Pembrolizumab (Keytruda) for the further treatment of advanced melanoma

In 2015, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) wanted to find out whether pembrolizumab (trade name: Keytruda) has any advantages or disadvantages when compared with the standard treatments for people with advanced melanoma who have had unsuccessful treatment. The standard treatment depends on things like which drug was used before and is individually tailored by the doctor.

To answer the research question, the researchers analyzed the data from one study. One group of participants (91 people) received pembrolizumab, while another group (97 people) received ipilimumab. For people who have had treatment before and who have the option of receiving ipilimumab, the study provided relevant results. These results are described below.

The study didn't provide suitable data for people who don't have the option of using ipilimumab. So it remains unclear whether pembrolizumab has any advantages or disadvantages for these people.

What are the advantages of pembrolizumab?

  • Severe side effects and treatment stopped due to side effects: The study provided some evidence that pembrolizumab can delay the onset of severe side effects. It also provided some evidence that pembrolizumab can delay the point at which people stop treatment due to side effects.

What are the disadvantages of pembrolizumab?

Pembrolizumab wasn’t found to have any disadvantages compared to ipilimumab.

No difference

  • Life expectancy: No difference was found between pembrolizumab and ipilimumab here.
  • Symptoms: Both treatment groups experienced an increase in disease-related symptoms after the same length of time. Disease-related symptoms include loss of appetite, difficulty breathing, diarrhea, fatigue, insomnia, pains, nausea and vomiting, as well as constipation.
  • Quality of life: There was also no difference regarding how long it took for quality of life to decrease.