KEYTRUDA for non-small cell lung cancer (NSCLC)

Treating lung cancer

Treatment depends on the type of lung cancer you have and how far it has progressed, as well as your age and general state of health. Here’s a summary of treatments cancer specialists use today:


Surgery may be appropriate in early stage non-small cell lung cancer (NSCLC). Careful checking is required to ensure there will be enough healthy lung tissue left after surgery.

During the operation the surgeon removes the lung cancer and a margin of healthy tissue around it. The surgeon may also remove lymph nodes from the chest, so that they can be checked for signs of cancer. Procedures to remove lung cancer include:

  • Wedge resection – removal of a small section of lung that contains the tumour, as well as a margin of healthy tissue
  • Segmental resection – removal of a larger portion of lung, but not an entire lobe
  • Lobectomy – removal of the entire lobe of one lung
  • Pneumonectomy – removal of an entire lung

Like any surgery, lung cancer surgery can come with the risk of bleeding and infection. You may expect to feel short of breath after lung surgery. If a portion of the lung was removed, physiotherapy can help to improve breathing as the remaining lung tissue adapts over time.


Chemotherapy (chemo) involves using drugs that kill cancer cells. These drugs can be given through a vein in the arm (intravenously) or taken orally (by mouth). Chemotherapy is usually delivered as a series of treatments, with breaks for recovery in between.

Chemotherapy can sometimes be used before surgery, to shrink cancers and make them easier to remove. It is also often used after surgery, with the goal of killing any cancer cells remaining.

For advanced cancer, chemotherapy can be used to relieve pain and other debilitating symptoms.

Radiation therapy

Radiation therapy uses high-powered energy beams, from sources such as X-rays and protons, to target cancer cells. It can be directed at cancer from outside the body (external beam radiation) or it can be positioned inside the body near the cancer (brachytherapy), using a needle or catheter (small plastic tube).

Like chemotherapy, radiation therapy can be used after surgery to kill remaining cancer cells. It can also be used instead of surgery, for lung cancers that can’t be operated on. For advanced lung cancer, radiation therapy may be used to reduce pain and other symptoms.

For very small lung cancer lesions, stereotactic body radiotherapy could be an option. This type of radiation therapy aims many beams of radiation from different angles at the lung cancer.

Personalised drug therapy

Recent advances in lung cancer treatment target specific abnormalities in cancer cells. Some of these treatments are used alone or in combination with chemotherapy drugs.

Immunotherapies, such as KEYTRUDA, are being used to treat advanced non-small cell lung cancer, by helping the immune system to detect and fight cancer cells.

KEYTRUDA may be used as a first treatment option when lung cancer has spread (advanced NSCLC), tests positive for PD-L1 and does not have an abnormal EGFR or ALK gene. More about KEYTRUDA >>

  • PD-L1 = programmed death ligand
  • EGFR = epidermal growth factor receptor
  • ALK = anaplastic lymphoma kinase

Palliative care

You might think of palliative care as ‘end of life’ care, but its true definition is much broader. Palliative care is about providing relief of suffering and improvement of quality of life for you and your family. It should be provided alongside any surgical or medical treatment you are receiving.

Your doctor may introduce you to a palliative care team soon after your diagnosis, to ensure you're comfortable during and after your cancer treatment.

Palliative care for lung cancer can involve:

  • Relief from your symptoms and side effects, such as nausea, pain, fatigue, or shortness of breath
  • Emotional and spiritual support
  • Support for your friends and family, who will be worried about you

How KEYTRUDA works

Questions to ask your doctor about lung cancer

Who can you talk to?


KEYTRUDA (pembrolizumab) 50mg powder for infusion
KEYTRUDA is a Prescription Only Medicine Use: KEYTRUDA is used:
  • in the treatment of melanoma which cannot be removed by surgery alone or when it has spread to multiple sites in the body.
  • in the treatment of a kind of lung cancer called non-small cell lung cancer (NSCLC).
  • in the treatment of classical Hodgkin Lymphoma (cHL)
  • in the treatment of urothelial carcinoma, including bladder cancer
  • in the treatment of a kind of head and neck cancer called head and neck squamous cell carcinoma (HNSCC)

Side effects: Immune-mediated side effects including inflammation of the lungs, colon, liver, kidneys, pituitary gland, brain, eye, muscles, nervous system, pancreas, and heart, thyroid disorders, type 1 diabetes mellitus. Severe skin reactions including Steven-Johnson syndrome and toxic epidermal necrolysis. Severe infusion reactions including hypersensitivity and anaphylaxis. Transplant recipients: rejection of a transplanted organ, graft-versus-host-disease (in people with a bone marrow transplant using donor cells). Very common side effects include diarrhea, nausea, itching, rash, joint pain, back pain, feeling tired, cough, patches of discoloured skin, stomach pain, decreased levels of sodium in blood. Tiredness, nausea, vomiting, diarrhea, constipation, shortness of breath, rash, itching, headache, hair loss, and, infections of the upper respiratory tract were reported when given in combination with chemotherapy. You may experience more than one side effect at the same time.

All medicines have risks and benefits. Talk to your doctor to see if KEYTRUDA is right for you. KEYTRUDA is a funded medicine for melanoma patients– restrictions apply. KEYTRUDA is an unfunded medicine for NSCLC, HNSCC, cHL and urothelial carcinoma patients. Ask your health professional the cost of the medicine and any other medical fees that may apply. Use only as directed and if symptoms continue or you have side effects, see your doctor, pharmacist, or health professional.

Based on data sheet prepared 17 July 2018. Marketed by: Merck Sharp & Dohme (New Zealand) Limited, Newmarket, Auckland. . For additional product information, consult the Consumer Medicine Information (CMI), available on request, phone 0800 500 673 or refer to the Medsafe website

This site is intended for New Zealand residents.

References to support this are available on request.

MSD recommends people always seek the medical advice of their healthcare professional.

Copyright © 2018 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, New Jersey, USA. All rights reserved.

Copyright © 2018 Merck Sharp & Dohme (New Zealand) Limited. Level 3, 123 Carlton Gore Road, Newmarket, Auckland. All rights reserved.

ONCO-1273154-0000 First Issued November 2017 TAPS NA10076 essence MSD8360

Updated: October 2018