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Oncology"}}]}},"content":[{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"38X0xdWaBoZkTfBFlR2Fbi","type":"Entry","createdAt":"2023-06-05T11:55:05.089Z","updatedAt":"2023-06-05T11:55:05.089Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"sectionRichTextContent"}},"locale":"en-US"},"fields":{"entryTitle":"Media Center > Blogs > Exploring One Medicine for One Patient: Individualized Neoantigen Therapies > Text 1","content":{"data":{},"content":[{"data":{},"content":[{"data":{},"marks":[],"value":"Each person’s cancer is different because cancer cells have genetic mutations that make them unique, which can make the cancer difficult to treat. That's why we, in collaboration with Merck, are researching mRNA medicines that are designed specifically for an individual patient. Individualized neoantigen therapies (INTs) are an innovative approach that tailor treatment to each patient's individual cancer.","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"This week, we are participating in the American Society for Clinical Oncology (ASCO) ","nodeType":"text"},{"data":{"uri":"https://conferences.asco.org/am/attend"},"content":[{"data":{},"marks":[],"value":"Annual Meeting","nodeType":"text"}],"nodeType":"hyperlink"},{"data":{},"marks":[],"value":", where distant metastasis-free survival (DMFS) results from the Phase 2b study of our investigational mRNA individualized neoantigen therapy, mRNA-4157 (V940), in combination with KEYTRUDA® (pembrolizumab), Merck’s anti-PD-1 therapy, for the adjuvant treatment of patients with high-risk stage III/IV melanoma following complete resection, will be presented. The ASCO Annual Meeting is the world’s largest oncology conference, and we are honored to share these new data with the global oncology community.","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"We are incredibly grateful to the participants in our clinical trials and the investigators and clinical trial staff who are helping to advance this important cancer research.","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[{"type":"bold"}],"value":"One Medicine for One Patient: Individualizing Cancer Research","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"Even after 50 years of clinical trials, cancer vaccine-based approaches have had little success, as no cancer vaccine containing regimen has shown recurrence-free survival benefit compared to the traditional standard of care.¹","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"Developments in the field of immunotherapy have transformed our understanding of the immune system’s role in fighting certain types of cancer. By building on developments in immunologic understanding and cancer biology, we are researching and developing an individualized treatment approach specific to each patient’s own tumor. Moderna, in collaboration with Merck, is exploring INTs as a therapeutic option designed to potentially train and activate the immune system to increase its ability to fight cancer. With this work, we hope to further advance the field of immuno-oncology.","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"Cancer cells express abnormal proteins, or neoantigens, that are not usually seen in normal cells. These cancer proteins make up a patient’s cancer “fingerprint.” Individualized neoantigen therapies are designed with the goal of specifically matching one patient's unique cancer fingerprint. The goal of individualized neoantigen therapies is to train a patient's immune cells to recognize the cancer fingerprint proteins and launch an immune response against the cancer cells.","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"Individualized neoantigen therapies are currently being studied in clinical trials. 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Sequencing is then performed in a lab to compare data from the tumor biopsy sample and the study participant’s healthy blood cells, which are not mutated, to identify the unique genetic mutations of that individual’s cancer.\n","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"A proprietary algorithm developed in collaboration with Merck then reviews these mutations and predicts up to 34 of those mutations that are believed to help the study participant’s immune system better recognize tumor cells and to launch an attack. Next, the investigational individualized neoantigen therapy is created to give cells instructions to make the “fingerprint” cancer protein, with the goal of helping the body recognize and attack that study participant’s unique cancer. \n","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Following the design stage, this information is then sent to our manufacturing facility in Norwood, MA, where the individualized neoantigen therapy is manufactured. The individualized neoantigen therapy is then placed in a vial and shipped back to the clinical trial site where a healthcare professional administers it to the study patient via intramuscular injection.","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Data Being Presented at the ASCO Annual Meeting","marks":[{"type":"bold"}],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Today, we are presenting distant metastasis-free survival (DMFS) results from the Phase 2b randomized KEYNOTE-942/mRNA-4157-P201 study. In the overall intention-to-treat population, adjuvant treatment with mRNA-4157 (V940) in combination with KEYTRUDA demonstrated a statistically significant and clinically meaningful improvement in DMFS, a key secondary endpoint of the study, compared with KEYTRUDA alone and reduced the risk of developing distant metastases or death by 65% (HR = 0.347 [95% CI, 0.145- 0.828]); one-sided p value=0.0063). The secondary endpoint of DMFS, defined as the time from the first dose of KEYTRUDA until the date of first distant recurrence or death from any cause, was pre-specified for statistical testing following the positive primary endpoint of recurrence-free survival (RFS).","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Adverse events reported with mRNA-4157 (V940) in KEYNOTE-942 were consistent with those previously observed in a Phase 1 clinical trial. The safety profile of KEYTRUDA was consistent with findings from previous studies. The number of patients reporting treatment related Grade ≥ 3 adverse events were similar between the arms (25% vs. 18%, respectively). The most common adverse events of any grade attributed to either mRNA-4157 (V940) or the combination of mRNA-4157 (V940) and KEYTRUDA were fatigue (60.6%), injection site pain (55.8%) and chills (50.0%).","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"At ASCO, we are also presenting data from an exploratory subgroup analysis of KEYNOTE-942/mRNA-4157-P201, evaluating minimal residual disease (MRD) by circulating tumor DNA (ctDNA) as a biomarker of recurrence-free survival (RFS) in resected high-risk melanoma patients treated with mRNA-4157 (V940) in combination with KEYTRUDA.","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Phase 2b Study of mRNA Individualized Neoantigen Therapy: Recurrence-Free Survival","marks":[{"type":"bold"}],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"With Merck, we are studying our investigational mRNA individualized neoantigen therapy given in combination with KEYTRUDA compared to KEYTRUDA alone. We selected KEYTRUDA as the comparator in KEYNOTE-942/mRNA-4157-P201 study because it is considered a standard of care in adjuvant melanoma. 107 patients received the combination of our investigational mRNA-4157 (V940) with KEYTRUDA and 50 patients were treated with KETRUDA alone.\n","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"In April at the American Association for Cancer Research (AACR) Annual Meeting, we presented data on the recurrence-free survival (RFS) primary endpoint of the KEYNOTE-942/mRNA-4157-P201 Phase 2b study in patients with stage III/IV melanoma following complete resection. These data showed that mRNA-4157 (V940) in combination with KEYTRUDA demonstrated a statistically significant and clinically meaningful improvement in RFS versus KEYTRUDA alone.","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Specifically, individualized neoantigen therapy in combination with KEYTRUDA reduced the risk of recurrence or death by 44% (HR =0.56 [95% CI, 0.31-1.017]; one-sided p value =0.0266), compared with KEYTRUDA alone.","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Adverse events reported with mRNA-4157 (V940) in KEYNOTE-942 previously presented at AACR were consistent with those currently shared at ASCO. ","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Based on data from the Phase 2b study, mRNA-4157 (V940) in combination with KEYTRUDA for the adjuvant treatment of patients with high-risk melanoma following complete resection was granted Breakthrough Therapy Designation by the U.S. Food and Drug Administration (FDA) and was granted Priority Medicines (PRIME) scheme by the European Medicines Agency. \n","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Looking Ahead","marks":[{"type":"bold"}],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"These results add greater insight into the potential promise of an mRNA individualized\nneoantigen approach to addressing cancer. ","marks":[],"data":{}},{"nodeType":"text","value":"Looking ahead, in collaboration with Merck,","marks":[],"data":{}},{"nodeType":"text","value":" we plan to initiate a Phase 3 study in melanoma in 2023 and rapidly expand our efforts to study additional tumor types including non-small cell lung cancer. We will continue to research individualized neoantigen approaches with the goal of potentially helping more patients with cancer. ","marks":[],"data":{}}]}]},"alignment":"center","sizing":"full","showImage":false}},{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"4aegwqBc3XepFAjB0dezFj","type":"Entry","createdAt":"2023-06-05T11:55:05.198Z","updatedAt":"2023-06-05T11:55:05.198Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"sectionMediaBlock"}},"locale":"en-US"},"fields":{"entryTitle":"Media Center > Blogs > Exploring One Medicine for One Patient: Individualized Neoantigen Therapies > Image 2","sizing":"center","media":{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"TjALs4xXddD6l2IU7XvT3","type":"Entry","createdAt":"2023-06-05T11:55:06.024Z","updatedAt":"2023-06-05T11:55:06.024Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"wrapperMedia"}},"locale":"en-US"},"fields":{"title":"Media Center > Blogs > Exploring One Medicine for One Patient: Individualized Neoantigen Therapies > Image 2","fileType":"Image","image":{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"11i40OujZfhDbNuxSetgW8","type":"Asset","createdAt":"2023-06-05T11:55:04.672Z","updatedAt":"2023-06-05T11:55:04.672Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"locale":"en-US"},"fields":{"title":"Media Center > Blogs > Exploring One Medicine for One Patient: Individualized Neoantigen Therapies > Image 2","description":"","file":{"url":"//images.ctfassets.net/87hacmv3x18u/11i40OujZfhDbNuxSetgW8/d147455eaeb2fa5afc41f7f6205ee828/What_makes_each_cancer_unique.png","details":{"size":929480,"image":{"width":2248,"height":1114}},"fileName":"What makes each cancer unique.png","contentType":"image/png"}}},"focalPoint":{"focalPoint":{"x":1124,"y":557}}}}}}],"localDisclaimer":{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"511Qn2I89pe4PLFrXzBzKt","type":"Entry","createdAt":"2023-06-05T11:55:05.319Z","updatedAt":"2023-06-05T11:55:05.319Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"sectionDisclaimer"}},"locale":"en-US"},"fields":{"entryTitle":"Media Center > Blogs > Exploring One Medicine for One Patient: Individualized Neoantigen Therapies","content":{"nodeType":"document","data":{},"content":[{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Moderna Forward-Looking Statements\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\n","marks":[],"data":{}},{"nodeType":"text","value":"This post contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, as amended, including statements regarding: the development by Moderna and Merck of an individualized neoantigen therapy (mRNA-4157/V940); the ability and potential for mRNA-4157/V940 to improve distant metastasis-free survival (DMFS) in patients with high-risk stage III/IV melanoma; the ability and potential for mRNA-4157/V940 to improve recurrence-free survival (RFS) rates in stage III/IV melanoma patients; the tolerability and safety profile for mRNA-4157/V940; the potential for mRNA, including mRNA-4157, to effectively treat different types of cancer; plans to initiate a Phase 3 study in melanoma in 2023 and rapidly expand to additional tumor types, including non-small cell lung cancer; the potential development of individualized neoantigen therapies and treatments the ability of an individualized neoantigen therapy to trigger a tailored antitumor response specific to a patient's tumor mutation signature; and the potential for regulatory approval and commercialization of mRNA-4157/V940 and the implications for the EMA's PRIME scheme designation for mRNA-4157/V940 and the FDA's Breakthrough Therapy Designation for mRNA-4157/V940. In some cases, forward-looking statements can be identified by terminology such as \"will,\" \"may,\" \"should,\" \"could,\" \"expects,\" \"intends,\" \"plans,\" \"aims,\" \"anticipates,\" \"believes,\" \"estimates,\" \"predicts,\" \"potential,\" \"continue,\" or the negative of these terms or other comparable terminology, although not all forward-looking statements contain these words. The forward-looking statements in this post are neither promises nor guarantees, and you should not place undue reliance on these forward-looking statements because they involve known and unknown risks, uncertainties, and other factors, many of which are beyond Moderna's control and which could cause actual results to differ materially from those expressed or implied by these forward-looking statements. These risks, uncertainties, and other factors include, among others, those risks and uncertainties described under the heading \"Risk Factors\" in Moderna's Annual Report on Form 10-K for the fiscal year ended December 31, 2022 filed with the U.S. Securities and Exchange Commission (SEC), and in subsequent filings made by Moderna with the SEC, which are available on the SEC's website at www.sec.gov. Except as required by law, Moderna disclaims any intention or responsibility for updating or revising any forward-looking statements contained in this post in the event of new information, future developments or otherwise. These forward-looking statements are based on Moderna's current expectations and speak only as of the date of this post.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"About Melanoma","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nThe most serious form of skin cancer, Melanoma is characterized by the uncontrolled growth of pigment-producing cells. The rates of melanoma have been rising over the past few decades, with nearly 325,000 new cases diagnosed worldwide in 2020. In the U.S., skin cancer is one of the most common types of cancer diagnosed, and melanoma accounts for a large majority of skin cancer deaths. It is estimated there will be nearly 100,000 new cases of melanoma diagnosed and almost 8,000 deaths resulting from the disease in the U.S. in 2022.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"About KEYTRUDA® (pembrolizumab) injection, 100 mg\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is an anti-programmed death receptor-1 (PD-1) therapy that works by increasing the ability of the body’s immune system to help detect and fight tumor cells.\nKEYTRUDA is a humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2, thereby activating T lymphocytes which may affect both tumor cells and healthy cells.