Previously treated advanced endometrial cancer treated with lenvatinib plus pembrolizumab results in greater survival than chemotherapy alone

1. Overall survival is longer for patients receiving a combination of lenvatinib plus pembrolizumab as compared with chemotherapy treatment alone

2. Progression-free survival was greater in the group receiving combination therapy

Evidence Rating Level: 1 (Excellent)

Study Rundown: This study examined whether treatment with the combination of lenvatinib plus pembrolizumab provided greater benefits for survival metrics in patients with advanced endometrial cancer that had previously received systemic treatment. The primary outcomes of this study were overall survival (OS) and progression-free survival (PFS). Secondary outcomes included confirmed objective response rate (ORR) in patients with mismatch repair proficient (pMMR) tumours. This study found an overall median OS was 18 months in the lenvatinib plus pembrolizumab group and 12.2 months in the chemotherapy group. Median PFS was longer in the combination medication study group as well, at 6.7 months, compared with 3.8 months in the chemotherapy group. ORR was higher in patients receiving the combination therapy, as compared with patients receiving chemotherapy. Limitations of this study include its limited generalizability beyond patients with previously treated advanced endometrial cancer. Overall, the results from this study further support the consideration of the combination treatment, lenvatinib plus pembrolizumab, as standard care in patients with previously treated advanced endometrial cancer.

Click to read the study in the Journal of Clinical Oncology

Relevant Reading: Lenvatinib Plus Pembrolizumab in Patients With Advanced Endometrial Cancer

In-Depth [randomized controlled trial]: This randomized clinical trial randomly assorted 411 patients to receive lenvatinib plus pembrolizumab, 84.2% of whom had pMMR tumours. 416 patients were assorted to receive chemotherapy, 84.4% of whom had pMMR tumours. Median OS was 18 months in the lenvatinib plus pembrolizumab group (95% confidence interval (CI), 14.9-20.5 months) as compared with the chemotherapy group at 12.2 months (95% CI, 11.0-14.1 months) (hazard ratio (HR), 0.70; 95% CI, 0.58-0.83). Median PFS was 6.7 months in the lenvatinib plus pembrolizumab group (95% CI, 5.6-7.4 months) compared with 3.8 months (95% CI, 3.6-5.0 months) in the chemotherapy group (HR, 0.60; 95% CI, 0.50-0.72).  ORR was 32.4% in patients receiving the combination therapy, as compared with 15.1% of patients receiving chemotherapy. The final results support the use of combinational TKI-PD-1 blockade as a treatment option for previously treated advanced endometrial cancer.

Image: PD

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