WHAT IS THIS MEDICINE AND WHAT IS IT USED FOR?
Panacer contains pembrolizumab, one of the most widely used immunotherapy
medicines in oncology. Like nivolumab, it is a PD-1 immune checkpoint inhibitor
— it blocks a protein called PD-1 on the surface of immune T-cells, which
cancer cells exploit to hide from the immune system.
By blocking PD-1, pembrolizumab removes the shield that cancer cells use
to avoid detection, allowing the immune system to recognise and destroy them.
Pembrolizumab is approved for a very wide range of cancers — including
non-small cell lung cancer (NSCLC), melanoma (skin cancer), head and neck
squamous cell carcinoma, classical Hodgkin lymphoma, bladder cancer (urothelial
carcinoma), cervical cancer, endometrial carcinoma, colorectal cancer with
specific genetic features (MSI-H/dMMR), triple-negative breast cancer,
oesophageal cancer, gastric cancer, liver cancer, biliary tract cancer, and
others.
The specific use in your case will be confirmed by your oncologist, based
on your cancer type, stage, and the results of any biomarker tests (such as
PD-L1 expression or microsatellite instability testing).
3. HOW TO TAKE THIS MEDICINE
Pembrolizumab is given as a slow drip into a vein (intravenous infusion)
by a nurse in a hospital or cancer centre. It is not a tablet or
self-injection.
Common dose schedules are: 200mg every 3 weeks, or 400mg every 6 weeks.
Each infusion takes approximately 30 minutes. Your oncologist will specify your
schedule based on your cancer type and any combination treatment plan.
Before each infusion, your care team will check your wellbeing, review
any symptoms since your last dose, and may perform blood tests. Every new
symptom — even one that seems unrelated to your cancer — should be reported to
your oncology team before or at each visit. Immune-related side effects can
develop between infusions and affect any organ in the body.
⚠ PATIENT TIP: Pembrolizumab stays active in the
body for some time after the last dose. Immune-related side effects can appear
weeks or even months after your last infusion — so stay alert to new symptoms
even after your treatment has ended, and tell any new doctor or emergency
department staff that you have recently received immunotherapy.
4. POSSIBLE SIDE EFFECTS
|
How Common? |
Side Effects |
|
Common |
Fatigue, rash or
itching, diarrhoea, nausea, decreased appetite, joint or muscle aches, cough,
shortness of breath, fever, anaemia |
|
Immune-Related Side
Effects (can affect any organ) |
Pneumonitis (lung
inflammation — breathlessness, new dry cough), colitis (bowel inflammation —
severe diarrhoea or tummy pain), hepatitis (liver inflammation — jaundice,
dark urine), thyroiditis or other endocrine gland problems (fatigue, weight
changes, heat or cold intolerance), nephritis (kidney inflammation — reduced
urine, swelling), skin reactions (rash, blistering), myocarditis (heart
muscle inflammation — chest pain, breathlessness, abnormal heart rhythm) |
|
Serious — Seek Urgent
Medical Help |
Any rapidly worsening
new symptom affecting breathing, bowel, liver, kidneys, heart, skin, or
neurological function. Immune-related reactions can escalate from mild to
severe quickly — early treatment with steroids significantly improves
outcomes. Go to A&E if symptoms are severe or your oncology team cannot
be reached promptly. |
5. WHO SHOULD NOT TAKE THIS MEDICINE
Pembrolizumab requires careful consideration in patients with active or
severe autoimmune conditions (e.g. lupus, rheumatoid arthritis, Crohn's
disease, multiple sclerosis) — it can trigger severe autoimmune flares.
Caution is needed in patients who have had organ transplants, as it can
trigger rejection. Pregnancy — pembrolizumab can harm an unborn baby. Use
effective contraception during treatment and for at least 4 months after the
last dose.
⚠ IMMUNE-RELATED ADVERSE EVENTS (irAEs): As with
all PD-1 inhibitors, pembrolizumab can cause the immune system to over-react
and attack healthy organs. This is the most important safety concern. Reactions
can affect any organ — lungs, bowel, liver, kidneys, heart, skin, hormonal
glands, nervous system — and can occur at any time, including after treatment
ends.
