Name of the Procedure:

• Common Name: Keytruda Injection
• Technical Term: Injection, pembrolizumab, 1 mg (HCPCS Code J9271)

Summary

Pembrolizumab is a type of cancer treatment known as immunotherapy. It involves injecting a medication called pembrolizumab, marketed under the brand name Keytruda, to help the body's immune system fight cancer cells.

Purpose

Pembrolizumab is primarily used to treat various types of cancer, including melanoma, non-small cell lung cancer, and head and neck squamous cell carcinoma. The goal of the injection is to boost the immune system's ability to detect and destroy cancer cells, potentially leading to reduced tumor size and slowed disease progression.

Indications

Pembrolizumab is indicated for patients with:

• Advanced melanoma
• Non-small cell lung cancer
• Head and neck squamous cell carcinoma
• Classical Hodgkin lymphoma
• Urothelial carcinoma
• Other specific types of cancers as determined by a healthcare provider

Preparation

• Patient Instructions: Generally, there are no special preparation steps like fasting, but patients should follow their healthcare provider's specific instructions.
• Pre-procedure Tests: Blood tests, imaging studies, and a thorough medical evaluation may be required to assess the suitability of the treatment.

Procedure Description

1. Step 1: The healthcare provider will confirm patient identity and review medical history.
2. Step 2: The injection site (usually an arm or thigh) will be cleaned with antiseptic.
3. Step 3: Pembrolizumab is injected subcutaneously or intravenously over a period of several minutes.
4. Tools and Equipment: Sterile syringe, antiseptic solution, and the pembrolizumab vial.
5. Anesthesia: Not typically required, but local topical anesthetic may be used to reduce injection site discomfort.

Duration

The injection process typically takes around 5-10 minutes.

Setting

Pembrolizumab injections are usually administered in outpatient clinics or hospital settings.

Personnel

• Doctor or Oncologist: Prescribes and oversees the procedure.
• Nurse: Administers the injection and monitors the patient during and after the injection for any adverse reactions.

Risks and Complications

• Common Risks: Injection site reactions (redness, pain), fatigue, fever, nausea.
• Rare Risks: Severe immune-mediated side effects affecting organs like the lungs, liver, or endocrine glands. Immediate medical attention is required for severe reactions.

Benefits

• Expected Benefits: Improved survival rates in patients with certain cancers, reduced tumor size, and potential stabilization of cancer progression.
• Timeline: Benefits may be realized within a few weeks to several months of continuous treatment.

Recovery

• Post-Procedure Care: Patients should stay for observation briefly after the injection to monitor for any immediate adverse reactions.
• Recovery Time: Typically, there is no extended recovery time, but patients might experience mild side effects.
• Follow-up: Regular follow-up appointments are necessary to monitor the patient’s response to treatment and manage any side effects.

Alternatives

• Other Treatments: Surgery, chemotherapy, radiation therapy, other immunotherapy drugs.
• Pros and Cons:
  • Surgery and Radiation: Often used for localized tumors, immediate results but invasive with longer recovery.
  • Chemotherapy: Systemic treatment that affects a broad range of rapidly dividing cells, with potentially more severe side effects.
  • Alternative Immunotherapies: May offer different efficacy and side effect profiles.

Patient Experience

• During the Procedure: Patients might feel a slight sting or pressure during the injection.
• After the Procedure: Some might experience mild fatigue, fever, or injection site reactions. Comfort measures include rest, hydration, and over-the-counter pain relief as recommended by the healthcare provider. Pain management strategies should be discussed with the medical team to ensure overall comfort during the treatment journey.