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Is there a difference in the incidence of serious immune-related adverse events with the lenvatinib + pembrolizumab combination vs pembrolizumab alone in endometrial cancer?

Anecdotally, I have seen more serious IRAEs in patients I'm treating with this regimen than anticipated. Is there higher risk with this drug combination?
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How does the potential for increased risk of serious immune-related adverse events in the lenvatinib + pembrolizumab combination vs pembrolizumab alone affect your use of the two drug combination?

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3 Answers
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Gynecologic Oncology · UCLA David Geffen School of Medicine/UCLA Medical Center
Answered on

Yes, high risk of both hypertension and diarrhea. The diarrhea can be very difficult to manage. The lenvatinib definitely adds a level of complexity to the management of pembro side effects. This requires dose reductions and interruptions, maybe even hospitalization for dehydration/renal insufficien...

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Gynecologic Oncology · UCSD Moores Cancer Center
Answered on

Their dose not appear to be a significant difference in immune mediated AEs with the combination regimen. There are some AEs that can result from either drug, perhaps best exemplified by the diarrhea, requiring close and careful monitoring.

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Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty
Answered on · Updated on

Combination of pembrolizumab and lenvatinib has been shown to be superior to sunitinib in advanced renal cancer (Motzer et al., PMID 33616314), and superior to chemotherapy in advanced (pMMR/dMMR) endometrial cancer (Makker et al., PMID 35045221). However, this combination has not been shown to be s...

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