pembrolizumab + melphalan + dactinomycin

This therapeutic regimen is a combination of the systemic immunotherapy drug pembrolizumab and regional chemotherapy consisting of melphalan and dactinomycin. Pembrolizumab is a humanized monoclonal antibody that acts as a checkpoint inhibitor by binding to the programmed cell death protein 1 (PD-1) receptor on T-cells, blocking its interaction with ligands PD-L1 and PD-L2, thereby restoring the immune system's ability to recognize and attack tumor cells. Melphalan is a nitrogen mustard alkylating agent that causes DNA cross-linking, while dactinomycin is a cytotoxic antibiotic that intercalates into DNA and inhibits RNA synthesis. In this specific protocol developed by Memorial Sloan Kettering Cancer Center, pembrolizumab is administered intravenously in conjunction with melphalan and dactinomycin delivered via isolated limb infusion (ILI), a technique that isolates the blood circulation of an extremity to deliver high-dose chemotherapy locally. This approach is being evaluated in Phase II trials for patients with locally advanced or metastatic extremity sarcomas, including myxofibrosarcoma, undifferentiated pleomorphic sarcoma, and alveolar soft part sarcoma.

Brand names

Keytruda

Other names

pembrolizumabmelphalandactinomycinactinomycin DIsolated Limb Infusion with Melphalan and Dactinomycin