Keytruda (pembrolizumab) vs Alunbrig (brigatinib)

Keytruda (pembrolizumab) is an immunotherapy drug that works by blocking the PD-1 pathway, which helps the immune system to detect and fight cancer cells, and is commonly used to treat various types of cancers, including melanoma, lung cancer, and head and neck cancer. Alunbrig (brigatinib), on the other hand, is a targeted therapy that specifically inhibits ALK, a protein that can be involved in the development of non-small cell lung cancer, and is used in patients who have an abnormal ALK gene. When deciding between Keytruda and Alunbrig, it is crucial to consider the specific type of cancer, the presence of certain genetic mutations, and the overall health profile of the patient, as these factors will determine which medication is the most appropriate.

Difference between Keytruda and Alunbrig

Metric	Keytruda (pembrolizumab)	Alunbrig (brigatinib)
Generic name	Pembrolizumab	Brigatinib
Indications	Various types of cancers including melanoma, lung cancer, head and neck cancer, Hodgkin lymphoma, and others.	Non-small cell lung cancer (NSCLC) with ALK mutations.
Mechanism of action	Programmed death receptor-1 (PD-1) blocking antibody.	Anaplastic lymphoma kinase (ALK) inhibitor.
Brand names	Keytruda	Alunbrig
Administrative route	Injection (IV)	Oral
Side effects	Fatigue, musculoskeletal pain, decreased appetite, pruritus, diarrhea, nausea, rash, fever, cough, dyspnea, constipation, pain, and abdominal pain.	Nausea, diarrhea, fatigue, cough, headache, pneumonia, abdominal pain, rash, hypertension, myalgia, and visual disturbances.
Contraindications	None specifically listed; use with caution in patients with a history of severe immune-mediated adverse reactions.	None specifically listed; however, caution is advised in patients with history of pancreatitis, pulmonary toxicity, and hypertension.
Drug class	Anti-PD-1 monoclonal antibody	Tyrosine kinase inhibitor
Manufacturer	Merck & Co.	Takeda Pharmaceutical Company

Efficacy

Keytruda (Pembrolizumab) Efficacy in Lung Cancer

Keytruda, known generically as pembrolizumab, is a highly effective immunotherapy drug used in the treatment of various forms of lung cancer. It is a type of monoclonal antibody that works by targeting the programmed death receptor-1 (PD-1) pathway, which is exploited by cancer cells to evade the immune system. 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. Clinical trials have demonstrated improved overall survival and progression-free survival in patients treated with Keytruda compared to chemotherapy alone.

For small cell lung cancer (SCLC), Keytruda has also been evaluated and has shown benefits in terms of response rate and durability of response. It is often used in the extensive-stage SCLC after the disease has progressed on other therapies. The efficacy of Keytruda in lung cancer has led to its approval as a first-line treatment option for certain patients with NSCLC and as part of combination therapy for SCLC, marking a significant advancement in the management of these challenging forms of cancer.

Alunbrig (Brigatinib) Efficacy in Lung Cancer

Alunbrig, or brigatinib, is a targeted therapy approved for the treatment of NSCLC in patients with anaplastic lymphoma kinase (ALK) positive tumors. It is a tyrosine kinase inhibitor that specifically targets and inhibits the activity of the ALK fusion protein, which can drive the growth of cancer cells. In clinical trials, Alunbrig has shown high efficacy in patients who have progressed on or are intolerant to crizotinib, which is another ALK inhibitor. The response rates to Alunbrig in these settings have been impressive, with a significant number of patients achieving partial or complete responses.

Moreover, Alunbrig has demonstrated effectiveness in controlling brain metastases, which is a common complication in ALK-positive NSCLC. The ability to cross the blood-brain barrier and impact brain lesions makes Alunbrig a valuable treatment option for patients with central nervous system involvement. The drug has received approval for use in patients with ALK-positive metastatic NSCLC, reflecting its role in addressing a critical need for this patient population. As research continues, the role of Alunbrig in earlier lines of therapy and in combination with other treatments is being explored to further enhance outcomes for patients with ALK-positive 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)

Alunbrig

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

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