I had urothelial cancer with spread to kidney. The kidney was removed with clean margins but my oncologist (not Mayo) suggested chemo followed by keytruda. The keytruda has been a nightmare for me. No issues until around the 5 month mark, then it gave me diabetes by triggering the immune system to attack and destroy insulin-producing pancreatic beta cells. By blocking the PD-1 protein, the drug removes "brakes" on T-cells, allowing them to attack cancer, but also causing them to mistakenly attack the pancreas. A month later, my eyes became extremely inflamed and swollen, the eye doctor said they're fine and gave me drops. At the same time I was beyond fatigued, couldn't get off the couch with fatigue. I ended up in the ER and admitted. They found that Keytruda had caused it and worried it had gotten to the back of the eye; it hadn't yet but I was in the hospital 5 days on 3i different antibiotic drips and home for 10 days and still blurry vision. While in the hopital imaging found that Keytruda had destroyed my adrenal gland so I was producing no coritsol, thus the extreme fatigue. I'm now on replacement coritsone for life.

I'm sure Keytruda has done a lot of good things for people, but I stopped after all this. Just beware that it can and does impact many things. Keep alert and best of luck.