This past week encouraging news came out regarding Merck pharmaceutical drug Keytruda and patients with previously untreated advanced non-small cell lung cancer. Keytruda is a drug that harnesses the immune system to attack tumors. It is an immunotherapy drug that works by targeting a protein called PD-1- programmed death receptors. It is thought that the cancer cells do not allow the white cells to attack and kill the cancer cells as they normally would do with other foreign invading toxins. The clinical trial that the news came from was presented by Dr. Leena Gandhi of New York University, Perlmutter Cancer Center and reported at the American Association for Cancer Research meeting in Chicago. The study showed that Keytruda was useful when added to the standard chemotherapy for non-small cell lung cancer, which is the type of lung cancer most commonly found in people that smoke. By adding Keytruda the one-year survival rate increased from 49% to 69% as compared to the group who received the standard chemotherapy only.

Keytruda whose generic name is Pembrolizumab, has been used to treat many different types of cancer. It has been used with some degree of success in patients with melanoma, Hodgkin’s lymphoma, cancer of the stomach, head, neck, and bladder. The total sales for the treatment with Keytruda was a total of 3.8 billion, with an average cost of $150,000 per year, per patient.  Keytruda is administered intravenously. The common side effects are nausea, anemia and fatigue. The standard chemotherapy treatment used in the study and for non-small cell lung cancer is pemextred and carboplatin in the control group with Keytruda in the other group.

The only approved chemotherapy treatment in the United States is pemextred and cisplatin.  Scientists are excited about the possibilities that immunological drugs can offer to patients with a variety of cancers. It is not a one size fit all approach. All the additions and timing of when to administer the chemotherapy with or without the immunological drugs has to be studied through clinical trials that are carefully regulated.

For patients with malignant mesothelioma the number of patients is small. With approximately 2,500 to 3,000 patients a year diagnosed with malignant mesothelioma in the United States per year, the challenge is to encourage enrollment in clinical trials that patients may qualify for. Other immunological drugs are also showing promising results with malignant mesothelioma.

The timing of treatment is critical. Diagnosis with malignant mesothelioma can sometimes take time due to the rarity of the disease, and most symptoms mimic other more common diseases. The importance of knowing what clinical trials that the patient with malignant mesothelioma may be eligible for is how progress to a cure is going to happen.

Currently there are 13 studies listed on www.clinicaltrials.gov that are studying Keytruda/ Pembrolizumab and malignant mesothelioma. Of that 13, 2 are not actively recruiting patients, 10 are recruiting, and one has been withdrawn.

Progress is exciting! Encouraging continued participation in clinical trials is the way forward both scientifically and economically.

Investigate the possibilities, www.clinicaltrials.gov