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Abstract

Purpose

Patients with advanced endometrial carcinoma have limited treatment options. We report final primary efficacy analysis results for a patient cohort with advanced endometrial carcinoma receiving lenvatinib plus pembrolizumab in an ongoing phase Ib/II study of selected solid tumors.

Methods

Patients took lenvatinib 20 mg once daily orally plus pembrolizumab 200 mg intravenously once every 3 weeks, in 3-week cycles. The primary end point was objective response rate (ORR) at 24 weeks (ORRWk24); secondary efficacy end points included duration of response (DOR), progression-free survival (PFS), and overall survival (OS). Tumor assessments were evaluated by investigators per immune-related RECIST.

Results

At data cutoff, 108 patients with previously treated endometrial carcinoma were enrolled, with a median follow-up of 18.7 months. The ORRWk24 was 38.0% (95% CI, 28.8% to 47.8%). Among subgroups, the ORRWk24 (95% CI) was 63.6% (30.8% to 89.1%) in patients with microsatellite instability (MSI)-high tumors (n = 11) and 36.2% (26.5% to 46.7%) in patients with microsatellite-stable tumors (n = 94). For previously treated patients, regardless of tumor MSI status, the median DOR was 21.2 months (95% CI, 7.6 months to not estimable), median PFS was 7.4 months (95% CI, 5.3 to 8.7 months), and median OS was 16.7 months (15.0 months to not estimable). Grade 3 or 4 treatment-related adverse events occurred in 83/124 (66.9%) patients.

Conclusion

Lenvatinib plus pembrolizumab showed promising antitumor activity in patients with advanced endometrial carcinoma who have experienced disease progression after prior systemic therapy, regardless of tumor MSI status. The combination therapy had a manageable toxicity profile.

Related Questions

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

1
3 Answers

Mednet Member
Mednet Member
Gynecologic Oncology · UCLA David Geffen School of Medicine/UCLA Medical Center

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...

How do you approach a patient with recurrent endometrial cancer within the field of prior primary radiation who is not a surgical or cytotoxic chemotherapy candidate?

1 Answers

Mednet Member
Mednet Member
Gynecologic Oncology · Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center

There are several things to consider here.Assuming that there is truly no potential for surgery or cytotoxic chemotherapy then the remaining options are: targeted therapy, hormonal therapy, discussing with radiation oncology any role for additional radiation, or best supportive care.First, though, I...