\nMerck has the industry’s largest immuno-oncology clinical research program. There are currently more than 1,600 trials studying KEYTRUDA across a wide variety of cancers and treatment settings. The KEYTRUDA clinical program seeks to understand the role of KEYTRUDA across cancers and the factors that may predict a patient's likelihood of benefitting from treatment with KEYTRUDA, including exploring several different biomarkers.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Selected KEYTRUDA® (pembrolizumab) Indications in the U.S.","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\n","marks":[],"data":{}},{"nodeType":"text","value":"Melanoma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with unresectable or metastatic melanoma.\nKEYTRUDA is indicated for the adjuvant treatment of adult and pediatric (12 years and older) patients with stage IIB, IIC, or III melanoma following complete resection.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Non-Small Cell Lung Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA, in combination with pemetrexed and platinum chemotherapy, is indicated for the first-line treatment of patients with metastatic nonsquamous non-small cell lung cancer (NSCLC), with no EGFR or ALK genomic tumor aberrations.\nKEYTRUDA, in combination with carboplatin and either paclitaxel or paclitaxel protein-bound, is indicated for the first-line treatment of patients with metastatic squamous NSCLC.\nKEYTRUDA, as a single agent, is indicated for the first-line treatment of patients with NSCLC expressing PD-L1 [tumor proportion score (TPS) ≥1%] as determined by an FDA-approved test, with no EGFR or ALK genomic tumor aberrations, and is:\n-stage III where patients are not candidates for surgical resection or definitive chemoradiation, or\n -metastatic.\nKEYTRUDA, as a single agent, is indicated for the treatment of patients with metastatic NSCLC whose tumors express PD-L1 (TPS ≥1%) as determined by an FDA-approved test, with disease progression on or after platinum-containing chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving KEYTRUDA.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Head and Neck Squamous Cell Cancer\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA, in combination with platinum and fluorouracil (FU), is indicated for the first-line treatment of patients with metastatic or with unresectable, recurrent head and neck squamous cell carcinoma (HNSCC).\nKEYTRUDA, as a single agent, is indicated for the first-line treatment of patients with metastatic or with unresectable, recurrent HNSCC whose tumors express PD-L1 [Combined Positive Score (CPS) ≥1] as determined by an FDA-approved test.\nKEYTRUDA, as a single agent, is indicated for the treatment of patients with recurrent or metastatic HNSCC with disease progression on or after platinum-containing chemotherapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Classical Hodgkin Lymphoma","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of adult patients with relapsed or refractory classical Hodgkin lymphoma (cHL).\nKEYTRUDA is indicated for the treatment of pediatric patients with refractory cHL, or cHL that has relapsed after 2 or more lines of therapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Primary Mediastinal Large B-Cell Lymphoma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma (PMBCL), or who have relapsed after 2 or more prior lines of therapy. \nKEYTRUDA is not recommended for treatment of patients with PMBCL who require urgent cytoreductive therapy.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Urothelial Carcinoma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC):\n- who are not eligible for any platinum-containing chemotherapy, or\n- who have disease progression during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Non-muscle Invasive Bladder Cancer\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with Bacillus Calmette-Guerin-unresponsive, high-risk, non-muscle invasive bladder cancer (NMIBC) with carcinoma in situ with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Microsatellite Instability-High or Mismatch Repair Deficient Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of adult and pediatric patients with unresectable or metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) solid tumors, as determined by an FDA-approved test, that have progressed following prior treatment and who have no satisfactory alternative treatment options.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Microsatellite Instability-High or Mismatch Repair Deficient Colorectal Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of patients with unresectable or metastatic MSI-H or dMMR colorectal cancer (CRC) as determined by an FDA-approved test.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Gastric Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA, in combination with trastuzumab, fluoropyrimidine- and platinum-containing chemotherapy, is indicated for the first-line treatment of patients with locally advanced unresectable or metastatic HER2-positive gastric or gastroesophageal junction (GEJ) adenocarcinoma. \nThis indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Esophageal Cancer\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with locally advanced or metastatic esophageal or gastroesophageal junction (GEJ) (tumors with epicenter 1 to 5 centimeters above the GEJ) carcinoma that is not amenable to surgical resection or definitive chemoradiation either:\n- in combination with platinum- and fluoropyrimidine-based chemotherapy, or\n- as a single agent after one or more prior lines of systemic therapy for patients with tumors of squamous cell histology that express PD-L1 (CPS ≥10) as determined by an FDA-approved test.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Cervical Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA, in combination with chemotherapy, with or without bevacizumab, is indicated for the treatment of patients with persistent, recurrent, or metastatic cervical cancer whose tumors express PD-L1 (CPS ≥1) as determined by an FDA-approved test.\nKEYTRUDA, as a single agent, is indicated for the treatment of patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express PD-L1 (CPS ≥1) as determined by an FDA-approved test. ","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Hepatocellular Carcinoma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Merkel Cell Carcinoma","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of adult and pediatric patients with recurrent locally advanced or metastatic Merkel cell carcinoma (MCC). This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Renal Cell Carcinoma","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA, in combination with axitinib, is indicated for the first-line treatment of adult patients with advanced renal cell carcinoma (RCC). \nKEYTRUDA is indicated for the adjuvant treatment of patients with RCC at intermediate-high or high risk of recurrence following nephrectomy, or following nephrectomy and resection of metastatic lesions. \n\n","marks":[],"data":{}},{"nodeType":"text","value":"Endometrial Carcinoma","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA, as a single agent, is indicated for the treatment of patients with advanced endometrial carcinoma that is MSI-H or dMMR, as determined by an FDA-approved test, who have disease progression following prior systemic therapy in any setting and are not candidates for curative surgery or radiation.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Tumor Mutational Burden-High Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of adult and pediatric patients with unresectable or metastatic tumor mutational burden-high (TMB-H) [≥10 mutations/megabase] solid tumors, as determined by an FDA-approved test, that have progressed following prior treatment and who have no satisfactory alternative treatment options. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials. The safety and effectiveness of KEYTRUDA in pediatric patients with TMB-H central nervous system cancers have not been established.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Cutaneous Squamous Cell Carcinoma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with recurrent or metastatic cutaneous squamous cell carcinoma (cSCC) or locally advanced cSCC that is not curable by surgery or radiation.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Triple-Negative Breast Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of patients with high-risk early-stage triple-negative breast cancer (TNBC) in combination with chemotherapy as neoadjuvant treatment, and then continued as a single agent as adjuvant treatment after surgery.\nKEYTRUDA, in combination with chemotherapy, is indicated for the treatment of patients with locally recurrent unresectable or metastatic TNBC whose tumors express PD-L1 (CPS ≥10) as determined by an FDA-approved test.\n","marks":[],"data":{}},{"nodeType":"text","value":"\nSelected Important Safety Information for KEYTRUDA\nSevere and Fatal Immune-Mediated Adverse Reactions\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is a monoclonal antibody that belongs to a class of drugs that bind to either the PD-1 or the PD-L1, blocking the PD-1/PD-L1 pathway, thereby removing inhibition of the immune response, potentially breaking peripheral tolerance and inducing immune-mediated adverse reactions. Immune-mediated adverse reactions, which may be severe or fatal, can occur in any organ system or tissue, can affect more than one body system simultaneously, and can occur at any time after starting treatment or after discontinuation of treatment. Important immune-mediated adverse reactions listed here may not include all possible severe and fatal immune-mediated adverse reactions.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Monitor patients closely for symptoms and signs that may be clinical manifestations of underlying immune-mediated adverse reactions. Early identification and management are essential to ensure safe use of anti–PD-1/PD-L1 treatments. Evaluate liver enzymes, creatinine, and thyroid function at baseline and periodically during treatment. For patients with TNBC treated with KEYTRUDA in the neoadjuvant setting, monitor blood cortisol at baseline, prior to surgery, and as clinically indicated. In cases of suspected immune-mediated adverse reactions, initiate appropriate workup to exclude alternative etiologies, including infection. Institute medical management promptly, including specialty consultation as appropriate.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Withhold or permanently discontinue KEYTRUDA depending on severity of the immune-mediated adverse reaction. In general, if KEYTRUDA requires interruption or discontinuation, administer systemic corticosteroid therapy (1 to 2 mg/kg/day prednisone or equivalent) until improvement to Grade 1 or less. Upon improvement to Grade 1 or less, initiate corticosteroid taper and continue to taper over at least 1 month. Consider administration of other systemic immunosuppressants in patients whose adverse reactions are not controlled with corticosteroid therapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Immune-Mediated Pneumonitis\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA can cause immune-mediated pneumonitis. The incidence is higher in patients who have received prior thoracic radiation. Immune-mediated pneumonitis occurred in 3.4% (94/2799) of patients receiving KEYTRUDA, including fatal (0.1%), Grade 4 (0.3%), Grade 3 (0.9%), and Grade 2 (1.3%) reactions. Systemic corticosteroids were required in 67% (63/94) of patients. Pneumonitis led to permanent discontinuation of KEYTRUDA in 1.3% (36) and withholding in 0.9% (26) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement; of these, 23% had recurrence. Pneumonitis resolved in 59% of the 94 patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Pneumonitis occurred in 8% (31/389) of adult patients with cHL receiving KEYTRUDA as a single agent, including Grades 3-4 in 2.3% of patients. Patients received high-dose corticosteroids for a median duration of 10 days (range: 2 days to 53 months). Pneumonitis rates were similar in patients with and without prior thoracic radiation. Pneumonitis led to discontinuation of KEYTRUDA in 5.4% (21) of patients. Of the patients who developed pneumonitis, 42% interrupted KEYTRUDA, 68% discontinued KEYTRUDA, and 77% had resolution.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Immune-Mediated Colitis","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated colitis, which may present with diarrhea. Cytomegalovirus infection/reactivation has been reported in patients with corticosteroid-refractory immune-mediated colitis. In cases of corticosteroid-refractory colitis, consider repeating infectious workup to exclude alternative etiologies. Immune-mediated colitis occurred in 1.7% (48/2799) of patients receiving KEYTRUDA, including Grade 4 (<0.1%), Grade 3 (1.1%), and Grade 2 (0.4%) reactions. Systemic corticosteroids were required in 69% (33/48); additional immunosuppressant therapy was required in 4.2% of patients. Colitis led to permanent discontinuation of KEYTRUDA in 0.5% (15) and withholding in 0.5% (13) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement; of these, 23% had recurrence. Colitis resolved in 85% of the 48 patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Hepatotoxicity and Immune-Mediated Hepatitis","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\n","marks":[],"data":{}},{"nodeType":"text","value":"KEYTRUDA as a Single Agent","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated hepatitis. Immune-mediated hepatitis occurred in 0.7% (19/2799) of patients receiving KEYTRUDA, including Grade 4 (<0.1%), Grade 3 (0.4%), and Grade 2 (0.1%) reactions. Systemic corticosteroids were required in 68% (13/19) of patients; additional immunosuppressant therapy was required in 11% of patients. Hepatitis led to permanent discontinuation of KEYTRUDA in 0.2% (6) and withholding in 0.3% (9) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement; of these, none had recurrence. Hepatitis resolved in 79% of the 19 patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"KEYTRUDA With Axitinib","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA in combination with axitinib can cause hepatic toxicity. Monitor liver enzymes before initiation of and periodically throughout treatment. Consider monitoring more frequently as compared to when the drugs are administered as single agents. For elevated liver enzymes, interrupt KEYTRUDA and axitinib, and consider administering corticosteroids as needed. With the combination of KEYTRUDA and axitinib, Grades 3 and 4 increased alanine aminotransferase (ALT) (20%) and increased aspartate aminotransferase (AST) (13%) were seen at a higher frequency compared to KEYTRUDA alone. Fifty-nine percent of the patients with increased ALT received systemic corticosteroids. In patients with ALT ≥3 times upper limit of normal (ULN) (Grades 2-4, n=116), ALT resolved to Grades 0-1 in 94%. Among the 92 patients who were rechallenged with either KEYTRUDA (n=3) or axitinib (n=34) administered as a single agent or with both (n=55), recurrence of ALT ≥3 times ULN was observed in 1 patient receiving KEYTRUDA, 16 patients receiving axitinib, and 24 patients receiving both. All patients with a recurrence of ALT ≥3 ULN subsequently recovered from the event. \n","marks":[],"data":{}},{"nodeType":"text","value":"\nImmune-Mediated Endocrinopathies\nAdrenal Insufficiency\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA can cause primary or secondary adrenal insufficiency. For Grade 2 or higher, initiate symptomatic treatment, including hormone replacement as clinically indicated. Withhold KEYTRUDA depending on severity. Adrenal insufficiency occurred