Pembrolizumab (Keytruda) for the treatment of previously untreated advanced melanoma without a BRAF V600 mutation

In 2015, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into whether pembrolizumab (trade name: Keytruda) has any advantages or disadvantages when compared with the standard treatments for people with advanced melanoma who have not had treatment before. Dacarbazine and ipilimumab are the standard treatment options.

The manufacturer provided one relevant study. One group of participants (135 people) received pembrolizumab, while another group (134 people) received ipilimumab. The results are described below.

What are the advantages of pembrolizumab?

  • Life expectancy: The study provides weak evidence that pembrolizumab can prolong life more than ipilimumab can.
  • Social life: The study provides weak evidence that pembrolizumab can delay the decline of participation in social life: In half of the people receiving pembrolizumab, participation in social life decreased after about 3 months. In half the people receiving ipilimumab, this already started after about 1.5 months. Participation in social life means family life or social activities that are influenced by your physical condition or treatment.

No difference

  • Disease-related problems: In both groups, it took the same time for disease-related problems to get worse, which included breathing problems, insomnia, pain, loss of appetite, diarrhea and constipation.
  • Quality of life: There was also no difference regarding how long it took for quality of life to decrease.
  • Severe side effects and treatment stopped due to side effects: There was no difference here either.