms of survival than chemotherapy alone.
A phase 3 clinical trial called KEYNOTE-483 included 440 people with unresectable, malignant pleural mesothelioma. Half of patients received Keytruda with chemotherapy. The other half received only chemotherapy:
- Median survival for patients receiving Keytruda with chemotherapy was 17.3 months. Chemotherapy alone led to a median survival of 16 months.
- Approximately 52% of patients had a positive anti-tumor response from Keytruda. Only 29% of patients had a positive anti-tumor response after only chemotherapy.
- Keytruda kept people’s mesothelioma from spreading for at least a year in 26% of cases. Chemotherapy had a lower percentage.
Side Effects of Keytruda
Safety is often measured in side effects. Chemotherapy’s side effects range from mild fatigue to severe nausea. Chemotherapy for mesothelioma also weakens bones and causes neuropathies or nerve damage in extremities.
The side effects of Keytruda are not usually as intense. They include:
- Fatigue
- Muscle pain
- Rash
- Diarrhea
- Fever
- Cough
- Decreased appetite
- Itching
- Shortness of breath
- Constipation
- Bones, joints or abdominal pain
- Nausea
- Low levels of thyroid hormone
If you experience any new or worsening side effects, contact your doctor. You may be eligible for a different immunotherapy treatment, or your doctor may elect to try a different type of mesothelioma treatment.
Process of Keytruda for Mesothelioma
Keytruda is given through an IV (intravenously) and is typically scheduled for once every three weeks.
Mesothelioma patients may have an opportunity to receive this immunotherapy treatment for an extended length of time. Some patients have received Keytruda every few weeks for multiple years. The length of treatment depends on how tumors respond to the immunotherapy and whether the patient experiences any severe side effects.
How to Get Keytruda for Mesothelioma
The first step to get Keytruda for mesothelioma is to receive a medical diagnosis. This involves an initial consultation with a doctor, imaging tests to look for evidence of cancer, and a biopsy at a hospital or cancer center.
If your mesothelioma is in an early stage, you may be a candidate for surgery. This is the best option for treatment. Keytruda is not approved by the FDA for patients who can have surgery.
If surgery isn’t possible, then you will likely qualify for Keytruda if you have the type of mesothelioma called pleural mesothelioma.
Mesothelioma patients can go to their local medical facility or a top cancer center to receive Keytruda. It is recommended for patients to see a doctor experienced at treating mesothelioma to make sure Keytruda is the right treatment option, or if surgery is possible.
Mesothelioma Guide has free resources to help you learn more about Keytruda and other treatments for mesothelioma. Contact registered nurse Karen Ritter at karen@mesotheliomaguide.com for personalized help.
Frequently Asked Questions About Keytruda for Mesothelioma
Is Keytruda approved for mesothelioma?
Yes, Keytruda is approved by the FDA as a first-line treatment option for unresectable, malignant pleural mesothelioma. Unresectable means surgery is not an option to treat the cancer. Keytruda is approved for use in combination with mesothelioma chemotherapy.
How does Keytruda work?
Keytruda is an immunotherapy drug, meaning it strengthens the immune system’s ability to respond to cancer and other diseases. It blocks two proteins from binding: one on immune system cells and one on mesothelioma cells. This blockade helps the immune system target and kill mesothelioma cells more accurately.
What are the side effects of Keytruda?
Side effects of Keytruda may include fatigue, muscle pain, diarrhea, cough, rash, fever, decreased appetite, itching, shortness of breath, constipation, bone pain, joint pain, abdominal pain, nausea and low levels of thyroid hormone. If you experience any now or worsening side effects, contact your doctor immediately.
Sources & Author
- FDA approves pembrolizumab with chemotherapy for unresectable advanced or metastatic malignant pleural mesothelioma. U.S. Food and Drug Administration. Retrieved from: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-pembrolizumab-chemotherapy-unresectable-advanced-or-metastatic-malignant-pleural. Accessed: 09/18/2024.
- How Does Keytruda Work? Keytruda (pembrolizumab). Retrieved from: https://www.keytruda.com/how-does-keytruda-work/. Accessed: 12/02/22.
AI Summary of Keytruda for Mesothelioma
Keytruda is a medication that has been approved by the U.S. Food and Drug Administration (FDA) to treat a specific form of mesothelioma called pleural mesothelioma, which develops in the lining of the lungs. It is a type of immunotherapy, meaning it helps the body's immune system better recognize and fight cancer cells. This treatment is typically used along with chemotherapy for patients whose cancer cannot be removed through surgery, known as unresectable mesothelioma. While Keytruda offers hope and may improve survival for some patients, it is not yet approved for all types of mesothelioma, such as those affecting the abdomen, called peritoneal mesothelioma.
Keytruda works by blocking proteins on cancer cells that hide them from the immune system. Specifically, it targets a protein called PD-L1 on mesothelioma cells, preventing it from attaching to a protein called PD-1 on immune cells. When these proteins bind, immune cells, known as T cells, often fail to recognize the cancer as a threat. By blocking this interaction, Keytruda helps T cells remain active and better able to attack mesothelioma tumors. This enhancement of the immune response can slow the spread of the disease and, in some cases, shrink tumors. Treatment involves receiving the medication through an intravenous (IV) infusion every three weeks, and the duration of treatment varies based on individual responses and side effects.
Clinical studies have shown promising results, with some patients experiencing extended survival times and tumor control after treatment with Keytruda combined with chemotherapy. The median survival time for patients on this combined therapy was approximately 17 months, slightly longer than those receiving chemotherapy alone. Additionally, many patients responded positively, with a better ability for their immune system to target the cancer. While side effects are generally mild, some patients may experience fatigue, rash, muscle pain, digestive issues, or other symptoms. It is important for individuals receiving this treatment to be closely monitored by their healthcare team, who can manage any side effects that occur. Overall, Keytruda offers an important option for those with advanced pleural mesothelioma when surgery is not feasible, providing hope for a better quality of life and potentially lengthening survival."