Any clinical trial with Keytruda (pembrolumizab) for pancreatic cancer

I have a friend that had pancreatic cancer and was afterwards diagnosed with Lynch Syndrome. She takes Keytruda and has experienced no tumors in about 1.5 years.

There is a clinical trial at the Markey Cancer Center at the University of Kentucky.

You can search the US government's website in general here:
https://clinicaltrials.gov/

You can also filter by specific criteria. For example, specifying "Pancreatic Cancer" as the Condition/Disease, "Keytruda" (Pembrolizumab) as the Intervention/Treatment, and "Recruiting" in the "Looking for participants" checkbox under "Study Status" returns a list of 37 studies (as of 11/6/2023):
https://clinicaltrials.gov/search?intr=keytruda&cond=Pancreatic%20Cancer&aggFilters=status:rec

You'll probably need to refine the filters even further to get the right type and stage of pancreatic cancer, the trial phase you want, the right locations and eligibility criteria, etc., but hopefully this gets you in the ballpark.

It can also be useful to select the "with results" checkbox if you're looking at studies that have already closed and want to see how the study worked out.

Thank you for the valuable information!
Blessinig

@henfayp, if you would like help finding clinical trials for which you may be eligible, you can contact Mayo Clinic Clinical Trials to find out more about active and upcoming trials.
Phone: 800-664-4542 (toll-free)
https://www.mayo.edu/research/clinical-trials

Thank you for the information.

My oncologist recommended I sign up for a study giving this on top of oleaparib (for BRCA mutation PDAC after first line chemo).

Any experiences with Keytruda? Is it automatically a good idea to add immunotherapy? I don’t know why this would be particularly appropriate for BRCA mutations.

The search keywords for discovering how any drug works are "mechanism of action"

Olaparib targets the DNA Damage Repair mechanism of cancer cells in BRCA-mutated patients. Cancer cells are sometimes able to self-repair broken DNA strands and survive rather than dying off.

https://www.keytruda.com/how-does-keytruda-work/#:~:text=KEYTRUDA%20blocks%20the%20PD%2D1,detect%20and%20fight%20cancer%20cells.
KEYTRUDA is a type of immunotherapy that works by blocking the PD-1 pathway to help prevent cancer cells from hiding. KEYTRUDA helps the immune system do what it was meant to do: detect and fight cancer cells.

Pathology or DNA testing might have revealed a sensitivity to related to the PD-1 pathway in your tumors, or this might just be a trial to explore if adding another drug that works independently of mutations produces a useful result.

"If one is good, two might be better" is their underlying hypothesis, I think. Please share here if you learn more!

On Keytruda, it is “working wonders” for many forms of cancer. I know Pcan patients whose pancreatic cancer was linked to Lynch syndrome. In their cases, Keytruda is working as a stabilizer and in some, they have remained NED for quite awhile.

I don't have pancreatic cancer, but I have taken Keytruda (for endometrial cancer) and have some thoughts, some of which are fairly cynical.

Keytruda, and other related "immune checkpoint inhibitors", can be true miracle drugs in certain situations. These are mostly in cancers that have high levels of new mutations that are only in the cancer (aka somatic mutations). Examples include melanomas (mutations from sun damage), lung cancers (especially in smokers), bladder cancers, and cancers that are defective in a DNA repair activity called mismatch repair (MMR). MMR is defective in cancers of people with Lynch syndrome, as well as in many non-Lynch cancers, particularly colorectal and endometrial. However, Keytruda does sometimes still work in cancers with very low levels of new mutations. Most pancreatic cancers have low levels of mutations (listed on sequencing reports as TMB. Less than "10" is low.)

But Keytruda is also sold by a capitalist enterprise (Merck) that is seeking to maximize profit. Their goal is to put as many people on Keytruda as possible, whether or not it's going to do them any good. (My hospital sends the insurance company a $56,000 bill on days I have a Keytruda infusion, including $40,000 for the Keytruda. The insurance company sends them $17,000 in total.)

In their initial clinical trials, Merck did try to distinguish between people who would benefit from Keytruda and those who would not, but more recently they have made minimal effort in this regard. In the endometrial cancer trials, they did distinguish between MMR deficient cancers (where it works great), and MMR proficient cancers (where it works poorly, but there is a statistically significant improvement in a fraction of patients.). But they made no attempt to determine which MMR proficient patients might benefit, and the FDA has now approved Keytruda for MMR proficient endometrial cancers in combination with two different sets of drugs. These are now standard of care for recurrent MMR proficient endometrial cancers, such as mine, even though they work very poorly in the majority of these patients. I have progressed while still on the first Keytruda drug combination, but, wouldn't you know, my doctors now want me to try the second one. Merck is looking golden, however.

I haven't had any side effects from the Keytruda, but some patients do, and you should consider that as well.

Before I started taking Keytruda, I thought it was very unlikely that I would benefit (for reasons I won't go into), but I figured that there was some hope that I would, and that the risk of harm was fairly low. And I'm not the one paying $17,000 every 3 weeks. So I did it.

Is it possible for you to take Olaparib alone outside the clinical trial? Or is the trial the only way for you to get Olaparib?