Keytruda (pembrolizumab) vs Krazati (adagrasib)

Keytruda (pembrolizumab) is an immune checkpoint inhibitor that works by blocking the PD-1 pathway, thereby enhancing the body's immune response against cancer cells and is widely used for various types of cancer, including melanoma, lung cancer, and head and neck cancer. Krazati (adagrasib), on the other hand, is a KRAS G12C inhibitor specifically designed to target and inhibit a mutated form of the KRAS G12C protein found in certain cancers, such as non-small cell lung cancer (NSCLC). The choice between Keytruda and Krazati would depend on the specific type of cancer, its genetic profile, and the overall health and treatment goals of the patient, as Keytruda has a broader range of indications, while Krazati is targeted towards tumors with the KRAS G12C mutation.

Difference between Keytruda and Krazati

Metric	Keytruda (pembrolizumab)	Krazati (adagrasib)
Generic name	pembrolizumab	adagrasib
Indications	Various types of cancers including melanoma, non-small cell lung cancer, head and neck squamous cell cancer, classical Hodgkin lymphoma, primary mediastinal large B-cell lymphoma, urothelial carcinoma, microsatellite instability-high cancer, gastric cancer, esophageal cancer, cervical cancer, hepatocellular carcinoma, Merkel cell carcinoma, renal cell carcinoma, endometrial carcinoma, and tumor mutational burden-high cancer	For the treatment of adult patients with KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC), as determined by an FDA-approved test, who have received at least one prior systemic therapy
Mechanism of action	Programmed death receptor-1 (PD-1) blocking antibody	Small molecule that specifically and irreversibly inhibits KRAS G12C mutant protein
Brand names	Keytruda	Krazati
Administrative route	Intravenous infusion	Oral
Side effects	Fatigue, musculoskeletal pain, decreased appetite, pruritus, diarrhea, nausea, rash, pyrexia, cough, dyspnea, constipation, pain in extremity, and headache	Nausea, diarrhea, increased alanine aminotransferase, increased aspartate aminotransferase, vomiting, fatigue, decreased appetite, and musculoskeletal pain
Contraindications	None known	None known
Drug class	Anti-PD-1 monoclonal antibody	KRAS G12C inhibitor
Manufacturer	Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.	Mirati Therapeutics, Inc.

Efficacy

Keytruda (Pembrolizumab) Efficacy in Lung Cancer

Keytruda, also known by its generic name pembrolizumab, is a highly effective immunotherapy drug used in the treatment of lung cancer. Specifically, it has shown significant efficacy in the treatment of non-small cell lung cancer (NSCLC), which is the most common type of lung cancer. Pembrolizumab is a programmed death receptor-1 (PD-1) inhibitor that works by enhancing the body's immune response against cancer cells. Clinical trials have demonstrated that Keytruda, particularly when used as a first-line treatment in patients with PD-L1-positive tumors, can significantly improve overall survival and progression-free survival compared to traditional chemotherapy regimens.

For patients with advanced NSCLC with no EGFR or ALK genomic tumor aberrations, pembrolizumab has been approved for use as a single agent in those whose tumors express PD-L1 with a proportion score (TPS) of 1% or more. In these settings, Keytruda has been shown to reduce the risk of death and slow the progression of the disease. When combined with chemotherapy, even without the expression of PD-L1, Keytruda has also demonstrated improved efficacy outcomes, offering a valuable treatment option for a broader patient population.

Krazati (Adagrasib) Efficacy in Lung Cancer

Krazati, with the generic name adagrasib, is a newer medication that targets a specific mutation in lung cancer known as KRAS G12C. Although not yet widely available as of the knowledge cutoff in early 2023, adagrasib has shown promise in early clinical trials for the treatment of NSCLC with the KRAS G12C mutation. This mutation has historically been difficult to target with existing therapies, making the development of adagrasib a significant step forward in the treatment of this subset of lung cancer patients.

In clinical studies, Krazati has demonstrated a notable response rate in patients with the KRAS G12C mutation, leading to tumor shrinkage and, in some cases, prolonged disease control. As a targeted therapy, adagrasib is designed to specifically inhibit the mutated KRAS protein, thereby disrupting cancer cell growth and survival. The efficacy of Krazati in clinical trials suggests that it could become an important treatment option for patients with KRAS G12C-mutant NSCLC, offering hope to those who have had limited treatment options in the past.

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)

Krazati

Food and Drug Administration (FDA), USA

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