Pembrolizumab (Keytruda)

Key Messages

• CADTH recommends that Keytruda be reimbursed by public drug plans, in combination with chemotherapy, for the treatment of adult patients with locally recurrent unresectable or metastatic triple-negative breast cancer (TNBC) who have not received prior chemotherapy for metastatic disease and whose tumours express programmed death-ligand 1 (PD‐L1) (combined positive score [CPS] ≥ 10) as determined by a validated test if certain conditions are met.
• Keytruda should only be covered for adult patients with centrally confirmed TNBC who have PD-L1–positive tumours (CPS ≥ 10), have not received treatment for locally recurrent or metastatic TNBC, and are in relatively good health (i.e., have a good performance status, as determined by a specialist). Patients with unstable central nervous system (CNS) metastases or those who have clinical contraindications to immunotherapy are not eligible for reimbursement.
• Keytruda should only be reimbursed if prescribed in combination with chemotherapy and given by a clinician who is experienced in treating breast cancer and the cost of Keytruda is reduced.