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Keytruda for Mesothelioma Immunotherapy

Keytruda® (generic name pembrolizumab) is an immunotherapy drug approved by the U.S. Food and Drug Administration (FDA) as a second-line treatment for specific cases of mesothelioma. Keytruda helps the immune system better fight cancer and has been shown to increase mesothelioma survival when combined with chemotherapy. Learn how to access Keytruda and other mesothelioma treatments with our team’s help.

Fact-Checked and Updated by: Jenna Tozzi, RN

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What Is Keytruda for Mesothelioma?

Keytruda is a type of immunotherapy drug that was first approved as a treatment for mesothelioma by the FDA in 2020. It works by boosting the body’s T cells, which kill mesothelioma cells.

Currently, doctors mainly use Keytruda to treat mesothelioma tumors that have significant genetic mutations.

Key Facts on Keytruda for Mesothelioma

  • Generic name: Pembrolizumab
  • Combined treatments: Surgery, radiation therapy, chemotherapy, and other types of immunotherapy
  • Delivery method: Intravenous (IV) injection
  • Possible side effects: Fatigue, difficulty breathing, fever, cough
  • Patient eligibility factors: Patients can get treated with Keytruda if they have metastatic mesothelioma (cancer that has spread through the body), if they can’t get surgery due to cancer spread, or if they are eligible to join a Keytruda clinical trial.
  • Impact on patient survival: Patients treated with Keytruda and chemotherapy lived for nearly a year longer than those treated with just chemotherapy, according to a 2023 Journal of Thoracic Oncology report.

Learn more about Keytruda and other drugs like it in our Free Immunotherapy Guide.

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Benefits of Keytruda for Mesothelioma

Keytruda immunotherapy can be very helpful to mesothelioma patients who are eligible to receive it.

Notable benefits of Keytruda for mesothelioma include:

  • Giving patients more treatment options: Doctors can use Keytruda if a patient’s cancer didn’t respond to other mesothelioma treatments, or if the tumors are too widespread to be removed with surgery.
  • Helping patients live longer: By working with the mesothelioma patient’s own immune system, Keytruda may increase overall survival time and quality of life.
  • Improving patient symptoms: Keytruda may help shrink tumors or stop them from growing, which can improve some of the symptoms of mesothelioma, such as chest pain and shortness of breath.

How Does Keytruda Work?

According to the American Cancer Society (ACS), Keytruda works by turning off a protein called PD-1 on T cells made by the immune system.

The PD-1 protein acts as an immune checkpoint that prevents T cells from attacking normal, healthy cells. Mesothelioma cells can sometimes escape detection by the T cells and grow at out-of-control rates.

By inhibiting the PD-1 protein, the T cells are able to find mesothelioma cells and kill them.

We can help you access Keytruda and other top mesothelioma treatments that you’re eligible for. Contact us now to find the best treatments for your diagnosis.

Keytruda Side Effects

You might experience some side effects while taking Keytruda for mesothelioma, depending on how your body reacts to the medication. This is because Keytruda may also cause your T cells to attack healthy tissues in your body.

Some common Keytruda side effects include:

  • Abdominal pain
  • Constipation
  • Coughing
  • Diarrhea
  • Difficulty breathing
  • Fatigue
  • Fever
  • Itching
  • Muscle or bone pain
  • Nausea
  • Rash

Your medical team will help you prepare for side effects of Keytruda and establish a plan to manage them.

What to Expect During Keytruda Treatment Sessions

If your mesothelioma doctor recommends Keytruda as part of your treatment plan, below are the general steps to expect.

1. Keytruda Infusions Every Three Weeks

Keytruda for mesothelioma is administered by intravenous (IV) injection every three weeks, with the procedure taking around 30 minutes each time.

The infusions are painless, and you can watch TV, read, or listen to a podcast while getting the infusion.

Your oncologist (cancer doctor) will determine when you’ll get Keytruda. Use our Free Doctor Match to find specialists who can see if Keytruda is right for your mesothelioma treatment plan.

