What's Keytruda, why is it a big deal in India's cancer fight, Pg1

Key Highlights:

• Keytruda (pembrolizumab), an immunotherapy drug by Merck & Co (MSD), is used to treat several cancers by enabling the body's T cells to attack cancerous cells.
• Approved by the US FDA in 2014, Keytruda is used globally for cancers like lung, cervical, renal cell, and aggressive breast cancer, generating $29.5 billion in 2024.
• In India, Keytruda's high cost (over Rs 3 lakh monthly) is somewhat mitigated by Merck's Patient Access Programme, offering 30 free vials upon purchasing five.
• The Indian Express investigation revealed a counterfeit Keytruda market due to lack of access and high dosing, exposing regulatory gaps and compromised hospital oversight.

Detailed Insights:

• Immunotherapy, including Keytruda, differs from chemotherapy and radiation by stimulating the body’s immune system to target cancer cells, sparing healthy cells and showing remarkable results in late-stage cancers.
• Keytruda is a monoclonal antibody that binds to PD-1 receptors on T cells, preventing them from interacting with PD-L1 receptors on cancer cells, thus triggering an immune response.
• Other immunotherapy treatments include CAR-T cell therapy, which involves modifying a patient's T cells to target cancer, and mRNA vaccines for cancer, which train the immune system to identify cancer-specific proteins.
• India's cancer incidence rate is rising, with projections estimating a surge to 24.56 lakh cases by 2045, making affordability and access to drugs like Keytruda critical.
• The government has removed basic custom duty on Keytruda to improve affordability, but counterfeit versions pose a threat, necessitating purchases from hospital pharmacies or through the patient access program.

Key Concepts Involved:

• Immunotherapy: Treatment that uses the body's immune system to fight diseases like cancer.
• Monoclonal antibodies: Laboratory-made molecules designed to bind with specific targets on cancer cells, enabling the immune system to destroy them.
• Checkpoint inhibitors: Drugs that release the brakes on the immune system, allowing T cells to attack cancer cells.