Level 1 — Absolute Beginner
Cancer is a sickness. Some medicine helps people fight cancer.
In the UK, the NHS gives this medicine to many people. The medicine is called pembrolizumab.
Before, the medicine took two hours to give. Now there is a small shot. It takes just one minute.
Doctors and patients are very happy. Patients can go home sooner. The NHS can help more people each day.
- cancer
- A serious sickness in the body's cells.
- medicine
- Something you take to feel better.
- NHS
- The free public health service in the UK.
- shot
- Medicine given with a needle.
- minute
- Sixty seconds of time.
- doctor
- A person trained to help sick people.
- patient
- A person who gets care from a doctor.
- happy
- Feeling good and pleased.
Level 2 — Elementary
The National Health Service in the UK started a new cancer treatment on Monday, May 11, 2026. The new treatment is an injection instead of a slow drip.
The medicine is called pembrolizumab. It is also known by the brand name Keytruda. It is a type of immunotherapy. This means it helps the body's own immune system attack cancer cells.
Before, patients sat in hospital chairs for up to two hours while the medicine flowed into their blood through a tube. The new shot is given under the skin in about 60 seconds.
Around 14,000 patients in England start this medicine every year. It is used for 14 different cancers, including lung, breast, and head and neck cancer. The NHS says the change will save many hours of nurse and chair time each week.
- treatment
- Medical care given to patients to help them get better.
- injection
- A way of giving medicine using a needle.
- drip
- A way of giving medicine slowly through a thin tube into a vein.
- immunotherapy
- A treatment that helps the immune system fight a disease.
- immune system
- The body's natural defense against germs and disease.
- tube
- A long, thin pipe used to carry liquid.
- under the skin
- Just below the surface of the skin.
- save
- To not spend or use as much of something.
Level 3 — Intermediate
On Monday, May 11, 2026, the UK's National Health Service began rolling out a subcutaneous formulation of pembrolizumab — sold under the brand name Keytruda — to cancer patients in England and Wales. Hospitals across the rest of the UK can now place orders for the new version following approval by the country's medicines regulator.
Pembrolizumab is a checkpoint-inhibitor immunotherapy. It works by blocking a protein called PD-1 on immune cells, freeing those cells to recognize and attack cancerous tumors. It is already used in the UK for 14 different cancer types, including non-small-cell lung cancer, melanoma, breast cancer, head-and-neck cancer, and several forms of cervical cancer.
Until now, the drug was delivered as an intravenous drip that could take up to two hours per session, tying up a chemotherapy chair and a nurse for much of that time. The new subcutaneous injection is given in the upper thigh or abdomen and delivers the same dose in roughly 60 seconds, every three or six weeks depending on the cancer type.
NHS England estimates that around 14,000 patients each year will benefit from the change, with an expected saving of tens of thousands of hours of clinical time. Clinical trial data published in 2025 showed the injection produced the same drug levels in the blood and similar safety as the intravenous form, paving the way for regulatory approval and the current rollout.
- subcutaneous
- Beneath the skin.
- formulation
- A particular way a medicine is prepared, such as a tablet or injection.
- checkpoint inhibitor
- A drug that blocks a protein that normally stops immune cells from attacking other cells.
- tumor
- A lump or growth of abnormal cells in the body.
- intravenous
- Given directly into a vein.
- dose
- A measured amount of medicine taken at one time.
- regulator
- An official body that approves and controls products such as medicines.
- clinical trial
- A scientific study that tests how well a treatment works in patients.
Level 4 — Advanced
On Monday, May 11, 2026, NHS England launched the rollout of a subcutaneous formulation of pembrolizumab — the world's best-selling oncology drug, marketed by Merck & Co. as Keytruda — to patients in England and Wales, with NHS trusts in Scotland and Northern Ireland now eligible to order the product. The shift follows last month's marketing authorization by the UK's Medicines and Healthcare products Regulatory Agency on the basis of the Phase III KEYNOTE-D77 non-small-cell lung cancer trial, which demonstrated bioequivalence to intravenous pembrolizumab and a non-inferior safety profile.
Pembrolizumab is the archetypal anti-PD-1 checkpoint inhibitor. By binding the programmed-cell-death-1 receptor expressed on activated T cells, the antibody prevents tumor cells from co-opting the PD-1/PD-L1 axis to evade immune surveillance. The drug has accumulated more than 20 NICE-recommended UK indications since its 2015 launch, spanning non-small-cell lung, melanoma, triple-negative breast, head-and-neck squamous cell, cervical, renal-cell, urothelial, gastric and microsatellite-instability-high tumors across diverse lines of therapy.
Clinically, the operational implications are substantial. The intravenous regimen requires roughly a two-hour chair time per cycle when factoring in pharmacy preparation, line flushing and observation; the subcutaneous version, packaged with a recombinant hyaluronidase to allow rapid drug dispersion through interstitial tissue, can be delivered in approximately 60 seconds every three weeks or 120 seconds every six weeks. NHS modelling, replicated by independent NICE costing analysts, estimates a freeing of at least 100,000 outpatient chair-hours per year nationally and the redirection of nursing capacity toward additional drug administration and supportive care.
The rollout also sets a precedent for the broader subcutaneous reformulation movement among monoclonal-antibody therapeutics. Roche's atezolizumab, BMS's nivolumab and Regeneron's cemiplimab — all checkpoint inhibitors with overlapping indications — have either launched or are in late-stage regulatory review for their own under-the-skin versions. Health economists view this trend as a key lever for absorbing the rising incidence of cancer in aging populations without proportional growth in oncology infrastructure, although questions remain about home-administration safety, autoinjector ergonomics for elderly patients, and equity of access between teaching hospitals and rural trusts.
- bioequivalence
- When two formulations of the same drug produce equivalent concentrations in the blood and equivalent effects in the body.
- non-inferior
- Statistically shown not to be meaningfully worse than a comparator treatment.
- checkpoint inhibitor
- A drug that blocks a protein that normally restrains immune cells, allowing them to attack tumor cells.
- immune surveillance
- The body's ongoing process of detecting and destroying abnormal cells before they form tumors.
