Pembrolizumab for persistant & advanced CC

Hello All

I was really happy to see that pembrolizumab (that’s a mouthful!) has been approved just now in the UK (after having been approved here in the US for some months) for immunotherapy treatment for adavanced cervical cancer-- or is it considered targeted…??

Anyway, Just checking out a couple of related studies it looks like Pembrolizumab is particularly effective for certain adenocarcinomas. Anyone know about this? I have finished chemo rads treatment & at my one month follow up, my Dr observed persistent tumor (was 5cm is now roughly 3cm) I know it takes a while for the adenos to die off (waaay longer than 1 month), but just in case I need further treatment—

Anyone know about this? And a BIG yay for all who are now able to partake, best of luck to you!

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Hey! Im interested in hearing more about this. Would you mind sharing the source of that info? Im in Northern Ireland and dont think the Pembro/Keytruda is available just yet but hopefully we’re not far behind!

Hi Shammy

From what I’m reading, you need to get a biomarker profile of your tumor, and based on that information your doctors can tell if you’d likely be responsive to Keytruda. A small number of patients have even had complete response, going from stage 4 to no evidence of disease for years. What they have found is that tumors that express PD-1 protein are good targets for Keytruda

From www.cancer.gov:

Upon administration, pembrolizumab binds to PD-1, an inhibitory signaling receptor expressed on the surface of activated T cells, and blocks the binding to and activation of PD-1 by its ligands , which results in the activation of T-cell-mediated immune responses against tumor cells.

https://www.annalsofoncology.org/article/S0923-7534(20)41009-9/fulltext

Some studies (above) have shown cervical Adenocarcinoma to over-express PD-1 more commonly than SCC, while other studies seem to show SCC more commonly to express PD-1. The interesting thing is that this biomarker seems to change as cancer advances, and even in different places in the tumor, so there is cause to question whether or not a biomarker test will really tell whether or not your cancer will be responsive to Keytruda.

I’m going to look for the Adenocarcinoma pt response examples that I found when looking over studies & I’ll be back—sorry if the above was not helpful or redundant…

One of the positive indications I’ve seen is that many of the other (non cervical) cancers successfully treated with Keytruda are Adenocarcinomas…!

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Thank you so so much for that info! Mine is an adenocarcinoma type so thats all reassuring

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There was a Q and A I just saw with a Gyno Onc online who was recommending all women with cervical cancer who are looking at second line treatments to get that bio-marker test done immediately, that way you have all the info ready to go for targeted/ immune therapy. I’ll be waiting until my PET results in June, but it’s my plan to get it done if bad news. There are more and more types of immunotherapy available these days & if you have a tumor profile your odds of being matched to something that will work go up. This is also the advice my mom got by her docs at the Mayo Clinic (one of the best cancer treatment centers in the US) when she had a rare type of cancer. Unfortunately for us with cervical Adenocarcinoma, the gold standard cervical cancer treatment doesn’t always work as well as with SCC. Immunotherapy does seem to hold the key to defeating these buggers. Best of luck, Shammy!

You got this! I see there is so much love & support here just willing you to get better :heart:

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Thank you - youve been refreshingly positive and encouraging! Sometimes us advanced girls are almost written off.

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Well Boo to that!! Hey, Shammy, have you ever been through divorce or seen someone close go through one? People get scared these type of /negative skewing/ life events are contagious, just nonsensical human behavior. We are all cancer patients here, and no one gets written off.

Ladies…? Can we send some love and support to our sisters who are fighting hard for their lives?

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No I haven’t! But ive witnessed the horrible way people ( who should know better ) literally say about a person who has a mets or advanced diagnosis " oh dear dear , thats them done now, shouldn’t think they’ll last much longer. "
So I know its been said about me. It has made me isolate myself from others to be honest. I dont feel safe around people with that mindset if that makes sense. I crave and love the positive outcome stories and there are so many! I have to keep my head in that space.

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I hope is it ok for me to post here . My sisyter has advanced Cervical cancer- squamous cell, recurrence after 10 years. I have been trying to get information re pembolizumab ; she is not currently on any treatment, she had 5 rounds of chemo last year. Shw was then on a trial for a few monthds but was taken off as it was ineffective. Her consultanct and chemo nurses are aware that she has consented for me and our younger sister to communicate with health care professionals regarding her treatmement. I have enquired whether my sister might be eligible for pembrol/Keytruda- leaving message with macmillan nurse at the hospital. The nurse did call back, but my sister ( the patient), who doesnt really take in information given verbally very well and whose journey to diagnosis was immensely traumatic and her mentalk health in incredibly fragile. I am trying to do the research on her behalf so that her hopes aren’t raised, only to be dashed again. New information sends her into panic so we are treading a delicate line . Sorry to waffle!!
To be brief, does anyone have any answers to the following:
-can Pembrol be precscribed for squamous cell cervical cancer -stage 4
-when is the optimal time to begin pembrol- should it bee as soon as possible OR, since she is managing well physically at the moment, should she put off beginning pebrol ( and its side effects) until she is more symptomatic?
If anyone has any advice re accessing pembrol ( I know the “specialist” has to refer the patient and it is through the Cancer Drug Fund) I would be immensely grateful.
Sending love to positive vibes to all affected by this illness. If I get any useful information on this from another source, I will of course share the details on this forum. XXX

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I should think it’s perfectly fine to post here. The problem is, because it’s such a new drug I don’t think it’ll be easy to get any answers about the best way to go about this. From what I understand, your sister needs to get a tumor marker test to identify the genetic makeup of her tumor. That will probably have to be done privately—you can always call around on her behalf to oncologists to see who is interested in this treatment/currently working with it & they would be able to guide your sister to get the tests. This is pure speculation on my part but if I were in your situation that’s what I would do. Just call gyno oncologists in your area & explain what you are looking for. At the very least you will get more information than anyone on here will be able to provide. Thank you for being such a wonderful sister, we should all be so lucky to have someone like you supporting us :heart:

Hi Marie

It’s fine to post here and hopefully one of the ladies in the advanced section of the forum (which only patients can access) will be able to help you with the correct information for the UK. I presumed as you mentioned Macmillan you are in the UK?

Although I’m a member in the advanced section of the forum I don’t have the experience you’re looking for as I was lucky enough to have surgery, but there are discussions about Pembro/keytruda there.

I’ll tag @Shewolf meantime to see if she can help.x

Hi Sammy, I have advanced CC adenocarcinomas and had my first round of chemo, Paclitaxel and Carboplatin together with pembrolizumab in May 2023.
Then 3 weeks later, I had the the 2nd round off chemo.Same 3 chemo drugs.
My liver got pretty upset and agitated after that.
Had to be admitted into emergency to calm and settle the liver.
For my 3round of chemo, my oncologist advised to take Pembro drug and my liver behaved.
I am talking from my own experience.
My oncologist said I can go back to Pembro if need be for future rounds.
I am in Australia and the Pembro is not government funded. I had to pay $3K each shot.

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I’d be interested in the studies specifically on adeno - looked after reading this and found lots of stuff but not specifically on immunotherapy and this type. Many thanks!