Pembrolizumab
Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.
| ID | DRUG-PEMBROLIZUMAB |
|---|---|
| Type | Médicament |
| Alias | KeytrudaПембролізумаб |
| État | reviewed 2026-04-26 | pending_clinical_signoff |
| Maladies | DIS-BREAST DIS-CERVICAL DIS-CHL DIS-CHOLANGIOCARCINOMA DIS-CRC DIS-ENDOMETRIAL DIS-ESOPHAGEAL DIS-HNSCC DIS-LARYNGEAL DIS-MELANOMA DIS-NSCLC DIS-PARATHYROID-CARCINOMA DIS-PENILE-SCC DIS-RCC DIS-UROTHELIAL DIS-VULVAR-VAGINAL-SCC |
| Sources | SRC-ESMO-BREAST-METASTATIC-2024 SRC-NCCN-BREAST-2025 |
Faits sur les drogues
| Catégorie | Anticorps monoclonal IgG4-kappa humanisé anti-PD-1 (inhibiteur du point de contrôle immunitaire) |
|---|---|
| Mécanisme | Humanized IgG4 monoclonal antibody binding the programmed cell death protein 1 (PD-1) receptor on activated T cells, B cells, and NK cells. Blocks the PD-1/PD-L1 and PD-1/PD-L2 interactions, releasing the tumor-induced inhibition of cytotoxic T-cell activity and restoring anti-tumor immunity. IgG4 backbone minimizes ADCC. Activity correlates with tumor PD-L1 expression (CPS or TPS), tumor mutational burden (TMB-H ≥10 mut/Mb), microsatellite instability (MSI-H / dMMR), and inflamed tumor microenvironment phenotypes. Approved across many solid tumors and classical Hodgkin / PMBCL lymphoma. |
| Dose typique | Standard adult: 200 mg IV q3 weeks OR 400 mg IV q6 weeks (over 30 min). Pediatric: 2 mg/kg (up to 200 mg) IV q3w. Treatment continued until disease progression, unacceptable toxicity, or 24 months in most solid-tumor indications (35 cycles q3w). Adjuvant melanoma: 1 year (KEYNOTE-054). Neoadjuvant + adjuvant TNBC (KEYNOTE-522): 200 mg q3w × 8 cycles with chemo, then 9 cycles adjuvant. Neoadjuvant + adjuvant NSCLC (KEYNOTE-671): 200 mg q3w × 4 cycles with platinum-doublet, then 13 cycles adjuvant. Combination doses unchanged when paired with chemo, lenvatinib, axitinib, or trastuzumab. |
| Ukraine enregistrée | Vrai |
| NSZU remboursé | Vrai |
| Ukraine vérifiée pour la dernière fois | 2026-04-27 |
Avertissements
- Effets indésirables immunitaires graves et fatals (tout organe; peut survenir après arrêt)
Notes
Cross-disease entity. ICI-class management protocols apply uniformly: baseline TFTs, cortisol, glucose, LFTs, renal panel, troponin if combo with CTLA-4 ICI; serial labs every cycle. Grade 2 irAE — hold, start prednisone 0.5-1 mg/kg/d; Grade 3-4 — discontinue, prednisone 1-2 mg/kg/d, escalate to infliximab/MMF/IVIG/tocilizumab if refractory. Permanent discontinuation for any Grade 3-4 endocrine event NOT required if hormone replacement controls (most can resume). Endpoint predictors: PD-L1 CPS / TPS by 22C3 IHC, MSI/dMMR, TMB. PD-L1 cutoff varies by indication (TPS ≥1% NSCLC adjuvant, TPS ≥50% NSCLC 1L mono, CPS ≥1 gastric, CPS ≥10 cervical / TNBC met).
