Are there circumstances where you would recommend every 6 week dosing schedule for pembrolizumab monotherapy?

I am considering every 6 week pembrolizumab dosing in patients >70 years old in whom I want to reduce clinic visits for, especially in the context of the COVID-19 pandemic. This schedule was approved in Europe based on modeling/simulation (https://ascopubs.org/doi/abs/10.1200/JCO.2018.36.15_suppl.3062), but the FDA rejected the every 6 week dosing in February 2020.

3 Answers

Mednet MemberInvited Expert

Medical Oncology · Cleveland Clinic

Answered on

FDA approval for q 6 week dosing of pembrolizumab is awaited but has yet to occur; this would represent a welcome change for our patients, as just happened with the recent approval of q 4 week dosing of atezolizumab.

Without FDA approval we are not using pembrolizumab 6 week dosing at this time, and...

Join for free or sign in to see the full answer

Mednet MemberInvited Expert

Medical Oncology · Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

Answered on

Based on exposure-response evaluation using modeling and simulation data (ASCO 2018), I feel comfortable spacing out treatment to every 6 weeks in the current COVID crisis, particularly in elderly patients who have been on the agent for a while with excellent response and minimal disease burden.

How...

Join for free or sign in to see the full answer

Mednet MemberInvited Expert

Medical Oncology · University of Maryland

Answered on · Updated on

I still favor 3-weekly pembrolizumab in the following situations:

1. During the induction of chemo-immunotherapy.

2. In maintenance phase with pemetrexed-pembrolizumab combination for adenocarcinoma.

3. When there is a concern of toxicity and I need to follow closely.

6-weekly 400 mg pembrolizumab...

Join for free or sign in to see the full answer