in 0.8% (22/2799) of patients receiving KEYTRUDA, including Grade 4 (<0.1%), Grade 3 (0.3%), and Grade 2 (0.3%) reactions. Systemic corticosteroids were required in 77% (17/22) of patients; of these, the majority remained on systemic corticosteroids. Adrenal insufficiency led to permanent discontinuation of KEYTRUDA in <0.1% (1) and withholding in 0.3% (8) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Hypophysitis","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated hypophysitis. Hypophysitis can present with acute symptoms associated with mass effect such as headache, photophobia, or visual field defects. Hypophysitis can cause hypopituitarism. Initiate hormone replacement as indicated. Withhold or permanently discontinue KEYTRUDA depending on severity. Hypophysitis occurred in 0.6% (17/2799) of patients receiving KEYTRUDA, including Grade 4 (<0.1%), Grade 3 (0.3%), and Grade 2 (0.2%) reactions. Systemic corticosteroids were required in 94% (16/17) of patients; of these, the majority remained on systemic corticosteroids. Hypophysitis led to permanent discontinuation of KEYTRUDA in 0.1% (4) and withholding in 0.3% (7) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Thyroid Disorders","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated thyroid disorders. Thyroiditis can present with or without endocrinopathy. Hypothyroidism can follow hyperthyroidism. Initiate hormone replacement for hypothyroidism or institute medical management of hyperthyroidism as clinically indicated. Withhold or permanently discontinue KEYTRUDA depending on severity. Thyroiditis occurred in 0.6% (16/2799) of patients receiving KEYTRUDA, including Grade 2 (0.3%). None discontinued, but KEYTRUDA was withheld in <0.1% (1) of patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Hyperthyroidism occurred in 3.4% (96/2799) of patients receiving KEYTRUDA, including Grade 3 (0.1%) and Grade 2 (0.8%). It led to permanent discontinuation of KEYTRUDA in <0.1% (2) and withholding in 0.3% (7) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement. Hypothyroidism occurred in 8% (237/2799) of patients receiving KEYTRUDA, including Grade 3 (0.1%) and Grade 2 (6.2%). It led to permanent discontinuation of KEYTRUDA in <0.1% (1) and withholding in 0.5% (14) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement. The majority of patients with hypothyroidism required long-term thyroid hormone replacement. The incidence of new or worsening hypothyroidism was higher in 1185 patients with HNSCC, occurring in 16% of patients receiving KEYTRUDA as a single agent or in combination with platinum and FU, including Grade 3 (0.3%) hypothyroidism. The incidence of new or worsening hypothyroidism was higher in 389 adult patients with cHL (17%) receiving KEYTRUDA as a single agent, including Grade 1 (6.2%) and Grade 2 (10.8%) hypothyroidism.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Type 1 Diabetes Mellitus (DM), Which Can Present With Diabetic Ketoacidosis","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nMonitor patients for hyperglycemia or other signs and symptoms of diabetes. Initiate treatment with insulin as clinically indicated. Withhold KEYTRUDA depending on severity. Type 1 DM occurred in 0.2% (6/2799) of patients receiving KEYTRUDA. It led to permanent discontinuation in <0.1% (1) and withholding of KEYTRUDA in <0.1% (1) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Immune-Mediated Nephritis With Renal Dysfunction","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated nephritis. Immune-mediated nephritis occurred in 0.3% (9/2799) of patients receiving KEYTRUDA, including Grade 4 (<0.1%), Grade 3 (0.1%), and Grade 2 (0.1%) reactions. Systemic corticosteroids were required in 89% (8/9) of patients. Nephritis led to permanent discontinuation of KEYTRUDA in 0.1% (3) and withholding in 0.1% (3) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement; of these, none had recurrence. Nephritis resolved in 56% of the 9 patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Immune-Mediated Dermatologic Adverse Reactions","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated rash or dermatitis. Exfoliative dermatitis, including Stevens-Johnson syndrome, drug rash with eosinophilia and systemic symptoms, and toxic epidermal necrolysis, has occurred with anti–PD-1/PD-L1 treatments. Topical emollients and/or topical corticosteroids may be adequate to treat mild to moderate nonexfoliative rashes. Withhold or permanently discontinue KEYTRUDA depending on severity. Immune-mediated dermatologic adverse reactions occurred in 1.4% (38/2799) of patients receiving KEYTRUDA, including Grade 3 (1%) and Grade 2 (0.1%) reactions. Systemic corticosteroids were required in 40% (15/38) of patients. These reactions led to permanent discontinuation in 0.1% (2) and withholding of KEYTRUDA in 0.6% (16) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement; of these, 6% had recurrence. The reactions resolved in 79% of the 38 patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Other Immune-Mediated Adverse Reactions","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nThe following clinically significant immune-mediated adverse reactions occurred at an incidence of <1% (unless otherwise noted) in patients who received KEYTRUDA or were reported with the use of other anti–PD-1/PD-L1 treatments. Severe or fatal cases have been reported for some of these adverse reactions. Cardiac/Vascular: Myocarditis, pericarditis, vasculitis; Nervous System: Meningitis, encephalitis, myelitis and demyelination, myasthenic syndrome/myasthenia gravis (including exacerbation), Guillain-Barré syndrome, nerve paresis, autoimmune neuropathy; Ocular: Uveitis, iritis and other ocular inflammatory toxicities can occur. Some cases can be associated with retinal detachment. Various grades of visual impairment, including blindness, can occur. If uveitis occurs in combination with other immune-mediated adverse reactions, consider a Vogt-Koyanagi-Harada-like syndrome, as this may require treatment with systemic steroids to reduce the risk of permanent vision loss; Gastrointestinal: Pancreatitis, to include increases in serum amylase and lipase levels, gastritis, duodenitis; Musculoskeletal and Connective Tissue: Myositis/polymyositis, rhabdomyolysis (and associated sequelae, including renal failure), arthritis (1.5%), polymyalgia rheumatica; Endocrine: Hypoparathyroidism; Hematologic/Immune: Hemolytic anemia, aplastic anemia, hemophagocytic lymphohistiocytosis, systemic inflammatory response syndrome, histiocytic necrotizing lymphadenitis (Kikuchi lymphadenitis), sarcoidosis, immune thrombocytopenic purpura, solid organ transplant rejection.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Infusion-Related Reactions\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA can cause severe or life-threatening infusion-related reactions, including hypersensitivity and anaphylaxis, which have been reported in 0.2% of 2799 patients receiving KEYTRUDA. Monitor for signs and symptoms of infusion-related reactions. Interrupt or slow the rate of infusion for Grade 1 or Grade 2 reactions. For Grade 3 or Grade 4 reactions, stop infusion and permanently discontinue KEYTRUDA.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Complications of Allogeneic Hematopoietic Stem Cell Transplantation (HSCT)\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"Fatal and other serious complications can occur in patients who receive allogeneic HSCT before or after anti–PD-1/PD-L1 treatments. Transplant-related complications include hyperacute graft-versus-host disease (GVHD), acute and chronic GVHD, hepatic veno-occlusive disease after reduced intensity conditioning, and steroid-requiring febrile syndrome (without an identified infectious cause). These complications may occur despite intervening therapy between anti–PD-1/PD-L1 treatment and allogeneic HSCT. Follow patients closely for evidence of these complications and intervene promptly. Consider the benefit vs risks of using anti–PD-1/PD-L1 treatments prior to or after an allogeneic HSCT.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Increased Mortality in Patients With Multiple Myeloma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"In trials in patients with multiple myeloma, the addition of KEYTRUDA to a thalidomide analogue plus dexamethasone resulted in increased mortality. Treatment of these patients with an anti–PD-1/PD-L1 treatment in this combination is not recommended outside of controlled trials.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Embryofetal Toxicity\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"Based on its mechanism of action, KEYTRUDA can cause fetal harm when administered to a pregnant woman. Advise women of this potential risk. In females of reproductive potential, verify pregnancy status prior to initiating KEYTRUDA and advise them to use effective contraception during treatment and for 4 months after the last dose.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse Reactions\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"In KEYNOTE-006, KEYTRUDA was discontinued due to adverse reactions in 9% of 555 patients with advanced melanoma; adverse reactions leading to permanent discontinuation in more than one patient were colitis (1.4%), autoimmune hepatitis (0.7%), allergic reaction (0.4%), polyneuropathy (0.4%), and cardiac failure (0.4%). The most common adverse reactions (≥20%) with KEYTRUDA were fatigue (28%), diarrhea (26%), rash (24%), and nausea (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-054, when KEYTRUDA was administered as a single agent to patients with stage III melanoma, KEYTRUDA was permanently discontinued due to adverse reactions in 14% of 509 patients; the most common (≥1%) were pneumonitis (1.4%), colitis (1.2%), and diarrhea (1%). Serious adverse reactions occurred in 25% of patients receiving KEYTRUDA. The most common adverse reaction (≥20%) with KEYTRUDA was diarrhea (28%). In KEYNOTE-716, when KEYTRUDA was administered as a single agent to patients with stage IIB or IIC melanoma, adverse reactions occurring in patients with stage IIB or IIC melanoma were similar to those occurring in 1011 patients with stage III melanoma from KEYNOTE-054. ","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-189, when KEYTRUDA was administered with pemetrexed and platinum chemotherapy in metastatic nonsquamous NSCLC, KEYTRUDA was discontinued due to adverse reactions in 20% of 405 patients. The most common adverse reactions resulting in permanent discontinuation of KEYTRUDA were pneumonitis (3%) and acute kidney injury (2%). The most common adverse reactions (≥20%) with KEYTRUDA were nausea (56%), fatigue (56%), constipation (35%), diarrhea (31%), decreased appetite (28%), rash (25%), vomiting (24%), cough (21%), dyspnea (21%), and pyrexia (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-407, when KEYTRUDA was administered with carboplatin and either paclitaxel or paclitaxel protein-bound in metastatic squamous NSCLC, KEYTRUDA was discontinued due to adverse reactions in 15% of 101 patients. The most frequent serious adverse reactions reported in at least 2% of patients were febrile neutropenia, pneumonia, and urinary tract infection. Adverse reactions observed in KEYNOTE-407 were similar to those observed in KEYNOTE-189 with the exception that increased incidences of alopecia (47% vs 36%) and peripheral neuropathy (31% vs 25%) were observed in the KEYTRUDA and chemotherapy arm compared to the placebo and chemotherapy arm in KEYNOTE-407.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-042, KEYTRUDA was discontinued due to adverse reactions in 19% of 636 patients with advanced NSCLC; the most common were pneumonitis (3%), death due to unknown cause (1.6%), and pneumonia (1.4%). The most frequent serious adverse reactions reported in at least 2% of patients were pneumonia (7%), pneumonitis (3.9%), pulmonary embolism (2.4%), and pleural effusion (2.2%). The most common adverse reaction (≥20%) was fatigue (25%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-010, KEYTRUDA monotherapy was discontinued due to adverse reactions in 8% of 682 patients with metastatic NSCLC; the most common was pneumonitis (1.8%). The most common adverse reactions (≥20%) were decreased appetite (25%), fatigue (25%), dyspnea (23%), and nausea (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-048, KEYTRUDA monotherapy was discontinued due to adverse events in 12% of 300 patients with HNSCC; the most common adverse reactions leading to permanent discontinuation were sepsis (1.7%) and pneumonia (1.3%). The most common adverse reactions (≥20%) were fatigue (33%), constipation (20%), and rash (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-048, when KEYTRUDA was administered in combination with platinum (cisplatin or carboplatin) and FU chemotherapy, KEYTRUDA was discontinued due to adverse reactions in 16% of 276 patients with HNSCC. The most common adverse reactions resulting in permanent discontinuation of KEYTRUDA were pneumonia (2.5%), pneumonitis (1.8%), and septic shock (1.4%). The most common adverse reactions (≥20%) were nausea (51%), fatigue (49%), constipation (37%), vomiting (32%), mucosal inflammation (31%), diarrhea (29%), decreased appetite (29%), stomatitis (26%), and cough (22%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-012, KEYTRUDA was discontinued due to adverse reactions in 17% of 192 patients with HNSCC. Serious adverse reactions occurred in 45% of patients. The most frequent serious adverse reactions reported in at least 2% of patients were pneumonia, dyspnea, confusional state, vomiting, pleural effusion, and respiratory failure. The most common adverse reactions (≥20%) were fatigue, decreased appetite, and dyspnea. Adverse reactions occurring in patients with HNSCC were generally similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy, with the exception of increased incidences of facial edema and new or worsening hypothyroidism.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-204, KEYTRUDA was discontinued due to adverse reactions in 14% of 148 patients with cHL. Serious adverse reactions occurred in 30% of patients receiving KEYTRUDA; those ≥1% were pneumonitis, pneumonia, pyrexia, myocarditis, acute kidney injury, febrile neutropenia, and sepsis. Three patients died from causes other than disease progression: 2 from complications after allogeneic HSCT and 1 from unknown cause. The most common adverse reactions (≥20%) were upper respiratory tract infection (41%), musculoskeletal pain (32%), diarrhea (22%), and pyrexia, fatigue, rash, and cough (20% each).