KEYTRUDA SC, as it will be marketed in the European Union (EU), [known as KEYTRUDA QLEX (pembrolizumab and berahyaluronidase alfa-pmph) in the U.S.], is a subcutaneous injection containing pembrolizumab and berahyaluronidase alfa and has been approved for use across all 33 KEYTRUDA indications for adult patients in Europe. Berahyaluronidase alfa is a variant of human hyaluronidase developed and manufactured by Alteogen Inc.
“We are honored to introduce KEYTRUDA SC, the first and only subcutaneous immune checkpoint inhibitor in Europe that can be administered in one minute every three weeks or in two minutes every six weeks,” said Dr Marjorie Green, senior vice president and head of oncology, global clinical development, Merck Research Laboratories. “We are committed to discovering patient-focused innovations for people with cancer like KEYTRUDA SC, which offers faster administration than KEYTRUDA, two dosing options and allows patients more choices of health care settings where they can receive therapy.”
The approval of KEYTRUDA SC is based on results from the pivotal 3475A-D77 trial, which compared KEYTRUDA SC and KEYTRUDA, both administered every six weeks, each in combination with chemotherapy, in patients with treatment naïve metastatic non-small cell lung cancer (NSCLC) with no EGFR, ALK or ROS1 genomic tumor aberrations. This trial demonstrated comparable pharmacokinetic exposure levels between KEYTRUDA SC and KEYTRUDA. In descriptive efficacy analyses, overall response rates (ORR) were consistent between KEYTRUDA SC and KEYTRUDA. The ORR in the KEYTRUDA SC with chemotherapy arm was 45% (95% CI, 39-52) and 42% (95% CI, 33-51) in the KEYTRUDA with chemotherapy arm. Additionally, no notable differences were observed in progression-free survival (PFS) and overall survival (OS).
This decision authorizes the marketing of KEYTRUDA SC in all 27 EU member states, as well as Iceland, Liechtenstein and Norway. Timing for commercial availability of KEYTRUDA SC in individual EU countries will depend on multiple factors, including the completion of national reimbursement procedures.
The EC approval follows the positive recommendation from the European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP) received in September 2025. Also in September 2025, KEYTRUDA QLEX was approved by the U.S. Food and Drug Administration (FDA). In the United States, KEYTRUDA QLEX is now approved for use in adults across all solid tumor indications approved for KEYTRUDA.
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