Adrienne's TRU Story: A Real Patient With Advanced Microsatellite Instability-High (MSI-H/dMMR) Cancer
Advanced microsatellite instability-high cancer (MSI-H/dMMR)


Adrienne is a real patient from a clinical trial. KEYTRUDA may not work for everyone, but this is her TRU STORY.

Adrienne's Journey With Advanced Microsatellite Instability-High (MSI-H/dMMR) Cancer

Adrienne’s journey

In times of turmoil, many of us turn to our families for support. For Adrienne, a digital media professional and single mother to 4 grown daughters, her battle with cancer was truly a family affair.

Some people are either living in the future or living in the past. I’m in the present.
- Adrienne, on her outlook

A shared connection

“When my sister was in her 40s, she went in for what was supposed to be a short surgery and they found she had multiple types of cancer.”

Through testing, doctors discovered her sister had Lynch syndrome, a rare genetic condition that increases the risk of certain cancers. This increased risk is often caused by a genetic defect that prevents DNA from repairing errors. This, in turn, may lead to high levels of a biomarker called MSI.

Doctors may test certain cancers for this biomarker (MSI-H), because it can impact the way the cancer is managed. And because Lynch syndrome is inherited, the rest of her family was tested immediately. Adrienne and many of her family members tested positive.

We talk about what you can do with the hand you’ve been dealt, not the cards you wanted.
- Adrienne, on staying optimistic

Embracing uncertainty

“It’s not a great feeling to know you’re walking around with a genetic mutation like this, but that’s the way it is.”

“I am an inherently optimistic person, and my family members are as well. So when they got tested and we got the results, they accepted it. They said, ‘We understand this is nobody’s fault. It’s just the way it is.’”

Through regular screenings, Adrienne’s doctors discovered she had ampullary cancer in 2013 (the ampulla is where the bile and pancreatic ducts meet and empty into the small intestine). Because doctors knew she had Lynch syndrome, they knew to test for MSI-H.

Her community, by her side

As she went through her journey, her upbeat attitude and close ties with her family and community helped carry her forward.

“I didn’t want to chuck everything and travel the world. I wanted to be connected.”

“So when I was having a tough time, I’d blog about my experiences. I’d crack jokes. Humor helps, because you have to stay positive.”

“I have an amazing support network of friends, between my church and other friends who are close to me, who took care of me. They drove my kid to piano lessons, brought me food, walked the dog. They were amazing.”

“Even the company I work for stood by me. They backed me up the whole way. That’s amazing.”

“That kind of support network is really important, and that’s why it’s important for me to give back now. Because you just never know. Something small can make a huge difference in someone’s life.”

You’ve got to have a sense of humor in life, because stuff can be hard. I make a joke, and it gets me through.
- Adrienne, on facing her diagnosis

FDA-Approved Indications

KEYTRUDA is a prescription medicine used to treat a kind of cancer that is shown by a laboratory test to be a microsatellite instability-high (MSI-H) or a mismatch repair deficient (dMMR) solid tumor. KEYTRUDA may be used in adults and children to treat:

  • cancer that has spread or cannot be removed by surgery (advanced cancer), and
  • has progressed following treatment, and you have no satisfactory treatment options.

This use is approved based on how many patients responded to treatment and how long they responded. Studies are ongoing to provide additional information about clinical benefit.

It is not known if KEYTRUDA is safe and effective in children with MSI-H cancers of the brain or spinal cord (central nervous system cancers).

Important Safety Information

KEYTRUDA is a medicine that may treat certain cancers by working with your immune system. KEYTRUDA can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become severe or life-threatening and can lead to death. You can have more than one of these problems at the same time. These problems may happen any time during treatment or even after your treatment has ended.

Call or see your health care provider right away if you develop any signs or symptoms of the following problems or if they get worse. These are not all of the signs and symptoms of immune system problems that can happen with KEYTRUDA:

Lung problems: cough, shortness of breath, or chest pain.

Intestinal problems: diarrhea (loose stools) or more frequent bowel movements than usual; stools that are black, tarry, sticky, or have blood or mucus; or severe stomach-area (abdomen) pain or tenderness.

Liver problems: yellowing of your skin or the whites of your eyes; severe nausea or vomiting; pain on the right side of your stomach area (abdomen); dark urine (tea colored); or bleeding or bruising more easily than normal.

Hormone gland problems: headaches that will not go away or unusual headaches; eye sensitivity to light; eye problems; rapid heartbeat; increased sweating; extreme tiredness; weight gain or weight loss; feeling more hungry or thirsty than usual; urinating more often than usual; hair loss; feeling cold; constipation; your voice gets deeper; dizziness or fainting; changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness.

