Pembrolizumab (30) – Keytruda®

Melanoma, ≥ 12 to < 18 years

Characteristics

Start date 01.08.2022 – Marketing authorisation: 22.06.2022
Resolution 19.01.2023
INN Pembrolizumab
Brand name Keytruda®
Pharm. company MSD Sharp & Dohme GmbH
G-BA Procedure ID D-847
ATC code L01FF02 PD-1/PDL-1 inhibitors (L01FF)
ICD-10 codes (AIS) C43.0Malignant melanoma of lip, C43.1Malignant melanoma of eyelid, including canthus, C43.2Malignant melanoma of ear and external auricular canal, C43.3Malignant melanoma of other and unspecified parts of face, C43.4Malignant melanoma of scalp and neck, C43.5Malignant melanoma of trunk, C43.6Malignant melanoma of upper limb, including shoulder, C43.7Malignant melanoma of lower limb, including hip, C43.8Malignant melanoma of overlapping sites of skin, C43.9Malignant melanoma of unspecified site of skin
Alpha-ID codes (AIS) I111156Malignant melanoma of the hairy scalp, I111633Malignant melanoma of the ear and external auditory canal, I18282Malignant melanoma, I18791Malignant melanoma of the eyelid, I3412Malignant melanoma of the lip, I3416Malignant melanoma of the face, I96395Malignant melanoma of the trunk n.c, I96441Malignant melanoma of the upper extremity n.c, I96442Malignant melanoma of the lower extremity n.c
DDD 9.5 mg P
Therapeutic area Oncological diseases Melanoma (MA)
Reason for procedure New therapeutic indication
Specialty Bundling

Therapeutic indication of the resolution

Keytruda is indicated as monotherapy for the treatment of advanced (non-resectable or metastatic) melanoma in children and adolescents aged 12 years and older

Subpopulation Indication Comparator
Children and adolescents aged 12 years and older with advanced (non-resectable or metastatic) melanoma. Treatment according to physician's choice

Studies and Results

No. of studies
(best subpopulation)
1 (KEYNOTE 051)
Study design
(best subpopulation)
Single-arm + no comparison
Meta analysis
(best subpopulation)
no

  • Clinical trials
    • The KEYNOTE 051 trial is an open-label, ongoing, non-randomised, multicentre, single-arm Phase I/II trial enrolling children and adolescents aged ≥ 6 months to < 18 years with various oncological diseases.

Children and adolescents aged 12 years and over with advanced (unresectable or metastatic) melanoma

  • The additional benefit is not proven.
  • For children and adolescents aged 12 years and over with advanced (unresectable or metastatic) melanoma, the pharmaceutical manufacturer was unable to identify any randomised controlled trial directly comparing pembrolizumab with the appropriate comparator therapy.
  • The descriptive data presented from the KEYNOTE 051 study are not suitable for drawing conclusions regarding the additional benefit of pembrolizumab in children and adolescents aged 12 years and over with advanced melanoma compared with the appropriate comparator therapy.
  • Morbidity – Treatment response
    • For the five patients, the pharmaceutical manufacturer presented the results for the endpoints ‘response to treatment’ and ‘adverse events’ in descriptive form.
    • The pharmaceutical manufacturer states that, due to the small number of patients, it is not possible to draw any conclusions regarding the efficacy of pembrolizumab.
  • Side effects – adverse events
    • The pharmaceutical manufacturer provided the results for the endpoints ‘response to treatment’ and ‘adverse events’ for the five patients in descriptive form.
  • Summary of the assessment
    • The pharmaceutical manufacturer provided individual data from the KEYNOTE 051 trial, in which children and adolescents with various oncological diseases were treated with pembrolizumab. Of these, 9 patients have advanced melanoma, with 5 belonging to the age group under consideration here (aged 12 years and over). For these 5 patients, the pharmaceutical manufacturer provided results on treatment response and adverse events in descriptive form. These data are not suitable for demonstrating additional benefit.
    • Overall, there are no suitable data available to enable an assessment of the additional benefit of pembrolizumab in children and adolescents aged 12 years and over with advanced melanoma compared with the appropriate comparator therapy. The additional benefit is therefore not proven.