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-087, KEYTRUDA was discontinued due to adverse reactions in 5% of 210 patients with cHL. Serious adverse reactions occurred in 16% of patients; those ≥1% were pneumonia, pneumonitis, pyrexia, dyspnea, GVHD, and herpes zoster. Two patients died from causes other than disease progression: 1 from GVHD after subsequent allogeneic HSCT and 1 from septic shock. The most common adverse reactions (≥20%) were fatigue (26%), pyrexia (24%), cough (24%), musculoskeletal pain (21%), diarrhea (20%), and rash (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-170, KEYTRUDA was discontinued due to adverse reactions in 8% of 53 patients with PMBCL. Serious adverse reactions occurred in 26% of patients and included arrhythmia (4%), cardiac tamponade (2%), myocardial infarction (2%), pericardial effusion (2%), and pericarditis (2%). Six (11%) patients died within 30 days of start of treatment. The most common adverse reactions (≥20%) were musculoskeletal pain (30%), upper respiratory tract infection and pyrexia (28% each), cough (26%), fatigue (23%), and dyspnea (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-052, KEYTRUDA was discontinued due to adverse reactions in 11% of 370 patients with locally advanced or mUC. Serious adverse reactions occurred in 42% of patients; those ≥2% were urinary tract infection, hematuria, acute kidney injury, pneumonia, and urosepsis. The most common adverse reactions (≥20%) were fatigue (38%), musculoskeletal pain (24%), decreased appetite (22%), constipation (21%), rash (21%), and diarrhea (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-045, KEYTRUDA was discontinued due to adverse reactions in 8% of 266 patients with locally advanced or mUC. The most common adverse reaction resulting in permanent discontinuation of KEYTRUDA was pneumonitis (1.9%). Serious adverse reactions occurred in 39% of KEYTRUDA-treated patients; those ≥2% were urinary tract infection, pneumonia, anemia, and pneumonitis. The most common adverse reactions (≥20%) in patients who received KEYTRUDA were fatigue (38%), musculoskeletal pain (32%), pruritus (23%), decreased appetite (21%), nausea (21%), and rash (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-057, KEYTRUDA was discontinued due to adverse reactions in 11% of 148 patients with high-risk NMIBC. The most common adverse reaction resulting in permanent discontinuation of KEYTRUDA was pneumonitis (1.4%). Serious adverse reactions occurred in 28% of patients; those ≥2% were pneumonia (3%), cardiac ischemia (2%), colitis (2%), pulmonary embolism (2%), sepsis (2%), and urinary tract infection (2%). The most common adverse reactions (≥20%) were fatigue (29%), diarrhea (24%), and rash (24%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with MSI-H or dMMR CRC were similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-811, when KEYTRUDA was administered in combination with trastuzumab, fluoropyrimidine- and platinum-containing chemotherapy, KEYTRUDA was discontinued due to adverse reactions in 6% of 217 patients with locally advanced unresectable or metastatic HER2+ gastric or GEJ adenocarcinoma. The most common adverse reaction resulting in permanent discontinuation was pneumonitis (1.4%). In the KEYTRUDA arm versus placebo, there was a difference of ≥5% incidence between patients treated with KEYTRUDA versus standard of care for diarrhea (53% vs 44%) and nausea (49% vs 44%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"The most common adverse reactions (reported in ≥20%) in patients receiving KEYTRUDA in combination with chemotherapy were fatigue/asthenia, nausea, constipation, diarrhea, decreased appetite, rash, vomiting, cough, dyspnea, pyrexia, alopecia, peripheral neuropathy, mucosal inflammation, stomatitis, headache, weight loss, abdominal pain, arthralgia, myalgia, and insomnia.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-590, when KEYTRUDA was administered with cisplatin and fluorouracil to patients with metastatic or locally advanced esophageal or GEJ (tumors with epicenter 1 to 5 centimeters above the GEJ) carcinoma who were not candidates for surgical resection or definitive chemoradiation, KEYTRUDA was discontinued due to adverse reactions in 15% of 370 patients. The most common adverse reactions resulting in permanent discontinuation of KEYTRUDA (≥1%) were pneumonitis (1.6%), acute kidney injury (1.1%), and pneumonia (1.1%). The most common adverse reactions (≥20%) with KEYTRUDA in combination with chemotherapy were nausea (67%), fatigue (57%), decreased appetite (44%), constipation (40%), diarrhea (36%), vomiting (34%), stomatitis (27%), and weight loss (24%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with esophageal cancer who received KEYTRUDA as a monotherapy were similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-826, when KEYTRUDA was administered in combination with paclitaxel and cisplatin or paclitaxel and carboplatin, with or without bevacizumab (n=307), to patients with persistent, recurrent, or first-line metastatic cervical cancer regardless of tumor PD-L1 expression who had not been treated with chemotherapy except when used concurrently as a radio-sensitizing agent, fatal adverse reactions occurred in 4.6% of patients, including 3 cases of hemorrhage, 2 cases each of sepsis and due to unknown causes, and 1 case each of acute myocardial infarction, autoimmune encephalitis, cardiac arrest, cerebrovascular accident, femur fracture with perioperative pulmonary embolus, intestinal perforation, and pelvic infection. Serious adverse reactions occurred in 50% of patients receiving KEYTRUDA in combination with chemotherapy with or without bevacizumab; those ≥3% were febrile neutropenia (6.8%), urinary tract infection (5.2%), anemia (4.6%), and acute kidney injury and sepsis (3.3% each).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"KEYTRUDA was discontinued in 15% of patients due to adverse reactions. The most common adverse reaction resulting in permanent discontinuation (≥1%) was colitis (1%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"For patients treated with KEYTRUDA, chemotherapy, and bevacizumab (n=196), the most common adverse reactions (≥20%) were peripheral neuropathy (62%), alopecia (58%), anemia (55%), fatigue/asthenia (53%), nausea and neutropenia (41% each), diarrhea (39%), hypertension and thrombocytopenia (35% each), constipation and arthralgia (31% each), vomiting (30%), urinary tract infection (27%), rash (26%), leukopenia (24%), hypothyroidism (22%), and decreased appetite (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"For patients treated with KEYTRUDA in combination with chemotherapy with or without bevacizumab, the most common adverse reactions (≥20%) were peripheral neuropathy (58%), alopecia (56%), fatigue (47%), nausea (40%), diarrhea (36%), constipation (28%), arthralgia (27%), vomiting (26%), hypertension and urinary tract infection (24% each), and rash (22%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-158, KEYTRUDA was discontinued due to adverse reactions in 8% of 98 patients with previously treated recurrent or metastatic cervical cancer. Serious adverse reactions occurred in 39% of patients receiving KEYTRUDA; the most frequent included anemia (7%), fistula, hemorrhage, and infections [except urinary tract infections] (4.1% each). The most common adverse reactions (≥20%) were fatigue (43%), musculoskeletal pain (27%), diarrhea (23%), pain and abdominal pain (22% each), and decreased appetite (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with HCC were generally similar to those in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy, with the exception of increased incidences of ascites (8% Grades 3-4) and immune-mediated hepatitis (2.9%). Laboratory abnormalities (Grades 3-4) that occurred at a higher incidence were elevated AST (20%), ALT (9%), and hyperbilirubinemia (10%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Among the 50 patients with MCC enrolled in study KEYNOTE-017, adverse reactions occurring in patients with MCC were generally similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy. Laboratory abnormalities (Grades 3-4) that occurred at a higher incidence were elevated AST (11%) and hyperglycemia (19%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-426, when KEYTRUDA was administered in combination with axitinib, fatal adverse reactions occurred in 3.3% of 429 patients. Serious adverse reactions occurred in 40% of patients, the most frequent (≥1%) were hepatotoxicity (7%), diarrhea (4.2%), acute kidney injury (2.3%), dehydration (1%), and pneumonitis (1%). Permanent discontinuation due to an adverse reaction occurred in 31% of patients; KEYTRUDA only (13%), axitinib only (13%), and the combination (8%); the most common were hepatotoxicity (13%), diarrhea/colitis (1.9%), acute kidney injury (1.6%), and cerebrovascular accident (1.2%). The most common adverse reactions (≥20%) were diarrhea (56%), fatigue/asthenia (52%), hypertension (48%), hepatotoxicity (39%), hypothyroidism (35%), decreased appetite (30%), palmar-plantar erythrodysesthesia (28%), nausea (28%), stomatitis/mucosal inflammation (27%), dysphonia (25%), rash (25%), cough (21%), and constipation (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-564, when KEYTRUDA was administered as a single agent for the adjuvant treatment of renal cell carcinoma, serious adverse reactions occurred in 20% of patients receiving KEYTRUDA; the serious adverse reactions (≥1%) were acute kidney injury, adrenal insufficiency, pneumonia, colitis, and diabetic ketoacidosis (1% each). Fatal adverse reactions occurred in 0.2% including 1 case of pneumonia. Discontinuation of KEYTRUDA due to adverse reactions occurred in 21% of 488 patients; the most common (≥1%) were increased ALT (1.6%), colitis (1%), and adrenal insufficiency (1%). The most common adverse reactions (≥20%) were musculoskeletal pain (41%), fatigue (40%), rash (30%), diarrhea (27%), pruritus (23%), and hypothyroidism (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with MSI-H or dMMR endometrial carcinoma who received KEYTRUDA as a single agent were similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a single agent.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with TMB-H cancer were similar to those occurring in patients with other solid tumors who received KEYTRUDA as a single agent.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with recurrent or metastatic cSCC or locally advanced cSCC were similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-522, when KEYTRUDA was administered with neoadjuvant chemotherapy (carboplatin and paclitaxel followed by doxorubicin or epirubicin and cyclophosphamide) followed by surgery and continued adjuvant treatment with KEYTRUDA as a single agent (n=778) to patients with newly diagnosed, previously untreated, high-risk early-stage TNBC, fatal adverse reactions occurred in 0.9% of patients, including 1 each of adrenal crisis, autoimmune encephalitis, hepatitis, pneumonia, pneumonitis, pulmonary embolism, and sepsis in association with multiple organ dysfunction syndrome and myocardial infarction. Serious adverse reactions occurred in 44% of patients receiving KEYTRUDA; those ≥2% were febrile neutropenia (15%), pyrexia (3.7%), anemia (2.6%), and neutropenia (2.2%). KEYTRUDA was discontinued in 20% of patients due to adverse reactions. The most common reactions (≥1%) resulting in permanent discontinuation were increased ALT (2.7%), increased AST (1.5%), and rash (1%). The most common adverse reactions (≥20%) in patients receiving KEYTRUDA were fatigue (70%), nausea (67%), alopecia (61%), rash (52%), constipation (42%), diarrhea and peripheral neuropathy (41% each), stomatitis (34%), vomiting (31%), headache (30%), arthralgia (29%), pyrexia (28%), cough (26%), abdominal pain (24%), decreased appetite (23%), insomnia (21%), and myalgia (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-355, when KEYTRUDA and chemotherapy (paclitaxel, paclitaxel protein-bound, or gemcitabine and carboplatin) were administered to patients with locally recurrent unresectable or metastatic TNBC who had not been previously treated with chemotherapy in the metastatic setting (n=596), fatal adverse reactions occurred in 2.5% of patients, including cardio-respiratory arrest (0.7%) and septic shock (0.3%). Serious adverse reactions occurred in 30% of patients receiving KEYTRUDA in combination with chemotherapy; the serious reactions in ≥2% were pneumonia (2.9%), anemia (2.2%), and thrombocytopenia (2%). KEYTRUDA was discontinued in 11% of patients due to adverse reactions. The most common reactions resulting in permanent discontinuation (≥1%) were increased ALT (2.2%), increased AST (1.5%), and pneumonitis (1.2%). The most common adverse reactions (≥20%) in patients receiving KEYTRUDA in combination with chemotherapy were fatigue (48%), nausea (44%), alopecia (34%), diarrhea and constipation (28% each), vomiting and rash (26% each), cough (23%), decreased appetite (21%), and headache (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Lactation\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"Because of the potential for serious adverse reactions in breastfed children, advise women not to breastfeed during treatment and for 4 months after the final dose.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Pediatric Use\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"In KEYNOTE-051, 161 pediatric patients (62 pediatric patients aged 6 months to younger than 12 years and 99 pediatric patients aged 12 years to 17 years) were administered KEYTRUDA 2 mg/kg every 3 weeks. The median duration of exposure was 2.1 months (range: 1 day to 24 months).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions that occurred at a ≥10% higher rate in pediatric patients when compared to adults were pyrexia (33%), vomiting (30%), leukopenia (30%), upper respiratory tract infection (29%), neutropenia (26%), headache (25%), and Grade 3 anemia (17%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Please see Prescribing Information for KEYTRUDA (pembrolizumab) at ","marks":[{"type":"bold"}],"data":{}},{"nodeType":"hyperlink","data":{"uri":"http://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_pi.pdf"},"content":[{"nodeType":"text","value":"http://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_pi.pdf","marks":[{"type":"bold"}],"data":{}}]},{"nodeType":"text","value":" and Medication Guide for KEYTRUDA at ","marks":[{"type":"bold"}],"data":{}},{"nodeType":"hyperlink","data":{"uri":"http://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_mg.pdf"},"content":[{"nodeType":"text","value":"http://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_mg.pdf","marks":[{"type":"bold"}],"data":{}}]},{"nodeType":"text","value":". 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Instead of thinking about how to conduct our trials from the Moderna view, we consider how to best conduct clinical trials from a participant’s perspective. This includes everything from how we gather insights from stakeholder groups, to how we raise awareness with the goal of increasing clinical trial access, to how we engage with participants at and after completion of trial participation. The participant experiences are at the forefront of every decision we make. ","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[{"type":"bold"}],"value":"Flexible Protocol Designs","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"An essential component of the clinical trial process is designing the protocol. Moderna takes a refreshed approach to protocol design by having the Patient Centricity Team review every protocol solely through the lens of how to best reduce trial burden for participants. We evaluate the schedule of assessments to assure it aligns as closely as possible with the participant’s healthcare journey, and we consider incorporating methods that could provide participants options in their clinical trial experience, such as home health, travel and logistics coordination. However, we have learned that you cannot take a one size fits all approach to these methods. For example, while some individuals may benefit from home health, others in the same clinical trial population may prefer or may even need to be seen in the clinic. Creating flexible protocols creates choice for participants, which is imperative in truly patient centric protocol designs.","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"At Moderna, we also review our protocols to ensure that they are written in a health literate manner. 