What Subcutaneous Keytruda Means for Patients With Melanoma

The U.S. Food and Drug Administration recently approved Keytruda Qlex (pembrolizumab and berahyaluronidase alfa-pmph) for subcutaneous use in adults and pediatric patients aged 12 years and older with solid tumor indications already approved for the intravenous formulation of Keytruda.

A subcutaneous injection uses a short needle to administer medication just below the surface of the skin, while intravenous, or IV, administration goes through a vein in the arm.

Among the patients who has benefited from this treatment is Betsy Halmin, a wife, mother and grandmother from Arkansas who was given the treatment option as part of a clinical trial after receiving a diagnosis of melanoma last year.

Halmin sat down for an interview with CURE to discuss her cancer journey and her clinical trial participation.

What was going through your head when you were first diagnosed with melanoma?

What first was going through my head was that it wasn't real, that it's not happening. I was 54 when I got diagnosed, so it wasn't possible. My mom got diagnosed with lung cancer when she was 54, she fought it for 14 years, so the correlation first, and then you get over that and you think, “Nope, it's not the end,” and “What are we doing?”

How did your care team present the opportunity to participate in a clinical trial to you, and what factors influenced your decision to participate?

I didn’t know anything about the possibilities that were out there for cancer treatment. So when they presented it, it was all foreign, all new. I watched my mom go through chemo, and she gets an IV, she sits there for a while. She's extremely sick. It's just horrible. Because it is, I mean, that's just what it is, right? So going into it, that was my only thought, “This is what's going to happen to me.”

So when they presented me with something else, it was an opportunity to be part of maybe a growing way to change the industry or the perception of a treatment. Because that's the biggest thing when we go into treatment, what's our mindset? And I think that your mind has a lot to do with getting over it. The mental game is huge. So they were great at presenting it and they said my standard of care is going to be the same, the only thing that's going to change was I was going to receive my treatment, whether it was going to be through an IV or through a shot, subcutaneous. Never thought I would learn that word, but OK. As far as part of being a study, I believe that our we have to do studies to get better at what we're doing. Modern medicine will never be modern unless we do studies.

How did your experience of transitioning from IV to subcutaneous treatment impact your everyday life?

I can't stress enough how huge it was. When you go and you're getting a treatment, you go into a room and you get a chair, and you sit down, and you meet these wonderful nurses who are special in every way, and you get an IV, and you're in a very comfortable chair, in a very comfortable environment, in a room full of everybody strapped up into an IV, and everybody is sick. They're extremely sick, and it sucks. It's, I'm extremely honest.

So it sucks, and it's horrible because you're strapped to a chair. You have to walk around with a pole and whether you equate that pole to being sick, because the only time you ever have it when you go to the bathroom or you're sitting there and you're you have an IV is when you are sick. So mentally, it it's a challenge, and it's crushing, even if you're not in the chair and you don't feel sick every second you are there, you know you are, it's a huge reminder. And you're there for hours and trying to have a life, trying to stay positive, being a mom and being a woman that has a job and has a career that you've worked really, really hard to establish. And then you're there for hours. And then they take it out. And then you try to get over that until the next time you go in there.

Switching to the shot, you're not strapped to a chair. You’re going into the same room, but you don't have to take a pole with you if you have to use the restroom. It's the same people, but you're not there for hours, and you get a shot and a Band-Aid. It truly gives you back a portion of yourself that you had before you were diagnosed.

When you go into the ring and you're going to fight cancer, it gives you an extra set of gloves, it gives you an advantage, not just medically but emotionally. I didn't have to sit in that chair and take a pole with me.

Transcript has been edited for clarity and conciseness.

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