What’s Keytruda, and why is it a big deal in India’s cancer fight?

In recent years, cancer treatment has been undergoing a major shift — from directly attacking tumours to empowering the body’s own immune system to fight them. At the centre of this shift is Keytruda, a drug that has become one of the most talked-about therapies globally and increasingly relevant in India.

But what exactly is Keytruda, and why is it being seen as a game-changer?

What is Keytruda?

Keytruda is the brand name for pembrolizumab, an advanced cancer drug developed by US pharmaceutical giant Merck & Co.

It belongs to a class of drugs called checkpoint inhibitors, a type of immunotherapy. Instead of killing cancer cells directly, it helps the immune system recognise and destroy them.

How does it work?

The human immune system uses T cells to detect and attack harmful cells. However, cancer cells often “hide” by exploiting a pathway involving proteins called PD-1 (on immune cells) and PD-L1 (on cancer cells).

Keytruda blocks this interaction:

• It attaches to PD-1 receptors on T cells
• This prevents cancer cells from switching off the immune response
• As a result, T cells can identify and attack cancer cells effectively

In simple terms, Keytruda removes the brakes from the immune system.

Why is it considered revolutionary?

Traditional cancer treatments like chemotherapy and radiation:

• Directly destroy cancer cells
• Often damage healthy cells as well
• Come with significant side effects

In contrast, immunotherapy like Keytruda:

• Targets cancer more precisely
• Spares most healthy cells
• Can show long-lasting effects

In some advanced-stage cancers, patients have seen:

• Tumours shrinking dramatically
• In rare cases, complete disappearance
• Improved survival even in aggressive cancers

This shift from “destroying cancer” to “training the immune system” is what makes Keytruda a breakthrough.

What cancers is Keytruda used for?

Initially approved in 2014 for advanced skin cancer (melanoma), Keytruda is now used globally for multiple cancers, including:

• Lung cancer
• Cervical cancer
• Kidney (renal) cancer
• Triple-negative breast cancer
• Head and neck cancers

It has become one of the world’s best-selling drugs, reflecting both its demand and effectiveness.

Where does Keytruda fit in modern cancer treatment?

Cancer treatment today is no longer one-size-fits-all. Doctors often combine therapies:

• Surgery → removes tumours
• Chemotherapy → kills fast-growing cells
• Radiotherapy → targets specific areas
• Immunotherapy (like Keytruda) → strengthens immune response

Among immunotherapies, Keytruda falls under monoclonal antibodies — lab-made molecules designed to target specific pathways in cancer.

Other emerging immunotherapies include:

• CAR-T cell therapy: patient’s immune cells are engineered and reintroduced
• Cancer vaccines (mRNA-based): still under development to prevent relapse

Is Keytruda available in India?

Yes, Keytruda is available in India, especially in tertiary care hospitals and cancer centres.

India has also seen progress in immunotherapy:

• Drugs like nivolumab (another checkpoint inhibitor) are available
• Some monoclonal antibodies have generic versions
• Indigenous innovation like NexCAR19 (CAR-T therapy) has emerged

However, access remains limited due to cost.

Why is Keytruda such a big deal in India?

1. Rising cancer burden

India is witnessing a steady increase in cancer cases. Advanced therapies like Keytruda offer new hope, especially for late-stage patients.

2. Better outcomes in difficult cases

For cancers where traditional treatments fail, immunotherapy has shown:

• Extended survival
• Improved quality of life

3. Shift towards precision medicine

Keytruda represents a move towards personalised and targeted treatment, which is the future of oncology.

The biggest challenge: Cost

Despite its benefits, cost remains the biggest barrier in India.

• Standard dose: 200 mg every 3 weeks
• Cost per 100 mg vial: ₹1.5 lakh+
• Monthly cost: ₹3 lakh or more

For most patients, this is unaffordable without support.

How do patients in India access it?

To improve accessibility, several options exist:

1. Patient Access Programmes

Pharmaceutical companies offer schemes where:

• Patients buy a limited number of doses
• Additional doses are provided free
• Total initial cost may still be around ₹10 lakh

2. Insurance coverage

• General health insurance may offer partial coverage
• Specialised cancer policies provide better support

3. Government schemes

• Some patients access treatment through schemes like CGHS

However, eligibility conditions often apply, limiting access.

The larger picture: Hope vs affordability

Keytruda symbolises both hope and inequality in healthcare:

• On one hand, it represents cutting-edge science that can save lives
• On the other, its high cost makes it inaccessible to many

This gap highlights the need for:

• More affordable alternatives
• Stronger insurance penetration
• Policy support for high-cost treatments

The bottom line

Keytruda marks a fundamental shift in how cancer is treated.

By harnessing the immune system, it offers:

• Better targeting
• Longer-lasting effects
• New hope in advanced cancers

In India, its impact is growing, but real transformation will depend on making such therapies accessible, affordable, and widely available.