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What is Pembrolizumab is used for which condition and explain in detail?
PD-1 inhibitors (pembrolizumab, nivolumab) * Ipilimumab was the first checkpoint inhibitor to improve overall survival in randomized phase III trials of advanced melanoma; however, checkpoint inhibitors that target the Programmed cell death-1 (PD-1) receptor have quickly become the preferred approach to immunotherapy since they are more effective and have fewer side effects * PD-1 is an immune checkpoint receptor expressed by activated T cells # Normally functions as a "brake" on the immune response # PD-1 on activated T cells binds to its ligands PD1-L1 (B7-H1) and PD1-L2 (B7-DC), which are expressed on tumor cells - deactivation of T cells - loss of immune response against tumor * Nivolumab and pembrolizumab # Monoclonal antibodies that target PD-1 - prevent T cell deactivation - | immune-mediated tumoricidal activity # Both are FDA approved for advanced melanoma # Phase 3 RCTs in patients w/advanced melanoma have demonstrated | overall survival, | progression-free survival, and fewer side effects with either agent when compared to ipilimumab or conventional chemotherapy * Some patients have durable responses even after completion of treatment * Efficacy improved when used in combination with ipilimumab (main disadvantage = | immune mediated side effects) # Most common adverse events: fatigue, pruritus, and rash * Less common (far less common than w/ ipilimumab): pneumonitis, colitis, hepatitis, nephritis and renal dysfunction, and thyroid dysfunction. Ref:- Review of Dermatology by Alikhan; pg num:-41