06.12.2024 | Original Article
The efficacy and safety of lenvatinib plus pembrolizumab in vulnerable patients with metastatic or recurrent endometrial cancer: a single institution experience
verfasst von:
Mayu Yunokawa, Akiko Abe, Xiaofei Wang, Yusuke Toyohara, Ryo Nimura, Takayuki Komoto, Satoki Misaka, Teruyuki Yoshimitsu, Ai Ikki, Mayumi Kamata, Shogo Nishino, Motoko Kanno, Atsushi Fusegi, Sachiho Netsu, Yoichi Aoki, Makiko Omi, Terumi Tanigawa, Sanshiro Okamoto, Hidetaka Nomura, Hiroyuki Kanao
Erschienen in:
International Journal of Clinical Oncology
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Abstract
Background
Effective management with second-line therapy with the lenvatinib + pembrolizumab regimen for patients with advanced endometrial cancer is necessary.
Methods
This retrospective study enrolled patients with endometrial cancer treated with the lenvatinib + pembrolizumab regimen. We evaluated progression-free survival (PFS), overall survival (OS), safety for patients non-eligible for the KEYNOTE775 trial, aged ≥65 years, or with ECOG performance status 1–2.
Results
Forty-five patients were analyzed: 21 (47%) were aged ˃ 65 years, 16 (36%) had performance status 1–2, and 15 (33%) were non-eligible for KEYNOTE775 trial participation. Overall, the median PFS was 8.5 months (95% confidence interval [CI] 4.6–12.4), and the median OS was 15.6 months (95% CI 9.4–NA). Median PFS was significantly shorter in patients not eligible for KEYNOTE775 participation and with performance status 1–2. The median OS was significantly shorter in patients with performance status 1–2. Grade ˃3 adverse events (AEs) occurred in 78% of patients who received the lenvatinib + pembrolizumab regimen. AEs resulted in lenvatinib dose reductions in 35 patients (78%) and lenvatinib and pembrolizumab discontinuation in 3 (7%) and 5 (11%), respectively. The median time to the first lenvatinib dose reduction was 1.5 (0.92–2.3) months in all patients and was significantly shorter in patients aged >65 years.
Conclusions
The current regimen has favorable efficacy and manageable safety with appropriate dose reduction of lenvatinib in the real world. However, the efficacy may be inferior in patients with performance status 1 or 2, heavily treated patients, and those with organ dysfunction. The current treatment status should reflect real-world data relative to the medical environment and management.