Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Treatment regimen

Pembrolizumab with chemotherapy in metastatic triple-negative breast cancer (KEYNOTE-355)

First line with PD-L1 (CPS 10 or more)

Updated: 28 October 20261 min read2 references

Summary for doctors

  • Metastatic or unresectable recurrent triple-negative breast cancer, first line, PD-L1 CPS 10 or more [1].
  • Three chemotherapy choices with pembrolizumab [2].

Dose and schedule

Pembrolizumab + chemotherapy

Metastatic TNBC, CPS 10 or moreEach drug’s schedule in the table

Metastatic TNBC, CPS 10 or more

DrugDoseRouteSchedule
Pembrolizumab200 mgIVEvery 3 weeks
One of
Nab-paclitaxel100 mg/m²IVDays 1, 8 and 15 every 28 days
Paclitaxel90 mg/m²IVDays 1, 8 and 15 every 28 days
Gemcitabine 1000 mg/m² + carboplatin AUC 2IVDays 1 and 8 every 21 days
Cycle schedule
Pembrolizumab every 3 weeks; chemotherapy according to the chosen regimen
Duration
Until progression; pembrolizumab up to 35 cycles

Dose source: [2].

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Premedication and supportive care

  • Paclitaxel premedication; antiemetics according to the regimen.

Monitoring and dose adjustment

Main evidence

Show detailsHide

KEYNOTE-355: with CPS 10 or more, median progression-free survival 9.7 vs 5.6 months [1].

Related cancer types

Breast cancer

Treatment regimens (physicians)

AC followed by paclitaxel (dose-dense and weekly)TC regimen (docetaxel and cyclophosphamide): dose and scheduleTCHP regimen: dose and schedule in HER2-positive breast cancerWeekly paclitaxel with trastuzumab (APT regimen)KEYNOTE-522 regimen: pembrolizumab and chemotherapy in triple-negative breast cancerTrastuzumab emtansine (T-DM1, Kadcyla): dose and scheduleTrastuzumab deruxtecan (T-DXd, Enhertu): dose and monitoringAdjuvant capecitabine after neoadjuvant treatment (CREATE-X)Sacituzumab govitecan (Trodelvy)

Physician tools and lessons

Cumulative Anthracycline Dose and Doxorubicin Equivalents10 cheap steps that save patients' livesBone-modifying agents in cancer: bone metastases, adjuvant use and osteonecrosis of the jawGermline genetic testing in cancer: who, and which genes?Management of brain metastasesFertility preservation before cancer treatmentMalignant pleural effusion: drainage, pleurodesis or an indwelling catheterCancer during pregnancy: chemotherapy and decisions

References

2 references
Show all referencesClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer (KEYNOTE-355): a randomised, placebo-controlled, double-blind, phase 3 clinical trialCortes J, Cescon DW, Rugo HS, et al · Lancet · 2020;396:1817-1828
    DOIPubMed Back to text: 1 2
  2. 2
    KEYTRUDA (PEMBROLIZUMAB) — Prescribing InformationMerck Sharp & Dohme LLC · FDA label · 2026
    Source Back to text: 1 2

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/pembrolizumab-chemotherapy-metastatic-tnbc/

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