Keytruda (Pembrolizumab) for Kidney Cancer

Overview
Keytruda is approved by the U.S. Food and Drug Administration (FDA) for the treatment of advanced renal cell carcinoma (RCC) in adults. It is used in combination with axitinib or lenvatinib as a first-line therapy for advanced disease. Keytruda is also approved as adjuvant treatment for individuals with intermediate-high or high risk of recurrence following nephrectomy (kidney removal), or after nephrectomy and removal of metastatic lesions. Keytruda is also known by its drug name, pembrolizumab.

Pembrolizumab is a programmed death receptor-1 (PD-1) blocking antibody. It works by helping the immune system recognize and destroy cancer cells. By blocking PD-1, pembrolizumab prevents cancer cells from evading immune attack, thereby enhancing the body’s natural ability to fight kidney cancer.

How do I take it?
Prescribing information states that Keytruda is given by intravenous (IV) infusion over 30 minutes. For advanced RCC, it is used in combination with axitinib taken orally twice daily or lenvatinib taken orally once daily. In the adjuvant setting, Keytruda is used as a single agent. It is typically administered every three weeks or every six weeks, depending on dosing size. The drug should be administered exactly as prescribed by a healthcare provider.

Side effects
Common side effects of Keytruda as a single agent include fatigue, musculoskeletal pain (pain in muscles, bones, or joints), rash, diarrhea, pyrexia (fever), cough, decreased appetite, pruritus (itching), dyspnea (shortness of breath), constipation, pain, abdominal pain, nausea, and hypothyroidism (low thyroid hormone levels).

Common side effects of Keytruda when used with axitinib include diarrhea, fatigue or asthenia (physical weakness), hypertension (high blood pressure), hepatotoxicity (liver damage), hypothyroidism, decreased appetite, palmar-plantar erythrodysesthesia (hand-foot syndrome), nausea, stomatitis or mucosal inflammation (soreness and swelling in the mouth), dysphonia (voice changes), rash, cough, and constipation.

Common side effects of Keytruda when used with lenvatinib include hypothyroidism, hypertension, fatigue, diarrhea, musculoskeletal disorders (conditions affecting muscles, bones, or joints), nausea, decreased appetite, vomiting, stomatitis (mouth inflammation), weight loss, abdominal pain, urinary tract infection, proteinuria (excess protein in urine), constipation, headache, hemorrhagic events (bleeding), palmar-plantar erythrodysesthesia, dysphonia, rash, hepatotoxicity, and acute kidney injury.

Rare but serious side effects may include immune-mediated pneumonitis (inflammation of the lungs), colitis (inflammation of the colon), hepatitis (inflammation of the liver), endocrinopathies (disorders of hormone-producing glands), nephritis with renal dysfunction (kidney inflammation and reduced function), dermatologic reactions (serious skin conditions), and solid organ transplant rejection. Other serious risks include infusion-related reactions, complications following allogeneic hematopoietic stem cell transplant (HSCT), embryo-fetal toxicity (harm to an unborn baby), and an increased risk of fatal outcomes when used with thalidomide analogs and dexamethasone in multiple myeloma.

For more information about this treatment, visit:

Label: Keytruda- Pembrolizumab Injection, Powder, Lyophilized, for Solution; Keytruda- Pembrolizumab Injection, Solution — DailyMed