Keytruda: what is it for and how does the treatment work?

According to data released in the estimate of the National Cancer Institute (INCA), in the coming years, Brazil will have 626 thousand new cases of cancer in the year 2020.

Some of the most common types are skin, prostate, breast, lung and stomach cancer.

This is a serious disease and several aspects are related to its causes.

For the treatment of some types, there are medications such as Keytruda, which helps in combating several tumors.


What is Keytruda injection?

Keytruda is the trade name of the active ingredient Pembrolizumab – synthetic antibody produced in the laboratory.

It is a medication used to treat some types of cancer, such as lung and kidney cancer, and its administration is via intravenous injection (into the vein).

Its use can be indicated in conjunction with chemotherapy drugs or in isolation, according to the condition treated.

It is manufactured by the pharmaceutical company Merck Sharp and Dohme and is used for adults.

What is the medicine Keytruda for?

Keytruda is used to treat several types of tumor. Being them:

  • Non-small cell lung cancer;
  • Advanced stage melanoma – skin cancer;
  • Renal cell carcinoma – kidney cancer;
  • Classical Hodgkin’s lymphoma – cancer in the lymphatic system;
  • Gastric adenocarcinoma – stomach cancer;
  • Urothelial carcinoma – cancer of the bladder;
  • Squamous cell head and neck carcinoma – head and neck cancer.

It is indicated for people in whom the cancer has spread or that cannot be removed by surgery.

It can also be used as an adjuvant treatment to prevent a tumor from returning in patients who have undergone surgery to remove melanoma .

How does the pembrolizumab active ingredient according to the package insert?

The active ingredient Pembrolizumab is a monoclonal antibody, that is, produced in the laboratory.

According to the package insert, it works by inhibiting some mechanisms and helping the immune system to fight tumors.

This is because, in patients, proteins called PD1 bind to their specific receptors, resulting in the control of lymphocytes and making it difficult to fight diseases.

Keytruda works by neutralizing PD1, as it binds to receptors, which reactivates tumor-specific cytotoxic T lymphocytes.

How does the package insert indicate using Keytruda?

The medication must be administered in a hospital environment, by a trained professional.

According to the package insert, the indicated dose is 200mg, applied via intravenous infusion over a period of 30 minutes. 1 application is recommended every 3 weeks.

If used as a combination treatment with chemotherapy, Keytruda should be administered first.

Despite the indications, always follow medical guidelines.

What are the side effects of Keytruda?

Like other medicines, Keytruda can cause side effects, although not everybody gets them.

They can be divided into: isolated use and joint use when undergoing chemotherapy.

Despite the reactions that will be listed, it is worth remembering that each organism reacts differently to the use of the medication. That way, not all patients will suffer from side effects.

Isolated use

When administered in isolation, that is, without the use of other medications in parallel to the very common reactions found are:

  • Reduction in the number of red blood cells;
  • Reduction of thyroid gland activity;
  • Itch;
  • Rash;
  • Headache;
  • Cough;
  • Lack of air;
  • Diarrhea;
  • Nausea;
  • Vomiting;
  • Stomach ache;
  • Constipation;
  • Muscle pain;
  • Joint pain;
  • Feeling tired;
  • Swelling;
  • Fever.

The effects common are:

  • Lung infection;
  • Inflammation in the lung;
  • High pressure;
  • Dry eye;
  • Reduction in the number of white blood cells;
  • Reduction in the number of platelets;
  • Chills;
  • Abnormal heart rate;
  • Trouble sleeping;
  • Dizziness;
  • Inflammation of the nerves;
  • Excessive activity of the thyroid gland;
  • Reduction of sodium, potassium or calcium in the blood;
  • Weakness;
  • Hair loss;
  • Elevated red rash;
  • Acne;
  • Dry skin;
  • Itch;
  • Abnormal renal function test;
  • Increased calcium in the blood;
  • Increased liver enzymes.

The uncommon ones , however, which may occur, are:

  • Reduction in white blood cell levels;
  • Inflammation of the kidneys;
  • Inflammation of the pancreas;
  • Inflammation of the liver;
  • Inflammation of the heart cover;
  • Inflammation of the eyes;
  • Inflammation around the tendons;
  • Inflammation of the skin;
  • Thyroid inflammation;
  • Pain in the eyes;
  • Growth of thick skin;
  • Change in hair color;
  • Skin wounds;
  • Seizure;
  • Diabetes type 1;
  • Immune disorder;
  • Fluid build-up around the heart;
  • Decreased secretion of adrenal hormones.

