What Is Pembrolizumab and How Is It Used in Kidney Cancer?

Pembrolizumab (brand name Keytruda) is an immunotherapy drug used to treat advanced or metastatic kidney cancer. It belongs to a class of medications called immune checkpoint inhibitors, which help the body’s immune system detect and destroy cancer cells.

In kidney cancer, pembrolizumab is used either:

  • In combination with lenvatinib as a first-line treatment, or
  • With other treatments in certain clinical trial settings

How Does It Work?

Pembrolizumab targets a protein called PD-1 found on immune cells. Cancer cells often use PD-1 to “hide” from the immune system. By blocking this signal, pembrolizumab activates immune cells to recognize and attack the tumor.

This doesn’t work like chemotherapy. Instead of killing cancer directly, it boosts your immune system's natural ability to fight the cancer more effectively.

How Is It Given?

  • Pembrolizumab is given as an IV infusion, usually every 3 or 6 weeks
  • Each infusion session takes about 30 minutes
  • Treatment may continue for up to 2 years, or longer in some cases

When combined with lenvatinib, patients also take a daily pill alongside the IV treatment.

What Are the Side Effects?

Because pembrolizumab activates the immune system, side effects are usually related to immune inflammation. These can include:

  • Fatigue
  • Rash or itching
  • Diarrhea
  • Thyroid problems
  • Liver inflammation
  • Lung inflammation (pneumonitis)

These effects are often manageable if recognized early and treated promptly, usually with corticosteroids.

How Effective Is It?

Pembrolizumab, especially in combination with lenvatinib, has shown high response rates and prolonged disease control in advanced kidney cancer. Many patients experience tumor shrinkage and longer progression-free survival.

Looking for more questions?

Visit our Kidney Cancer Questions page for all other topics explained in plain language.

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