Generic Name: pembrolizumab (pem-broe-LIZ-ue-mab)
Medically reviewed by Drugs.com. Last updated on April 25, 2021.
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antineoplastic Agent
Pharmacologic Class: Monoclonal Antibody
Uses for pembrolizumab
Pembrolizumab injection is used to treat melanoma (a type of skin cancer) that has spread or cannot be removed by surgery. It is also used to help prevent melanoma from coming back after it and lymph nodes affected by cancer have been removed by surgery.
Pembrolizumab injection is used alone to treat non-small cell lung cancer (NSCLC) that has spread, whose tumors express PD-L1 and do not have an abnormal EGFR or ALK gene in patients who have not received other cancer treatments. It is also used alone to treat NSCLC that has spread, whose tumors express PD-L1 and have an abnormal EGFR or ALK gene in patients who have received other cancer medicines (eg, platinum) that did not work well. Pembrolizumab injection is also used alone as first-line treatment for stage III NSCLC in patients who cannot have surgery or chemotherapy with radiation or for NSCLC that has spread and whose tumors express PD-L1 without an abnormal EGFR or ALK gene. Pembrolizumab is also used in combination with pemetrexed and platinum-containing chemotherapy to treat NSCLC that has spread and whose tumors do not have an abnormal EGFR or ALK gene. Pembrolizumab injection is also used together with carboplatin and paclitaxel or nab-paclitaxel to treat squamous NSCLC that has spread.
Pembrolizumab injection is also used to treat metastatic (cancer that has spread) small cell lung cancer (SCLC) that has progressed in patients who had received platinum-containing chemotherapy or at least one other line of treatment that did not work well.
Pembrolizumab injection is used in combination with platinum and fluorouracil as first-line treatment of head and neck squamous cell cancer (HNSCC) that has spread or cannot be removed by surgery. Pembrolizumab is also given to patients whose tumors express PD-L1 or patients who have received other cancer medicines (eg, platinum) that did not work well.
Pembrolizumab injection is used to treat relapsed (cancer that has come back) or refractory (cancer that did not respond to treatment) classical Hodgkin lymphoma (cHL) in adults. Pembrolizumab is also used to treat cHL in children who have tried a treatment that did not work, or whose cHL has returned after 2 or more previous lines of treatment.
Pembrolizumab injection is used to treat primary mediastinal large B-cell lymphoma (PMBCL) in patients who have tried a treatment that did not work, or whose PMBCL has returned after 2 or more previous lines of treatment.
Pembrolizumab injection is also used to treat urothelial carcinoma (a type of urinary tract cancer) that has spread throughout the body (metastatic) or cannot be removed by surgery (advanced). Pembrolizumab is given to patients who are not able to receive cisplatin and whose tumors express PD-L1, patients who are not able to receive carboplatin or cisplatin, or patients who have received other cancer medicines (eg, platinum) that did not work well. Pembrolizumab is also used to treat patients with high-risk Bacillus Calmette-Guerin (BCG)-unresponsive, high-risk, non-muscle invasive bladder cancer (NMIBC) with a tumor type called carcinoma in situ (CIS) with or without papillary tumors who cannot receive or have not decided to have surgery to remove the bladder.
Pembrolizumab injection is also used to treat microsatellite instability high (MSI-H) or mismatch repair deficient (dMMR) solid tumor or colorectal cancer (cancer of the colon or rectum) that has spread or cannot be removed by surgery. It is given to patients who have received other cancer treatments (eg, fluoropyrimidine, oxaliplatin, irinotecan) that did not work well. Pembrolizumab is also used as first-line treatment of MSI-H or dMMR colorectal cancer (CRC) that has spread or cannot be removed by surgery.
Pembrolizumab injection is also used to treat a type of stomach cancer called gastric or gastroesophageal junction adenocarcinoma that has returned or spread, and whose tumors express PD-L1. It is given to patients who have received 2 or more types of cancer treatment (eg, fluoropyrimidine, platinum) that did not work well, or in patients with tumor that has an abnormal HER2/neu gene and have received a HER2/neu-targeted medicine that did not work well.
Pembrolizumab injection is also used to treat squamous cell carcinoma of the esophagus that has returned or spread, and whose tumors express PD-L1. It is given to patients who have received 1 or more types of treatment that did not work well.
