Hunt Jonathan T, Chambers Laura M, Yao Meng, Joehlin-Price Amy, Debernardo Robert, Rose Peter G
Department of Obstetrics, Gynecology, Women's Health Institute, Cleveland Clinic, Desk A81, 9500 Euclid Avenue, Cleveland, OH 44195, United States.
Division of Gynecologic Oncology, Obstetrics, Gynecology, Women's Health Institute, Cleveland Clinic, Desk A81, 9500 Euclid Avenue, Cleveland, OH 44195, United States.
Gynecol Oncol Rep. 2021 Jul 24;37:100840. doi: 10.1016/j.gore.2021.100840. eCollection 2021 Aug.
To investigate the efficacy of pembrolizumab plus lenvatinib as a second-line or later-line therapy in women with advanced or recurrent uterine carcinosarcoma (UCS).
A single-institution pharmacy database was queried for women with advanced or recurrent UCS who were prescribed concurrent pembrolizumab and lenvatinib. Patient demographic, oncologic, and immunotherapy outcomes data were recorded. Univariate analysis summarized progression-free survival (PFS) and overall survival (OS).
Seven patients with advanced or recurrent UCS were treated with combination pembrolizumab and lenvatinib, with a median age of 63.0 years. The majority had stage III or IV disease (n = 6, 85.7%) and had failed two or more lines of therapy (n = 7, 100.0%), and a minority were MMR deficient (n = 1, 14.3%) or PD-L1+ (n = 1, 14.3%). No partial or complete responses were observed. The median PFS was 2.6 months (95% CI, 0.9-11.2 months), and the median OS was 2.8 months (95% CI, 2.4-NE).
In this small, retrospective series, we demonstrate that pembrolizumab and lenvatinib combination therapy may not be highly active in UCS and may be associated with similar PFS and OS as traditional cytotoxic regimens. Further study is warranted to assess the efficacy of this regimen in more targeted cohorts of women with advanced or recurrent UCS.
探讨帕博利珠单抗联合乐伐替尼作为晚期或复发性子宫癌肉瘤（UCS）女性二线或后续治疗的疗效。
查询单机构药房数据库中接受帕博利珠单抗和乐伐替尼联合治疗的晚期或复发性UCS女性患者。记录患者的人口统计学、肿瘤学和免疫治疗结果数据。单因素分析总结无进展生存期（PFS）和总生存期（OS）。
7例晚期或复发性UCS患者接受了帕博利珠单抗和乐伐替尼联合治疗，中位年龄为63.0岁。大多数患者为III期或IV期疾病（n = 6，85.7%），且已接受过两线或更多线治疗失败（n = 7，100.0%），少数患者为错配修复缺陷（n = 1，14.3%）或程序性死亡受体配体1阳性（PD-L1+，n = 1，14.3%）。未观察到部分或完全缓解。中位PFS为2.6个月（95%CI，0.9 - 11.2个月），中位OS为2.8个月（95%CI，2.4 - 未达到）。
在这个小型回顾性系列研究中，我们证明帕博利珠单抗和乐伐替尼联合治疗在UCS中可能活性不高，且PFS和OS可能与传统细胞毒性方案相似。有必要进一步研究评估该方案在更有针对性的晚期或复发性UCS女性队列中的疗效。
