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

Pembrolizumab alone in lung cancer with high PD-L1 (KEYNOTE-024)

First line in non-small cell lung cancer with PD-L1 of at least 50% and no EGFR/ALK

Updated: 28 October 20261 min read2 references

Summary for doctors

  • PD-L1 in 50% or more of tumour cells and no EGFR mutation or ALK rearrangement [1].
  • No chemotherapy; fewer side effects than chemotherapy [1].

Dose and schedule

Pembrolizumab alone

Advanced non-small cell lung cancer, PD-L1 50% or moreCycle length: Every 3 or 6 weeks

Advanced non-small cell lung cancer, PD-L1 50% or more

DrugDoseRouteSchedule
Pembrolizumab200 mg every 3 weeks (or 400 mg every 6 weeks)IVDay 1
Cycle length
Every 3 or 6 weeks
Duration
Up to 2 years or until progression

As in KEYNOTE-024 [1]; dose source: [2].

Evidence: KEYNOTE-024 (2016)

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

  • No premedication is needed; teach the symptoms of immune-related toxicity.
  • Have the EGFR and ALK results before starting (checklist).

Monitoring and dose adjustment

Main evidence

Show detailsHide

KEYNOTE-024: progression-free survival 10.3 vs 6.0 months with chemotherapy and longer overall survival, with fewer grade 3 to 5 adverse events (26.6% vs 53.3%) [1].

Related cancer types

Lung cancer

Treatment regimens (physicians)

Trastuzumab deruxtecan (T-DXd, Enhertu): dose and monitoringCarboplatin, pemetrexed and pembrolizumab (KEYNOTE-189)Carboplatin, paclitaxel and pembrolizumab (KEYNOTE-407)Carboplatin-etoposide with atezolizumab or durvalumab in small cell lung cancerDurvalumab after chemoradiotherapy in stage 3 lung cancer (PACIFIC)Osimertinib with pemetrexed and platinum (FLAURA2)Amivantamab with lazertinib (MARIPOSA)Adjuvant alectinib after surgery for ALK-positive lung cancer (ALINA)

Physician tools and lessons

Khorana Score (Cancer-Associated Thrombosis Risk)Should I Be Screened for Lung Cancer? (Pack-Year Calculator)10 cheap steps that save patients' livesManagement of brain metastasesMalignant pleural effusion: drainage, pleurodesis or an indwelling catheter

References

2 references
Show all references, 1 with a study cardClose 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 versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung CancerReck M, Rodríguez-Abreu D, Robinson AG, et al · N Engl J Med · 2016;375:1823-1833
    Study cardDOIPubMed Back to text: 1 2 3 4
  2. 2
    KEYTRUDA (PEMBROLIZUMAB) — Prescribing InformationMerck Sharp & Dohme LLC · FDA label · 2026
    Source Back to text

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-first-line-nsclc/

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