Keytruda (pembrolizumab) vs Retsevmo (selpercatinib)

Keytruda (pembrolizumab) is an immune checkpoint inhibitor, specifically targeting the PD-1 pathway, and is commonly used in the treatment of various types of cancer, including melanoma, lung cancer, and head and neck cancer, by enhancing the body's immune response against cancer cells. Retsevmo (selpercatinib), on the other hand, is a selective RET kinase inhibitor used for cancers that are RET-driven, such as certain thyroid cancers and non-small cell lung cancer with RET gene alterations. The choice between Keytruda and Retsevmo would depend on the specific genetic makeup of the cancer, as Retsevmo is chosen for RET-positive cancers, while Keytruda is a broader option for cancers with PD-L1 expression or a high mutational burden, among other FDA-approved indications.

Difference between Keytruda and Retsevmo

Metric	Keytruda (pembrolizumab)	Retsevmo (selpercatinib)
Generic name	Pembrolizumab	Selpercatinib
Indications	Various types of cancers including melanoma, lung cancer, head and neck cancer, Hodgkin lymphoma, and others	RET-altered thyroid cancers and non-small cell lung cancer
Mechanism of action	Programmed death receptor-1 (PD-1) blocking antibody	Receptor tyrosine kinase inhibitor targeting RET fusions and mutations
Brand names	Keytruda	Retsevmo
Administrative route	Injection (IV)	Oral
Side effects	Fatigue, musculoskeletal pain, decreased appetite, pruritus, diarrhea, nausea, rash, fever, cough, dyspnea, constipation, pain in extremity, and headache	Increased ALT/AST, increased blood glucose, decreased leukocytes, decreased albumin, decreased calcium, dry mouth, diarrhea, increased creatinine, hypertension, fatigue, edema, rash, and pyrexia
Contraindications	Patients with severe hypersensitivity to pembrolizumab or any of its excipients	Patients with severe hypersensitivity to selpercatinib or any of its excipients
Drug class	Anti-PD-1 monoclonal antibody	Kinase inhibitor
Manufacturer	Merck & Co.	Eli Lilly and Company

Efficacy

Keytruda (Pembrolizumab) in Lung Cancer Treatment

Keytruda, also known by its generic name pembrolizumab, is a highly effective immunotherapy drug used in the treatment of certain types of lung cancer. It is a monoclonal antibody that works by targeting the programmed death receptor-1 (PD-1) pathway, which is a mechanism that tumors use to evade the immune system. By blocking this pathway, Keytruda enables the immune system to better recognize and destroy cancer cells.

In non-small cell lung cancer (NSCLC), Keytruda has shown significant efficacy, particularly in patients whose tumors express PD-L1, a protein that indicates the tumor's use of the PD-1 pathway. Studies have demonstrated that Keytruda improves overall survival and progression-free survival compared to chemotherapy alone in these patients. It is approved for use as a first-line treatment in metastatic NSCLC with high PD-L1 expression and as a combination therapy with chemotherapy irrespective of PD-L1 status.

Retsevmo (Selpercatinib) in Lung Cancer Treatment

Retsevmo, with the generic name selpercatinib, is a newer targeted therapy approved for the treatment of lung cancer. It is specifically designed for patients with non-small cell lung cancer (NSCLC) that harbors RET (rearranged during transfection) gene alterations. These alterations are present in a small percentage of NSCLC patients and drive tumor growth. Selpercatinib is a RET inhibitor that blocks the activity of the RET protein, thereby inhibiting the growth of cancer cells.

Clinical trials have shown that Retsevmo is highly effective in patients with RET fusion-positive NSCLC, leading to substantial response rates and durable responses. The drug has been granted accelerated approval based on these results, providing a new treatment option for patients with this specific genetic profile. Ongoing studies continue to evaluate the long-term benefits and potential for Retsevmo to become a standard treatment for RET-altered lung cancers.

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)

Retsevmo

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

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