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How long does it take for Keytruda to work?

Medically reviewed by Nicole France, BPharm. Last updated on Sep 9, 2021.

Official answer

by Drugs.com

Keytruda (pembrolizumab) is a programmed death receptor-1 (PD-1)-blocking monoclonal antibody used to treat a number of different types of cancer. Keytruda is administered via a 30 min intravenous (IV) infusion every 3-6 weeks. A response to treatment is typically seen within 2-4 months of starting treatment with Keytruda, but the time it takes to work will vary based on cancer type and the stage of disease.

Keytruda is a type of immunotherapy that works by preventing cancer cells from hiding from your immune system. Immunotherapy works differently to traditional chemotherapy drugs - it takes time for the immune system to identify and attack cancer cells once Keytruda helps prevent the cancer cells from hiding.

When determining how long Keutruda takes to work, researchers measure the ‘time to response’, which gives the time frame in which you’d expect to see a patient’s cancer show signs that it is responding to treatment.

‘Time to response’ is the time taken from the day a patient is assigned to receive a particular therapy until the first day that the patient has a partial or complete response to the treatment. The ‘time to response’ observed in a number of clinical trials used to gain approval of Keytruda are reported in the table below.

Time to response following treatment with Keytruda

Cancer Type
(Trial name)
Median Time to Response
Melanoma
(KEYNOTE-006)
Keytruda: 85-86 days (range 32-251)
vs
Yervoy (ipilimumab): 87 days (range 80-250)
Melanoma
(KEYNOTE-002)
Keytruda: 13-15 weeks (IQR 12-18)
vs
Investigator-choice (paclitaxel plus carboplatin, paclitaxel, carboplatin, dacarbazine, or oral temozolomide): 13 weeks (12-18)
Non-small cell lung cancer
(KEYNOTE-189)
Keytruda + pemetrexed + cisplatin or carboplatin: 1.4 months (1.2-3.0)
vs
Placebo + Alimta (pemetrexed) + cisplatin or carboplatin: 1.4 months (1.2-4.9)
Non-small cell lung cancer
(KEYNOTE-407)
Keytruda + carboplatin + paclitaxel or Abraxane (nanoparticle albumin-bound paclitaxel): 1.4 months
vs
Placebo + carboplatin + paclitaxel or Abraxane: 1.4 months
Non-small cell lung cancer
(KEYNOTE-024)
Keytruda: 2.2 months
vs
Investigator-choice (carboplatin plus pemetrexed, cisplatin plus pemetrexed, carboplatin plus gemcitabine, cisplatin plus gemcitabine, or carboplatin plus paclitaxel): 2.2 months
Head and neck squamous cell cancer
(KEYNOTE-012)
Keytruda: 2 months (2-17)
Classical Hodgkin lymphoma
(KEYNOTE-204)
Keytruda: 2.8 months (1.0-31.2)
vs
Adcetris (brentuximab vedotin): 2.8 months (1.0-7.3)
Classical Hodgkin lymphoma
(KEYNOTE-087)
Keytruda: 2.8 months (2.1-16.5)
Primary mediastinal large B-cell lymphoma
(KEYNOTE-170)
Keytruda: 2.9 months (2.4-8.5)
Urothelial Carcinoma
(KEYNOTE-052)
Keytruda: 2.1 months (1.3-9.0)
Urothelial Carcinoma
(KEYNOTE-045)
Keytruda: 2.1 months (1.4-6.3)
vs
Investigator-choice (paclitaxel, Taxotere (docetaxel), Javlor (vinflunine)): 2.1 months (1.7-4.9)
Microsatellite instability-high or mismatch repair deficient cancer
(KEYNOTE-164)
Keytruda: Following ≥2 prior lines of standard chemotherapy - 4.3 months (1.8-24.9)
Following ≥1 prior lines of standard chemotherapy - 3.9 months (1.8-12.5)
Microsatellite instability-high or mismatch repair deficient cancer
(KEYNOTE-012)
Keytruda: 2 months (2-17)
Microsatellite instability-high or mismatch repair deficient cancer
(KEYNOTE-028)
Keytruda: 2 months (1.7-3.7)
Microsatellite instability-high or mismatch repair deficient cancer
(KEYNOTE-158)
Keytruda: 2.1 months
Microsatellite instability-high or mismatch repair deficient colorectal cancer
(KEYNOTE-177)
Keytruda: 2.2 months (1.8-18.8)
vs
5-fluorouracil–based therapy with or without Avastin (bevacizumab) or Erbitux (cetuximab): 2.1 (1.7-24.9)
Gastric cancer
(KEYNOTE-059)
Keytruda: 2.1 months (1.7-6.6)
Esophageal cancer
(KEYNOTE-180)
Keytruda: 4.1 months (2.0-6.3)
Hepatocellular carcinoma
(KEYNOTE-224)
Keytruda: 2.1 months (1.8-4.8)
Merkel cell carcinoma
(KEYNOTE-017)
Keytruda: 2.8 months (1.5-9.7)
Renal cell carcinoma
(KEYNOTE-426)
Keytruda + Inlyta (axitinib): 2.8 months (1.5-16.6)
vs
Sutent (sunitinib): 2.9 months (2.1-15.1)
Endometrial carcinoma
(KEYNOTE-775)
Keytruda + Lenvima (lenvatinib): 2.1 months
vs
Investigator choice (doxorubicin or paclitaxel): 2.1 months
Cutaneous squamous cell carcinoma
(KEYNOTE-629)
Keytruda: 2.0 months (1.4-3.3)

References
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  • Zhu AX, Finn RS, Cattan S. et al. KEYNOTE-224: Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib. Journal of Clinical Oncology 2018 36:4_suppl, 209-209.
  • Nghiem P, Bhatia S, Lipson EJ, et al. Durable Tumor Regression and Overall Survival in Patients With Advanced Merkel Cell Carcinoma Receiving Pembrolizumab as First-Line Therapy. J Clin Oncol. 2019;37(9):693-702. doi:10.1200/JCO.18.01896.
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