How is adjuvant therapy given?
Dr. Jason Luke: The treatment with pembrolizumab is an intravenous (by vein) infusion. It can be given every three weeks or every six weeks. So, in my practice, we usually do the every-three-weeks regimen to start out because I want to make sure people are feeling okay and they’re not having any side effects. I believe it is very important to see people in person and have that interaction to make sure that we’re doing okay. And then if people are doing just fine, we sometimes stretch it to six-week intervals later on. But this varies by practice. Some people go straight to every six weeks right off the bat, and it’s not good or bad. Again, I start on the three-week interval before switching to a six-week interval just to make sure that I’m having very close communication with people because just like any medicine, you’re more likely to get side effects at the beginning when you start it, and we want to make sure we’re not missing anything.
We give pembrolizumab for up to one year unless patients get an intolerable side effect or have a recurrence, in which case we stop the drug and reevaluate what to do.
Khan S, Gerber DE. Autoimmunity, checkpoint inhibitor therapy and immune-related adverse events: A review. Semin Cancer Biol. 2020;64:93-101. doi:10.1016/j.semcancer.2019.06.012. Epub 2019 Jul 19. PMID: 31330185; PMCID: PMC6980444
Luke JJ, Rutkowski P, Queirolo P, et al. Pembrolizumab versus placebo as adjuvant therapy in completely resected stage IIB or IIC melanoma (KEYNOTE-716): a randomised, double-blind, phase 3 trial. Lancet. 2022;399(10336):1718-1729. doi:10.1016/S0140-6736(22)00562-1