What Is High-risk NMIBC and How Does KEYTRUDA® (pembrolizumab) Fit in to the Treatment Journey?
High-risk non-muscle invasive bladder cancer (NMIBC)

HIGH-RISK NMIBC AND THE TREATMENT JOURNEY

What is high-risk NMIBC and how does KEYTRUDA fit into the treatment journey?

When a kind of bladder cancer has not spread to nearby tissue in the bladder, but is at a high-risk for spreading, this is called high-risk NMIBC. High-risk non-muscle invasive bladder cancer (NMIBC) is an early stage bladder cancer. This means the cancer has not reached the muscle layer of the bladder wall. Early treatment for high-risk NMIBC typically means using treatments that fight the cancer and prevent its progression into the muscle layer of the bladder wall.

It may be time to have a conversation with your doctors

Typically, bladder removal surgery is recommended if a patient’s high-risk NMIBC is no longer responding to other treatments. If your tumor is a type called carcinoma in situ (CIS), you have tried BCG treatment and it did not work, and you are not able to or have decided not to remove your bladder, KEYTRUDA, an immunotherapy treatment, may be an option.

KEYTRUDA is an intravenous (IV) immunotherapy. Here’s what to expect while taking KEYTRUDA:

Your Doctor Will Give You KEYTRUDA® (pembrolizumab) Into Your Vein Through an IV.

How will I receive KEYTRUDA?

Your doctor will give you KEYTRUDA into your vein through an IV.

Treatment With KEYTRUDA® (pembrolizumab) May Take Place in Your Doctor's Office or an Infusion Clinic, and Your Urologist May Partner With an Oncologist's Office to Manage Your Treatment.

Where does treatment take place?

Treatment with KEYTRUDA may take place in your doctor’s office or an infusion clinic, and your urologist may partner with an oncologist’s office to manage your treatment. Talk to your urologist about how and where KEYTRUDA is administered.

Each Treatment With KEYTRUDA® (pembrolizumab) Is Given Over 30 Minutes Every 3 Weeks.

How long do treatments take?

Treatment with KEYTRUDA is given over 30 minutes every 3 weeks.

KEYTRUDA® (pembrolizumab) Is an Immunotherapy.

How does KEYTRUDA work?

KEYTRUDA is not chemotherapy or radiation therapy—it is an immunotherapy that works with your immune system to help fight cancer.

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. These problems may happen any time during treatment or even after your treatment has ended.

Questions You May Want to Ask Your Doctors About High-risk NMIBC

Questions you may want to ask your doctors about high-risk NMIBC

Your care team, which may include your urologist, an oncologist, or other specialists, can help answer your questions and offer you guidance regarding your treatment path.

  1. What is the next step in my plan if my early treatment options stop working as expected?
  2. What surgical options do I have in my treatment plan?
  3. I’ve decided bladder removal surgery isn’t right for me. Are there any other options?
  4. Is KEYTRUDA right for me?
Patient Support Program for KEYTRUDA® (pembrolizumab)

Patient support anytime, anywhere you need it

This program is designed to offer educational resources to help with the practical and emotional challenges of cancer. Patients prescribed KEYTRUDA for an approved indication can receive 24/7 phone support, e-mails, and online activities.

FDA-Approved Indications

KEYTRUDA is a prescription medicine used to treat a kind of bladder cancer called urothelial carcinoma. KEYTRUDA may be used when your cancer has not spread to nearby tissue in the bladder, but is at high-risk for spreading (high-risk, non-muscle invasive bladder cancer [NMIBC]) and when your tumor is a type called “carcinoma in situ” (CIS), and you have tried treatment with Bacillus Calmette-Guerin (BCG) and it did not work, and you are not able to or have decided not to have surgery to remove your bladder.

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. These problems may happen any time during treatment or even after your treatment has ended.

Call or see your doctor right away if you develop any symptoms of the following problems or these symptoms get worse:

Lung problems (pneumonitis). Symptoms of pneumonitis may include shortness of breath, chest pain, or new or worse cough.

Intestinal problems (colitis) that can lead to tears or holes in your intestine. Signs and symptoms of colitis may include diarrhea or more 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, including hepatitis. Signs and symptoms of liver problems may include yellowing of your skin or the whites of your eyes, nausea or vomiting, pain on the right side of your stomach area (abdomen), dark urine, or bleeding or bruising more easily than normal.

Hormone gland problems (especially the thyroid, pituitary, adrenal glands, and pancreas). Signs and symptoms that your hormone glands are not working properly may include rapid heartbeat, weight loss or weight gain, increased sweating, feeling more hungry or thirsty, urinating more often than usual, hair loss, feeling cold, constipation, your voice gets deeper, muscle aches, feeling very weak, dizziness or fainting, or headaches that will not go away or unusual headache.

Kidney problems, including nephritis and kidney failure. Signs of kidney problems may include change in the amount or color of your urine.

Skin problems. Signs of skin problems may include rash, itching, blisters, peeling or skin sores, or painful sores or ulcers in your mouth or in your nose, throat, or genital area.

Problems in other organs. Signs and symptoms of these problems may include changes in eyesight; severe or persistent muscle or joint pains; severe muscle weakness; low red blood cells (anemia); swollen lymph nodes, rash or tender lumps on skin, cough, shortness of breath, vision changes, or eye pain (sarcoidosis); confusion, fever, muscle weakness, balance problems, nausea, vomiting, stiff neck, memory problems, or seizures (encephalitis); and shortness of breath, irregular heartbeat, feeling tired, or chest pain (myocarditis).

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

Rejection of a transplanted organ. People who have had an organ transplant may have an increased risk of organ transplant rejection if they are treated with KEYTRUDA.

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 severe and can lead to death. These complications may happen if you underwent transplantation either before or after being treated with KEYTRUDA. Your doctor will monitor you for the following signs and symptoms: skin rash, liver inflammation, abdominal pain, and diarrhea.

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

Before you receive KEYTRUDA, tell your doctor if you have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus; have had an organ transplant or plan to have or have had a bone marrow (stem cell) transplant that used donor stem cells (allogeneic); have lung or breathing problems; have liver problems; or have any other medical problems.

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

If you are breastfeeding or plan to breastfeed, tell your doctor. 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 doctor 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, bones, or joints and stomach area (abdominal) pain; decreased appetite; itching; diarrhea; nausea; rash; fever; cough; shortness of breath; and constipation.

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; and mouth sores.

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.

In children, feeling tired, vomiting and stomach-area (abdominal) pain, and increased levels of liver enzymes and decreased levels of salt (sodium) in the blood are more common than in adults.

These are not all the possible side effects of KEYTRUDA. Tell your doctor if you have any side effect that bothers you or that does not go away. For more information, ask your doctor or pharmacist.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch 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.