Among the rare side effects , there are:

  • Perforation in the small intestine;
  • Itches and sores on the mucous membranes of the face and genital region;
  • Swollen and reddish skin;
  • Inflammation of the heart muscle;
  • Inflammation of the membrane around the spinal cord and brain;
  • Urinary incontinence;
  • Tingling in the arms and legs;
  • Weakness in the arms and legs;
  • Inflammation of the nerves;
  • Inflammation of the brain;
  • Inflammatory response against platelets or red blood cells.

If there is an abnormal reaction, your doctor should be informed.

Use with chemotherapy

When medication is administered in conjunction with chemotherapy, the side effects may be slightly different.

Among the most common are:

  • Decrease in the number of red blood cells;
  • Decrease in the number of white blood cells;
  • Decrease in the number of platelets;
  • Reduction of potassium in the blood;
  • Lack of appetite;
  • Dizziness;
  • Headache;
  • Inflammation of the nerves;
  • Lack of air;
  • Diarrhea;
  • Vomiting;
  • Nausea;
  • Stomachache;
  • Constipation;
  • Rash;
  • Itch;
  • Hair loss;
  • Muscle pain;
  • Pain in the bones;
  • Fever;
  • Increased tearing;
  • Feeling tired and weak.

Common reactions are:

  • Lung infection;
  • Inflammation in the lung;
  • Thyroid gland problems;
  • Reduction of sodium in the blood;
  • Reduction of calcium in the blood;
  • Trouble sleeping;
  • Altered heart rate;
  • High pressure;
  • Inflammation of the intestine;
  • Muscle pain;
  • Inflammation of the kidneys;
  • Chills;
  • Increased calcium in the blood.

Already the uncommon , but that can occur:

  • Diabetes type 1;
  • Epileptic attacks;
  • Accumulation of fluid around the heart;
  • Inflammation of the pancreas;
  • Inflammation of the liver;
  • Inflammation of the skin;
  • Growth of thick skin;
  • Changes in skin color;
  • Inflammation around the tendons;
  • Increase in the number of amylase enzymes – substances that break down starch.

Rare reactions include:

  • Reduction in the number of white blood cells;
  • Inflammation of the heart muscle;
  • Change in hair color.

If there is an abnormal reaction, consult your doctor.

Value: what is the price of Keytruda?

The price of Keytruda may vary according to the geographic region and establishment of purchase.

In general, its value is R $ 18,500 *.

If there is a need to buy prices, the Consulta Remédios website can be used, as it indicates the values ​​of medicines in different pharmacies in each region.

* Prices consulted in March 2020. Prices may change.

Free treatment: does pembrolizumab have SUS?

No . The active ingredient Pembrolizumab is not part of the National List of Essential Medicines (Rename), that is, the list of drugs distributed directly by SUS.

However, for patients with a medical prescription and who are unable to afford the treatment, there is the possibility of requesting funding by the State, going to court.

In this case, it is necessary to file a lawsuit and submit some documents such as: medical report, exams and the budget in 3 different pharmacies.

Is Keytruda approved in Brazil by ANVISA?

-Yeah . The drug Keytruda was registered with the National Health Surveillance Agency (ANVISA) in 2016.

It is part of the therapeutic class of “other antineoplastics”, that is, drugs that aim to prevent and inhibit the growth of tumors.

How to budget Keytruda?

Patients who need medication, but cannot afford it, have the possibility to go to court and request the cost of treatment by the State.

For that, it is necessary to open a judicial process, with some documents. Between them:

  • Medical report;
  • Exams;
  • Standard requirement;
  • Budget in 3 different pharmacies.

For the realization of the budget, it is possible to obtain assistance in advising on the quotation of high-cost medications, which makes a personalized quotation simply and quickly. Just access the link and fill in the necessary data.

The discovery of a cancer can be difficult, both for those who suffer from the problem and for those who live with the person.

To reduce discomfort and help in the fight against the disease, there are some medications.

This is the case of Keytruda, a drug that helps the immune system to attack the tumor.

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