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2. Lifestyle Changes to Boost Immune System Health

Your doctor may recommend lifestyle changes that you can undertake that may help make your Keytruda treatments more effective.

Lifestyle changes to boost your immune system health include:

  • Exercising regularly and staying physically active
  • Getting enough sleep
  • Maintaining a healthy diet
  • Quitting smoking and the use of alcohol

3. Follow-Up Care for Keytruda and Mesothelioma

While getting Keytruda for mesothelioma, you should attend regular follow-up appointments with your oncology team.

During these visits, doctors can help address any side effects and see how well Keytruda is working.

Mesothelioma pembrolizumab follow-up care includes:

  • Imaging tests, such as MRIs and CT scans, to see if the cancer is going away
  • Lab tests, such as bloodwork, to test for liver and kidney function as well as for treatment-related toxicity levels

You may start to see results after around 2-3 months of Keytruda treatments. You can take the medication for up to 2 years or more if it’s helping you and you aren’t having severe side effects.

How Much Does Keytruda Cost?

Keytruda for mesothelioma can be quite expensive if you don’t have health insurance.

According to the medication’s manufacturer Merck, each Keytruda dose costs $11,115.04 when given in 3-week intervals.

Even when insurance is taken into account, getting Keytruda can still be quite expensive — and this doesn’t account for other bills, such as lost wages if you or a loved one can’t work, travel costs if you don’t live near a hospital, and more.

Mesothelioma Hope can help you pursue financial assistance for treatment. Call us now at (866) 608-8933 to see if you’re eligible.

Clinical Research on Mesothelioma and Keytruda

Several mesothelioma clinical trials have studied how Keytruda can help treat patients with this rare cancer.

Recent trials testing Keytruda for mesothelioma include:

  • International Keytruda study: A November 2023 study from researchers in Canada, France, Italy, and the United States looked at how Keytruda treated mesothelioma. Patients who received Keytruda and chemotherapy had a median overall survival of 17.3 months in this study.
  • KEYNOTE-158: This 2020 study looked at how Keytruda could help advanced malignant pleural mesothelioma patients whose cancer had returned despite treatments. There was an average response rate (time in which the cancer growth slowed or stopped) of 14.3 months.
  • KEYNOTE-483: The results of this study, which were published in 2023, found that patients treated with Keytruda and chemotherapy lived for 19.8 months, compared to 8.9 months for patients who received chemotherapy alone.

See How Keytruda for Mesothelioma Could Help You

If you or a loved one has been diagnosed with mesothelioma, you can speak with doctors at top cancer centers about Keytruda. This immunotherapy medication may help you extend your life expectancy — and it could be useful if other treatments are not working.

Mesothelioma Hope can find out if Keytruda is right for you and help you find cancer specialists in your area.

Our caring mesothelioma nurses and Patient Advocates can:

  • Connect you with skilled mesothelioma doctors
  • Determine if Keytruda or other treatments could help you
  • Help you access compensation for medical bills and other costs

Get started by calling our team at (866) 608-8933 or using our Free Doctor Match right now.

Mesothelioma and Keytruda FAQs

Does Keytruda work for mesothelioma?

Yes, Keytruda (pembrolizumab) for mesothelioma has shown to be effective in treating this cancer and in improving the life spans of many patients.

For example, a 2023 study found that patients treated with Keytruda and chemotherapy drugs like pemetrexed and cisplatin had an average survival time of 19.8 months — more than a year and a half.

What are some signs that Keytruda is working?

A notable sign that Keytruda is working includes a lessening of cancer symptoms. Your mesothelioma tumors may also shrink or stop growing.

Your health care provider or mesothelioma doctor will monitor you and note whether your cancer is shrinking, staying the same, or growing while you take Keytruda.

This will usually be done through blood tests and imaging tests like CT scans and MRIs.

Is Keytruda FDA approved?

Yes. Keytruda was first approved by the FDA to treat mesothelioma and other solid tumors in 2020 on a limited basis.