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collaboration with Merck, where data will be presented during the plenary session from the Phase 2b study of our investigational mRNA individualized neoantigen therapy (mRNA-4157/V940) in combination with KEYTRUDA® (pembrolizumab), Merck’s anti-PD-1 therapy, for the adjuvant treatment of patients with high-risk stage III/IV melanoma following complete resection. These data will be presented today during AACR’s plenary session; additional subgroup analysis data will be presented during a poster session on Tuesday, April 18.","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"We expect to advance to a Phase 3 study in adjuvant melanoma with Merck this year and to rapidly begin additional studies in other tumor types including non-small cell lung cancer (NSCLC). mRNA-4157 (V940) is an investigational asset and has not been determined safe or effective by the FDA.","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"As we look ahead, we are evolving from calling mRNA-4157 (V940) a personalized cancer vaccine to an individualized neoantigen therapy, to better describe the goal of the program.","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[{"type":"bold"}],"value":"What are Individualized Neoantigen Therapies? ","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"Each cancer is different – no two are the same – because cancer cells have genetic mutations that make them unique. Genetic mutations create neoantigens, pieces of proteins in cancer cells, that are not usually seen in normal cells. These cancer proteins make up a patient’s cancer “fingerprint.”","nodeType":"text"}],"nodeType":"paragraph"}],"nodeType":"document"},"alignment":"center","sizing":"full"}},{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"6sK7OoeyWKvTZRgH5qa72h","type":"Entry","createdAt":"2023-04-16T15:00:13.679Z","updatedAt":"2023-04-16T15:00:13.679Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"sectionRichTextContent"}},"locale":"en-US"},"fields":{"entryTitle":"Media Center > Blogs > One Medicine for One Patient:  An Investigational mRNA Individualized Neoantigen Therapy text 2","content":{"data":{},"content":[{"data":{},"content":[{"data":{},"marks":[],"value":"Individualized neoantigen therapies are made with the goal of specifically matching each patient's cancer fingerprint. The goal of individualized neoantigen therapies is to train a patient's immune cells to recognize the cancer fingerprint proteins and launch an immune response against the cancer cells.","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"Individualized neoantigen therapies are currently being studied in clinical trials. As of today, there are currently no approved individualized neoantigen therapies.","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[{"type":"bold"}],"value":"Manufacturing our Investigational mRNA Individualized Neoantigen Therapy ","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"The process to make our individualized neoantigen therapy starts in the clinic, where a study participant has their blood drawn and their tumor biopsied. Sequencing is then performed in a lab to compare data from the tumor biopsy sample and the study participant’s healthy blood cells, which are not mutated, to identify the unique genetic mutations of that individual’s cancer. ","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"A proprietary algorithm developed in collaboration with Merck then reviews these mutations and predicts up to 34 of those mutations that are believed to help the study participant’s immune system better recognize tumor cells and to launch an attack. Next, the investigational individualized neoantigen therapy is created to give cells instructions to make the “fingerprint” cancer protein, with the goal of helping the body recognize and attack that study participant’s unique cancer. ","nodeType":"text"}],"nodeType":"paragraph"},{"data":{},"content":[{"data":{},"marks":[],"value":"Following the design stage, this information is then sent to our manufacturing facility in Norwood, MA, where the individualized neoantigen therapy is manufactured. The individualized neoantigen therapy is then placed in a vial and shipped back to the clinical trial site where a healthcare professional administers it to the study patient via intramuscular injection.","nodeType":"text"}],"nodeType":"paragraph"}],"nodeType":"document"},"alignment":"center","sizing":"full"}},{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"2jV6VGuIdbo5HXxfqwdcdg","type":"Entry","createdAt":"2023-04-16T15:00:13.398Z","updatedAt":"2023-04-16T15:00:13.398Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"sectionMediaBlock"}},"locale":"en-US"},"fields":{"entryTitle":"Media Center > Blogs > One Medicine for One Patient:  An Investigational mRNA Individualized Neoantigen Therapy image 1","sizing":"center","media":{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"2LMt1Vo0Td5mIKYJnzvONx","type":"Entry","createdAt":"2023-04-16T15:00:13.422Z","updatedAt":"2023-04-16T15:00:13.422Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"wrapperMedia"}},"locale":"en-US"},"fields":{"title":"Media Center > Blogs > One Medicine for One Patient:  An Investigational mRNA Individualized Neoantigen Therapy image 1","fileType":"Image","image":{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"1nIqwV6heejwTEraN1c0KU","type":"Asset","createdAt":"2023-04-16T15:00:13.236Z","updatedAt":"2023-04-16T15:00:13.236Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"locale":"en-US"},"fields":{"title":"Media Center > Blogs > One Medicine for One Patient:  An Investigational mRNA Individualized Neoantigen Therapy image 1","description":"","file":{"url":"//images.ctfassets.net/87hacmv3x18u/1nIqwV6heejwTEraN1c0KU/82fb5322175884246a0abae9f5af924d/Screenshot_2023-04-14_at_4.02.07_PM.png","details":{"size":144034,"image":{"width":1728,"height":886}},"fileName":"Screenshot 2023-04-14 at 4.02.07 PM.png","contentType":"image/png"}}},"focalPoint":{"focalPoint":{"x":869,"y":495}}}}}},{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"7dpVac5KjfWEEVp1bZHlzl","type":"Entry","createdAt":"2023-04-16T15:00:13.729Z","updatedAt":"2023-04-16T15:00:13.729Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"sectionRichTextContent"}},"locale":"en-US"},"fields":{"entryTitle":"Media Center > Blogs > One Medicine for One Patient:  An Investigational mRNA Individualized Neoantigen Therapy Text 3","content":{"nodeType":"document","data":{},"content":[{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Phase 2b Study of mRNA Individualized Neoantigen Therapy in Combination with KEYTRUDA for Adjuvant Treatment of Patients with Stage III/IV Melanoma","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\n\nToday, Jeffrey Weber, MD, PhD; Deputy Director of the ","marks":[],"data":{}},{"nodeType":"hyperlink","data":{"uri":"https://nyulangone.org/locations/perlmutter-cancer-center"},"content":[{"nodeType":"text","value":"Perlmutter Cancer Center","marks":[],"data":{}}]},{"nodeType":"text","value":" and Co-Director of the Melanoma Research Program at NYU Langone Health and Principal Investigator of the Phase 2b study will present these data during the plenary session at the AACR Annual Meeting. ","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"mRNA-4157 (V940) in combination with KEYTRUDA demonstrated a statistically significant and clinically meaningful improvement in the primary endpoint of recurrence-free survival versus KEYTRUDA alone for the adjuvant treatment of patients with stage III/IV melanoma following complete resection. In the study, 107 patients received the combination of our investigational individualized neoantigen therapy with KEYTRUDA and 50 patients were treated with KETRUDA alone. ","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Adjuvant treatment with mRNA-4157 (V940) in combination with KEYTRUDA reduced the risk of recurrence or death by 44% (HR =0.56 [95% CI, 0.31-1.017]; one-sided p value =0.0266), compared with KEYTRUDA alone.","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"With Merck, we are studying our investigational mRNA individualized neoantigen therapy given in combination with KEYTRUDA compared to KEYTRUDA alone. We selected KEYTRUDA as the comparator in the trial because it is considered a standard of care in adjuvant melanoma.\n\nAdverse events observed with mRNA-4157 (V940) in KEYNOTE-942 were consistent with those previously reported in a Phase 1 clinical trial. The safety profile of KEYTRUDA was consistent with that observed in previously reported studies. The number of patients reporting treatment related Grade ≥ 3 adverse events were similar between the arms (25% vs 18%, respectively). The most common adverse event of any grade attributed to either mRNA-4157 (V940) alone or to both mRNA-4157 (V940) and KEYTRUDA were fatigue (60.6%), injection site pain (55.8%) and chills (50.0%).","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Collaborating with Merck to Advance This Program for Patients","marks":[{"type":"bold"}],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"In 2016, we entered into a strategic collaboration with Merck to evaluate novel mRNA-based personalized cancer vaccines, now known as individualized neoantigen therapies, and without KEYTRUDA for the treatment of multiple types of cancer. We have accelerated this program – we hired our first employee working on this program and filed our Investigational New Drug Application (IND) for mRNA-4157 (V940) with the U.S. FDA within 18 months. The first participant in the Phase 1 study of mRNA-4157 was dosed in November 2017. In October 2022, Merck ","marks":[],"data":{}},{"nodeType":"hyperlink","data":{"uri":"https://investors.modernatx.com/news/news-details/2022/Merck-and-Moderna-Announce-Exercise-of-Option-by-Merck-for-Joint-Development-and-Commercialization-of-Investigational-Personalized-Cancer-Vaccine/default.aspx"},"content":[{"nodeType":"text","value":"exercised","marks":[],"data":{}}]},{"nodeType":"text","value":" their option for joint development and commercialization mRNA-4157 (V940). We appreciate the ongoing, productive collaboration that we have had with Merck. ","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"Our Next Steps","marks":[{"type":"bold"}],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"We are extremely grateful to the participants in our clinical trials and the investigators and staff at our trial sites who are helping to advance this important research. Looking ahead, with Merck, we plan to initiate a Phase 3 study in melanoma in 2023 and rapidly expand our efforts to study additional tumor types including non-small cell lung cancer. ","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"At Moderna, we work collaboratively across the company to set ambitious goals and we continue to push past possible even when those goals are met. I would like to thank the incredible Moderna team for their dedication to positively impact human health globally. ","marks":[],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"We will continue to act with sense of deep sense of responsibility as we pursue our mission to deliver the greatest possible impact to people through mRNA medicines. ","marks":[],"data":{}}]}]},"alignment":"center","sizing":"full"}}],"localDisclaimer":{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"c1pSVgNZlQtSUulKJvA2q","type":"Entry","createdAt":"2023-04-16T15:00:13.786Z","updatedAt":"2023-06-05T11:55:05.936Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":2,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"sectionDisclaimer"}},"locale":"en-US"},"fields":{"entryTitle":"Media Center > Blogs > One Medicine for One Patient:  An Investigational mRNA Individualized Neoantigen Therapy","content":{"nodeType":"document","data":{},"content":[{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Moderna Forward-Looking Statements\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\n","marks":[],"data":{}},{"nodeType":"text","value":"This post contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, as amended, including statements regarding: the development by Moderna and Merck of an individualized neoantigen therapy (mRNA-4157/V940); the ability and potential for mRNA-4157/V940 to improve recurrence-free survival (RFS) rates in stage III/IV melanoma patients; the tolerability and safety profile for mRNA-4157/V940; the potential for mRNA, including mRNA-4157, to effectively treat different types of cancer, including melanoma, and plans for studying treatment in additional types of cancer; the potential development of individualized neoantigen therapies and treatments; plans to conduct a Phase 3 trial of mRNA-4157/V940; the ability of an individualized neoantigen therapy to trigger a tailored antitumor response specific to a patient's tumor mutation signature; and the potential for regulatory approval and commercialization of mRNA-4157/V940 and the implications for the EMA's PRIME scheme designation for mRNA-4157/V940 and the FDA's Breakthrough Therapy Designation for mRNA-4157/V940. In some cases, forward-looking statements can be identified by terminology such as \"will,\" \"may,\" \"should,\" \"could,\" \"expects,\" \"intends,\" \"plans,\" \"aims,\" \"anticipates,\" \"believes,\" \"estimates,\" \"predicts,\" \"potential,\" \"continue,\" or the negative of these terms or other comparable terminology, although not all forward-looking statements contain these words. The forward-looking statements in this post are neither promises nor guarantees, and you should not place undue reliance on these forward-looking statements because they involve known and unknown risks, uncertainties, and other factors, many of which are beyond Moderna's control and which could cause actual results to differ materially from those expressed or implied by these forward-looking statements. These risks, uncertainties, and other factors include, among others, those risks and uncertainties described under the heading \"Risk Factors\" in Moderna's Annual Report on Form 10-K for the fiscal year ended December 31, 2022 filed with the U.S. Securities and Exchange Commission (SEC), and in subsequent filings made by Moderna with the SEC, which are available on the SEC's website at www.sec.gov. Except as required by law, Moderna disclaims any intention or responsibility for updating or revising any forward-looking statements contained in this post in the event of new information, future developments or otherwise. These forward-looking statements are based on Moderna's current expectations and speak only as of the date of this post.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"About Melanoma","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nThe most serious form of skin cancer, Melanoma is characterized by the uncontrolled growth of pigment-producing cells. The rates of melanoma have been rising over the past few decades, with nearly 325,000 new cases diagnosed worldwide in 2020. In the U.S., skin cancer is one of the most common types of cancer diagnosed, and melanoma accounts for a large majority of skin cancer deaths. It is estimated there will be nearly 100,000 new cases of melanoma diagnosed and almost 8,000 deaths resulting from the disease in the U.S. in 2022.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"About KEYTRUDA® (pembrolizumab) injection, 100 mg\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is an anti-programmed death receptor-1 (PD-1) therapy that works by increasing the ability of the body’s immune system to help detect and fight tumor cells.\nKEYTRUDA is a humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2, thereby activating T lymphocytes which may affect both tumor cells and healthy cells.\nMerck has the industry’s largest immuno-oncology clinical research program. There are currently more than 1,600 trials studying KEYTRUDA across a wide variety of cancers and treatment settings. The KEYTRUDA clinical program seeks to understand the role of KEYTRUDA across cancers and the factors that may predict a patient's likelihood of benefitting from treatment with KEYTRUDA, including exploring several different biomarkers.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Selected KEYTRUDA® (pembrolizumab) Indications in the U.S.","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\n","marks":[],"data":{}},{"nodeType":"text","value":"Melanoma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with unresectable or metastatic melanoma.