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Pembrolizumab 400 mg every six weeks is approved and works like 200 mg every three weeks, and it halves the number of clinic visits, infusion chairs and travel days without changing the drug bill.
The FDA approved pembrolizumab 400 mg every six weeks in 2020 on pharmacokinetic modelling and later clinical data; nivolumab 480 mg every four weeks has a similar basis. The drug quantity is the same, so the saving is in administration fees, chair time, staff, and patients' travel and time off work. Many practices still default to three-weekly schedules. A default schedule change in electronic order sets, with the shorter interval reserved for patients who need frequent review, is the cheapest capacity gain available in immunotherapy.
Patients whose kidney cancer has been removed but who are at high risk of recurrence (large or high-grade tumours, node involvement, or resected metastases) can now be offered a year of pembrolizumab, which increases the chance of being alive and cancer-free several years later. Roughly nine patients need treatment to prevent one recurrence at two years, and some will have permanent side effects, so shared decision-making matters. Why pembrolizumab succeeded where similar drugs failed is not fully understood.
Most patients with newly diagnosed advanced non-squamous lung cancer that lacks a targetable mutation should receive chemotherapy plus pembrolizumab; those with PD-L1 of 50% or more may reasonably receive pembrolizumab alone. About one in five patients is alive at five years, compared with roughly one in ten with chemotherapy alone. Patients with EGFR or ALK alterations were excluded and should have targeted therapy first.
With CheckMate 057 this trial ended docetaxel's role as the default second-line treatment in lung cancer and gave the first phase 3 proof that PD-1 blockade extends life in a common carcinoma. Its PD-L1-independent benefit in squamous disease still shapes how the biomarker is used.
Shares CheckMate 017: nivolumab beats docetaxel in squamous lung cancer after chemotherapy, KEYNOTE-564: a year of pembrolizumab after kidney cancer surgery, KEYNOTE-189: pembrolizumab plus chemotherapy as first treatment for non-squamous lung cancer without a driver mutation, Wrong doses.
Shares CheckMate 017: nivolumab beats docetaxel in squamous lung cancer after chemotherapy, KEYNOTE-189: pembrolizumab plus chemotherapy as first treatment for non-squamous lung cancer without a driver mutation, Not enough oncologists, nurses, pathologists, physicists, Fragmented care and guideline gaps.
Shares Wrong doses, Nivolumab, Pembrolizumab, Immune checkpoint inhibitors.
Shares KEYNOTE-564: a year of pembrolizumab after kidney cancer surgery, KEYNOTE-189: pembrolizumab plus chemotherapy as first treatment for non-squamous lung cancer without a driver mutation, Pembrolizumab.
Shares Wrong doses, Nivolumab, Pembrolizumab.
Shares KEYNOTE-189: pembrolizumab plus chemotherapy as first treatment for non-squamous lung cancer without a driver mutation, Pembrolizumab, Immune checkpoint inhibitors.
Shares Not enough oncologists, nurses, pathologists, physicists, Fragmented care and guideline gaps.
Shares CheckMate 017: nivolumab beats docetaxel in squamous lung cancer after chemotherapy, Nivolumab, Pembrolizumab.