Pembrolizumab
About
Pembrolizumab is an anti-cancer medicine used in the treatment of various types of cancers in both adult and paediatric populations. Cancer is a disease caused due to the abnormal growth of cells that divide uncontrollably. This medicine is used in treating advanced renal cell carcinoma, hepatocellular carcinoma, colorectal cancer, non-small cell lung cancer, metastatic melanoma, small cell lung cancer, gastric cancer, classical Hodgkin’s disease, urothelial carcinoma, cervical cancer, primary mediastinal large B-cell lymphoma, endometrial cancer, microsatellite instability-high cancer, and head and neck cancer.
Pembrolizumab contains Pembrolizumab, which belongs to the class of monoclonal antibodies. It works by inhibiting the action of a programmed death receptor-1 (PD-1) and thereby stops the abnormal growth of cancer cells.
Pembrolizumab may cause certain side effects such as diarrhoea, nausea, vomiting, tiredness, itching, rash, headache, fever, cough, shortness of breath, muscle/joint pain, loss of appetite and injection site reactions. Inform your doctor if any of these side effects persist for a longer duration. Pembrolizumab will be administered by an oncologist. Avoid self-administration.
Avoid taking Pembrolizumab if you are allergic to it or any other components of it. Before taking Pembrolizumab, inform your doctor if you have/had liver or kidney disease, autoimmune disorders such as ulcerative colitis, Crohn’s disease, any history of organ transplants, received a stem cell transplant that uses donor stem cells (allogeneic), undergone radiation treatment to the chest or any other medical conditions. This medicine is known to cause embryo-fetal toxicity. Hence, it is not recommended for use in pregnancy and breastfeeding.
Uses of Pembrolizumab
Medicinal Benefits
Pembrolizumab contains Pembrolizumab, which is used in the treatment different types of cancers. It works by inhibiting the action of a programmed death receptor-1 (PD-1) that causes the multiplication of cancerous cells. This helps stop the abnormal growth of cancer cells and thus reduce the further spread to other parts of the body.
Directions for Use
Storage
Side Effects of Pembrolizumab
- Nausea
- Vomiting
- Diarrhoea
- Loss of appetite
- Tiredness
- Dizziness
- Weakness
- Pain in muscles/joints/bones
- Cough
- Headache
- Fever
- Itching
- Rash
- Back pain
- Shortness of breath
- Injection site reactions
In-Depth Precautions and Warning
Drug Warnings
To treat your condition effectually, continue taking Pembrolizumab for the period that your doctor has prescribed. Pembrolizumab may cause severe immune-mediated adverse reactions (IMAR) such as immune-mediated colitis, hepatitis (hepatotoxicity), nephritis, endocrinopathies (such as adrenal insufficiency, diabetes, thyroid disorders), pneumonitis, and dermatologic reactions (such as Stevens-Johnson syndrome, epidermal necrolysis). It may also cause infusion-related reactions in some patients. Therefore, caution should be exercised if you have/had liver or kidney disease, any history of organ transplant, received a stem cell transplant that uses donor stem cells (allogeneic), undergone radiation treatment to the chest and autoimmune disorders such as ulcerative colitis, or Crohn’s disease while receiving Pembrolizumab. Discontinue the treatment if any severe infusion reactions occur. Inform your doctor if you are pregnant or are planning to become pregnant before starting the treatment, as this medicine is known to cause embryo-fetal toxicity. Breastfeeding should be discontinued in nursing mothers during the treatment as it passes into breast milk and may cause a possible risk to the infant. This medicine is not recommended for use in children below 2 years of age as the safety and efficacy are not established.
Drug Interactions
Drug-Drug Interactions: Pembrolizumab may have interaction with immunomodulator drugs (thalidomide), corticosteroids (prednisolone, methylprednisolone, prednisone), etc.
Drug-Food Interactions: Avoid alcohol consumption and smoking.
Dug-Disease Interactions: Tell your doctor if you have liver or kidney disease, heart problems, GI disorders, eye problems, dermatitis, or weak immune system before starting the treatment.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
consult your doctorIt is unknown whether Pembrolizumab interacts with alcohol. Consult your doctor.
Pregnancy
unsafePembrolizumab is not recommended for use in pregnancy as it may cause embryo-fetal toxicity and harm your foetus. Hence, if you are pregnant or planning pregnancy, inform your doctor before receiving Pembrolizumab. You should not become pregnant while you are taking Pembrolizumab for at least 4 months from the last dose of Pembrolizumab. Using effective birth control methods while on treatment is suggested.
Breast Feeding
unsafePembrolizumab should not be taken if you are breastfeeding as it passes into breast milk and may harm your infant. Avoid nursing your child while on treatment with this medicine and at least for 4 months from the last dose of medicine.
Driving
cautionPembrolizumab will be administered in the hospital setting. Driving is not recommended.