\nKEYTRUDA is indicated for the adjuvant treatment of adult and pediatric (12 years and older) patients with stage IIB, IIC, or III melanoma following complete resection.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Non-Small Cell Lung Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA, in combination with pemetrexed and platinum chemotherapy, is indicated for the first-line treatment of patients with metastatic nonsquamous non-small cell lung cancer (NSCLC), with no EGFR or ALK genomic tumor aberrations.\nKEYTRUDA, in combination with carboplatin and either paclitaxel or paclitaxel protein-bound, is indicated for the first-line treatment of patients with metastatic squamous NSCLC.\nKEYTRUDA, as a single agent, is indicated for the first-line treatment of patients with NSCLC expressing PD-L1 [tumor proportion score (TPS) ≥1%] as determined by an FDA-approved test, with no EGFR or ALK genomic tumor aberrations, and is:\n-stage III where patients are not candidates for surgical resection or definitive chemoradiation, or\n -metastatic.\nKEYTRUDA, as a single agent, is indicated for the treatment of patients with metastatic NSCLC whose tumors express PD-L1 (TPS ≥1%) as determined by an FDA-approved test, with disease progression on or after platinum-containing chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving KEYTRUDA.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Head and Neck Squamous Cell Cancer\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA, in combination with platinum and fluorouracil (FU), is indicated for the first-line treatment of patients with metastatic or with unresectable, recurrent head and neck squamous cell carcinoma (HNSCC).\nKEYTRUDA, as a single agent, is indicated for the first-line treatment of patients with metastatic or with unresectable, recurrent HNSCC whose tumors express PD-L1 [Combined Positive Score (CPS) ≥1] as determined by an FDA-approved test.\nKEYTRUDA, as a single agent, is indicated for the treatment of patients with recurrent or metastatic HNSCC with disease progression on or after platinum-containing chemotherapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Classical Hodgkin Lymphoma","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of adult patients with relapsed or refractory classical Hodgkin lymphoma (cHL).\nKEYTRUDA is indicated for the treatment of pediatric patients with refractory cHL, or cHL that has relapsed after 2 or more lines of therapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Primary Mediastinal Large B-Cell Lymphoma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma (PMBCL), or who have relapsed after 2 or more prior lines of therapy. \nKEYTRUDA is not recommended for treatment of patients with PMBCL who require urgent cytoreductive therapy.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Urothelial Carcinoma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC):\n- who are not eligible for any platinum-containing chemotherapy, or\n- who have disease progression during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Non-muscle Invasive Bladder Cancer\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with Bacillus Calmette-Guerin-unresponsive, high-risk, non-muscle invasive bladder cancer (NMIBC) with carcinoma in situ with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Microsatellite Instability-High or Mismatch Repair Deficient Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of adult and pediatric patients with unresectable or metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) solid tumors, as determined by an FDA-approved test, that have progressed following prior treatment and who have no satisfactory alternative treatment options.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Microsatellite Instability-High or Mismatch Repair Deficient Colorectal Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of patients with unresectable or metastatic MSI-H or dMMR colorectal cancer (CRC) as determined by an FDA-approved test.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Gastric Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA, in combination with trastuzumab, fluoropyrimidine- and platinum-containing chemotherapy, is indicated for the first-line treatment of patients with locally advanced unresectable or metastatic HER2-positive gastric or gastroesophageal junction (GEJ) adenocarcinoma. \nThis indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Esophageal Cancer\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with locally advanced or metastatic esophageal or gastroesophageal junction (GEJ) (tumors with epicenter 1 to 5 centimeters above the GEJ) carcinoma that is not amenable to surgical resection or definitive chemoradiation either:\n- in combination with platinum- and fluoropyrimidine-based chemotherapy, or\n- as a single agent after one or more prior lines of systemic therapy for patients with tumors of squamous cell histology that express PD-L1 (CPS ≥10) as determined by an FDA-approved test.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Cervical Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA, in combination with chemotherapy, with or without bevacizumab, is indicated for the treatment of patients with persistent, recurrent, or metastatic cervical cancer whose tumors express PD-L1 (CPS ≥1) as determined by an FDA-approved test.\nKEYTRUDA, as a single agent, is indicated for the treatment of patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express PD-L1 (CPS ≥1) as determined by an FDA-approved test. ","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Hepatocellular Carcinoma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Merkel Cell Carcinoma","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of adult and pediatric patients with recurrent locally advanced or metastatic Merkel cell carcinoma (MCC). This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Renal Cell Carcinoma","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA, in combination with axitinib, is indicated for the first-line treatment of adult patients with advanced renal cell carcinoma (RCC). \nKEYTRUDA is indicated for the adjuvant treatment of patients with RCC at intermediate-high or high risk of recurrence following nephrectomy, or following nephrectomy and resection of metastatic lesions. \n\n","marks":[],"data":{}},{"nodeType":"text","value":"Endometrial Carcinoma","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA, as a single agent, is indicated for the treatment of patients with advanced endometrial carcinoma that is MSI-H or dMMR, as determined by an FDA-approved test, who have disease progression following prior systemic therapy in any setting and are not candidates for curative surgery or radiation.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Tumor Mutational Burden-High Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of adult and pediatric patients with unresectable or metastatic tumor mutational burden-high (TMB-H) [≥10 mutations/megabase] solid tumors, as determined by an FDA-approved test, that have progressed following prior treatment and who have no satisfactory alternative treatment options. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials. The safety and effectiveness of KEYTRUDA in pediatric patients with TMB-H central nervous system cancers have not been established.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Cutaneous Squamous Cell Carcinoma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is indicated for the treatment of patients with recurrent or metastatic cutaneous squamous cell carcinoma (cSCC) or locally advanced cSCC that is not curable by surgery or radiation.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Triple-Negative Breast Cancer","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA is indicated for the treatment of patients with high-risk early-stage triple-negative breast cancer (TNBC) in combination with chemotherapy as neoadjuvant treatment, and then continued as a single agent as adjuvant treatment after surgery.\nKEYTRUDA, in combination with chemotherapy, is indicated for the treatment of patients with locally recurrent unresectable or metastatic TNBC whose tumors express PD-L1 (CPS ≥10) as determined by an FDA-approved test.\n","marks":[],"data":{}},{"nodeType":"text","value":"\nSelected Important Safety Information for KEYTRUDA\nSevere and Fatal Immune-Mediated Adverse Reactions\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA is a monoclonal antibody that belongs to a class of drugs that bind to either the PD-1 or the PD-L1, blocking the PD-1/PD-L1 pathway, thereby removing inhibition of the immune response, potentially breaking peripheral tolerance and inducing immune-mediated adverse reactions. Immune-mediated adverse reactions, which may be severe or fatal, can occur in any organ system or tissue, can affect more than one body system simultaneously, and can occur at any time after starting treatment or after discontinuation of treatment. Important immune-mediated adverse reactions listed here may not include all possible severe and fatal immune-mediated adverse reactions.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Monitor patients closely for symptoms and signs that may be clinical manifestations of underlying immune-mediated adverse reactions. Early identification and management are essential to ensure safe use of anti–PD-1/PD-L1 treatments. Evaluate liver enzymes, creatinine, and thyroid function at baseline and periodically during treatment. For patients with TNBC treated with KEYTRUDA in the neoadjuvant setting, monitor blood cortisol at baseline, prior to surgery, and as clinically indicated. In cases of suspected immune-mediated adverse reactions, initiate appropriate workup to exclude alternative etiologies, including infection. Institute medical management promptly, including specialty consultation as appropriate.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Withhold or permanently discontinue KEYTRUDA depending on severity of the immune-mediated adverse reaction. In general, if KEYTRUDA requires interruption or discontinuation, administer systemic corticosteroid therapy (1 to 2 mg/kg/day prednisone or equivalent) until improvement to Grade 1 or less. Upon improvement to Grade 1 or less, initiate corticosteroid taper and continue to taper over at least 1 month. Consider administration of other systemic immunosuppressants in patients whose adverse reactions are not controlled with corticosteroid therapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Immune-Mediated Pneumonitis\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA can cause immune-mediated pneumonitis. The incidence is higher in patients who have received prior thoracic radiation. Immune-mediated pneumonitis occurred in 3.4% (94/2799) of patients receiving KEYTRUDA, including fatal (0.1%), Grade 4 (0.3%), Grade 3 (0.9%), and Grade 2 (1.3%) reactions. Systemic corticosteroids were required in 67% (63/94) of patients. Pneumonitis led to permanent discontinuation of KEYTRUDA in 1.3% (36) and withholding in 0.9% (26) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement; of these, 23% had recurrence. Pneumonitis resolved in 59% of the 94 patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Pneumonitis occurred in 8% (31/389) of adult patients with cHL receiving KEYTRUDA as a single agent, including Grades 3-4 in 2.3% of patients. Patients received high-dose corticosteroids for a median duration of 10 days (range: 2 days to 53 months). Pneumonitis rates were similar in patients with and without prior thoracic radiation. Pneumonitis led to discontinuation of KEYTRUDA in 5.4% (21) of patients. Of the patients who developed pneumonitis, 42% interrupted KEYTRUDA, 68% discontinued KEYTRUDA, and 77% had resolution.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Immune-Mediated Colitis","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated colitis, which may present with diarrhea. Cytomegalovirus infection/reactivation has been reported in patients with corticosteroid-refractory immune-mediated colitis. In cases of corticosteroid-refractory colitis, consider repeating infectious workup to exclude alternative etiologies. Immune-mediated colitis occurred in 1.7% (48/2799) of patients receiving KEYTRUDA, including Grade 4 (<0.1%), Grade 3 (1.1%), and Grade 2 (0.4%) reactions. Systemic corticosteroids were required in 69% (33/48); additional immunosuppressant therapy was required in 4.2% of patients. Colitis led to permanent discontinuation of KEYTRUDA in 0.5% (15) and withholding in 0.5% (13) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement; of these, 23% had recurrence. Colitis resolved in 85% of the 48 patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Hepatotoxicity and Immune-Mediated Hepatitis","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\n","marks":[],"data":{}},{"nodeType":"text","value":"KEYTRUDA as a Single Agent","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated hepatitis. Immune-mediated hepatitis occurred in 0.7% (19/2799) of patients receiving KEYTRUDA, including Grade 4 (<0.1%), Grade 3 (0.4%), and Grade 2 (0.1%) reactions. Systemic corticosteroids were required in 68% (13/19) of patients; additional immunosuppressant therapy was required in 11% of patients. Hepatitis led to permanent discontinuation of KEYTRUDA in 0.2% (6) and withholding in 0.3% (9) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement; of these, none had recurrence. Hepatitis resolved in 79% of the 19 patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"KEYTRUDA With Axitinib","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA in combination with axitinib can cause hepatic toxicity. Monitor liver enzymes before initiation of and periodically throughout treatment. Consider monitoring more frequently as compared to when the drugs are administered as single agents. For elevated liver enzymes, interrupt KEYTRUDA and axitinib, and consider administering corticosteroids as needed. With the combination of KEYTRUDA and axitinib, Grades 3 and 4 increased alanine aminotransferase (ALT) (20%) and increased aspartate aminotransferase (AST) (13%) were seen at a higher frequency compared to KEYTRUDA alone. Fifty-nine percent of the patients with increased ALT received systemic corticosteroids. In patients with ALT ≥3 times upper limit of normal (ULN) (Grades 2-4, n=116), ALT resolved to Grades 0-1 in 94%. Among the 92 patients who were rechallenged with either KEYTRUDA (n=3) or axitinib (n=34) administered as a single agent or with both (n=55), recurrence of ALT ≥3 times ULN was observed in 1 patient receiving KEYTRUDA, 16 patients receiving axitinib, and 24 patients receiving both. All patients with a recurrence of ALT ≥3 ULN subsequently recovered from the event. \n","marks":[],"data":{}},{"nodeType":"text","value":"\nImmune-Mediated Endocrinopathies\nAdrenal Insufficiency\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA can cause primary or secondary adrenal insufficiency. For Grade 2 or higher, initiate symptomatic treatment, including hormone replacement as clinically indicated. Withhold KEYTRUDA depending on severity. Adrenal insufficiency occurred in 0.8% (22/2799) of patients receiving KEYTRUDA, including Grade 4 (<0.1%), Grade 3 (0.3%), and Grade 2 (0.3%) reactions. Systemic corticosteroids were required in 77% (17/22) of patients; of these, the majority remained on systemic corticosteroids. Adrenal insufficiency led to permanent discontinuation of KEYTRUDA in <0.1% (1) and withholding in 0.3% (8) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Hypophysitis","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated hypophysitis. Hypophysitis can present with acute symptoms associated with mass effect such as headache, photophobia, or visual field defects. Hypophysitis can cause hypopituitarism. Initiate hormone replacement as indicated. Withhold or permanently discontinue KEYTRUDA depending on severity. Hypophysitis occurred in 0.6% (17/2799) of patients receiving KEYTRUDA, including Grade 4 (<0.1%), Grade 3 (0.3%), and Grade 2 (0.2%) reactions. Systemic corticosteroids were required in 94% (16/17) of patients; of these, the majority remained on systemic corticosteroids. Hypophysitis led to permanent discontinuation of KEYTRUDA in 0.1% (4) and withholding in 0.3% (7) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Thyroid Disorders","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated thyroid disorders. Thyroiditis can present with or without endocrinopathy. Hypothyroidism can follow hyperthyroidism. Initiate hormone replacement for hypothyroidism or institute medical management of hyperthyroidism as clinically indicated. Withhold or permanently discontinue KEYTRUDA depending on severity. Thyroiditis occurred in 0.6% (16/2799) of patients receiving KEYTRUDA, including Grade 2 (0.3%). None discontinued, but KEYTRUDA was withheld in <0.1% (1) of patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Hyperthyroidism occurred in 3.4% (96/2799) of patients receiving KEYTRUDA, including Grade 3 (0.1%) and Grade 2 (0.8%). It led to permanent discontinuation of KEYTRUDA in <0.1% (2) and withholding in 0.3% (7) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement. Hypothyroidism occurred in 8% (237/2799) of patients receiving KEYTRUDA, including Grade 3 (0.1%) and Grade 2 (6.2%). It led to permanent discontinuation of KEYTRUDA in <0.1% (1) and withholding in 0.5% (14) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement. The majority of patients with hypothyroidism required long-term thyroid hormone replacement. The incidence of new or worsening hypothyroidism was higher in 1185 patients with HNSCC, occurring in 16% of patients receiving KEYTRUDA as a single agent or in combination with platinum and FU, including Grade 3 (0.3%) hypothyroidism. The incidence of new or worsening hypothyroidism was higher in 389 adult patients with cHL (17%) receiving KEYTRUDA as a single agent, including Grade 1 (6.2%) and Grade 2 (10.8%) hypothyroidism.