Pembrolizumab (Keytruda)

Key Messages

• CADTH recommends that Keytruda monotherapy be reimbursed by public drug plans for the treatment of adults with metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) endometrial cancer that cannot be treated with surgery or has spread to other body parts, and whose tumours have progressed following prior therapy and who have no alternative treatment options, if certain conditions are met.
• Keytruda should only be covered to treat adults with unresectable or metastatic MSI-H or dMMR endometrial cancer who are in relatively good health (i.e., have good performance status [PS] as determined by a specialist). Keytruda also should only be covered for patients who have not been treated previously with a programmed cell death 1 protein (PD-1) or programmed cell death 1 ligand 1 (PD-L1) inhibitor, and do not have active central nervous system (CNS) metastases or active autoimmune disease.
• Keytruda should only be reimbursed if it is prescribed in an outpatient oncology clinic where treatment is supervised and delivered in institutions with expertise in systemic therapy delivery, and if the cost is reduced. Keytruda should not be reimbursed in combination with other systemic therapies for dMMR or MSI-H endometrial cancer.