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Is Pembrolizumab effective for urothelial cancer?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am 62 years old. My urothelial cancer has spread, and after not responding to chemotherapy, my doctor recommended Pembrolizumab (Keytruda) as the next treatment.

  1. How does this treatment compare to traditional chemotherapy in terms of effectiveness?
  2. I am especially concerned about my quality of life during treatment. Are the side effects from Pembrolizumab milder or more severe than those from chemotherapy?
  3. Also, what is the success rate of Pembrolizumab in cases like mine, where the cancer has already spread?

Kindly help.

Thank you.

Answered by Dr. Sugandh Garg

Education:

MBBS

Professional Bio:

Dr. Sugandh Garg is a qualified medical professional with an MBBS degree and an MD in Forensic Medicine, with significant experience as a COVID-19 expert. Since March 2020, he has been actively working with the government civil hospital COVID team, managing emergency cases and overseeing quarantine and isolation protocols. He has played a key role in supporting COVID-19 patients through structured treatment guidance and diet protocols, contributing to effective patient care during the pandemic.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

I understand your concern.

Pembrolizumab is an immunotherapy drug that works as a PD-1 (programmed death receptor-1) inhibitor. Unlike chemotherapy, which directly targets and kills rapidly dividing cancer cells, Pembrolizumab boosts the immune system's ability to recognise and attack cancer cells. It does this by blocking the PD-1 receptor on T-cells, which ‘reactivates’ the immune system to fight the cancer.

Pembrolizumab has been shown to provide a survival benefit in advanced urothelial cancer, especially when chemotherapy has not worked. It is generally better tolerated than chemotherapy. While chemotherapy can cause severe side effects like nausea, vomiting, hair loss, fatigue, and an increased risk of infections due to bone marrow suppression, the side effects of Pembrolizumab are usually milder, including fatigue, skin rash, diarrhea, and hypothyroidism.

One of the advantages of Pembrolizumab is its treatment schedule, which is every three to six weeks. This means fewer hospital visits compared to chemotherapy. Be sure to discuss this treatment with your oncologist.

I hope you are satisfied with my answer.

Thank you.

Medically reviewed by iCliniq medical review team
Published At December 10, 2024
Reviewed At June 22, 2026

Education:

MBBS

Professional Bio:

Dr. Sugandh Garg is a qualified medical professional with an MBBS degree and an MD in Forensic Medicine, with significant experience as a COVID-19 expert. Since March 2020, he has been actively working with the government civil hospital COVID team, managing emergency cases and overseeing quarantine and isolation protocols. He has played a key role in supporting COVID-19 patients through structured treatment guidance and diet protocols, contributing to effective patient care during the pandemic.

This doctor is not available for online consultations on the platform anymore.

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Education:

MBBS

Professional Bio:

Dr. Sugandh Garg is a qualified medical professional with an MBBS degree and an MD in Forensic Medicine, with significant experience as a COVID-19 expert. Since March 2020, he has been actively working with the government civil hospital COVID team, managing emergency cases and overseeing quarantine and isolation protocols. He has played a key role in supporting COVID-19 patients through structured treatment guidance and diet protocols, contributing to effective patient care during the pandemic.

This doctor is not available for online consultations on the platform anymore.

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