KEYNOTE-522 (pembrolizumab + chemotherapy, then adjuvant pembrolizumab)
Checked 2026-09-09
Stage II-III triple-negative breast cancer
One cycle
every 21 days × 4 · about 12 weeks in totalComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Pembrolizumab Monoclonal antibody (anti-PD-1) | 200 mg | IV | D1 | or 400 mg every 6 weeks |
Paclitaxel Cytotoxic chemotherapy (taxane) | 80 mg/m² | IV | D1, 8, 15 | cycles 1-4 |
Carboplatin Cytotoxic chemotherapy (platinum) | AUC 5 day 1 (or AUC 1.5 weekly) | IV | D1 | cycles 1-4 |
Doxorubicin Cytotoxic chemotherapy (anthracycline) | 60 mg/m² (or epirubicin 90 mg/m²) | IV | D1 | cycles 5-8 |
Cyclophosphamide Alkylating agent (oxazaphosphorine prodrug) | 600 mg/m² | IV | D1 | cycles 5-8 |
Cycles
4 paclitaxel-carboplatin then 4 AC/EC, surgery, then 9 adjuvant pembrolizumab
21-day cycle
Emetogenicity
High (>90%)
G-CSF
Consider (10-20% FN risk)
Notes
- pCR 64.8% vs 51.2%; event-free survival and overall survival benefit confirmed at later analyses.
- Immune-related endocrinopathies (thyroid, adrenal, hypophysitis) can be permanent; check baseline TSH and cortisol.
Used in
Trials
Source
KEYNOTE-522, NEJM 2020 (Schmid)
Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.
Other regimens for these cancers
Dose-dense AC → T
Node-positive or high-risk early breast cancer, adjuvant or neoadjuvant
every 14 days × 4
TC (docetaxel + cyclophosphamide)
Early breast cancer when an anthracycline is not wanted
every 21 days × 4
Trastuzumab deruxtecan 5.4 mg/kg
HER2-positive metastatic breast cancer second line; HER2-low or ultralow after chemotherapy or endocrine therapy; HER2-mutant NSCLC
every 21 days
Sacituzumab govitecan
Metastatic TNBC after two lines (one for metastatic disease); HR-positive after endocrine therapy and two chemotherapies
every 21 days
Capecitabine (post-neoadjuvant)
Residual invasive disease after neoadjuvant chemotherapy, HER2-negative
every 21 days × 6-8
Olaparib (adjuvant, OlympiA)
Germline BRCA1/2, HER2-negative, high-risk early breast cancer after chemotherapy
every 28 days × 13
Eribulin
Metastatic breast cancer after an anthracycline and a taxane; liposarcoma
every 21 days
Weekly paclitaxel
Platinum-resistant ovarian cancer (with or without bevacizumab); metastatic breast cancer
every 28 days