Courtesy translation only, please refer to the German original.

Associated procedures

Pembrolizumab (41) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Resectable locally advanced squamous cell carcinoma of the head and neck, PD-L1 expression ≥ 1 per cent, neoadjuvant and adjuvant therapy, in combination with radiotherapy with or without concomitant cisplatin therapy 2,550–4,240 86% Hint for minor additional benefit
Pembrolizumab (40) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Malignant pleural mesothelioma, non-epithelioid, first-line treatment, in combination with pemetrexed and platinum-based chemotherapy 55–105 100% additional benefit not proven
Pembrolizumab (38) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Cervical carcinoma (stage III to IVA), first-line, combination with radiochemotherapy 750 100% Indication of non-quantifiable additional benefit
Pembrolizumab (39) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Endometrial carcinoma, first-line, combination with carboplatin and paclitaxel 1,370–3,330 100% additional benefit not proven
Pembrolizumab (36) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Urothelial carcinoma, non-resectable or metastatic, first-line, combination with enfortumab vedotin 1,050–2,601 39% Indication of considerable additional benefit
Pembrolizumab (37) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Breast cancer, triple-negative, high risk of recurrence, neoadjuvant and adjuvant therapy, monotherapy or combination with chemotherapy 2,440–2,610 50% Indication of minor additional benefit
Pembrolizumab (35) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Non-small cell lung cancer, high risk of recurrence, neoadjuvant and adjuvant therapy, monotherapy or combination with platinum-based chemotherapy 5,090–6,780 100% additional benefit not proven
Pembrolizumab (34) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Non-small cell lung cancer, adjuvant therapy with high risk of recurrence after resection, after prior chemotherapy 2,690–3,200 100% additional benefit not proven
Pembrolizumab (32) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Adenocarcinoma of the stomach or gastroesophageal junction, PD-L1 expression ≥ 1, HER2, first-line, combination with fluoropyrimidine- and platinum-based chemotherapy 285–2,613 100% additional benefit not proven
Pembrolizumab (33) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Biliary tumours, first-line, combination with gemcitabine and cisplatin 1,480–2,180 100% Indication of minor additional benefit
Pembrolizumab (31) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Adenocarcinoma of the stomach or gastroesophageal junction, PD-L1 expression ≥ 1, HER2+, first-line, combination with trastuzumab, fluoropyrimidine- and platinum-based chemotherapy 70–710 100% additional benefit not proven
Pembrolizumab (28) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Cervical carcinoma, PD-L1 expression ≥ 1 (CPS), combination with or without bevacizumab 1,315–1,525 40% Indication of considerable additional benefit
Pembrolizumab (30) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Melanoma, ≥ 12 to < 18 years 1–4 100% additional benefit not proven
Pembrolizumab (22) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Renal cell carcinoma (RCC), adjuvant, monotherapy, pre-treated patients 1,518–1,973 100% Hint for minor additional benefit
Pembrolizumab (23) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Colorectal cancer (CRC)) with MSI-H or with dMMR, after fluoropyrimidine-based combination therapy. 350–1,470 100% additional benefit not proven
Pembrolizumab (24) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Endometrial carcinoma with MSI-H or with dMMR, pre-treated 230–3,360 100% additional benefit not proven
Pembrolizumab (25) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Gastric carcinoma with MSI-H or dMMR, pre-treated 80–110 74% Hint for non-quantifiable additional benefit
Pembrolizumab (26) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Small bowel carcinoma with MSI-H or dMMR, pre-treated 40–380 100% additional benefit not proven
Pembrolizumab (27) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Biliary carcinoma with MSI-H or dMMR, pre-treated 20–150 100% additional benefit not proven
Pembrolizumab (29) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Melanoma, adjuvant therapy, ≥ 12 years, monotherapy 1,621–2,314 100% Indication of non-quantifiable additional benefit
