Cancers & treatments·Regimen libraryNeoadjuvant

KEYNOTE-522 (pembrolizumab + chemotherapy, then adjuvant pembrolizumab)

Checked 2026-09-09

Stage II-III triple-negative breast cancer

One cycle

every 21 days × 4 · about 12 weeks in total

21-day cycle × 4 paclitaxel-carboplatin then 4 AC/EC, surgery, then 9 adjuvant pembrolizumab (about 12 weeks)Intravenous

Components

Drug	Dose	Route	Days	Note
Pembrolizumab Monoclonal antibody (anti-PD-1)	200 mg	IV	D1	or 400 mg every 6 weeks
Paclitaxel Cytotoxic chemotherapy (taxane)	80 mg/m²	IV	D1, 8, 15	cycles 1-4
Carboplatin Cytotoxic chemotherapy (platinum)	AUC 5 day 1 (or AUC 1.5 weekly)	IV	D1	cycles 1-4
Doxorubicin Cytotoxic chemotherapy (anthracycline)	60 mg/m² (or epirubicin 90 mg/m²)	IV	D1	cycles 5-8
Cyclophosphamide Alkylating agent (oxazaphosphorine prodrug)	600 mg/m²	IV	D1	cycles 5-8

Cycles

4 paclitaxel-carboplatin then 4 AC/EC, surgery, then 9 adjuvant pembrolizumab

21-day cycle

Emetogenicity

High (>90%)

G-CSF

Consider (10-20% FN risk)

Notes

pCR 64.8% vs 51.2%; event-free survival and overall survival benefit confirmed at later analyses.
Immune-related endocrinopathies (thyroid, adrenal, hypophysitis) can be permanent; check baseline TSH and cortisol.

Used in

Triple-negative breast cancer (TNBC)

Trials

KEYNOTE-522

Products

PembrolizumabPaclitaxel / nab-paclitaxelCarboplatinDoxorubicinCyclophosphamide

Source

KEYNOTE-522, NEJM 2020 (Schmid)

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.