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 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. 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, bones or joints, and stomach-area (abdominal) pain; decreased appetite; itching; diarrhea; nausea; rash; fever; cough; shortness of breath; and constipation.

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 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 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.