Kidney problems: decrease in the amount of your urine; blood in your urine; swelling of your ankles; loss of appetite.

Skin problems: rash; itching; skin blistering or peeling; painful sores or ulcers in your mouth or in your nose, throat, or genital area; fever or flu-like symptoms; swollen lymph nodes.

Problems can also happen in other organs and tissues. Signs and symptoms of these problems may include: chest pain; irregular heartbeat; shortness of breath; swelling of ankles; confusion; sleepiness; memory problems; changes in mood or behavior; stiff neck; balance problems; tingling or numbness of the arms or legs; double vision; blurry vision; sensitivity to light; eye pain; changes in eyesight; persistent or severe muscle pain or weakness; muscle cramps; low red blood cells; bruising.

Infusion reactions that can sometimes be severe or life-threatening. Signs and symptoms of infusion reactions may include chills or shaking, itching or rash, flushing, shortness of breath or wheezing, dizziness, feeling like passing out, fever, and back pain.

Rejection of a transplanted organ. Your health care provider should tell you what signs and symptoms you should report and they will monitor you, depending on the type of organ transplant that you have had.

Complications, including graft-versus-host disease (GVHD), in people who have received a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic). These complications can be serious and can lead to death. These complications may happen if you underwent transplantation either before or after being treated with KEYTRUDA. Your health care provider will monitor you for these complications.

Getting medical treatment right away may help keep these problems from becoming more serious. Your health care provider will check you for these problems during treatment with KEYTRUDA. They may treat you with corticosteroid or hormone replacement medicines. They may also need to delay or completely stop treatment with KEYTRUDA if you have severe side effects.

Before you receive KEYTRUDA, tell your health care provider if you have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus; have had an organ transplant or have had or plan to have a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic); have had radiation treatment in your chest area; have a condition that affects your nervous system, such as myasthenia gravis or Guillain-Barré syndrome.

If you are pregnant or plan to become pregnant, tell your health care provider. KEYTRUDA can harm your unborn baby. If you are able to become pregnant, you will be given a pregnancy test before you start treatment. Use effective birth control during treatment and for at least 4 months after your final dose of KEYTRUDA. Tell them right away if you think you may be pregnant or you become pregnant during treatment with KEYTRUDA.

Tell your health care provider if you are breastfeeding or plan to breastfeed. It is not known if KEYTRUDA passes into your breast milk. Do not breastfeed during treatment with KEYTRUDA and for 4 months after your final dose of KEYTRUDA.

Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Common side effects of KEYTRUDA when used alone include feeling tired; pain, including pain in muscles; rash; diarrhea; fever; cough; decreased appetite; itching; shortness of breath; constipation; bones or joints and stomach-area (abdominal) pain; nausea; and low levels of thyroid hormone.

In children, when KEYTRUDA is used alone, fever, vomiting, upper respiratory tract infection, headache, and low levels of white blood cells and red blood cells (anemia) are more common than in adults.

Common side effects of KEYTRUDA when given with certain chemotherapy medicines include feeling tired or weak; nausea; constipation; diarrhea; decreased appetite; rash; vomiting; cough; trouble breathing; fever; hair loss; inflammation of the nerves that may cause pain, weakness, and paralysis in the arms and legs; swelling of the lining of the mouth, nose, eyes, throat, intestines, or vagina; mouth sores; headache; weight loss; stomach-area (abdominal) pain; joint and muscle pain; and trouble sleeping.

Common side effects of KEYTRUDA when given with chemotherapy and bevacizumab include tingling or numbness of the arms or legs; hair loss; low red blood cell count; feeling tired or weak; nausea; low white blood cell count; diarrhea; high blood pressure; decreased platelet count; constipation; joint aches; vomiting; urinary tract infection; rash; low levels of thyroid hormone; and decreased appetite.

Common side effects of KEYTRUDA when given with axitinib include diarrhea; feeling tired or weak; high blood pressure; liver problems; low levels of thyroid hormone; decreased appetite; blisters or rash on the palms of your hands and soles of your feet; nausea; mouth sores or swelling of the lining of the mouth, nose, eyes, throat, intestines, or vagina; hoarseness; rash; cough; and constipation.

These are not all the possible side effects of KEYTRUDA. Talk to your health care provider for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

Please read the accompanying Medication Guide for KEYTRUDA and discuss it with your doctor. The physician Prescribing Information also is available.