Clinical Outcomes and Safety of Pembrolizumab Monotherapy in Iraqi Patients with Metastatic Lung Cancer and Renal Cell Carcinoma

Keywords:
Pembrolizumab, Lung Cancer, Renal Cell Carcinoma, Immunotherapy, Immune-Related Adverse Events
Abstract

Pembrolizumab, an anti-programmed cell death protein 1 (PD-1) immune checkpoint inhibitor, has demonstrated efficacy across various malignancies, including non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC). However, real-world treatment responses and toxicity profiles remain insufficiently characterised in Iraqi populations. This study aimed to evaluate the clinical response and safety outcomes of pembrolizumab in patients with metastatic lung cancer and RCC. A retrospective observational study was conducted involving 100 patients, comprising 50 with lung cancer and 50 with RCC, who received pembrolizumab. Demographic characteristics, disease features, treatment timelines, radiological responses at 3, 6, and 9 months, and immune-related adverse events (irAEs) were recorded. Treatment responses were assessed according to the Response Evaluation Criteria in Solid Tumours (RECIST), and toxicity was graded using the Common Terminology Criteria for Adverse Events (CTCAE). Among patients with lung cancer, the mean age was 58.6 ± 13.9 years, 72% were male, and 68% were non-smokers. Patients with RCC had a mean age of 55.6 ± 13.3 years and showed similar demographic characteristics. All patients in both groups had metastatic disease. In the lung cancer group, the reported partial response (PR) rate increased from 2% at 3 months to 52.3% at 9 months, while the complete response (CR) rate reached 14.2% at 9 months. Patients with RCC demonstrated earlier responses, with the PR rate increasing from 18% at 3 months to 53.3% at 6 months, while the CR rate reached 20% at 9 months. Treatment-related toxicities were reported in 25 patients with lung cancer and 9 patients with RCC. Common irAEs included diarrhoea, hypothyroidism, rash, and pneumonitis, while Grade III toxicities were uncommon. Overall, pembrolizumab demonstrated clinical activity in both patient groups, with the reported responses suggesting earlier tumour regression in the RCC group. The observed toxicities were consistent with recognised immune-related adverse event profiles. However, further investigation is required to confirm these findings and assess their generalisability to routine clinical practice in Iraq.

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Published
2026-06-25
Data Availability Statement

The data that supports the findings of this study are available from the corresponding author upon reasonable request.

Section
Research Article/Original Research
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Copyright (c) 2026 Ayat Saeb Sarhan, Alaadin Sahham Naji

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Sarhan, A. S., & Naji, A. S. (2026). Clinical Outcomes and Safety of Pembrolizumab Monotherapy in Iraqi Patients with Metastatic Lung Cancer and Renal Cell Carcinoma. Middle Eastern Cancer and Oncology Journal, 2(2), 59-66. https://doi.org/10.61706/MECOJ160228

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