Keytruda (pembrolizumab) vs Zynlonta (loncastuximab tesirine-lpyl)

Keytruda (pembrolizumab) is an immune checkpoint inhibitor 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 in various types of cancers including melanoma, non-small cell lung cancer, and head and neck cancers. Zynlonta (loncastuximab tesirine-lpyl) is an antibody-drug conjugate specifically targeting CD19, a protein found on the surface of certain cancer cells, and is used in the treatment of relapsed or refractory diffuse large B-cell lymphoma. The choice between Keytruda and Zynlonta would depend on the specific type of cancer a patient has, the stage and specific characteristics of their disease, and their overall health, as each medication is tailored for different indications and mechanisms of action.

Difference between Keytruda and Zynlonta

Metric	Keytruda (pembrolizumab)	Zynlonta (loncastuximab tesirine-lpyl)
Generic name	Pembrolizumab	Loncastuximab tesirine-lpyl
Indications	Various cancers including melanoma, non-small cell lung cancer, head and neck squamous cell carcinoma, classical Hodgkin lymphoma, primary mediastinal large B-cell lymphoma, urothelial carcinoma, microsatellite instability-high cancer, gastric cancer, esophageal cancer, cervical cancer, hepatocellular carcinoma, Merkel cell carcinoma, renal cell carcinoma, endometrial carcinoma, and tumor mutational burden-high cancer.	Relapsed or refractory diffuse large B-cell lymphoma (DLBCL).
Mechanism of action	Programmed death receptor-1 (PD-1) blocking antibody.	Antibody-drug conjugate targeting CD19, a protein expressed on the surface of B-cells, followed by delivery of a cytotoxic agent.
Brand names	Keytruda	Zynlonta
Administrative route	Intravenous infusion	Intravenous infusion
Side effects	Fatigue, musculoskeletal pain, decreased appetite, pruritus, diarrhea, nausea, rash, pyrexia, cough, dyspnea, constipation, pain in extremity, and headache.	Thrombocytopenia, neutropenia, anemia, fatigue, musculoskeletal pain, edema, nausea, and fever.
Contraindications	Individuals with a history of severe hypersensitivity reaction to pembrolizumab or any of its excipients.	Individuals with a history of severe hypersensitivity to loncastuximab tesirine-lpyl or any of its components.
Drug class	Anti-PD-1 monoclonal antibody	Antibody-drug conjugate
Manufacturer	Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.	ADC Therapeutics SA

Efficacy

Efficacy of Keytruda (pembrolizumab) in Lymphoma

Keytruda (pembrolizumab) is a monoclonal antibody that has shown efficacy in the treatment of various types of cancer, including lymphoma. Pembrolizumab targets and blocks the PD-1 receptor, a protein on T cells that normally helps keep these cells from attacking other cells in the body. By blocking PD-1, Keytruda boosts the immune response against cancer cells. In the context of lymphoma, Keytruda has been studied in patients with relapsed or refractory classical Hodgkin lymphoma (cHL) and has demonstrated significant efficacy in shrinking tumors and, in some cases, leading to complete remission.

Studies have shown that Keytruda can induce a durable response in a subset of patients with cHL, particularly those who have failed to respond to previous treatments. The overall response rate (ORR) in these studies has been reported to be around 65-70%, with a complete remission rate of about 20-30%. However, it is important to note that the response to Keytruda can vary, and not all patients with lymphoma will experience the same level of benefit.

Efficacy of Zynlonta (loncastuximab tesirine-lpyl) in Lymphoma

Zynlonta (loncastuximab tesirine-lpyl) is an antibody-drug conjugate specifically designed for the treatment of certain types of B-cell lymphomas. It works by targeting CD19, a protein expressed on the surface of B-cells, and delivering a cytotoxic agent directly to the cancer cells. Zynlonta has shown promise in treating relapsed or refractory diffuse large B-cell lymphoma (DLBCL), which is the most common type of non-Hodgkin lymphoma.

In clinical trials, Zynlonta has demonstrated significant efficacy in patients with DLBCL who have failed multiple prior lines of therapy. The ORR for Zynlonta in pivotal trials was approximately 48.3%, with a complete remission rate of 24.1%. These results indicate that Zynlonta can provide a meaningful therapeutic option for patients with limited treatment choices. As with any therapy, the efficacy of Zynlonta can vary among individuals, and ongoing research continues to better understand which patients are most likely to benefit from this treatment.

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)

Zynlonta

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

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