Pembrolizumab injection is used to treat cervical cancer that has returned or spread, and whose tumors express PD-L1.
Pembrolizumab injection is also used to treat a type of liver cancer called hepatocellular carcinoma (HCC) in patients who have been previously treated with sorafenib that did not work well.
Pembrolizumab injection is also used to treat a kind of skin cancer called Merkel cell carcinoma (MCC) that has returned or spread, or cutaneous squamous cell carcinoma (cSCC) that has returned or spread and cannot be cured by surgery or radiation.
Pembrolizumab injection is also used in combination with axitinib as first-line treatment of advanced renal cell carcinoma (RCC), a kind of kidney cancer, in patients whose cancer has spread or cannot be removed by surgery.
Pembrolizumab injection is also used in combination with lenvatinib to treat advanced endometrial cancer (cancer of the lining of the uterus or womb) that is not MSI-H or dMMR, in patients who have received other cancer medicines but did not work well and cannot be removed by surgery or radiation.
Pembrolizumab injection is also used to treat a type of cancer called tumor mutational burden-high (TMB-H) in patients whose solid tumors have spread or cannot be removed by surgery. It is given to patients who have received other cancer treatments that did not work well and who have no other treatment options.
Pembrolizumab is a monoclonal antibody that changes the immune system to help control the growth of cancer cells.
Pembrolizumab is to be given only by or under the direct supervision of your doctor.
Before using pembrolizumab
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For pembrolizumab, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to pembrolizumab or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of pembrolizumab injection in children with lymphoma, solid tumors, colorectal cancer, Merkel cell carcinoma, microsatellite instability-high cancer, or tumor mutational burden-high cancer. However, safety and efficacy have not been established in children with other cancers.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of pembrolizumab injection in the elderly. Safety and efficacy have been established.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving pembrolizumab, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using pembrolizumab with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Interactions with food/tobacco/alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other medical problems
The presence of other medical problems may affect the use of pembrolizumab. Make sure you tell your doctor if you have any other medical problems, especially:
- Central nervous system (brain and spinal cord) cancer—Safety and efficacy have not been established in patients with solid tumors in the brain and spinal cord.
- Colitis (inflammation of the bowels) or
- Diabetic ketoacidosis or
- Hepatitis (inflammation of the liver) or
- Hyperthyroidism (high levels of thyroid hormone) or
- Hypophysitis (inflammation of the pituitary gland) or
- Hypothyroidism (low levels of thyroid hormone) or
- Immune system problems or
- Nephritis (inflammation of the kidneys) or
- Pneumonitis (inflammation of the lungs) or
- Type 1 diabetes—Use with caution. May make these conditions worse.
- Organ transplant (eg, kidney or liver transplant), recent—Use with caution. May increase risk for organ transplant rejection.
Patients who have had allogeneic hematopoietic stem cell transplant (HSCT)—Use with caution. May cause side effects to become worse.
Proper use of pembrolizumab
A nurse or other trained health professional will give you pembrolizumab. It is given through a needle placed into one of your veins. It must be given slowly, so the needle will have to remain in place for at least 30 minutes. The infusion will be given every 3 or 6 weeks, depending on your dose. If you are also receiving chemotherapy for NSCLC, pembrolizumab will be given first on the same day.
Pembrolizumab comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.
Pembrolizumab needs to be given on a fixed schedule. If you miss a dose, call your doctor, home health caregiver, or treatment clinic for instructions.
Precautions while using pembrolizumab
It is very important that your doctor check your progress at regular visits to make sure that pembrolizumab is working properly. Blood and urine tests may be needed to check for unwanted effects.
Receiving pembrolizumab while you are pregnant can harm your unborn baby. If you are a woman who can bear children, your doctor may give you a pregnancy test before you start using pembrolizumab to make sure you are not pregnant. Use an effective form of birth control to keep from getting pregnant during treatment with pembrolizumab and for at least 4 months after the last dose. If you think you have become pregnant while receiving the medicine, tell your doctor right away.
Tell your doctor right away if you have a cough, chest tightness, or any type of breathing problem with pembrolizumab. These could be symptoms of a serious lung problem.
