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pembrolizumab

✓ Approved

Dako · CD274 · 辅助诊断

什么是 pembrolizumab？

pembrolizumab 是一种辅助诊断，由Dako研发。该药已获批，用于治疗相关适应症，给药途径：Others。

药物档案

公司Dako
药物类别辅助诊断
分子靶点CD274
给药途径Others
状态Approved
来源： ClinicalTrials.gov, Dako

作用机制

分子靶点

pembrolizumab 作用于 1 个分子靶点：

CD274CD274 molecule (B7H1, B7-H)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

pembrolizumab 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Neoplasms benign, malignant and unspecified (incl cysts and polyps)Uterine cancer✓ Approved

相关研究文献

PubMedAntibiotics (Basel, Switzerland)2026-07-27

Evolution and Antimicrobial Resistance Profiles of Klebsiella spp. Infections in Companion Animals in the Iberian Peninsula.

Jiménez-Serrano María M, Vidal Anna A, Duran Inma I, Seminati Chiara C et al.

Antimicrobial resistance (AMR) in companion animals is an increasing concern within the One Health framework, particularly regarding opportunistic pathogens such as Klebsiella spp. This retrospective study evaluated the epidemiology, antimicrobial susceptibility profiles, and temporal resistance trends of Klebsiella spp. infections in dogs and cats across the Iberian Peninsula. A total of 809 clinical isolates collected between 2016 and 2024 and submitted to a private diagnostic laboratory in Barcelona were analysed. Klebsiella pneumoniae was the predominant species (70%), more frequently identified in cats (76%) than in dogs (68%). Dermatological and respiratory samples exhibited the highest prevalence of multidrug-resistant (MDR) isolates. Overall MDR prevalence was high, particularly in cats (51.1%; 95% CI 41.1-60.9%) compared with dogs (38.4%; 95% CI 34.1-42.8%) although it was not statistically significant. K. pneumoniae generally exhibited higher resistance rates than K. oxytoca, particularly to amoxicillin/clavulanic acid, first-/second-generation cephalosporins, third-/fourth-generation cephalosporins (3/4th GC), fluoroquinolones, and tetracyclines. In both bacterial species, resistance rates were consistently higher among feline isolates. In contrast, aminoglycosides and phenicols retained high activity against most isolates. Temporal analysis revealed a significant increasing resistance trend to amoxicillin/clavulanic acid, which is particularly concerning given the widespread use of this antimicrobial as a first-line treatment in small animal practice. However, resistance trend to aminoglycosides showed a significant decline. No significant temporal changes were detected for 3/4th GC and fluoroquinolones, suggesting the persistence of resistant populations within companion animals. Resistance to aminoglycosides and phenicols remained comparatively low in this study. Whereas critically important category B antimicrobials, such as 3/4th GC and fluoroquinolones, exhibited low to moderate effectiveness, raising concerns about their empirical use. These findings highlight the substantial AMR and MDR burden of K. pneumoniae in companion animals in the Iberian Peninsula and reinforce the need for prudent antimicrobial use, routine susceptibility testing, and integrated One Health surveillance strategies.

PMID 42505641
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PubMedInternational journal of clinical pharmacy2026-07-27

Cost-effectiveness of first-line pembrolizumab monotherapy in PD-L1-high metastatic non-small cell lung cancer in Australia: evidence from trials and real-world practice.

Teppala Srinivas S, Koo Juhee J, Tan Edwin C K ECK, Clarke Stephen S et al.

