Memorial Sloan Kettering Cancer Center, New York, NY.
Oregon Health & Science University, Portland, OR.
J Clin Oncol. 2020 Sep 10;38(26):2981-2992. doi: 10.1200/JCO.19.02627. Epub 2020 Mar 13.
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.
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 (ORR); 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.
At data cutoff, 108 patients with previously treated endometrial carcinoma were enrolled, with a median follow-up of 18.7 months. The ORR was 38.0% (95% CI, 28.8% to 47.8%). Among subgroups, the ORR (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.
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.
晚期子宫内膜癌患者的治疗选择有限。我们报告了一项正在进行的选定实体瘤的 Ib/II 期研究中,晚期子宫内膜癌患者接受仑伐替尼联合 pembrolizumab 治疗的患者队列的最终主要疗效分析结果。
患者每日口服仑伐替尼 20mg,每 3 周静脉注射 pembrolizumab 200mg,每 3 周一个周期。主要终点是 24 周时的客观缓解率(ORR);次要疗效终点包括缓解持续时间(DOR)、无进展生存期(PFS)和总生存期(OS)。研究者根据免疫相关 RECIST 评估肿瘤评估。
数据截止时,共纳入 108 例先前治疗的子宫内膜癌患者,中位随访时间为 18.7 个月。ORR 为 38.0%(95%CI,28.8%至 47.8%)。在亚组中,MSI 高肿瘤(n=11)患者的 ORR(95%CI)为 63.6%(30.8%至 89.1%),MSI 稳定肿瘤(n=94)患者的 ORR(95%CI)为 36.2%(26.5%至 46.7%)。对于先前治疗的患者,无论肿瘤 MSI 状态如何,中位 DOR 为 21.2 个月(95%CI,7.6 个月至无法估计),中位 PFS 为 7.4 个月(95%CI,5.3 个月至 8.7 个月),中位 OS 为 16.7 个月(15.0 个月至无法估计)。83/124(66.9%)例患者发生 3 级或 4 级治疗相关不良事件。
仑伐替尼联合 pembrolizumab 治疗先前接受过系统治疗后疾病进展的晚期子宫内膜癌患者具有良好的抗肿瘤活性,无论肿瘤 MSI 状态如何。联合治疗具有可管理的毒性特征。