Barw Barw Medical Journal 2960-1959 2023 07 27 Pembrolizumab (Anti-PD-1) Immunotherapy in Malignant Pleural Mesothelioma: A Systematic Review of the Current Literature 10.58742/bmj.v1i2.34 eng Rebaz M. Ali Hiwa Cancer Hospital, Sulaimani Directorate of Health, Sulaimani, Kurdistan, Iraq.. rebaz.ali@gmail.com Fahmi H. Kakamad College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq. fahmi.hussein@univsul.edu.iq Hiwa O. Abdullah Smart Health Tower, Scientific Affairs Department, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq. hiwa.abdulla@gmail.com Shalaw H. Abdulla Hiwa Cancer Hospital, Sulaimani Directorate of Health, Sulaimani, Kurdistan, Iraq.. shalaw.abdulla@gmail.com Shaho F. Ahmed Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq. shaho.ahmed@gmail.com Bnar J. Hama Amin Shar Hospital, Department of Medicine, Sulaimani, Kurdistan, Iraq. bnar.abdulla@gmail.com Marwan N. Hassan Smart Health Tower, Scientific Affairs Department, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq. marwan.nasih12@gmail.com Sabah J. Hasan Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq. sabah.jalal@gmail.com Hussein M. Hamasalih Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq. hussein.hama@gmail.com Berun A. Abdalla Smart Health Tower, Scientific Affairs Department, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq. berun.anwer95@gmail.com Rawezh Q. Salih Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq. rawezh.salih@gmail.com Gasha S. Ahmed Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey. Gasha.Ahmed@gmail.com 2023 07 10 Introduction Malignant pleural mesothelioma is an infrequent and aggressive type of cancer that is difficult to treat, and standard therapies have shown limited effectiveness. There have been recent advances in the development of targeted therapies for malignant pleural mesothelioma, including immunotherapy with pembrolizumab. Methods This is a systematic review of the current role of pembrolizumab in the treatment of this disease. A systematic search was conducted through the databases and search engines. The eligible studies to be included were those that primarily focused on the outcomes of treating this disease with pembrolizumab, regardless of study design, line of therapy, mode of therapy, and ECOG performance status. Results After the initial and full-text screenings, 15 studies were reviewed. The number of cases was 454 with a mean age of 68.13 years, of which males (79.7%) were the predominant gender. Most of the cases were affected by epithelioid mesothelioma (76.7%). Pembrolizumab had been used as the first line of treatment in 62 (13.7%) cases. In 92.73% of cases, the therapy mode was pembrolizumab monotherapy. A total of 68 different adverse events were recorded. The most commonly associated adverse events were fatigue (14.8%), pruritis/rash (13.7%), and diarrhea (9.7%). Two patients died due to adverse events. The overall objective response was 17.8%, stable disease was 35.7%, progression-free survival was about 47.6% with a mean of 4.73 months, and 117 cases (25.8%) could reach treatment-related survival. Conclusion Pembrolizumab can serve as a viable alternative in the management of malignant pleural mesothelioma, offering satisfactory outcomes and acceptable safety profiles.