AlternativeKeytruda

Pembrolizumab (in cervical/endometrial cancer)

Anti-PD-1 immune checkpoint inhibitor

Adds to chemo/chemoradiation in PD-L1+ / dMMR gynae cancers.

IV

First-line for

Advanced/recurrent cervical cancer (PD-L1 CPS ≥ 1) with chemo ± bevacizumab
Advanced dMMR/MSI-H endometrial cancer (± lenvatinib)

Mechanism

Blocks PD-1 → restores cytotoxic T-cell activity against tumour.

"itis" toxicities

Thyroiditis / hypothyroidism
Colitis, pneumonitis, hepatitis
Hypophysitis, adrenalitis

Dosing

Standard: 200 mg IV q3-weekly or 400 mg q6-weekly

Contraindications

AbsolutePregnancy
CautionActive autoimmune disease, prior solid organ transplant

Side effects

Immune-related pneumonitis, colitis, hepatitis
Endocrinopathies
Skin reactions

Fetal & maternal notes

• Teratogenic in animals; contraception during and 4 months after

Key interactions

Systemic corticosteroids
Caution
May reduce efficacy — use only for immune-related AEs

Clinical pearls

💡 Test PD-L1 CPS in cervix cancer; MMR/MSI in endometrial cancer
💡 Suspect immune-related AE for any new inflammatory symptom

Content last reviewed: REPLACE_ME (e.g. 2026-07)

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