Lynparza (olaparib) vs Keytruda (pembrolizumab)

Lynparza (olaparib) is a targeted therapy known as a PARP inhibitor, primarily used to treat certain types of breast, ovarian, prostate, and pancreatic cancers in patients with specific genetic mutations (such as BRCA mutations). Keytruda (pembrolizumab), on the other hand, is an immunotherapy drug that works as a PD-1 inhibitor, used to treat a wide range of cancers including melanoma, lung cancer, head and neck cancer, and others by helping the immune system to detect and fight cancer cells. The choice between Lynparza and Keytruda would depend on the type of cancer, the presence of specific genetic markers, the overall health of the patient, and the treatment goals, which should be discussed with an oncologist to determine the most appropriate therapy.

Difference between Lynparza and Keytruda

Metric	Lynparza (olaparib)	Keytruda (pembrolizumab)
Generic name	Olaparib	Pembrolizumab
Indications	Ovarian, breast, pancreatic, and prostate cancers with specific genetic mutations (BRCA or HRR gene-mutated)	Various types of cancers including melanoma, non-small cell lung cancer, head and neck cancer, classical Hodgkin lymphoma, urothelial carcinoma, and more
Mechanism of action	Poly (ADP-ribose) polymerase (PARP) inhibitor, which prevents cancer cells from repairing their DNA damage, leading to cell death	Programmed death receptor-1 (PD-1) blocking antibody, which helps the immune system to detect and fight cancer cells
Brand names	Lynparza	Keytruda
Administrative route	Oral	Intravenous
Side effects	Anemia, nausea, fatigue, vomiting, respiratory infections, and blood count abnormalities	Fatigue, cough, nausea, itching, skin rash, decreased appetite, constipation, joint pain, and diarrhea
Contraindications	Known hypersensitivity to the active substance or to any of the excipients	Severe hypersensitivity to pembrolizumab or any of its excipients
Drug class	PARP inhibitor	PD-1 inhibitor
Manufacturer	AstraZeneca and Merck & Co. (MSD)	Merck & Co. (MSD)

Efficacy

Lynparza (Olaparib) Efficacy in Breast Cancer

Lynparza, also known as olaparib, is a targeted therapy known as a PARP inhibitor. It has been shown to be effective in treating certain types of breast cancer. Specifically, Lynparza is approved for the treatment of HER2-negative breast cancer that is associated with a germline BRCA mutation. Patients with this type of mutation tend to respond well to PARP inhibitors because the drugs target cancer cells' ability to repair DNA, leading to cell death. Clinical trials have demonstrated that Lynparza significantly improves progression-free survival in patients with BRCA-mutated, advanced breast cancer compared to standard chemotherapy.

In the OlympiAD trial, which was a pivotal phase III study, patients treated with Lynparza showed a median progression-free survival of 7.0 months compared to 4.2 months for those receiving chemotherapy. This study was instrumental in the approval of Lynparza for breast cancer treatment. Additionally, the quality of life was reported to be better in patients receiving Lynparza compared to those on chemotherapy, indicating not just an efficacy benefit but also an improvement in the overall treatment experience for patients.

Keytruda (Pembrolizumab) Efficacy in Breast Cancer

Keytruda, known generically as pembrolizumab, is an immunotherapy drug that works by blocking the PD-1 pathway, which some tumors exploit to evade the immune system. For breast cancer, Keytruda has shown efficacy in treating triple-negative breast cancer (TNBC), which is a more aggressive and difficult-to-treat form of the disease. The drug has been studied in combination with chemotherapy and has been found to improve survival rates in patients with advanced or metastatic TNBC that expresses PD-L1.

In the KEYNOTE-355 trial, pembrolizumab combined with chemotherapy was shown to significantly improve progression-free survival in patients with metastatic TNBC whose tumors expressed PD-L1 compared with chemotherapy alone. The median progression-free survival was 9.7 months for the pembrolizumab-chemotherapy combination versus 5.6 months for the chemotherapy alone group. This improvement in progression-free survival highlights the potential of Keytruda to enhance outcomes for patients with this challenging form of breast cancer. It is important to note that the efficacy of Keytruda can vary based on PD-L1 expression and other tumor characteristics, and it is approved for use in specific patient populations within the breast cancer spectrum.

Regulatory Agency Approvals

Lynparza

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia
Medsafe (NZ)

Keytruda

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia
Medsafe (NZ)

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