Utilisé par
Contraindications
CI-PEMBROLIZUMAB-AUTOIMMUNE- CI-PEMBROLIZUMAB-AUTOIMMUNE
Médicament
DRUG-TORIPALIMAB- Toripalimab
Indication
IND-HNSCC-RM-1L-PEMBRO-MONO-CPS-HIGH- IND-HNSCC-RM-1L-PEMBRO-MONO-CPS-HIGHIND-LARYNGEAL-RM-1L-PEMBRO-CHEMO- IND-LARYNGEAL-RM-1L-PEMBRO-CHEMOIND-LARYNGEAL-RM-1L-PEMBRO-MONO-CPS-HIGH- IND-LARYNGEAL-RM-1L-PEMBRO-MONO-CPS-HIGHIND-PARATHYROID-CARCINOMA-2L-PEMBROLIZUMAB-MSI- IND-PARATHYROID-CARCINOMA-2L-PEMBROLIZUMAB-MSIIND-PENILE-SCC-METASTATIC-1L-MSI-H-PEMBRO- IND-PENILE-SCC-METASTATIC-1L-MSI-H-PEMBROIND-VULVAR-VAGINAL-SCC-METASTATIC-1L-PEMBRO- IND-VULVAR-VAGINAL-SCC-METASTATIC-1L-PEMBRO
Protocole thérapeutique
REG-EV-PEMBRO-UROTHELIAL- Enfortumab vedotin + pembrolizumab (métastatique urothéliale, 1L)REG-LENV-PEMBRO-RCC- Lenvatinib + pembrolizumab (RCC, 1L)REG-PEMBRO-ADJUVANT-MELANOMA- Pembrolizumab adjuvant (étape résistée) III/IV mélanome; KEYNOTE-054)REG-PEMBRO-ADJUVANT-NSCLC- Pembrolizumab adjuvant (resected NSCLC; KEYNOTE-671)REG-PEMBRO-AXI-RCC- Pembrolizumab + axitinib (RCC, tout-risque 1L)REG-PEMBRO-CARBO-NAB-PACLITAXEL-NSCLC-SQ- Pembrolizumab + carboplatin + nab-paclitaxel (squamous NSCLC, first line)REG-PEMBRO-CARBO-PACLI-ENDOM- Pembrolizumab + carbo + paclitaxel (endométrie avancée 1L)REG-PEMBRO-CARBO-PACLITAXEL-NSCLC-SQ- Pembrolizumab + carboplatin + paclitaxel (squamous NSCLC, first line)REG-PEMBRO-CHEMO-HNSCC-1L- Pembrolizumab + 5-FU + platine (HNSCC R/M, 1L; PD-L1 CPS ≥1)REG-PEMBRO-CHEMO-NEOADJ-NSCLC- Pembrolizumab + cisplatin-based chemo (NSCLC neoadjuvant; KEYNOTE-671)REG-PEMBRO-CHEMO-NSCLC-NONSQ- Pembrolizumab + carboplatin + pemetrexed (NSCLC non-squamous, 1L)REG-PEMBRO-CHEMO-TNBC-MET- Pembrolizumab + chimiothérapie (TNBC, PD-L1+ métastatique)REG-PEMBRO-CHEMO-TNBC-NEOADJUVANT- Pembrolizumab + chimio (TNBC néoadjuvant)REG-PEMBRO-CISPLATIN-5FU-ESOPH- Pembrolizumab + cisplatin + fluorouracilREG-PEMBRO-GEM-CIS-CHOLANGIO- Pembrolizumab + gemcitabine + cisplatin (KEYNOTE-966) — 1L advanced biliary tract cancerREG-PEMBRO-LENVATINIB-ENDOM- Pembrolizumab + Lenvatinib (KEYNOTE-775) — 2L pMMR endométrialREG-PEMBRO-MONO-ESOPH-2L- Pembrolizumab en monothérapie — 2L PD-L1 CPS ≥10 (KEYNOTE-181)REG-PEMBRO-MONO-HNSCC-1L- Pembrolizumab en monothérapie (HNSCC R/M, 1L; PD-L1 CPS ≥20)REG-PEMBRO-MONO-MELANOMA- Pembrolizumab en monothérapie (mélanome avancé/métastatique, 1L; KEYNOTE-006)REG-PEMBRO-MONO-NSCLC- Pembrolizumab monotherapy (NSCLC PD-L1 ≥50%, driver-negative, 1L)REG-PEMBRO-PACLI-CARBO-BEV-CERVICAL- Pembrolizumab + paclitaxel + carboplatin ± bevacizumab (cancer du col de l'utérus, 1L)REG-PEMBROLIZUMAB-CERVICAL-1L- Pembrolizumab + carboplatin + paclitaxel ± bevacizumab (persistant/récurrent/métastatique c...REG-PEMBROLIZUMAB-CHL- Pembrolizumab 200 mg IV q3w — r/r cHL post-BV (horaire KEYNOTE-204)REG-PEMBROLIZUMAB-MAINTENANCE- Maintien du pembrolizumab (suite de la chimio+pembro post-induction), q3w jusqu'à 35 cyclesREG-PEMBROLIZUMAB-MONO- Pembrolizumab en monothérapieREG-PEMBROLIZUMAB-MSI-MONO- Pembrolizumab en monothérapie (MSI-H mCRC 1L)