Pembrolizumab (Keytruda) for the first-line treatment of advanced renal cell cancer with a poor prognosis

In 2020, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of pembrolizumab in combination with axitinib compared to the standard treatments for advanced renal cell carcinoma with a poor in adults who have not yet had any treatment.

The manufacturer provided one study for this assessment. It was possible to analyze the data of 108 patients from this study. 56 of them were given pembrolizumab and axitinib, and 52 received sunitinib.

This is what was found:

What are the advantages of pembrolizumab?

Life expectancy: The study suggests that pembrolizumab in combination with axitinib can increase life expectancy. People who had treatment with this combination of drugs passed away after about 22 months on average (median value). People who were given sunitinib passed away after only 10 months on average (median value).

Severe side effects overall: Early results suggest that pembrolizumab has an advantage here. Study participants who were given pembrolizumab in combination with axitinib developed severe side effects within 3 months on average (median value). In those who had treatment with sunitinib, severe side effects occurred after only 1 month on average (median value).

Early research results suggest that the combination of pembrolizumab and axitinib has an advantage regarding the following severe side effects too: diseases of the blood and lymphatic system and nutritional and metabolic disorders.

The early results also suggest that the combination of drugs has an advantage in terms of side effects related to the nervous system.

What are the disadvantages of pembrolizumab?

Pembrolizumab in combination with axitinib didn’t have any disadvantages compared to the standard treatment of sunitinib.

No difference

There was no difference between the treatments in terms of treatments stopped due to side effects or severe immune-mediated side effects. Immune-mediated side effects are medical conditions in which a person's attacks their own body.

What remains unanswered?

The manufacturer didn’t provide any data on the symptoms of the illness, overall health or health-related quality of life.

Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Pembrolizumab (combination with axitinib, renal cell carcinoma)  – Benefit assessment according to §35a Social Code Book V. Dossier assessment; Commission A19-99. February 27, 2020. (IQWiG reports; Volume 887).

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on April 23, 2020
Next planned update: 2023

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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