So I’m pretty much closing the book on my 4th year on Keytruda (pembroluzimab). I’ve recently completely my 33rd Pembro infusion. Keytruda was my Hail Mary after running through most other SOC. My PSA was rising while on chemo the second time when I found out I had the markers that made me eligible for pembro. Pembro crushed my PSA from 86 to undetectable (<0.01) in just a couple cycles. It remained undetectable for yr 1, over the next 2 1/2 years I had a slow rise to 1.2. Finally I was able to get a PSMA Pet scan to ID the source of the PSA. I had trouble getting support for more radiation, but finally got it zapped. Palliative of course! Following the high dose proton beam radiation my PSA has been reduced to 0.01.
Each of these infusion cycles (every 6 weeks) bills at over 100k, most recently at about $120k; insurance negotiates it to more like 38K; needless to say I I hit my maximum out of pocket expenses for the year every January. Merck has a co pay assistance program. But they changed the rules to only allow its use for the first 2 years, because of a hospital error I only was able to use it in year one. Any of you guys on Keytruda having issues with copay assistance? Not trying to complain- happy to be alive, but this liquid life is expensive!
stay strong!!
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Chugach
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My husband as I've told before ONLY had 2 doses of Keytruda never got anymore and now entering his 4th year undetectable so never had to deal with expense wish I could help in that category. But so happy it continues to work for you.
such great news!!! I’ve heard similar from others. Early on, they said I had a lot of genetic diversity in my cancer- I suspected that the cancer that was recently hit with radiation didn’t have the MSI-h markers and was just slowly building over the last few years. While I don’t want to ‘rock the boat’, pembro and probably more notable- Lupron, are probably not necessary any longer. Does your husband still take Lupron?
If you would DM me the name of your husband’s medical oncologist and hospital- I’d appreciate another opinion on this course of treatment.
My husband gets a shot in his stomach every 3 months I think it is Lupron I will double check and Dr Michael Morris was his Dr at Memorial Sloan Kettering NYC but working now in Washington D C I believe with MSKCC for the government. He still is avail in the event my husband needs him. Another Dr has taken his place but just telehealth calls since then.
Congrats. It seems odd something so effective would be limited to cases where all else fails since the "else" is much more intrusive. I want to see if I can push for immunology treatment earlier vs. later.
It was more of a case of not being aware of the right markers early enough- but I do recall at the beginning asking about immunotherapy and being told that I was not ‘sick enough. I’m also not sure pembro was SOC for PC when I was first diagnosed (2016). But earlier the better!!!!
Did you go to or were you referred to a specialist in immunology? Any recommended doctor or hospital? I wonder if immunology is a choice before radiation?
Radiation and immunotherapy can be complimentary. I’m not sure of the mechanism, but it basically helps expose the cancer so that the immunotherapy can find it.
Congrats. Unfortunately, I fall into the category where, despite all the biomarkers, Keytruda has not worked. In fact, I'm part of a small percentage where there is hyper-progression on checkpoint inhibitors. Stopped after 3 infusions as my PSA went up rapidly & recent PSMA PET shows many more mets. Will be starting Pluvicto in 2 weeks.
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