Dr. Whitman on the Role of Pembrolizumab in Melanoma

Eric Whitman, MD, surgeon, Atlantic Health System, discusses the role of pembrolizumab (Keytruda) in the treatment of patients with melanoma.

Being treated with pembrolizumab has provided a longer life for patients with melanoma, says Whitman. Previously, patients with metastatic melanoma would be put on clinical trials, but the outcomes were not successful. However, now with the addition of pembrolizumab, patients seem to be doing quite well, Whitman adds.

There are many toxicities that are intrinsic to treatment with pembrolizumab. Physicians are often used to chemotherapy-related toxicities, such as hair loss or tongue swelling, but toxicities associated with immunotherapy are different, explains Whitman. Since these drugs affect the immune system, the side effects are mostly autoimmune-related.

In the phase III EORTC1325/KEYNOTE-054 trial, adjuvant pembrolizumab reduced the risk of recurrence by 43% in patients with stage III resected high-risk melanoma. The hazard ratio for recurrence-free survival was 0.57 for pembrolizumab versus placebo (98.4% CI, 0.43-0.74; P <.0001). There were no new safety concerns in the KEYNOTE-054 trial compared with outcomes reported in previous studies of the PD-1 inhibitor.