Keytruda (pembrolizumab) vs Tabrecta (capmatinib)

Keytruda (pembrolizumab) is an immunotherapy drug that works by blocking the PD-1 pathway, which helps the body's immune system to detect and fight cancer cells, and is commonly used for various types of cancers, including melanoma, lung, head and neck, and others. Tabrecta (capmatinib), on the other hand, is a targeted therapy specifically designed to inhibit the activity of the MET gene in cases where there are mutations or amplification, and is approved for the treatment of non-small cell lung cancer (NSCLC) with MET exon 14 skipping mutations. When deciding between Keytruda and Tabrecta, it is crucial to consider the specific type of cancer, its molecular profile, and the presence of specific genetic mutations, as Tabrecta is only indicated for cancers with a certain genetic alteration, while Keytruda has a broader range of indications but depends on PD-L1 expression and other factors.

Difference between Keytruda and Tabrecta

Metric	Keytruda (pembrolizumab)	Tabrecta (capmatinib)
Generic name	Pembrolizumab	Capmatinib
Indications	Various cancers including melanoma, lung cancer, head and neck cancer, Hodgkin lymphoma, and others	Metastatic non-small cell lung cancer (NSCLC) with MET exon 14 skipping mutations
Mechanism of action	Programmed death receptor-1 (PD-1) blocking antibody	MET kinase inhibitor
Brand names	Keytruda	Tabrecta
Administrative route	Intravenous infusion	Oral
Side effects	Fatigue, musculoskeletal pain, decreased appetite, pruritus, diarrhea, nausea, rash, pyrexia, cough, dyspnea, constipation, pain in extremity, and headache	Nausea, vomiting, fatigue, edema, decreased appetite, and dyspnea
Contraindications	None listed specifically; use with caution in patients with autoimmune disease or those receiving immunosuppressive therapy	None listed specifically; use with caution in patients with hepatic impairment or renal impairment
Drug class	Anti-PD-1 monoclonal antibody	Small molecule tyrosine kinase inhibitor
Manufacturer	Merck & Co.	Novartis

Efficacy

Efficacy of Keytruda (pembrolizumab) in Lung Cancer

Keytruda, known generically as pembrolizumab, is a highly effective immunotherapy drug used in the treatment of various forms of lung cancer, including non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). 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. It has shown significant efficacy in improving survival rates in patients with metastatic NSCLC, particularly those whose tumors express PD-L1 with a proportion score of 1% or more, and who have previously undergone chemotherapy.

Keytruda has been evaluated in multiple clinical trials, with many studies demonstrating a significant improvement in progression-free survival (PFS) and overall survival (OS) compared to chemotherapy alone. In the KEYNOTE-024 study, for instance, Keytruda significantly improved median PFS and OS in patients with advanced NSCLC with high PD-L1 expression, leading to its approval as a first-line treatment. The drug's efficacy is also noted in its ability to maintain a higher quality of life and lower rates of treatment-related adverse effects compared to traditional chemotherapy.

Efficacy of Tabrecta (capmatinib) in Lung Cancer

Tabrecta, or capmatinib, is a targeted therapy approved for the treatment of adult patients with metastatic NSCLC that have mutations leading to mesenchymal-epithelial transition (MET) exon 14 skipping. This oral medication is a MET inhibitor that specifically targets the genetic alterations in the MET gene, which can drive the growth and spread of cancer cells. Capmatinib has shown promising efficacy in patients with MET exon 14 skipping mutations, which are present in a small percentage of NSCLC cases.

The approval of Tabrecta was based on the results of the GEOMETRY mono-1 trial, which demonstrated that capmatinib provided a high overall response rate (ORR) in previously treated as well as treatment-naive patients with MET exon 14-altered NSCLC. The study showed that capmatinib led to rapid and durable responses, offering a new line of treatment for patients with this specific genetic profile. The efficacy of Tabrecta, as seen in the trial, offers hope for improved outcomes in a subset of lung cancer patients who previously had limited treatment options.

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)

Tabrecta

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Pharmaceuticals and Medical Devices Agency (PMDA), Japan

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