Keytruda (pembrolizumab) vs Fotivda (tivozanib)

Keytruda (pembrolizumab) is an immune checkpoint inhibitor that works by blocking the PD-1 pathway, thereby enhancing the body's immune response against cancer cells, and is commonly used for a variety of cancers, including melanoma, non-small cell lung cancer, and head and neck cancer. Fotivda (tivozanib), on the other hand, is a tyrosine kinase inhibitor that targets vascular endothelial growth factor receptors (VEGFRs), and is specifically indicated for the treatment of advanced renal cell carcinoma (RCC). When deciding between Keytruda and Fotivda, it is crucial to consider the type of cancer being treated, the patient's overall health, and the specific mechanism of action of each drug, as well as consulting with a healthcare provider for a personalized treatment recommendation.

Difference between Keytruda and Fotivda

Metric	Keytruda (pembrolizumab)	Fotivda (tivozanib)
Generic name	Pembrolizumab	Tivozanib
Indications	Various types of cancers including melanoma, lung cancer, head and neck cancer, Hodgkin lymphoma, and stomach cancer	Advanced renal cell carcinoma
Mechanism of action	Programmed death receptor-1 (PD-1) blocking antibody	Vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor
Brand names	Keytruda	Fotivda
Administrative route	Intravenous infusion	Oral
Side effects	Fatigue, musculoskeletal pain, decreased appetite, itching, diarrhea, nausea, rash, fever, cough, dyspnea, constipation, pain, and abdominal pain	Hypertension, diarrhea, fatigue, dysphonia, hypothyroidism, decreased appetite, nausea, stomatitis, vomiting, weight decreased, asthenia
Contraindications	None specifically listed; however, should be used with caution in patients with a history of severe immune-mediated adverse reactions	None specifically listed; however, patients should be monitored for hypertension and proteinuria
Drug class	Anti-PD-1 monoclonal antibody	Tyrosine kinase inhibitor
Manufacturer	Merck & Co.	Aveo Pharmaceuticals

Efficacy

Keytruda (Pembrolizumab) Efficacy in Kidney Cancer

Keytruda, known generically as pembrolizumab, is a type of immunotherapy that has shown efficacy in the treatment of kidney cancer, specifically advanced renal cell carcinoma (RCC). Pembrolizumab is a programmed death receptor-1 (PD-1) blocking antibody that helps the immune system to detect and fight cancer cells. In clinical trials for kidney cancer, Keytruda has been evaluated both as a monotherapy and in combination with other therapies. When used in combination with axitinib, a tyrosine kinase inhibitor, pembrolizumab has been shown to significantly improve overall survival and progression-free survival compared to sunitinib in the first-line treatment of advanced RCC.

Results from the KEYNOTE-426 study, a phase 3 trial, demonstrated that the combination of pembrolizumab and axitinib reduced the risk of death by nearly half compared to sunitinib, which is a standard treatment. The combination also improved the response rate and delayed disease progression. This has led to the approval of pembrolizumab in combination with axitinib by regulatory agencies for the first-line treatment of patients with advanced RCC, marking a significant advancement in the management of this type of cancer.

Fotivda (Tivozanib) Efficacy in Kidney Cancer

Fotivda, with the generic name tivozanib, is another targeted therapy approved for the treatment of advanced renal cell carcinoma. Tivozanib is a vascular endothelial growth factor (VEGF) receptor tyrosine kinase inhibitor that works by inhibiting the growth of new blood vessels to the tumor, effectively starving the cancer of the nutrients it needs to grow. In clinical trials, tivozanib has shown efficacy as a treatment for RCC in patients who have received prior antiangiogenic therapy.

The pivotal phase 3 trial known as TIVO-3 compared tivozanib to sorafenib, another tyrosine kinase inhibitor, in patients with refractory advanced RCC. The study found that tivozanib significantly improved progression-free survival compared to sorafenib. Additionally, tivozanib demonstrated a favorable safety profile and was generally well-tolerated. These findings have contributed to the approval of tivozanib for the treatment of adult patients with relapsed or refractory advanced RCC following two or more prior systemic therapies.

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)

Fotivda

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA

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