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Type 1 Diabetes Mellitus (DM), Which Can Present With Diabetic Ketoacidosis","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nMonitor patients for hyperglycemia or other signs and symptoms of diabetes. Initiate treatment with insulin as clinically indicated. Withhold KEYTRUDA depending on severity. Type 1 DM occurred in 0.2% (6/2799) of patients receiving KEYTRUDA. It led to permanent discontinuation in <0.1% (1) and withholding of KEYTRUDA in <0.1% (1) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Immune-Mediated Nephritis With Renal Dysfunction","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated nephritis. Immune-mediated nephritis occurred in 0.3% (9/2799) of patients receiving KEYTRUDA, including Grade 4 (<0.1%), Grade 3 (0.1%), and Grade 2 (0.1%) reactions. Systemic corticosteroids were required in 89% (8/9) of patients. Nephritis led to permanent discontinuation of KEYTRUDA in 0.1% (3) and withholding in 0.1% (3) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement; of these, none had recurrence. Nephritis resolved in 56% of the 9 patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Immune-Mediated Dermatologic Adverse Reactions","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nKEYTRUDA can cause immune-mediated rash or dermatitis. Exfoliative dermatitis, including Stevens-Johnson syndrome, drug rash with eosinophilia and systemic symptoms, and toxic epidermal necrolysis, has occurred with anti–PD-1/PD-L1 treatments. Topical emollients and/or topical corticosteroids may be adequate to treat mild to moderate nonexfoliative rashes. Withhold or permanently discontinue KEYTRUDA depending on severity. Immune-mediated dermatologic adverse reactions occurred in 1.4% (38/2799) of patients receiving KEYTRUDA, including Grade 3 (1%) and Grade 2 (0.1%) reactions. Systemic corticosteroids were required in 40% (15/38) of patients. These reactions led to permanent discontinuation in 0.1% (2) and withholding of KEYTRUDA in 0.6% (16) of patients. All patients who were withheld reinitiated KEYTRUDA after symptom improvement; of these, 6% had recurrence. The reactions resolved in 79% of the 38 patients.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Other Immune-Mediated Adverse Reactions","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"\nThe following clinically significant immune-mediated adverse reactions occurred at an incidence of <1% (unless otherwise noted) in patients who received KEYTRUDA or were reported with the use of other anti–PD-1/PD-L1 treatments. Severe or fatal cases have been reported for some of these adverse reactions. Cardiac/Vascular: Myocarditis, pericarditis, vasculitis; Nervous System: Meningitis, encephalitis, myelitis and demyelination, myasthenic syndrome/myasthenia gravis (including exacerbation), Guillain-Barré syndrome, nerve paresis, autoimmune neuropathy; Ocular: Uveitis, iritis and other ocular inflammatory toxicities can occur. Some cases can be associated with retinal detachment. Various grades of visual impairment, including blindness, can occur. If uveitis occurs in combination with other immune-mediated adverse reactions, consider a Vogt-Koyanagi-Harada-like syndrome, as this may require treatment with systemic steroids to reduce the risk of permanent vision loss; Gastrointestinal: Pancreatitis, to include increases in serum amylase and lipase levels, gastritis, duodenitis; Musculoskeletal and Connective Tissue: Myositis/polymyositis, rhabdomyolysis (and associated sequelae, including renal failure), arthritis (1.5%), polymyalgia rheumatica; Endocrine: Hypoparathyroidism; Hematologic/Immune: Hemolytic anemia, aplastic anemia, hemophagocytic lymphohistiocytosis, systemic inflammatory response syndrome, histiocytic necrotizing lymphadenitis (Kikuchi lymphadenitis), sarcoidosis, immune thrombocytopenic purpura, solid organ transplant rejection.\n\n","marks":[],"data":{}},{"nodeType":"text","value":"Infusion-Related Reactions\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"KEYTRUDA can cause severe or life-threatening infusion-related reactions, including hypersensitivity and anaphylaxis, which have been reported in 0.2% of 2799 patients receiving KEYTRUDA. Monitor for signs and symptoms of infusion-related reactions. Interrupt or slow the rate of infusion for Grade 1 or Grade 2 reactions. For Grade 3 or Grade 4 reactions, stop infusion and permanently discontinue KEYTRUDA.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Complications of Allogeneic Hematopoietic Stem Cell Transplantation (HSCT)\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"Fatal and other serious complications can occur in patients who receive allogeneic HSCT before or after anti–PD-1/PD-L1 treatments. Transplant-related complications include hyperacute graft-versus-host disease (GVHD), acute and chronic GVHD, hepatic veno-occlusive disease after reduced intensity conditioning, and steroid-requiring febrile syndrome (without an identified infectious cause). These complications may occur despite intervening therapy between anti–PD-1/PD-L1 treatment and allogeneic HSCT. Follow patients closely for evidence of these complications and intervene promptly. Consider the benefit vs risks of using anti–PD-1/PD-L1 treatments prior to or after an allogeneic HSCT.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Increased Mortality in Patients With Multiple Myeloma\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"In trials in patients with multiple myeloma, the addition of KEYTRUDA to a thalidomide analogue plus dexamethasone resulted in increased mortality. Treatment of these patients with an anti–PD-1/PD-L1 treatment in this combination is not recommended outside of controlled trials.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Embryofetal Toxicity\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"Based on its mechanism of action, KEYTRUDA can cause fetal harm when administered to a pregnant woman. Advise women of this potential risk. In females of reproductive potential, verify pregnancy status prior to initiating KEYTRUDA and advise them to use effective contraception during treatment and for 4 months after the last dose.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse Reactions\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"In KEYNOTE-006, KEYTRUDA was discontinued due to adverse reactions in 9% of 555 patients with advanced melanoma; adverse reactions leading to permanent discontinuation in more than one patient were colitis (1.4%), autoimmune hepatitis (0.7%), allergic reaction (0.4%), polyneuropathy (0.4%), and cardiac failure (0.4%). The most common adverse reactions (≥20%) with KEYTRUDA were fatigue (28%), diarrhea (26%), rash (24%), and nausea (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-054, when KEYTRUDA was administered as a single agent to patients with stage III melanoma, KEYTRUDA was permanently discontinued due to adverse reactions in 14% of 509 patients; the most common (≥1%) were pneumonitis (1.4%), colitis (1.2%), and diarrhea (1%). Serious adverse reactions occurred in 25% of patients receiving KEYTRUDA. The most common adverse reaction (≥20%) with KEYTRUDA was diarrhea (28%). In KEYNOTE-716, when KEYTRUDA was administered as a single agent to patients with stage IIB or IIC melanoma, adverse reactions occurring in patients with stage IIB or IIC melanoma were similar to those occurring in 1011 patients with stage III melanoma from KEYNOTE-054. ","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-189, when KEYTRUDA was administered with pemetrexed and platinum chemotherapy in metastatic nonsquamous NSCLC, KEYTRUDA was discontinued due to adverse reactions in 20% of 405 patients. The most common adverse reactions resulting in permanent discontinuation of KEYTRUDA were pneumonitis (3%) and acute kidney injury (2%). The most common adverse reactions (≥20%) with KEYTRUDA were nausea (56%), fatigue (56%), constipation (35%), diarrhea (31%), decreased appetite (28%), rash (25%), vomiting (24%), cough (21%), dyspnea (21%), and pyrexia (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-407, when KEYTRUDA was administered with carboplatin and either paclitaxel or paclitaxel protein-bound in metastatic squamous NSCLC, KEYTRUDA was discontinued due to adverse reactions in 15% of 101 patients. The most frequent serious adverse reactions reported in at least 2% of patients were febrile neutropenia, pneumonia, and urinary tract infection. Adverse reactions observed in KEYNOTE-407 were similar to those observed in KEYNOTE-189 with the exception that increased incidences of alopecia (47% vs 36%) and peripheral neuropathy (31% vs 25%) were observed in the KEYTRUDA and chemotherapy arm compared to the placebo and chemotherapy arm in KEYNOTE-407.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-042, KEYTRUDA was discontinued due to adverse reactions in 19% of 636 patients with advanced NSCLC; the most common were pneumonitis (3%), death due to unknown cause (1.6%), and pneumonia (1.4%). The most frequent serious adverse reactions reported in at least 2% of patients were pneumonia (7%), pneumonitis (3.9%), pulmonary embolism (2.4%), and pleural effusion (2.2%). The most common adverse reaction (≥20%) was fatigue (25%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-010, KEYTRUDA monotherapy was discontinued due to adverse reactions in 8% of 682 patients with metastatic NSCLC; the most common was pneumonitis (1.8%). The most common adverse reactions (≥20%) were decreased appetite (25%), fatigue (25%), dyspnea (23%), and nausea (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-048, KEYTRUDA monotherapy was discontinued due to adverse events in 12% of 300 patients with HNSCC; the most common adverse reactions leading to permanent discontinuation were sepsis (1.7%) and pneumonia (1.3%). The most common adverse reactions (≥20%) were fatigue (33%), constipation (20%), and rash (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-048, when KEYTRUDA was administered in combination with platinum (cisplatin or carboplatin) and FU chemotherapy, KEYTRUDA was discontinued due to adverse reactions in 16% of 276 patients with HNSCC. The most common adverse reactions resulting in permanent discontinuation of KEYTRUDA were pneumonia (2.5%), pneumonitis (1.8%), and septic shock (1.4%). The most common adverse reactions (≥20%) were nausea (51%), fatigue (49%), constipation (37%), vomiting (32%), mucosal inflammation (31%), diarrhea (29%), decreased appetite (29%), stomatitis (26%), and cough (22%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-012, KEYTRUDA was discontinued due to adverse reactions in 17% of 192 patients with HNSCC. Serious adverse reactions occurred in 45% of patients. The most frequent serious adverse reactions reported in at least 2% of patients were pneumonia, dyspnea, confusional state, vomiting, pleural effusion, and respiratory failure. The most common adverse reactions (≥20%) were fatigue, decreased appetite, and dyspnea. Adverse reactions occurring in patients with HNSCC were generally similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy, with the exception of increased incidences of facial edema and new or worsening hypothyroidism.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-204, KEYTRUDA was discontinued due to adverse reactions in 14% of 148 patients with cHL. Serious adverse reactions occurred in 30% of patients receiving KEYTRUDA; those ≥1% were pneumonitis, pneumonia, pyrexia, myocarditis, acute kidney injury, febrile neutropenia, and sepsis. Three patients died from causes other than disease progression: 2 from complications after allogeneic HSCT and 1 from unknown cause. The most common adverse reactions (≥20%) were upper respiratory tract infection (41%), musculoskeletal pain (32%), diarrhea (22%), and pyrexia, fatigue, rash, and cough (20% each).