KEYTRUDA for advanced melanoma

What is melanoma?

Melanoma is a form of skin cancer. It happens when melanocytes (pigment cells) become cancerous. It can emerge anywhere on the body, but typically appears in skin that has been sunburned. It usually begins as a flat spot that changes over time (size, shape and colour), but sometimes it's raised from the start (nodular melanoma) and these melanomas grow quickly. Melanoma can occur in the eye (ocular melanoma), the mouth, vulva or vagina (mucosal melanoma) and under fingernails or toenails (subungual melanoma), but this is rare.

Who is at risk?

New Zealand has one of the highest rates of melanoma globally. It's diagnosed most often in older people, but sometimes occurs in younger adults and occasionally teenagers. It is rare in children. Certain types of skin are more prone to melanoma than others.

Risk factors:

  • fair skin and red or fair hair
  • one or more severe sunburns – especially in childhood and adolescence
  • use of sunbeds, particularly by young people.

High-risk factors:

  • previous skin cancers, including melanoma
  • a family history of melanoma (in a first degree relative)
  • large, irregularly shaped and unevenly coloured moles (atypical or dysplastic naevi)
  • large numbers of moles.

Causes of melanoma

Genetics plays a large part, but one major risk factor is avoidable, and that is high sun exposure and sunburn. When unprotected skin is exposed to the sun's UV radiation, the structure of the cells is changed and permanent damage occurs. The damage worsens with more UV radiation. Exposure to UV radiation during childhood and early adult years greatly increases the chance of getting melanoma later in life, so this is a time when sun protection is essential.

Advanced melanoma

How is melanoma diagnosed

Treating melanoma


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