Initially, the FDA only approved Keytruda to treat tumors that had a high tissue mutational burden (a lot of genetic mutations).

Further, the FDA mandated that Keytruda could only be used for cancer patients who had gotten prior treatments but had their cancer start to progress again.

The FDA expanded its approval of Keytruda for mesothelioma in 2023, allowing it to be used in other cases where mesothelioma and other types of cancer tumors have notable problems related to their genetic structure.

It may also be possible to get Keytruda as part of a mesothelioma clinical trial, where newer and potentially more effective versions of this treatment are being studied.

What is Keytruda used to treat?

Keytruda is currently used to treat mesothelioma tumors that can’t be removed through surgery (unresectable tumors) or that have come back despite earlier treatments.

It may also be used to treat lung cancer, ovarian cancer, and other cancers.

How long does it take for Keytruda to work?

It generally takes between 2-3 months for people to see results after starting on Keytruda.

However, the amount of time can vary with each patient based on factors like their cancer stage and other treatments they’re receiving.

How long does Keytruda treatment for mesothelioma last?

How long the treatment will last depends on how effective Keytruda is at destroying cancer cells. You can continue getting Keytruda for 2 years or longer if it is helping you.

A mesothelioma doctor can determine how long you can take Keytruda for mesothelioma and help you explore other treatment options if needed. Use our Free Mesothelioma Doctor Match to find a specialist near you now.

Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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  2. Astor, L. (2020, June 16). FDA Approves Pembrolizumab for TMB-High Solid Tumors. Retrieved November 28, 2023, from
  3. Business Wire. (2023, June 3). KEYTRUDA® (pembrolizumab) Plus Chemotherapy Significantly Improved Overall Survival Versus Chemotherapy Alone as First-Line Treatment for Unresectable Advanced Pleural Mesothelioma. Retrieved November 28, 2023, from
  4. Chu, Q., et al. (2023, November 3). Pembrolizumab plus chemotherapy versus chemotherapy in untreated advanced pleural mesothelioma in Canada, Italy, and France: a phase 3, open-label, randomised controlled trial. Retrieved November 28, 2023, from
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  6. Marmarelis ME, Wang X, Roshkovan L, et al. Clinical Outcomes Associated With Pembrolizumab Monotherapy Among Adults With Diffuse Malignant Peritoneal Mesothelioma. JAMA Netw Open. 2023;6(3):e232526. Retrieved November 28, 2023, from 4
  7. Merck. (2023, March 29). FDA Converts to Full Approval Indication for KEYTRUDA® (pembrolizumab) for Certain Adult and Pediatric Patients With Advanced Microsatellite Instability-High (MSI-H) or Mismatch Repair Deficient (dMMR) Solid Tumors. Retrieved November 28, 2023, from
  8. Merck – Keytruda. (2023). Cost Info & Financial Help. Retrieved November 28, 2023, from
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  10. Merck – Keytruda (2023). How Keytruda Is Given. Retrieved November 28, 2023, from
  11. Moffitt Cancer Center. (n.d.). How Can You Tell if Immunotherapy Is Working? Retrieved November 28, 2023, from
  12. National Library of Medicine. (2019). Efficacy and safety of pembrolizumab in patients with advanced mesothelioma in the open-label, single-arm, phase 2 KEYNOTE-158 study. Retrieved November 28, 2023, from
  13. NBC News. (2016, May 18). Cancer Drug Keytruda Keeps Some Patients Alive For 3 Years. Retrieved November 28, 2023, from
  14. Piccirillo, M., et al. (2023, February 24). Brief Report: Canadian Cancer Trials Group IND.227: A Phase 2 Randomized Study of Pembrolizumab in Patients With Advanced Malignant Pleural Mesothelioma (NCT02784171). Retrieved November 28, 2023, from
  15. U.S. Food and Drug Administration. (2020, June 7). FDA approves pembrolizumab for adults and children with TMB-H solid tumors. Retrieved November 28, 2023, from
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