Pembrolizumab

Pembrolizumab
Monoclonal antibody
Type Whole antibody
Source Humanized (from mouse)
Target PD-1
Clinical data
Pregnancy
category
  • not for pregnant women
Routes of
administration
IV
Legal status
Legal status
  • Approved (US)
Identifiers
CAS Number 1374853-91-4
ATC code L01XC18 (WHO)
ChemSpider none
Chemical data
Formula C6534H10004N1716O2036S46 (peptide)
Molar mass 146.3 kg/mol (peptide)

Pembrolizumab (formerly MK-3475 and lambrolizumab, trade name Keytruda[1]) is a humanized antibody used in cancer immunotherapy. It targets the programmed cell death 1 (PD-1) receptor.[2] The drug was initially used in treating metastatic melanoma.[3][4]

History

Pembrolizumab was invented by Gregory Carven, Hans van Eenennaam and John Dulos at Organon Biosciences.[5] MRC Technology humanized the antibody pembrolizumab for Organon in 2016.

On September 4, 2014 the US Food and Drug Administration (FDA) approved pembrolizumab under the FDA Fast Track Development Program.[6] It is approved for use following treatment with ipilimumab, or after treatment with Ipilimumab and a BRAF inhibitor in advanced melanoma patients who carry a BRAF mutation.[7] It is marketed by Merck.

On October 2, 2015, the FDA approved pembrolizumab for the treatment of metastatic non-small cell lung cancer in patients whose tumors express PD-L1 and who have failed treatment with other chemotherapeutic agents.[8][9]

Pembrolizumab was priced at $150,000 per year when it launched.[10]

Mechanism of action

Pembrolizumab is a therapeutic antibody that blocks the inhibitory ligand of programmed cell death 1 receptor. This receptor is responsible for inhibiting the immune response to cancer cells. Normally, this effect is necessary to avoid inappropriate overreaction, such as an auto-immune disease, in healthy individuals.[11] In cancer patients antibody blockade against this receptor such as with Pembrolizumab reinvigorates the immune system, allowing it to target and destroy cancer cells.[12] Pembrolizumab is one of a number of closely related therapies dubbed checkpoint therapy.

Clinical trials

As of 2015 a large phase I clinical trial produced response rates of 37–38% in patients with advanced melanoma and an overall response rate of 26% in patients who had progressive disease after treatment with Ipilimumab.[13]

Also in 2015 the drug was in Phase II clinical trials for non-small-cell lung cancer (NSCLC) in patients with oligometastatic disease.[14]

See also

External links

References

  1. "Statement on a Nonproprietary Name Adopted by the USAN Council" (PDF). November 27, 2013.
  2. Pollack, Andrew (May 29, 2015). "New Class of Drugs Shows More Promise in Treating Cancer I believe this drug was at Sheba Medical Center, the Ella Institute, in Israel.". New York Times. Retrieved May 30, 2015.
  3. Hamid, O; Robert, C; Daud, A; Hodi, F. S.; Hwu, W. J.; Kefford, R; Wolchok, J. D.; Hersey, P; Joseph, R. W.; Weber, J. S.; Dronca, R; Gangadhar, T. C.; Patnaik, A; Zarour, H; Joshua, A. M.; Gergich, K; Elassaiss-Schaap, J; Algazi, A; Mateus, C; Boasberg, P; Tumeh, P. C.; Chmielowski, B; Ebbinghaus, S. W.; Li, X. N.; Kang, S. P.; Ribas, A (2013). "Safety and tumor responses with lambrolizumab (anti-PD-1) in melanoma". New England Journal of Medicine 369 (2): 134–44. doi:10.1056/NEJMoa1305133. PMID 23724846.
  4. Duek, Nechama (June 9, 2014). "Israeli-American team unveils revolutionary drug in fight against skin cancer". ynetnews.com. Retrieved June 2015.
  5. US 8952136 Antibodies to human programmed death receptor PD-1
  6. U.S. Food and Drug Administration (September 4, 2014). "FDA approves Keytruda for advanced melanoma". U.S. Food and Drug Administration. U.S. Food and Drug Administration. Retrieved 24 December 2015.
  7. "FDA Approves Anti-PD-1 Drug for Advanced Melanoma". cancernetwork.com.
  8. "FDA approves Keytruda for advanced non-small cell lung cancer".
  9. U.S. Food and Drug Administration (October 2, 2015). "FDA approves Keytruda for advanced non-small-cell lung cancer". U.S. Food and Drug Administration. U.S. Food and Drug Administration. Retrieved 24 December 2015.
  10. Amgen slaps record-breaking $178K price on rare leukemia drug Blincyto
  11. Francisco LM, Sage PT, Sharpe AH (Jul 2010). "The PD-1 pathway in tolerance and autoimmunity". Immunological Reviews 236: 219–42. doi:10.1111/j.1600-065X.2010.00923.x. PMC 2919275. PMID 20636820.
  12. Pardoll, DM (Mar 22, 2012). "The blockade of immune checkpoints in cancer immunotherapy.". Nature reviews. Cancer 12 (4): 252–64. doi:10.1038/nrc3239. PMID 22437870.
  13. Sharma, Pamanee; Allison, James P. (April 3, 2015). "The future of immune checkpoint therapy". Science 348: 56–61. doi:10.1126/science.aaa8172. PMID 25838373. Retrieved June 2015.
  14. Press release, "Penn Medicine's New Immunotherapy Study Will Pit PD-1 Inhibitor Against Advanced Lung Cancer", University of Pennsylvania, February 4, 2015.
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