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Immune
Keytruda
Pembrolizumab (Keytruda)
• It blocks a protective mechanism on cancer
cells, and allows the immune system to
destroy those cancer cells. It targets the
programmed cell death 1 (PD-1) receptor.
PD- 1
• PD-1 and CD279 279, is a cell surface receptor
that plays an important role in down-regulating
the immune system and promoting self
tolerance by suppressing T cell inflammatory
activity. PD-1 is an immune checkpoint and
guards against autoimmunity through a dual
mechanism of promoting apoptosis
(programmed cell death) in antigen specific Tcells in lymph nodes while simultaneously
reducing apoptosis in regulatory T cells (antiinflammatory, suppressive T cells.
• As of 2017, pembrolizumab is used via
intravenous infusion to treat inoperable or
metastatic melanoma, metastatic non-small
cell lung cancer (NSCLC) in certain situations,
as a second-line treatment for head and neck
squamous cell carcinoma (HNSCC), after
platinum-based chemotherapy, and for the
treatment of adult and pediatric patients with
refractory classic Hodgkin's lymphoma.
• For NSCLC (non-small cell lung cancer),
pembrolizumab is a first line treatment if the
cancer overexpresses PD-L1, a PD-1 receptor
ligand, and the cancer has no mutations in
EGFR or in ALK.
Programmed death-ligand 1 (PD-L1) is a
transmembrane protein that has been
speculated to play a major role in
suppressing the immune system during
particular events such as pregnancy,
tissue allografts, autoimmune disease
and other disease states such as
hepatitis.
Normally the immune system reacts to
foreign antigens that are associated with
exogenous or endogenous Danger signals,
which triggers a proliferation of antigenspecific CD8+ T cells and/or CD4+ helper
cells. The binding of PD-L1 to PD-1 or B7.1
transmits an inhibitory signal that reduces
the proliferation of these T cells and can also
induce apoptosis, which is further mediated
by a lower regulation of the gene Bcl-2