Common brand names

• Keytruda

How it is administered

Pembrolizumab is given as an intravenous (IV) infusion. It is administered by a healthcare professional, usually in a hospital or clinic setting. The medication is available in vials containing 100 mg of pembrolizumab in 4 mL of solution. The typical dosing for adults with classical Hodgkin lymphoma (cHL) is 200 mg every 3 weeks or 400 mg every 6 weeks. For pediatric patients, the dose is 2 mg/kg (up to a maximum of 200 mg) every 3 weeks. Each infusion takes about 30 minutes.

How it works

Pembrolizumab is a type of immunotherapy called a PD-1-blocking antibody. In some cancers, including Hodgkin lymphoma, cancer cells use a pathway called PD-1/PD-L1 to hide from the immune system. Pembrolizumab works by blocking the PD-1 receptor on T cells, preventing it from interacting with PD-L1 and PD-L2 proteins on cancer cells. This releases the 'brakes' on the immune system, allowing T cells to recognize and attack cancer cells more effectively.

By enhancing the body's natural immune response, pembrolizumab can help control or shrink tumors in patients with Hodgkin lymphoma, especially when other treatments have not worked or the disease has returned.

Who should take it

Pembrolizumab is indicated for adults with relapsed or refractory classical Hodgkin lymphoma (cHL), meaning the disease has come back after or did not respond to previous treatments. It is also approved for pediatric patients with refractory cHL or cHL that has relapsed after two or more lines of therapy.

This medication is typically used when standard treatments such as chemotherapy or stem cell transplant have not been successful, or when patients are not candidates for those treatments. Your doctor will determine if pembrolizumab is appropriate based on your medical history and previous treatments.

Who should not take it

There are no absolute contraindications listed for pembrolizumab. However, patients who have had severe allergic reactions to pembrolizumab or any of its components should not receive it.

Caution is advised in patients with active autoimmune diseases, those who have received organ transplants, or those with a history of severe immune-related side effects. Pembrolizumab can cause the immune system to attack normal organs and tissues, leading to serious or life-threatening side effects. It should not be used in pregnancy, as it may harm the unborn baby. Always discuss your full medical history with your healthcare provider before starting pembrolizumab.

Commonly used with

Pembrolizumab is often used as a single agent for relapsed or refractory classical Hodgkin lymphoma. In other cancers, it may be combined with chemotherapy or other targeted therapies, but for Hodgkin lymphoma, it is typically used alone after other treatments have failed.

If you have received a stem cell transplant, your doctor will closely monitor you for complications if pembrolizumab is used before or after the transplant.

Commonly tested with

Pembrolizumab has been compared to other treatments such as brentuximab vedotin in clinical trials for Hodgkin lymphoma. It may also be studied in combination with chemotherapy or other immunotherapies in research settings, but its main use in cHL is as a single agent after other therapies have not worked.