Fame and Mortality: Evidence from a Retrospective Analysis of Singers
November 26, 2025
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Brand Name :
pembrolizumab/berahyaluronidase alfa-pmph, Keytruda Qlex
Synonyms :
Pembrolizumab / Berahyaluronidase
Class :
PD-1/PD-L1 Inhibitors
Brand Name :
pembrolizumab/berahyaluronidase alfa-pmph, Keytruda Qlex
Synonyms :
Pembrolizumab / Berahyaluronidase
Class :
PD-1/PD-L1 Inhibitors
ADULT DOSING
Dosage Forms & Strengths
Solution
[pembrolizumab/berahyaluronidase]
[(395mg/4800 units)/2.4mL] single-dose vial
[(790mg/9600 units)/4.8mL] single-dose vial
Unresectable or metastatic melanoma Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks
Subcutaneous (SC)
every 3 weeks
Single agent for localized disease Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks
Combination therapy Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks Administer on the same day as enfortumab vedotin
HER2-positive Administer dose of 790 mg/9600 units through subcutaneous route every six weeks Give prior to trastuzumab and chemotherapy when administered on the same day
Single-agent therapy Administer dose of 790 mg/9600 units through subcutaneous route every six weeks
Single-agent therapy Administer dose of 790 mg/9600 units through subcutaneous route every six weeks
Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks
Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks
First-line treatment In combination with axitinib Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks With dose of axitinib 5 mg orally two times daily In combination with lenvatinib Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks With dose of lenvatinib 20 mg orally daily
Combination therapy with lenvatinib Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks With dose of lenvatinib 20 mg orally daily Tumor Mutational Burden-High Cancer Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks
Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks Administer prior to chemotherapy when given on the same day
Malignant Pleural MesotheliomaÂ
Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks Administer prior to chemotherapy when given on the same day
Solution
[pembrolizumab/berahyaluronidase]
[(395mg/4800 units)/2.4mL] single-dose vial
[(790mg/9600 units)/4.8mL] single-dose vial
Aged ≥12 years who weigh at least 40 kg Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks
Aged ≥12 years who weigh at least 40 kg 395 mg/4,800 units SC q3Weeks Administer dose of 395 mg/4,800 units through subcutaneous route every three weeks
Refer adult dosing
Pembrolizumab inhibits the interaction between PD-1 and its ligands, PD-L1 and PD-L2, which are often produced by antigen-presenting cells and tumor cells.
Hyaluronic acid hydrolysis in the extracellular matrix is catalyzed by hyaluronidase. This improves the dispersion and absorption of injected medications or fluids while increasing tissue permeability.
It makes subcutaneous delivery of fluids and biologics easier by decreasing subcutaneous tissue resistance.
Frequency defined
>50%
Leukopenia
Neutropenia
Anemia
Lymphopenia
>10-50%
Thrombocytopenia
Hyponatremia
Increased creatinine
Hypocalcemia
Musculoskeletal pain
Hypokalemia
Rash
Hypothyroidism
Pruritus
Peripheral neuropathy
Hypoalbuminemia
Increased ALT
Increased alkaline phosphatase
Nausea
Fatigue
Pneumonia
Constipation
Decreased appetite
Hyperglycemia
Grade 3 or 4
Lymphopenia
Leukopenia
Neutropenia
Anemia
Thrombocytopenia
1-10%
Cough
Grade 3 or 4
Increased creatinine
Hyponatremia
Fatigue
Increased ALT
Hypocalcemia
Rash
Increased AST
Pneumonia
Hypokalemia
Musculoskeletal pain
Diarrhea
Nausea
<1%
Grades 3 or 4
Hyperglycemia
Peripheral neuropathy
Decreased appetite
Hypoalbuminemia
None
Contraindications:
Hypersensitivity
Caution:
Immune-mediated adverse reactions
Hypersensitivity and administration-related reactions
Complication of allogeneic HSCT
Embryo-fetal toxicity
Pregnancy Warnings:
Pregnancy category: N/A
Lactation: Maternal IgG is known present in human milk
Pregnancy categories:
Category A: Satisfactory and well-controlled studies show no evidence of risk to the fetus in the first trimester or in the later trimester.
Category B: No evidence of risk to fetus found in animal reproduction studies and there are not enough studies on pregnant women.
Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for an effect in humans, care must be taken for potential risks in pregnant women.
Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite potential risks may be used only in emergency cases for potential benefits.
Category X: Drugs listed in this category clearly outweigh risks over benefits. These category drugs should be prohibited for pregnant women.
Category N: There is no data available for the drug under this category.
Pharmacology:
A monoclonal antibody called pembrolizumab inhibits the interaction between the programmed cell death-1 protein (PD-1) and its ligands, PD-L1 and PD-L2.
By depolymerizing hyaluronan, the endoglycosidase beragahyaluronidase alfa enhances the permeability of subcutaneous tissue.
Pharmacodynamics:
Under normal circumstances, active T cells express PD-1 and its associated target PD-ligand 1 (PD-L1). When bound, the PD-L1/PD-1 interaction suppresses immunological activation and lowers T-cell cytotoxic activity.
During chronic inflammation, this negative feedback loop restricts T-cell activity to preserve healthy cells and is crucial for preserving appropriate immune responses.
PD-L1 expression on the tumor or on immune cells that have infiltrated the tumor can help tumor cells evade T-cell-mediated cytotoxicity by preventing immune-mediated destruction of tumor cells.
Pharmacokinetics:
Absorption:
It shows bioavailability up to 60%.
It has peak plasma time of 4 days.
Distribution:
It has volume of distribution of 6 L.
Excretion and elimination:
It has half-life of 22 days and clearance of 195 mL/day.
It is administered subcutaneously.
Solution ready for usage, do not dilute, and avoid shaking.
Take the vial out of the fridge and give it at least half an hour to get to room temperature.
Unpunctured vials can be kept for up to 24 hours at room temperature before to administration.
Examine the solution visually for discoloration and particle debris before to delivery. It should be clear to slight opalescent and colorless to slightly yellow.
If particles are visible, discard the vial. It must be given by a medical practitioner.
Avoid the 5 cm region around the navel and administer to the thigh or abdomen.
Inject into healthy skin rather than areas that are hard, painful, bruised, or read.
A minimum of 2.5 cm should separate the injection location from the prior injection site.
Never give another SC drug at the same injection location.
At their next planned dosage, patients receiving SC pembrolizumab can transition to IV administration, and vice versa.
The dosage is 395 mg of pembrolizumab plus 4,800 units of berahyaluronidase administered SC over one minute every three weeks.
Dose of 9600 units of berahyaluronidase and 790 mg of pembrolizumab are injected SC over two minutes every six weeks.
Patient information leaflet
Generic Name: pembrolizumab/
berahyaluronidase
Why do we use pembrolizumab/ berahyaluronidase?
It is indicated in treatment of unresectable or metastatic melanoma.
It is indicated as adjuvant treatment following resection and platinum-based chemotherapy for Stage IB or Non-small Cell Lung Cancer.
It is indicated for first-line treatment of metastatic, recurrent Head & Neck Squamous Cell Carcinoma with tumors.
It is indicated for urothelial cancer that has spread or progressed locally when used with enfortumab vedotin.
It is indicated as a first-line treatment for locally progressed, incurable, or metastatic HER2-positive cancers when combined with trastuzumab, fluoropyrimidine-, and platinum-containing chemotherapy.
It is recommended in cases of cervical cancer that has returned or spread, with the disease progressing during or after treatment.
It is recommended for people who have previously had systemic therapy for hepatocellular carcinoma (HCC) caused by hepatitis B.
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