Pembrolizumab monotherapy improves survival in advanced non-small cell lung cancer (NSCLC) with programmed death ligand 1 (PD-L1) tumour proportion score (TPS) ≥ 50%. However, survival in randomised trials may not fully reflect outcomes in routine practice, with implications for economic evaluation. To evaluate the cost-effectiveness of pembrolizumab monotherapy compared with platinum-based chemotherapy from an Australian health-payer perspective, integrating both randomised controlled trial (RCT) and real-world evidence (RWE). A semi-Markov model with three health states (progression-free, progressed disease, death) was developed over a 3-year horizon. Clinical inputs were derived from KEYNOTE-024 for the RCT scenario and from nationwide Australian real-world data for the RWE scenario, with chemotherapy outcomes retained from the pivotal trials in both scenarios. Direct medical costs (2024 AU$) and quality-adjusted life years (QALYs) were estimated. Incremental cost-effectiveness ratios (ICERs) were calculated, probabilistic and deterministic sensitivity analyses conducted. Compared with chemotherapy, pembrolizumab monotherapy was associated with incremental costs of AU$87,399 (RCT-based) and AU$75,935 (RWE-based), and incremental QALY gains of 0.23 and 0.11, respectively. Corresponding ICERs were AU$385,561/QALY (RCT) and AU$705,729/QALY (RWE). At a AU$75,000/QALY willingness-to-pay (WTP) threshold, the probability of cost-effectiveness was < 1% in both scenarios. Differences in overall survival between trial and real-world cohorts likely contributed to the variation in ICERs. At current pricing and Australian WTP thresholds, pembrolizumab monotherapy is unlikely to be cost-effective, with RWE-informed scenarios yielding less favourable cost-effectiveness estimates than from trial data. These findings highlight that cost-effectiveness estimates may be sensitive to differences between trial-based and real-world effectiveness inputs.

PMID 42507245
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PubMedCureus2026-07-27

Pembrolizumab-Induced Checkpoint Inhibitor-Associated Diabetes Mellitus in Triple-Negative Breast Cancer: A Case Report.

Jahan Shawlin S, Paabon Haseen Ishraque HI, Cho Kabyar K

Immune checkpoint inhibitors (ICIs) have transformed the management of multiple malignancies but can lead to immune-related adverse events (irAEs) affecting endocrine organs. Diabetes mellitus secondary to ICIs is uncommon but potentially life-threatening. We report a case of new-onset insulin-dependent diabetes developing during pembrolizumab therapy in a patient treated for triple-negative breast cancer. The patient presented with severe hyperglycaemia and ketosis after several cycles of immunotherapy. Autoimmune diabetes antibodies were negative, and C-peptide levels indicated relative insulin deficiency. Glycaemic control remained challenging after discharge, with alternating hyperglycaemia and hypoglycaemia despite insulin therapy. This case highlights the variability in the presentation of checkpoint inhibitor-associated diabetes and the challenges in ongoing glycaemic management.

PMID 42504311
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PubMedAntibiotics (Basel, Switzerland)2026-07-27

First Report of a blaOXA-484-Harbouring Escherichia coli ST167 Isolated from the Urine Sample of a Dog of Italian Origin.

Biggel Michael M, Nüesch-Inderbinen Magdalena M, Schmitt Sarah S, Schneeberger Marianne M et al.

Antimicrobial resistance (AMR) is a global threat to both human and animal health. Carbapenems are last-resort antimicrobials used to treat severe infections with multidrug-resistant Gram-negative nosocomial pathogens in humans. Therefore, the dissemination of carbapenemase-producing Enterobacterales (CPE) has emerged as a major concern worldwide. Although carbapenems are not routinely used in veterinary medicine, CPE, including OXA-48-like-producing Escherichia coli, are increasingly being reported in companion animals. We document the first report of E. coli-harbouring blaOXA-484 isolated from a urine sample from a dog with a history of chronic thoracolumbar myelopathy. Using a combined Oxford Nanopore (ONT) long-reads and Illumina short-reads sequencing approach, the isolate was characterized and an IncF plasmid containing blaOXA-484 was reconstructed. The isolate belonged to sequence type (ST)167, which is an emerging high-risk clone frequently reported among human clinical isolates. The blaOXA-484 gene was harboured in a composite transposon bracketed by IS26 identical to that of blaOXA-484 carried on an IncX plasmid pOXA-484-JS316 from a human clinical E. coli ST410 from Germany. The isolation of the epidemic clone ST167 harbouring blaOXA-484 from a canine infection raises the hypothesis of a transmission event between humans and companion animals.

