Keytruda (pembrolizumab) vs Lorviqua (lorlatinib)

Keytruda (pembrolizumab) vs Lorviqua (lorlatinib)

Keytruda (pembrolizumab) is an immune checkpoint inhibitor that works by enhancing the body's immune response against cancer cells, and it is commonly used for various types of cancers, including melanoma, non-small cell lung cancer, and head and neck cancers. Lorviqua (lorlatinib), on the other hand, is a targeted therapy specifically designed to inhibit ALK and ROS1 tyrosine kinases, and it is used for the treatment of ALK-positive non-small cell lung cancer, particularly in patients who have developed resistance to earlier ALK inhibitors. The choice between Keytruda and Lorviqua would largely depend on the specific genetic characteristics of the cancer, such as the presence of ALK mutations for Lorviqua, and the overall health and treatment history of the patient.

Difference between Keytruda and Lorviqua

Metric Keytruda (pembrolizumab) Lorviqua (lorlatinib)
Generic name Pembrolizumab Lorlatinib
Indications Various types of cancers including melanoma, lung cancer, head and neck cancer, Hodgkin lymphoma, and others ALK-positive metastatic non-small cell lung cancer (NSCLC)
Mechanism of action Programmed death receptor-1 (PD-1) blocking antibody ALK and ROS1 tyrosine kinase inhibitor
Brand names Keytruda Lorviqua
Administrative route Intravenous infusion Oral
Side effects Fatigue, musculoskeletal pain, decreased appetite, pruritus, diarrhea, nausea, rash, fever, cough, dyspnea, constipation, pain in extremity, and headache Edema, peripheral neuropathy, cognitive effects, dyspnea, fatigue, weight gain, arthralgia, mood effects, and diarrhea
Contraindications None known specific to pembrolizumab itself; however, should be used with caution in patients with a history of severe hypersensitivity to pembrolizumab or any of its excipients None known specific to lorlatinib itself; however, should be used with caution in patients with severe hypersensitivity to lorlatinib or any of its excipients
Drug class Anti-PD-1 monoclonal antibody Anaplastic lymphoma kinase (ALK) inhibitor
Manufacturer Merck & Co. Pfizer Inc.

Efficacy

Efficacy of Keytruda (Pembrolizumab) in Lung Cancer

Keytruda, known generically as pembrolizumab, is a highly effective immunotherapy drug used in the treatment of certain types of lung cancer, specifically non-small cell lung cancer (NSCLC). It functions as a programmed death receptor-1 (PD-1) blocking antibody, which helps the immune system to detect and fight cancer cells. The efficacy of Keytruda has been demonstrated in multiple clinical trials, where it has shown to improve survival rates significantly when compared to traditional chemotherapy, especially in patients whose tumors express PD-L1 with a proportion score of 1% or more. Keytruda has been approved for use as a first-line treatment in metastatic NSCLC and as a combination therapy with other drugs.

Efficacy of Keytruda in Different Settings of Lung Cancer

In the first-line setting for advanced NSCLC with high PD-L1 expression, Keytruda has been shown to extend overall survival and progression-free survival when compared to chemotherapy. Additionally, in cases where it is used as a monotherapy or in combination with chemotherapy, Keytruda can lead to a higher response rate, meaning that a greater proportion of patients experience a reduction in tumor size. Its efficacy is also noted in improving the quality of life for patients with advanced lung cancer, as it is generally associated with fewer side effects than traditional chemotherapy.

Efficacy of Lorviqua (Lorlatinib) in Lung Cancer

Lorviqua, also known as lorlatinib, is a newer targeted therapy approved for the treatment of a specific type of lung cancer known as ALK-positive metastatic NSCLC. It is a third-generation anaplastic lymphoma kinase (ALK) inhibitor designed to overcome resistance to earlier ALK inhibitors. Lorlatinib has shown high efficacy in patients who have progressed on prior ALK inhibitors, with substantial intracranial activity, which is particularly important as brain metastases are common in ALK-positive NSCLC patients. Lorlatinib's approval was based on the overall response rate and duration of response observed in clinical trials, indicating a significant proportion of patients achieved tumor shrinkage that was sustained over time.

Role of Lorlatinib in Treatment-Resistant Lung Cancer

Lorlatinib plays a crucial role in the treatment landscape of ALK-positive NSCLC, especially for patients who have developed resistance to first- and second-generation ALK inhibitors. Its ability to penetrate the blood-brain barrier makes it a valuable option for treating and controlling central nervous system metastases, a common site of progression in ALK-positive NSCLC. The efficacy of lorlatinib in patients with brain metastases has been a particular highlight, offering hope for improved outcomes in this difficult-to-treat population.

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)
Lorviqua
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
  • Health Canada
  • Therapeutic Goods Administration (TGA), Australia

Access Keytruda or Lorviqua today

If Keytruda or Lorviqua are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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