Keytruda for Mesothelioma

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).

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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.

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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:

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

1. 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.
2. How Does Keytruda Work? Keytruda (pembrolizumab). Retrieved from: https://www.keytruda.com/how-does-keytruda-work/. Accessed: 12/02/22.

About the Writer, Camryn Keeble

Camryn Keeble is a content writer and editor for Mesothelioma Guide. She creates informative content to educate mesothelioma patients and their loved ones on news, treatments and more. She also works diligently to raise awareness of the dangers of asbestos exposure and the effects of mesothelioma.