Keytruda (pembrolizumab) vs Xpovio (selinexor)

Keytruda (pembrolizumab) vs Xpovio (selinexor)

Keytruda (pembrolizumab) is an immune checkpoint inhibitor, specifically targeting the PD-1 pathway, and is widely used in various types of cancer, including melanoma, non-small cell lung cancer, and head and neck cancers, to enhance the body's immune response against cancer cells. Xpovio (selinexor) works differently as a selective inhibitor of nuclear export, blocking the export of tumor suppressor proteins from the nucleus of cancer cells, leading to their accumulation and tumor cell death; it is approved for use in multiple myeloma and certain types of diffuse large B-cell lymphoma. The choice between Keytruda and Xpovio would depend on the specific type of cancer, its molecular characteristics, the patient's overall health status, and previous treatments, as each drug has a distinct mechanism of action and spectrum of approved indications.

Difference between Keytruda and Xpovio

Metric Keytruda (pembrolizumab) Xpovio (selinexor)
Generic name Pembrolizumab Selinexor
Indications Various types of cancers including melanoma, lung cancer, head and neck cancer, Hodgkin lymphoma, and others Multiple myeloma, diffuse large B-cell lymphoma
Mechanism of action Programmed death receptor-1 (PD-1) blocking antibody Selective inhibitor of nuclear export (SINE) compounds that inhibits exportin 1 (XPO1)
Brand names Keytruda Xpovio
Administrative route Injection (intravenous) Oral
Side effects Fatigue, musculoskeletal pain, decreased appetite, itching, diarrhea, nausea, rash, fever, cough, shortness of breath, constipation Nausea, vomiting, fatigue, decreased appetite, weight loss, diarrhea, fever, anemia, thrombocytopenia
Contraindications Individuals with hypersensitivity to pembrolizumab or any of its excipients Individuals with hypersensitivity to selinexor or any of its excipients
Drug class Anti-PD-1 monoclonal antibody Antineoplastic agent
Manufacturer Merck & Co. Karyopharm Therapeutics

Efficacy

Keytruda (Pembrolizumab) Efficacy in Treating Lymphoma

Keytruda, known generically as pembrolizumab, is a type of immunotherapy that has shown efficacy in treating certain types of lymphoma. It is a programmed death receptor-1 (PD-1) blocking antibody that helps the immune system detect and fight cancer cells. The U.S. Food and Drug Administration (FDA) has approved Keytruda for the treatment of adult and pediatric patients with refractory classical Hodgkin lymphoma (cHL) or those who have relapsed after three or more prior lines of therapy. Clinical trials have demonstrated that pembrolizumab can induce a significant response in a subset of these patients, leading to partial or complete remission of the disease.

While the efficacy of Keytruda can vary based on the individual and specific lymphoma subtype, studies have shown that the overall response rate (ORR) for patients with relapsed or refractory cHL is approximately 69%, with a complete remission rate of 22%. The median duration of response has been reported to be around 16.5 months, indicating a potential for long-term benefit in some patients. However, it is important to note that not all patients with lymphoma will respond to pembrolizumab, and further research is ongoing to better understand its efficacy and to identify which patients are most likely to benefit from this treatment.

Xpovio (Selinexor) Efficacy in Treating Lymphoma

Xpovio, with the active ingredient selinexor, is a first-in-class, oral selective inhibitor of nuclear export (SINE) compound. It works by inhibiting the nuclear export protein XPO1, leading to the accumulation of tumor suppressor proteins in the cell nucleus and the induction of cancer cell death. Xpovio has been granted accelerated approval by the FDA for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, including DLBCL arising from follicular lymphoma, after at least two lines of systemic therapy.

The approval of Xpovio for DLBCL was based on a multicenter, single-arm clinical trial, which demonstrated an ORR of 29% with a median duration of response of 9.2 months for the entire response population. This indicates that selinexor can provide a meaningful clinical benefit in a population of patients with limited treatment options. However, as with any cancer therapy, responses to Xpovio can vary, and it is essential to consider individual patient factors when evaluating its potential efficacy. Ongoing clinical trials continue to assess the long-term benefits and optimal use of selinexor in various lymphoma subtypes.

Regulatory Agency Approvals

Keytruda
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
  • Health Canada
  • Therapeutic Goods Administration (TGA), Australia
  • Medsafe (NZ)
Xpovio
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA

Access Keytruda or Xpovio today

If Keytruda or Xpovio are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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