Liver
cautionIf you have a pre-existing or a history of liver problems, tell your doctor before receiving this medicine. Hence, this medicine should be taken cautiously in patients with moderate liver impairment. Your doctor may suggest tests to monitor your liver function while on treatment with this medicine.
Kidney
cautionIf you have a pre-existing or a history of kidney diseases, inform your doctor before receiving Pembrolizumab. Your doctor may adjust the dose of this medicine or prescribe a suitable alternative based on your condition.
Children
safe if prescribedPembrolizumab is safe for use in children above two years of age when recommended by the physician. It will be administered only if the benefits outweigh risks.
Habit Forming
Diet & Lifestyle Advise
- Physical activity helps strengthen muscles, reduces fatigue, helps in weight loss, and gives strength. Gentle activities like 20-30 minutes of walking or swimming would be helpful.
- Maintain a healthy weight by performing regular low-strain exercises and eating healthy food.
- Getting adequate sleep as resting helps improve your health and mental ability and improves attention.
- De-stress yourself by meditating, reading books, taking a warm bubble bath, or listening to soothing music.
- Eat food rich in antioxidants such as berries, spinach, etc.
- Foods containing fibre help in better digestion. These include beans, peas, lentils, whole grains, nuts, and seeds.
- Avoid smoking and alcohol consumption.
- Maintain a healthy weight.
Special Advise
- Your doctor may suggest periodic liver function tests, kidney function tests, lung function tests to monitor the function of the liver, kidney and lungs due to the use of Pembrolizumab.
- It is advised to use contraceptive pills while using Pembrolizumab to prevent pregnancy.
- Monitoring of thyroid function and adrenocorticotropic hormone levels will be done during the treatment to avoid any life-threatening side effects.
Patients Concern
Disease/Condition Glossary
Renal Cell Carcinoma: It is the most common type of cancer in which the cancer/ malignant cells grow uncontrollably in the kidney and form a tumour. Symptoms include red, orange, or pink-coloured urine due to the presence of blood in the urine. Pembrolizumab is used in combination with axitinib for the treatment of advanced renal cell carcinoma.
Hepatocellular carcinoma: It occurs when the cancer/ malignant cells grow out of control. This infects the liver, destroys the liver cells and affects the ability of the liver to work properly. Symptoms may include abdominal pain, loss of appetite, weight loss, and pale bowel motions. Pembrolizumab is used in treating liver cancer who are previously treated with sorafenib.
Metastatic Malignant Melanoma: Melanoma is a type of skin cancer in which the cancer cells grow in melanocytes. It is mainly caused by harmful UV radiation from the sun. Malignant melanoma is common in fair-skinned and freckled individuals. It results in mole formation, typically on the skin of the face.
Non-Small Cell Lung Cancer (NSCLC): It is the most common form of lung cancer which occurs when cells that form the lining of the lung start growing uncontrollably. It is mostly seen in persons who smoke. Symptoms may include chest pain, weight loss, hoarseness, and difficulty breathing. Pembrolizumab is used in combination with pemetrexed and platinum chemotherapy, as first-line treatment or in combination with carboplatin and either paclitaxel or paclitaxel protein-bound, as first-line treatment of patients with metastatic squamous NSCLC.
Head and neck cancer: It is a type of cancer which causes abnormal growth of cancer cells in the tissues of the neck and head. This cancer generally starts in the cells known as squamous cells which appear in the lining of the surface of moist mucosa in the head and neck (e.g., inside of the throat, nose, and mouth).
Bladder cancer: It is a cancer that begins in the bladder. It typically affects older adults. The most common symptom is blood in the urine.
Stomach Cancer (Gastric adenocarcinoma): It is a type of cancer that develops from the stomach lining. This condition can occur mainly due to smoking, a highly processed or salty diet, and severe bacterial infection of H. pylori. Symptoms of stomach cancer include feeling bloated after eating, feeling full after eating small amounts of food, nausea, heartburn or indigestion.
Hodgkin’s Disease: Hodgkin’s disease or lymphoma is a blood cancer of a certain type of cells called WBCs, specifically lymphocytes. Lymphocytes normally help control infection and maintain the body's normal immunity. However, in a cancerous state, there is an abnormal multiplication of these blood cells, causing many problems such as fatigue, fever, loss of appetite, itching, night sweats and lymph node swelling.
Endometrial cancer: It is a cancer which affects the endometrium (lining of the womb or uterus). Symptoms may include bleeding between periods, pelvic pain, and pain during sexual intercourse. This cancer is mostly occurred due to certain factors such as increasing age, obesity, never been pregnant, family history of cancer, and diabetes. It is usually seen in women above the age of 55 years. This condition is not life-threatening when it is diagnosed and treated in the early stages.
FAQs
Pembrolizumab contains Pembrolizumab, which works by inhibiting the action of a PD-1 that causes the multiplication of cancerous cells.