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-087, KEYTRUDA was discontinued due to adverse reactions in 5% of 210 patients with cHL. Serious adverse reactions occurred in 16% of patients; those ≥1% were pneumonia, pneumonitis, pyrexia, dyspnea, GVHD, and herpes zoster. Two patients died from causes other than disease progression: 1 from GVHD after subsequent allogeneic HSCT and 1 from septic shock. The most common adverse reactions (≥20%) were fatigue (26%), pyrexia (24%), cough (24%), musculoskeletal pain (21%), diarrhea (20%), and rash (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-170, KEYTRUDA was discontinued due to adverse reactions in 8% of 53 patients with PMBCL. Serious adverse reactions occurred in 26% of patients and included arrhythmia (4%), cardiac tamponade (2%), myocardial infarction (2%), pericardial effusion (2%), and pericarditis (2%). Six (11%) patients died within 30 days of start of treatment. The most common adverse reactions (≥20%) were musculoskeletal pain (30%), upper respiratory tract infection and pyrexia (28% each), cough (26%), fatigue (23%), and dyspnea (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-052, KEYTRUDA was discontinued due to adverse reactions in 11% of 370 patients with locally advanced or mUC. Serious adverse reactions occurred in 42% of patients; those ≥2% were urinary tract infection, hematuria, acute kidney injury, pneumonia, and urosepsis. The most common adverse reactions (≥20%) were fatigue (38%), musculoskeletal pain (24%), decreased appetite (22%), constipation (21%), rash (21%), and diarrhea (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-045, KEYTRUDA was discontinued due to adverse reactions in 8% of 266 patients with locally advanced or mUC. The most common adverse reaction resulting in permanent discontinuation of KEYTRUDA was pneumonitis (1.9%). Serious adverse reactions occurred in 39% of KEYTRUDA-treated patients; those ≥2% were urinary tract infection, pneumonia, anemia, and pneumonitis. The most common adverse reactions (≥20%) in patients who received KEYTRUDA were fatigue (38%), musculoskeletal pain (32%), pruritus (23%), decreased appetite (21%), nausea (21%), and rash (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-057, KEYTRUDA was discontinued due to adverse reactions in 11% of 148 patients with high-risk NMIBC. The most common adverse reaction resulting in permanent discontinuation of KEYTRUDA was pneumonitis (1.4%). Serious adverse reactions occurred in 28% of patients; those ≥2% were pneumonia (3%), cardiac ischemia (2%), colitis (2%), pulmonary embolism (2%), sepsis (2%), and urinary tract infection (2%). The most common adverse reactions (≥20%) were fatigue (29%), diarrhea (24%), and rash (24%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with MSI-H or dMMR CRC were similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-811, when KEYTRUDA was administered in combination with trastuzumab, fluoropyrimidine- and platinum-containing chemotherapy, KEYTRUDA was discontinued due to adverse reactions in 6% of 217 patients with locally advanced unresectable or metastatic HER2+ gastric or GEJ adenocarcinoma. The most common adverse reaction resulting in permanent discontinuation was pneumonitis (1.4%). In the KEYTRUDA arm versus placebo, there was a difference of ≥5% incidence between patients treated with KEYTRUDA versus standard of care for diarrhea (53% vs 44%) and nausea (49% vs 44%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"The most common adverse reactions (reported in ≥20%) in patients receiving KEYTRUDA in combination with chemotherapy were fatigue/asthenia, nausea, constipation, diarrhea, decreased appetite, rash, vomiting, cough, dyspnea, pyrexia, alopecia, peripheral neuropathy, mucosal inflammation, stomatitis, headache, weight loss, abdominal pain, arthralgia, myalgia, and insomnia.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-590, when KEYTRUDA was administered with cisplatin and fluorouracil to patients with metastatic or locally advanced esophageal or GEJ (tumors with epicenter 1 to 5 centimeters above the GEJ) carcinoma who were not candidates for surgical resection or definitive chemoradiation, KEYTRUDA was discontinued due to adverse reactions in 15% of 370 patients. The most common adverse reactions resulting in permanent discontinuation of KEYTRUDA (≥1%) were pneumonitis (1.6%), acute kidney injury (1.1%), and pneumonia (1.1%). The most common adverse reactions (≥20%) with KEYTRUDA in combination with chemotherapy were nausea (67%), fatigue (57%), decreased appetite (44%), constipation (40%), diarrhea (36%), vomiting (34%), stomatitis (27%), and weight loss (24%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with esophageal cancer who received KEYTRUDA as a monotherapy were similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-826, when KEYTRUDA was administered in combination with paclitaxel and cisplatin or paclitaxel and carboplatin, with or without bevacizumab (n=307), to patients with persistent, recurrent, or first-line metastatic cervical cancer regardless of tumor PD-L1 expression who had not been treated with chemotherapy except when used concurrently as a radio-sensitizing agent, fatal adverse reactions occurred in 4.6% of patients, including 3 cases of hemorrhage, 2 cases each of sepsis and due to unknown causes, and 1 case each of acute myocardial infarction, autoimmune encephalitis, cardiac arrest, cerebrovascular accident, femur fracture with perioperative pulmonary embolus, intestinal perforation, and pelvic infection. Serious adverse reactions occurred in 50% of patients receiving KEYTRUDA in combination with chemotherapy with or without bevacizumab; those ≥3% were febrile neutropenia (6.8%), urinary tract infection (5.2%), anemia (4.6%), and acute kidney injury and sepsis (3.3% each).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"KEYTRUDA was discontinued in 15% of patients due to adverse reactions. The most common adverse reaction resulting in permanent discontinuation (≥1%) was colitis (1%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"For patients treated with KEYTRUDA, chemotherapy, and bevacizumab (n=196), the most common adverse reactions (≥20%) were peripheral neuropathy (62%), alopecia (58%), anemia (55%), fatigue/asthenia (53%), nausea and neutropenia (41% each), diarrhea (39%), hypertension and thrombocytopenia (35% each), constipation and arthralgia (31% each), vomiting (30%), urinary tract infection (27%), rash (26%), leukopenia (24%), hypothyroidism (22%), and decreased appetite (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"For patients treated with KEYTRUDA in combination with chemotherapy with or without bevacizumab, the most common adverse reactions (≥20%) were peripheral neuropathy (58%), alopecia (56%), fatigue (47%), nausea (40%), diarrhea (36%), constipation (28%), arthralgia (27%), vomiting (26%), hypertension and urinary tract infection (24% each), and rash (22%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-158, KEYTRUDA was discontinued due to adverse reactions in 8% of 98 patients with previously treated recurrent or metastatic cervical cancer. Serious adverse reactions occurred in 39% of patients receiving KEYTRUDA; the most frequent included anemia (7%), fistula, hemorrhage, and infections [except urinary tract infections] (4.1% each). The most common adverse reactions (≥20%) were fatigue (43%), musculoskeletal pain (27%), diarrhea (23%), pain and abdominal pain (22% each), and decreased appetite (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with HCC were generally similar to those in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy, with the exception of increased incidences of ascites (8% Grades 3-4) and immune-mediated hepatitis (2.9%). Laboratory abnormalities (Grades 3-4) that occurred at a higher incidence were elevated AST (20%), ALT (9%), and hyperbilirubinemia (10%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Among the 50 patients with MCC enrolled in study KEYNOTE-017, adverse reactions occurring in patients with MCC were generally similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy. Laboratory abnormalities (Grades 3-4) that occurred at a higher incidence were elevated AST (11%) and hyperglycemia (19%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-426, when KEYTRUDA was administered in combination with axitinib, fatal adverse reactions occurred in 3.3% of 429 patients. Serious adverse reactions occurred in 40% of patients, the most frequent (≥1%) were hepatotoxicity (7%), diarrhea (4.2%), acute kidney injury (2.3%), dehydration (1%), and pneumonitis (1%). Permanent discontinuation due to an adverse reaction occurred in 31% of patients; KEYTRUDA only (13%), axitinib only (13%), and the combination (8%); the most common were hepatotoxicity (13%), diarrhea/colitis (1.9%), acute kidney injury (1.6%), and cerebrovascular accident (1.2%). The most common adverse reactions (≥20%) were diarrhea (56%), fatigue/asthenia (52%), hypertension (48%), hepatotoxicity (39%), hypothyroidism (35%), decreased appetite (30%), palmar-plantar erythrodysesthesia (28%), nausea (28%), stomatitis/mucosal inflammation (27%), dysphonia (25%), rash (25%), cough (21%), and constipation (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-564, when KEYTRUDA was administered as a single agent for the adjuvant treatment of renal cell carcinoma, serious adverse reactions occurred in 20% of patients receiving KEYTRUDA; the serious adverse reactions (≥1%) were acute kidney injury, adrenal insufficiency, pneumonia, colitis, and diabetic ketoacidosis (1% each). Fatal adverse reactions occurred in 0.2% including 1 case of pneumonia. Discontinuation of KEYTRUDA due to adverse reactions occurred in 21% of 488 patients; the most common (≥1%) were increased ALT (1.6%), colitis (1%), and adrenal insufficiency (1%). The most common adverse reactions (≥20%) were musculoskeletal pain (41%), fatigue (40%), rash (30%), diarrhea (27%), pruritus (23%), and hypothyroidism (21%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with MSI-H or dMMR endometrial carcinoma who received KEYTRUDA as a single agent were similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a single agent.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with TMB-H cancer were similar to those occurring in patients with other solid tumors who received KEYTRUDA as a single agent.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions occurring in patients with recurrent or metastatic cSCC or locally advanced cSCC were similar to those occurring in patients with melanoma or NSCLC who received KEYTRUDA as a monotherapy.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-522, when KEYTRUDA was administered with neoadjuvant chemotherapy (carboplatin and paclitaxel followed by doxorubicin or epirubicin and cyclophosphamide) followed by surgery and continued adjuvant treatment with KEYTRUDA as a single agent (n=778) to patients with newly diagnosed, previously untreated, high-risk early-stage TNBC, fatal adverse reactions occurred in 0.9% of patients, including 1 each of adrenal crisis, autoimmune encephalitis, hepatitis, pneumonia, pneumonitis, pulmonary embolism, and sepsis in association with multiple organ dysfunction syndrome and myocardial infarction. Serious adverse reactions occurred in 44% of patients receiving KEYTRUDA; those ≥2% were febrile neutropenia (15%), pyrexia (3.7%), anemia (2.6%), and neutropenia (2.2%). KEYTRUDA was discontinued in 20% of patients due to adverse reactions. The most common reactions (≥1%) resulting in permanent discontinuation were increased ALT (2.7%), increased AST (1.5%), and rash (1%). The most common adverse reactions (≥20%) in patients receiving KEYTRUDA were fatigue (70%), nausea (67%), alopecia (61%), rash (52%), constipation (42%), diarrhea and peripheral neuropathy (41% each), stomatitis (34%), vomiting (31%), headache (30%), arthralgia (29%), pyrexia (28%), cough (26%), abdominal pain (24%), decreased appetite (23%), insomnia (21%), and myalgia (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"In KEYNOTE-355, when KEYTRUDA and chemotherapy (paclitaxel, paclitaxel protein-bound, or gemcitabine and carboplatin) were administered to patients with locally recurrent unresectable or metastatic TNBC who had not been previously treated with chemotherapy in the metastatic setting (n=596), fatal adverse reactions occurred in 2.5% of patients, including cardio-respiratory arrest (0.7%) and septic shock (0.3%). Serious adverse reactions occurred in 30% of patients receiving KEYTRUDA in combination with chemotherapy; the serious reactions in ≥2% were pneumonia (2.9%), anemia (2.2%), and thrombocytopenia (2%). KEYTRUDA was discontinued in 11% of patients due to adverse reactions. The most common reactions resulting in permanent discontinuation (≥1%) were increased ALT (2.2%), increased AST (1.5%), and pneumonitis (1.2%). The most common adverse reactions (≥20%) in patients receiving KEYTRUDA in combination with chemotherapy were fatigue (48%), nausea (44%), alopecia (34%), diarrhea and constipation (28% each), vomiting and rash (26% each), cough (23%), decreased appetite (21%), and headache (20%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Lactation\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"Because of the potential for serious adverse reactions in breastfed children, advise women not to breastfeed during treatment and for 4 months after the final dose.","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Pediatric Use\n","marks":[{"type":"bold"}],"data":{}},{"nodeType":"text","value":"In KEYNOTE-051, 161 pediatric patients (62 pediatric patients aged 6 months to younger than 12 years and 99 pediatric patients aged 12 years to 17 years) were administered KEYTRUDA 2 mg/kg every 3 weeks. The median duration of exposure was 2.1 months (range: 1 day to 24 months).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Adverse reactions that occurred at a ≥10% higher rate in pediatric patients when compared to adults were pyrexia (33%), vomiting (30%), leukopenia (30%), upper respiratory tract infection (29%), neutropenia (26%), headache (25%), and Grade 3 anemia (17%).","marks":[],"data":{}}]},{"nodeType":"heading-6","data":{},"content":[{"nodeType":"text","value":"Please see Prescribing Information for KEYTRUDA (pembrolizumab) at ","marks":[{"type":"bold"}],"data":{}},{"nodeType":"hyperlink","data":{"uri":"http://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_pi.pdf"},"content":[{"nodeType":"text","value":"http://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_pi.pdf","marks":[{"type":"bold"}],"data":{}}]},{"nodeType":"text","value":" and Medication Guide for KEYTRUDA at ","marks":[{"type":"bold"}],"data":{}},{"nodeType":"hyperlink","data":{"uri":"http://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_mg.pdf"},"content":[{"nodeType":"text","value":"http://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_mg.pdf","marks":[{"type":"bold"}],"data":{}}]},{"nodeType":"text","value":". ","marks":[{"type":"bold"}],"data":{}}]},{"nodeType":"paragraph","data":{},"content":[{"nodeType":"text","value":"","marks":[],"data":{}}]}]}}},"extraFooter":{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"6gue0QiruHfAo8pSgNhNVv","type":"Entry","createdAt":"2023-04-16T15:00:13.652Z","updatedAt":"2023-04-16T15:00:13.652Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"sectionExternalReferences"}},"locale":"en-US"},"fields":{"entryTitle":"Media Center > Blogs > One Medicine for One Patient:  An Investigational mRNA Individualized Neoantigen Therapy","header":"References","externalLinks":[{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"5aditztt2u66bltUb6xhxt","type":"Entry","createdAt":"2023-04-16T15:00:13.527Z","updatedAt":"2023-04-16T15:00:13.527Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"subpartExternalLink"}},"locale":"en-US"},"fields":{"entryTitle":"Media Center > Blogs > One Medicine for One Patient:  An Investigational mRNA Individualized Neoantigen Therapy - link 1","linkText":"https://www.cancer.gov/publications/dictionaries/cancer-terms/def/t-cell","externalUrl":"https://www.cancer.gov/publications/dictionaries/cancer-terms/def/t-cell"}},{"metadata":{"tags":[]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"inEQRovQZGVeQMFNjfpet","type":"Entry","createdAt":"2023-04-16T15:00:13.839Z","updatedAt":"2023-04-16T15:00:13.839Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":1,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"subpartExternalLink"}},"locale":"en-US"},"fields":{"entryTitle":"Media Center > Blogs > One Medicine for One Patient:  An Investigational mRNA Individualized Neoantigen Therapy - link 2","linkText":" https://www.nature.com/articles/s43018-022-00418-6","externalUrl":" https://www.nature.com/articles/s43018-022-00418-6"}}]}}}}}}}}}}]}},{"metadata":{"tags":[{"sys":{"type":"Link","linkType":"Tag","id":"countryUS"}},{"sys":{"type":"Link","linkType":"Tag","id":"propertyModernaCorporate"}}]},"sys":{"space":{"sys":{"type":"Link","linkType":"Space","id":"87hacmv3x18u"}},"id":"oxxakxgAOWCldNRX1M56K","type":"Entry","createdAt":"2022-03-10T23:03:58.843Z","updatedAt":"2023-03-07T12:57:29.512Z","environment":{"sys":{"id":"master","type":"Link","linkType":"Environment"}},"revision":6,"contentType":{"sys":{"type":"Link","linkType":"ContentType","id":"sectionFeedMedia"}},"locale":"en-US"},"fields":{"entryTitle":"Media Center > Blogs","mediaType":"Blog Posts","header":"All blogs","itemsPerPage":6,"buttonText":"See more","emptyErrorMessage":"empty"}}]}}}