⚠ REPORT SYMPTOMS PROMPTLY: Your oncology team
will provide a 24/7 contact number. Use it without hesitation if you develop
any new or worsening symptom between appointments. Early recognition and
steroid treatment prevent serious organ damage.
⚠ AFTER TREATMENT ENDS: Immune-related reactions
can develop weeks to months after your last dose. If you are seen by any other
doctor during or after treatment, always tell them you have received
pembrolizumab — this is critical information for safe management of any future
health issues.
6. MEDICINES THAT INTERACT WITH THIS TREATMENT
Systemic corticosteroids used to treat immune-related side effects are
compatible and commonly co-administered. High-dose routine corticosteroid
prophylaxis before infusions may reduce pembrolizumab's effectiveness. Other
immunosuppressants may blunt pembrolizumab's anti-tumour effect. Always inform
all healthcare providers that you are receiving immunotherapy.
7. HOW TO STORE THIS MEDICINE
Store in a refrigerator at 2–8°C. Do not freeze or shake. Protect from
light. Prepared infusion solutions should be used within the stability window
specified by the hospital pharmacy. Single-use vial — discard unused portion.
8. PRESCRIPTION REQUIREMENT
|
Field |
Details |
|
Status |
Prescription Only
Medicine (POM) — Specialist (oncology) prescription required; indication may
require biomarker testing (PD-L1 expression, MSI status) prior to initiation |
9. GUIDANCE FOR PATIENTS & CAREGIVERS
Pembrolizumab is given as a 30-minute drip every 3 or 6 weeks in a cancer
clinic. Between appointments, pay close attention to how you feel and report
any new symptom — a rash, diarrhoea, new cough, joint pain, unusual fatigue, or
anything else that does not feel right — to your oncology team promptly.
Save your oncology team's phone number in your phone and do not hesitate
to call. Tell every other doctor or A&E team that you are on immunotherapy
— it changes how they should manage any health problem you develop.
Use effective contraception during treatment and for 4 months after your
last dose. Even after treatment ends, stay alert to new symptoms — immune
reactions can appear long after the last infusion.
10. PHARMACIST & PRESCRIBER NOTES
|
Field |
Details |
|
Clinical Dispensing
Notes |
PD-1 checkpoint
inhibitor — comprehensive irAE education is central to patient safety.
Provide written irAE recognition and reporting information and confirm
patient has 24/7 oncology contact details. Emphasise persistence of
immunological activity after last dose — irAEs can occur weeks to months
post-treatment. Monitor thyroid function (TSH, free T4), LFTs, renal function
(creatinine), full blood count, and blood glucose before each cycle.
Biomarker testing (PD-L1, MSI/MMR status) should be confirmed before first
dispensing. Cold chain: 2–8°C — do not freeze or shake. Embryo-fetal
toxicity: contraception required during treatment and 4 months after last
dose. Caution in active autoimmune disease — MDT assessment required. Steroid
treatment for irAEs: prednisolone/methylprednisolone per local protocol. |
11. FREQUENTLY ASKED QUESTIONS
Q: How will I know if I am having an immune-related reaction?
Immune-related reactions can be very varied — any new symptom can be
significant. Watch for: new breathlessness or cough (lungs), severe diarrhoea
or tummy cramps (bowel), yellow skin or eyes (liver), unusual fatigue or
hormonal changes (glands), reduced urine output (kidneys), new rash or
blistering (skin), chest pain or palpitations (heart). Report these to your
oncology team promptly — do not wait.
Q: What happens if I develop an immune-related reaction?
Most immune-related reactions respond well to steroid treatment (usually
prednisolone). Pembrolizumab may be paused while the reaction is treated and
can usually be restarted once it resolves, unless the reaction was very severe.
The aim is always to manage the reaction and allow treatment to continue
wherever safe.
Q: Do I need contraception?
Yes — pembrolizumab can harm an unborn baby. Use effective contraception
during treatment and for at least 4 months after your last dose.
Q: What should I do if I visit A&E or see a different doctor?
Tell them immediately that you are receiving pembrolizumab immunotherapy.
This information changes how they should investigate and treat any symptoms you
have — particularly if those symptoms might be immune-related. Carry a written
record of your treatment with you.