Odomzo (sonidegib) vs Keytruda (pembrolizumab)

Odomzo (sonidegib) is a medication specifically indicated for the treatment of locally advanced basal cell carcinoma (BCC) that has recurred following surgery or radiation therapy, or for those who are not candidates for these therapies, and it works by inhibiting the Hedgehog signaling pathway, which is active in BCC. Keytruda (pembrolizumab), on the other hand, is an immune checkpoint inhibitor that targets the PD-1 receptor and is used to treat a variety of cancers, including melanoma, lung cancer, head and neck cancer, and others, by enhancing the body's immune response against cancer cells. When deciding between the two, it is crucial to consider the type of cancer being treated, as Odomzo is specific for advanced BCC, while Keytruda has a broader range of indications but may not be suitable for BCC.

Difference between Odomzo and Keytruda

Metric	Odomzo (sonidegib)	Keytruda (pembrolizumab)
Generic name	Sonidegib	Pembrolizumab
Indications	Locally advanced basal cell carcinoma (BCC) not amenable to curative surgery or radiation therapy	Various types of cancers including melanoma, non-small cell lung cancer (NSCLC), head and neck squamous cell carcinoma (HNSCC), classical Hodgkin lymphoma (cHL), urothelial carcinoma, and more
Mechanism of action	Hedgehog pathway inhibitor	Programmed death receptor-1 (PD-1) blocking antibody
Brand names	Odomzo	Keytruda
Administrative route	Oral	Intravenous (IV)
Side effects	Muscle spasms, alopecia, dysgeusia, fatigue, nausea, musculoskeletal pain, decreased weight, decreased appetite, diarrhea, vomiting, and others	Fatigue, cough, nausea, itching, skin rash, decreased appetite, constipation, joint pain, diarrhea, and others
Contraindications	Pregnancy, severe hepatic impairment	Pregnancy, history of severe hypersensitivity to pembrolizumab or any of its excipients
Drug class	Hedgehog pathway inhibitor	Anti-PD-1 monoclonal antibody
Manufacturer	Sun Pharmaceutical Industries, Inc.	Merck & Co., Inc.

Efficacy

Odomzo (Sonidegib) Efficacy in Skin Cancer

Odomzo (sonidegib) is a medication approved by the U.S. Food and Drug Administration (FDA) for the treatment of adults with locally advanced basal cell carcinoma (BCC) that has recurred following surgery or radiation therapy, or those who are not candidates for surgery or radiation therapy. Sonidegib functions as a hedgehog pathway inhibitor, which is a key component in the regulation of cell growth and differentiation. This pathway is known to be abnormally activated in most BCCs. Clinical trials have demonstrated that Odomzo can significantly reduce tumor size and inhibit the progression of BCC. The efficacy of Odomzo was assessed in a double-blind study where participants treated with Odomzo showed a higher objective response rate compared to those who received a placebo.

Keytruda (Pembrolizumab) Efficacy in Skin Cancer

Keytruda (pembrolizumab) is a highly effective treatment option for certain types of skin cancer, including advanced melanoma and cutaneous squamous cell carcinoma (cSCC). Pembrolizumab is an immune checkpoint inhibitor that works by blocking the PD-1 protein on the surface of immune cells, thereby enhancing the immune system's ability to detect and fight tumor cells. In clinical trials, Keytruda has shown significant improvement in overall survival rates for patients with advanced melanoma. It has become a standard treatment option for this condition, often used when the cancer cannot be removed by surgery or has metastasized to other parts of the body.

For cutaneous squamous cell carcinoma, Keytruda has been shown to be effective in patients with recurrent or metastatic cSCC who are not candidates for curative surgery or radiation. The efficacy of Keytruda in cSCC was demonstrated in a multicenter, non-randomized, open-label trial, where a substantial proportion of patients achieved a durable response, indicating that Keytruda can provide long-term control of the disease in some patients.

Overall, both Odomzo and Keytruda have brought significant advancements in the treatment of skin cancer, offering hope to patients with advanced or difficult-to-treat forms of the disease. Their efficacy has been validated through rigorous clinical trials, and they continue to be the subject of ongoing research to further understand their full potential in the management of skin cancer.

Regulatory Agency Approvals

Odomzo

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Therapeutic Goods Administration (TGA), Australia

Keytruda

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia
Medsafe (NZ)

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