How effective is Pembrolizumab for urothelial cancer?

Question

Hello doctor,

I am 62 years old. My urothelial cancer has spread, and after not responding to chemotherapy, my doctor recommended Pembrolizumab (Keytruda) as the next treatment.

How does this treatment compare to traditional chemotherapy in terms of effectiveness?
I am especially concerned about my quality of life during treatment. Are the side effects from Pembrolizumab milder or more severe than those from chemotherapy?
Also, what is the success rate of Pembrolizumab in cases like mine, where the cancer has already spread?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Pembrolizumab is an immunotherapy drug that works as a PD-1 (programmed death receptor-1) inhibitor. Unlike chemotherapy, which directly targets and kills rapidly dividing cancer cells, Pembrolizumab boosts the immune system's ability to recognise and attack cancer cells. It does this by blocking the PD-1 receptor on T-cells, which ‘reactivates’ the immune system to fight the cancer.

Pembrolizumab has been shown to provide a survival benefit in advanced urothelial cancer, especially when chemotherapy has not worked. It is generally better tolerated than chemotherapy. While chemotherapy can cause severe side effects like nausea, vomiting, hair loss, fatigue, and an increased risk of infections due to bone marrow suppression, the side effects of Pembrolizumab are usually milder, including fatigue, skin rash, diarrhea, and hypothyroidism.

One of the advantages of Pembrolizumab is its treatment schedule, which is every three to six weeks. This means fewer hospital visits compared to chemotherapy. Be sure to discuss this treatment with your oncologist.

I hope you are satisfied with my answer.

Thank you.