PMID 42505615
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PubMedIJU case reports2026-07-27

Laparoscopic Transplant Nephrectomy Using a Combination of Intracapsular and Extracapsular Approaches for Graft Intolerance Syndrome in Failed Renal Allografts.

Naroda Yuto Y, Ochi Atsuhiko A, Fukagai Ryutaro R, Shimogawa Maiko M et al.

Transplant nephrectomy for graft intolerance syndrome is technically challenging because severe perirenal adhesions increase bleeding risk. Despite the increasing adoption of minimally invasive techniques, optimal laparoscopic strategies remain limited. A 49-year-old man developed pembrolizumab-induced graft intolerance syndrome (GIS) following surgery for native renal cell carcinoma. To enable safe continuation of immunotherapy, laparoscopic transplant nephrectomy was performed. Despite severe adhesions, a combined intracapsular and extracapsular approach enabled safe graft removal. Multiple feeding vessels were divided using a vessel-sealing device and soft coagulation, while avoiding extensive hilar dissection. Postoperative computed tomography confirmed complete resection of the allograph, with no radiologically evident residual tissue or postoperative complications. This hybrid laparoscopic approach is a safe, minimally invasive option for managing GIS with severe adhesions.

PMID 42504327
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PubMedJournal of clinical microbiology2026-07-27

Veterinary-specific breakpoints for ceftiofur applicable to canine Escherichia coli.

Dang Xukun X, Chen Siyu S, Lyu Hening H, Zou Zhiyu Z et al.

Ceftiofur is a third-generation cephalosporin approved for veterinary applications and is used to treat Escherichia coli infections in dogs, particularly urinary tract infections (UTIs), in countries including China. Despite this use, there are no approved breakpoints for interpretation of ceftiofur susceptibility testing results. This absence limits the guidance that veterinarians need to effectively prescribe ceftiofur in dogs. It also limits the analysis of data from resistance monitoring and surveillance programs. This study aimed to establish ceftiofur interpretive categories and breakpoints that can be used to assess antimicrobial susceptibility testing results for canine E. coli isolates. Our methods included a definition of the wild-type cutoff (COWT) based on resistance phenotypes from two sources, deriving the pharmacokinetics/pharmacodynamics (PK-PD) cutoff (COPD) through PK-PD analyses and Monte Carlo simulations and determining the clinical cutoff (COCL) from a trial in dogs. Minimal inhibitory concentration (MIC) data were collected from China and the European database (European Committee on Antimicrobial Susceptibility Testing [EUCAST]). COWT was determined as 1 μg/mL. The COPD was 0.25 μg/mL. Through a canine cystitis trial, a COCL of 2 μg/mL was determined. Based on these findings and Clinical and Laboratory Standards Institute (CLSI)-recommended methods, we propose urinary tract infection-specific MIC breakpoints of ≤1 µg/mL (susceptible), 2 μg/mL (intermediate), and ≥4 µg/mL (resistant) and corresponding disk diffusion zone diameter breakpoints, determined by the error rate-bounded (ERB) method, of ≥23 mm (susceptible), 20-22 mm (intermediate), and ≤19 mm (resistant). The systemic breakpoints (non-urine) were determined to be ≤0.125 µg/mL (susceptible), 0.25 μg/mL (intermediate), and ≥0.5 µg/mL (resistant).IMPORTANCECeftiofur can be legally used, but laboratories and veterinarians lack canine-specific breakpoints to determine whether an isolate is susceptible or resistant. Without such criteria, test results can be inconsistent, treatment choices uncertain, and early signs of emerging resistance overlooked. This study fills that gap by defining evidence-based, canine-specific breakpoints for ceftiofur, particularly for urinary tract infections (UTIs). Adoption of these breakpoints will allow more consistent reporting by diagnostic laboratories, improve therapeutic decision-making for veterinarians, and provide a reliable basis for resistance surveillance. These advances strengthen the One-Health antimicrobial stewardship and help preserve the effectiveness of important antimicrobials for companion animals and the wider community.

PMID 42506934
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