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Brand Name
Keytruda®
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Immune Checkpoint Inhibitor Class
PD-1 Inhibitor
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Conventional Dosing
- Canadian funding supports 2 mg/kg IV every 3 weeks up to a maximum of 200 mg and 4 mg/kg IV every 6 weeks up to a maximum of 400 mg
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Extended-Interval Dosing
4 mg/kg (400 mg) IV every 6 weeks
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Fixed Dose or Capped Weight Based Dose
200mg and 400 mg
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Treatment Duration
- Adjuvant renal cell carcinoma - 1 year (17 doses at every 3 weeks or 9 doses at every 6 weeks) or until PD / unacceptable toxicity.
- Adjuvant melanoma - 1 year (17 doses at every 3 weeks or 9 doses at every 6 weeks) or until PD / unacceptable toxicity.
- Neoadjuvant with chemotherapy / adjuvant triple negative breast cancer - 1 year (17 doses at every 3 weeks) or until PD / unacceptable toxicity.
- Other indications - 2 years total treatment (35 doses at every 3 weeks or 18 doses at every 6 weeks) or until PD / unacceptable toxicity.
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Preferred Dosing Frequency with Other Agents
- Enfortumab Vedotin (1L Urothelial carcinoma) - 2 mg/kg (200 mg) IV every 3 weeks.
- Chemotherapy (Neoadjuvant triple negative breast cancer) - 2 mg/kg (200 mg) IV every 3 weeks.
- Chemotherapy (Metastatic triple negative breast cancer) - 2 mg/kg (200 mg) IV every 3 weeks OR 4 mg/kg (400 mg ) IV every 6 weeks.
- ■ Note: If using a taxane for chemotherapy backbone, it may require a 21 day cycle VS 28 day cycle to allow for co-administration of pembrolizumab, regardless of dosing strategy.
- Chemotherapy ± trastuzumab (Advanced or metastatic esophageal, GEJ, or Gastric cancer) - 2 mg/kg (200 mg) IV every 3 weeks (CapOx, Cisplatin + 5-FU) OR 4 mg/kg (400 mg) IV every 6 weeks (FOLFOX).
- Chemotherapy (Metastatic or unresectable recurrent head and neck squamous cell carcinoma) - 2 mg/kg (200 mg ) IV every 3 weeks OR 4 mg/kg (400 mg ) IV every 6 weeks.
- Axitinib or Lenvatinib (1L Advanced or metastatic renal cell carcinoma) - 2 mg/kg (200 mg) IV every 3 weeks OR 4 mg/kg (400 mg ) IV every 6 weeks.
- Lenvatinib (Advanced or metastatic endometrial cancer) - 2 mg/kg (200 mg) IV every 3 weeks OR 4 mg/kg (400 mg ) IV every 6 weeks.
- Chemotherapy (Advanced or metastatic NSCLC with (squamous or non-squamous)) - 2 mg/kg (200 mg) IV every 3 weeks OR 4 mg/kg (400 mg ) IV every 6 weeks.
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Administration
All doses administered IV over 30 minutes.
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Vial availability
100 mg (25 mg/mL)
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Dose Relationship to efficacy and toxicity
Flat dose-response and dose-toxicity relationship.
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Half-Life (5 x T1/2)
26 days (130 days)
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Unique Pharmacokinetics or Pharmacodynamics
None.