General Comments / Chat, page-13328

Gemini AI
Pembrolizumab (Keytruda®) is a highly effective immunotherapy for NSCLC, but like all powerful medications, it comes with potential problems and side effects. These can range from common and mild to rare and severe, and they arise because the drug works by modulating the immune system, which can sometimes lead to the immune system attacking healthy tissues.

Challenges in Pembrolizumab Treatment:

Beyond side effects, there are other challenges:

• Response Variability: Not all patients respond to Pembrolizumab, and predicting who will benefit remains an area of active research. PD-L1 expression is a biomarker, but it's not perfect.

  
  

• Acquired Resistance: As mentioned in the initial statement, many patients who initially respond to ICIs eventually develop resistance, leading to disease progression.

  
  

• Pseudoprogression: In some cases, scans may initially show the tumor growing, or new lesions appearing, due to an influx of immune cells. This is called pseudoprogression and does not necessarily mean the treatment is failing. It can be challenging to differentiate from true progression.

• Cost: Pembrolizumab, like other ICIs, is an expensive medication, which can be a barrier to access for some healthcare systems and patients.

  
  

• Management of irAEs: While treatable, managing irAEs requires careful monitoring, patient education, and timely intervention, often with corticosteroids, which can have their own side effects and potentially impact the efficacy of immunotherapy if used long-term or at high doses.

  
  

• Long-term Effects: As these therapies are relatively new, the full spectrum of long-term side effects and their management is still being studied.

Patients receiving Pembrolizumab require close monitoring by their healthcare team to detect and manage these potential problems and side effects effectively.