Berahyaluronidase Alfa and Pembrolizumab

**Semantic type:** Amino Acid, Peptide, or Protein|Immunologic Factor|Pharmacologic Substance

**Definition:** A fixed-dose co-formulation composed of pembrolizumab, a humanized immunoglobulin G4 (IgG4) monoclonal antibody directed against human cell surface receptor PD-1 (programmed death-1; programmed cell death-1; cluster of differentiation 279; CD279), and berahyaluronidase alfa, a recombinant variant of human hyaluronidase, with potential immune checkpoint inhibitory and antineoplastic activities. Upon subcutaneous administration of berahyaluronidase alfa and pembrolizumab, berahyaluronidase alfa reversibly depolymerizes the polysaccharide hyaluronan in the subcutaneous tissue. This increases the permeability of the subcutaneous tissue and enhances the absorption of pembrolizumab into the systemic circulation. In turn, pembrolizumab binds to PD-1, an inhibitory signaling receptor expressed on the surface of activated T-cells, and blocks the binding to and activation of PD-1 by its ligands, which results in the activation of T-cell-mediated immune responses against tumor cells. The ligands for PD-1 include programmed cell death ligand 1 (PD-L1; cluster of differentiation 274; CD274), overexpressed on certain cancer cells, and programmed cell death ligand 2 (PD-L2), which is primarily expressed on antigen presenting cells (APCs). Activated PD-1 negatively regulates T-cell activation and plays a key role in tumor evasion from host immunity. When administered subcutaneously, berahyaluronidase alfa, an endoglycosidase, increases the dispersion and absorption of co-administered drugs.

**Synonyms:** - Berahyaluronidase Alfa/Pembrolizumab - Keytruda Qlex - MK 3475A - MK-3475A - MK-5180 and Pembrolizumab - MK-5180/Pembrolizumab - MK3475A - Pembrolizumab and Berahyaluronidase Alfa - Pembrolizumab and Berahyaluronidase Alfa-pmph - Pembrolizumab/Berahyaluronidase Alfa