Keytruda (pembrolizumab) vs Zepzelca (lurbinectedin)

Keytruda (pembrolizumab) vs Zepzelca (lurbinectedin)

Keytruda (pembrolizumab) is an immune checkpoint inhibitor that works by blocking the PD-1 protein on immune cells, thereby activating the immune system to attack cancer cells, and is commonly used for a variety of cancers including melanoma, non-small cell lung cancer, and head and neck cancers. Zepzelca (lurbinectedin) is a newer anticancer medication that functions by inhibiting RNA polymerase II, leading to the death of tumor cells, and is specifically approved for the treatment of metastatic small cell lung cancer after disease progression on or after platinum-based chemotherapy. When deciding between Keytruda and Zepzelca, it is crucial to consider the specific type of cancer being treated, the patient's overall health, previous treatments, and the unique mechanism of action of each drug, as well as consulting with a healthcare professional to determine the most appropriate treatment plan.

Difference between Keytruda and Zepzelca

Metric Keytruda (pembrolizumab) Zepzelca (lurbinectedin)
Generic name Pembrolizumab Lurbinectedin
Indications Various types of cancers including melanoma, lung cancer, head and neck cancer, Hodgkin lymphoma, and others Metastatic Small Cell Lung Cancer (SCLC) after platinum-based chemotherapy
Mechanism of action Programmed death receptor-1 (PD-1) blocking antibody Trabectedin analogue that binds to DNA and inhibits transcription
Brand names Keytruda Zepzelca
Administrative route Injection (intravenous) Injection (intravenous)
Side effects Fatigue, musculoskeletal pain, decreased appetite, pruritus, diarrhea, nausea, rash, fever, cough, dyspnea, constipation, pain, and abdominal pain Fatigue, leukopenia, lymphopenia, anemia, increased creatinine, increased alanine aminotransferase, increased glucose, thrombocytopenia, nausea, decreased appetite, musculoskeletal pain, dyspnea, diarrhea, vomiting, cough, constipation
Contraindications Individuals with hypersensitivity to pembrolizumab or its excipients Individuals with hypersensitivity to lurbinectedin or its excipients
Drug class Anti-PD-1 monoclonal antibody Alkylating drug
Manufacturer Merck & Co. Pharma Mar

Efficacy

Keytruda (Pembrolizumab) Efficacy in Lung Cancer

Keytruda, also known by its generic name pembrolizumab, is a highly effective immunotherapy medication used in the treatment of various forms of lung cancer. As a programmed death receptor-1 (PD-1) blocking antibody, Keytruda works by enhancing the body's immune system to help detect and fight cancer cells. In non-small cell lung cancer (NSCLC), Keytruda has shown significant efficacy, particularly in patients whose tumors express PD-L1 with a proportion score of 1% or more. For these patients, Keytruda has been approved as a first-line treatment and has been associated with improved overall survival and progression-free survival compared to traditional chemotherapy regimens.

In addition to its use as a monotherapy, Keytruda has also demonstrated efficacy in combination with other therapies. For instance, when combined with chemotherapy, Keytruda has been shown to improve outcomes in patients with metastatic nonsquamous NSCLC irrespective of PD-L1 expression. The use of Keytruda in small cell lung cancer (SCLC) has also been explored, with the drug receiving approval for the treatment of SCLC patients with disease progression on or after platinum-based chemotherapy and at least one other line of therapy, based on the results of clinical trials demonstrating a beneficial response rate.

Zepzelca (Lurbinectedin) Efficacy in Lung Cancer

Zepzelca, with the active ingredient lurbinectedin, is a newer anticancer medication that has shown promise in the treatment of lung cancer, specifically small cell lung cancer (SCLC). Lurbinectedin is a selective inhibitor of oncogenic transcription and works by binding to DNA, halting the growth of cancer cells. In clinical trials, Zepzelca has been evaluated for its efficacy in patients with SCLC who have progressed after prior platinum-containing therapy. The results from these studies have indicated that Zepzelca can lead to a meaningful reduction in tumor size and has a manageable safety profile, leading to its accelerated approval by regulatory agencies for this indication.

The efficacy of Zepzelca in SCLC is particularly noteworthy given the limited treatment options available for this aggressive form of lung cancer. While the full clinical benefit of Zepzelca is still being investigated in ongoing clinical trials, the current data suggest that it provides a valuable treatment option for patients with relapsed or refractory SCLC. As with all cancer treatments, the efficacy of Zepzelca can vary based on individual patient characteristics, and its use should be guided by a healthcare professional experienced in the treatment of lung cancer.

Regulatory Agency Approvals

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

Access Keytruda or Zepzelca today

If Keytruda or Zepzelca are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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