ISSUE 1455
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The FDA has approved pembrolizumab (Keytruda – Merck), a human programmed death receptor-1 (PD-1) blocking antibody, for treatment of unresectable or metastatic melanoma that has progressed following treatment with ipilimumab (Yervoy) and, if the patient is BRAF V600 mutation positive, a BRAF inhibitor. It is the first PD-1 inhibitor to be marketed in the US. Nivolumab, another PD-1 inhibitor, is available in Japan. Pembrolizumab was previously known as lambrolizumab.
STANDARD TREATMENT — Metastatic melanoma has traditionally been treated with the cytotoxic agent dacarbazine (DTIC), which has not been shown to improve survival. Other therapies have included high-dose interleukin-2 (aldesleukin, Proleukin), which has produced responses in 16% of patients, but can cause severe toxicity and requires hospitalization for treatment. The anti-CTLA4 monoclonal antibody ipilimumab has produced response
... more- Ipilimumab (Yervoy) for metastatic melanoma. Med Lett Drugs Ther 2011; 53:51.
- Vemurafenib (Zelboraf) for metastatic melanoma. Med Lett Drugs Ther 2011; 53:77.
- Dabrafenib (Tafinlar) and trametinib (Mekinist) for metastatic melanoma. Med Lett Drugs Ther 2013; 55:62.
- DM Pardoll. The blockade of immune checkpoints in cancer immunotherapy. Nat Rev Cancer 2012; 12:252.
- C Robert et al. Anti-programmed-death-receptor-1 treatment with pembrolizumab in ipilimumab-refractory advanced melanoma: a randomised dose-comparison cohort of a phase 1 trial. Lancet 2014; 384:1109.
- O Hamid et al. Safety and tumor responses with lambrolizumab (anti-PD-1) in melanoma. N Engl J Med 2013; 369:134.

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