Lenvatinib plus pembrolizumab not associated with improved survival compared to standard therapy for recurrent endometrial cancer

1. In patients with advanced or recurrent endometrial cancer (EC) with previous exposure to carboplatin and paclitaxel (PT), lenvatinib plus pembrolizumab was not associated with improved survival compared with re-challenge PT. 

Evidence Rating Level: 2 (Good)

Currently, PT three times per week remains the first-line therapy for recurrent or advanced endometrial cancer. However, outcomes associated with second-line therapy for recurrent or advanced EC have been poor, necessitating further research to identify novel strategies for second-line management. This retrospective study therefore sought to investigate the use of lenvatinib plus pembrolizumab or re-challenge PT in patients with PT-pretreated advanced or recurrent EC. Propensity score matching was conducted to identify 334 pairs of individuals with PT-pretreated advanced or recurrent EC and who received one of re-challenge PT (median age, 65.5 years) or lenvatinib plus pembrolizumab (median age, 66.8 years) from the TriNetX Research Network in the United States. 378 individuals receiving doxorubicin were also included. After propensity score matching, there was no significant difference in the median overall survival (OS) rate between those receiving re-challenge PT and lenvatinib plus pembrolizumab (median OS: 19.5 vs. 17.1 months, p = 0.53; aHR: 0.88, 95% CI 0.62–1.24). After propensity score matching, lenvatinib plus pembrolizumab was associated with a significantly greater median OS compared to doxorubicin (median OS: 16.7 vs. 9.1 months, p < 0.001; aHR: 0.44, 95% CI 0.32–0.59). Overall, this study found that among patients with PT-pretreated advanced or recurrent EC, lenvatinib plus pembrolizumab was not associated with improved survival compared with re-challenge PT.

Click to read the study in BMC Medicine

Image: PD

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