Colitis (swelling of the colon or bowel) may occur with pembrolizumab. Tell your doctor right away if you have stomach pain or tenderness, watery or bloody diarrhea, or a fever after receiving the medicine.
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.
Serious problems with the adrenal, pituitary, or thyroid glands (hormone glands) may occur while you are receiving pembrolizumab. Tell your doctor if you start having continuing or unusual headaches, changes in mood or behavior (eg, being irritable or forgetful), lightheadedness, dizziness, or fainting, unusual sluggishness, or an increase in weight.
Pembrolizumab may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.
Pembrolizumab may cause serious kidney problems (eg, nephritis, kidney failure). Tell your doctor right away if you have bloody or cloudy urine, nausea, vomiting, trouble breathing, swelling of the face, feet, or lower legs, unusual tiredness or weakness, or unusual weight gain.
Tell your doctor right away if you have changes in your eyesight, severe or persistent muscle or joint pain, or severe muscle weakness after receiving pembrolizumab.
Pembrolizumab may increase your risk for possible organ transplant rejection. Talk to your doctor about this risk.
Serious skin reactions can occur with pembrolizumab. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills with pembrolizumab.
Pembrolizumab may cause infusion-related reactions. These can be life-threatening and require immediate medical attention. Tell your doctor right away if you start to have a fever, chills or shaking, dizziness, trouble breathing, itching or rash, lightheadedness or fainting after receiving pembrolizumab.
Pembrolizumab side effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
- Bladder pain
- bloating or swelling of the face, arms, hands, lower legs, or feet
- bloody or cloudy urine
- blurred vision
- body aches or pain
- burning, numbness, tingling, or painful sensations
- clay-colored stools
- dark urine
- decreased appetite
- depressed mood
- difficult, burning, or painful urination
- difficulty with breathing
- difficulty with moving
- dry skin and hair
- ear congestion
- feeling cold
- frequent urge to urinate
- hair loss
- hoarseness or husky voice
- itching, skin rash
- joint or bone pain
- loss of voice
- lower back or side pain
- muscle cramps, pain, and stiffness
- neck pain
- pale skin
- pounding in the ears
- rapid weight gain
- redness, swelling, or pain of the skin
- runny or stuffy nose
- scaling of the skin on the hands and feet
- slow or fast heartbeat
- sore throat
- stomach pain or tenderness
- tingling of the hands or feet
- ulceration of the skin
- unsteadiness or awkwardness
- unusual bleeding or bruising
- unusual tiredness or weakness
- unusual weight gain or loss
- weakness in the arms, hands, legs, or feet
- yellow eyes or skin
- Blue lips, fingernails, or skin
- chest pain or discomfort
- decrease in urine output or decrease in urine-concentrating ability
- difficulty with chewing, swallowing, or talking
- double vision
- drooping eyelids
- general feeling of discomfort or illness
- inability to speak
- irregular, fast or slow, or shallow breathing
- muscle weakness
- pain and swelling in the genitals or anal area
- sensitivity to heat
- severe or sudden headache
- slurred speech
- stomach cramps
- temporary blindness
- thickening of bronchial secretions
- trouble sleeping
- watery or bloody diarrhea
- weakness in the arm or leg on one side of the body, sudden and severe
- Back or leg pain
- bleeding gums
- cracks in the skin
- eye pain
- general body swelling
- joint redness or swelling
- light-colored stools
- loss of heat from the body
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pale skin
- red, swollen skin
- redness of the eye
- scaly skin
- sensitivity of the eye to light
- upper right abdominal or stomach pain
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Cracked lips
- hair loss or thinning
- sores, ulcers, or white spots on the lips, tongue, or inside the mouth
- swelling or inflammation of the mouth
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Frequently asked questions
- Pembrolizumab vs. nivolumab: how do they compare?
- How does it affect the immune system?
- How does it kill cancer cells?
- What type of cancer is it used for?
- How are axitinib and pembrolizumab used in kidney cancer?
- Is this used for endometrial cancer?
- How is it administered?
More about pembrolizumab
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- En Español
- 129 Reviews
- Drug class: anti-PD-1 monoclonal antibodies
- Other brands
Related treatment guides
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