Pembrolizumab (21) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Breast carcinoma (BC), triple-negative (TNBC), high risk of recurrence, neoadjuvant and adjuvant therapy, monotherapy or combination with chemotherapy 0
2,440–2,520
50% Hint for minor additional benefit repealed
Pembrolizumab (19) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Endometrial carcinoma (EC) , after platinum-based therapy, combination with lenvatinib 1,130–5,070 100% Indication of considerable additional benefit
Pembrolizumab (20) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Advanced renal cell carcinoma (RCC), first-line, combination with lenvatinib 2,790–4,189 100% additional benefit not proven
Pembrolizumab (17) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Carcinoma of the esophagus or gastroesophageal junction, PD-L1 expression ≥ 10 (CPS), first-line, combination with platinum- and fluoropyrimidine-based chemotherapy. 535–805 34% Indication of considerable additional benefit
Pembrolizumab (18) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Breast cancer (BC), triple-negative, PD-L1 expression ≥ 10 (CPS), combination with chemotherapy 260–270 50% Hint for considerable additional benefit
Pembrolizumab (14) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Hodgkin lymphoma (HL), pre-treated patients, ≥ 3 years 120–240 46% Hint for considerable additional benefit
Pembrolizumab (16) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Urothelial carcinoma (UC), CPS ≥ 10, first-line 225–380 100% additional benefit not proven
Pembrolizumab (15) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Colorectal carcinoma (CRC) with MSI-H or dMMR, first-line 370–955 87% Hint for minor additional benefit
Pembrolizumab (12) Keytruda® MSD SHARP & DOHME GMBH Oncological diseases Renal cell carcinoma (RCC), first-line, combination with axitinib 3,500 23% Indication of considerable additional benefit
Pembrolizumab (13) Keytruda® MSD SHARP & DOHME GMBH Oncological diseases Squamous cell carcinoma head and neck, PD-L1 expression ≥ 1%, first-line, combination with platinum and 5-fluorouracil (5-FU) chemotherapy 4,950–5,370 100% Indication of minor additional benefit
Pembrolizumab (11) Keytruda® MSD SHARP & DOHME GMBH Oncological diseases Squamous cell carcinoma head and neck, PD-L1 expression ≥ 1%, first-line, monotherapy 4,955–5,370 100% Hint for considerable additional benefit
Pembrolizumab (10) Keytruda® MSD SHARP & DOHME GMBH Oncological diseases Non-small cell lung carcinoma (NSCLC), squamous cell histology, first-line, combination with carboplatin and (nab-) paclitaxel 5,340–5,570 71% Hint for considerable additional benefit
Pembrolizumab (9) Keytruda® MSD SHARP & DOHME GMBH Oncological diseases Non-small cell lung carcinoma (NSCLC), non-squamous cell histology, first-line, combination with pemetrexed and platinum chemotherapy 8,020–9,120 100% Hint for non-quantifiable additional benefit
Pembrolizumab (8) Keytruda® MSD SHARP & DOHME GMBH Oncological diseases Melanoma, adjuvant therapy 2,670–3,400 100% Indication of non-quantifiable additional benefit
Pembrolizumab (7) Keytruda® MSD SHARP & DOHME GMBH Oncological diseases Urothelial carcinoma (UC), CPS ≥ 10, first-line 0
240–420
100% additional benefit not proven repealed
Pembrolizumab (6) Keytruda® MSD SHARP & DOHME GMBH Oncological diseases Squamous cell carcinoma head and neck 470–3,290 100% additional benefit not proven
Pembrolizumab (5) Keytruda® MSD SHARP & DOHME GMBH Oncological diseases Urothelial carcinoma (UC) 0
2,300–3,300
61% Indication of considerable additional benefit repealed
Pembrolizumab (4) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Hodgkin lymphoma (HL) 60–180 100% additional benefit not proven
Pembrolizumab (3) Keytruda® MSD SHARP & DOHME GMBH Oncological diseases Non-small cell lung carcinoma (NSCLC), first-line 4,000 100% Indication of considerable additional benefit
Pembrolizumab (2) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Non-small cell lung carcinoma (NSCLC), after prior chemotherapy 12,500–24,300 40% Indication of considerable additional benefit
Pembrolizumab (1) Keytruda® MSD Sharp & Dohme GmbH Oncological diseases Melanoma 2,500–4,500 71% Indication of considerable additional benefit


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