Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Expert Rev Anticancer Ther. 2023 Apr;23(4):361-368. doi: 10.1080/14737140.2023.2194634. Epub 2023 Mar 28.
Advanced and recurrent endometrial carcinoma remains a difficult diagnosis to treat due to the limited and ineffective available treatment options following platinum and taxane chemotherapy. Patients who are microsatellite stable (MSS) or mismatch repair proficient (pMMR) have even poorer outcomes with fewer effective therapies. Fortunately, recent Phase Ib/II and Phase III trials have demonstrated that combination pembrolizumab and lenvatinib resulted in improved ORR, PFS, and OS than currently used therapies in this setting.
In this article, we review the history and notable clinical trials responsible for the advancement and status of treatment options available for advanced endometrial cancer. Most importantly, we review the recently published data on the efficacy, safety, and tolerability of the combination pembrolizumab and lenvatinib in advanced and recurrent endometrial cancer.
The combination pembrolizumab and lenvatinib is an effective treatment regimen for patients with advanced and recurrent endometrial cancer who are MSS or pMMR who have failed prior platinum-based treatment. This combination should be routinely offered to patients following progression or recurrence of systemic platinum and taxane chemotherapy. Although this regimen is safe and effective, clinicians should be aware of the known toxicities and assess patients regularly to determine if dose modifications or interruptions are indicated.
高级别和复发性子宫内膜癌仍然难以治疗,因为在铂类和紫杉烷化疗后,可用的治疗选择有限且效果不佳。微卫星稳定(MSS)或错配修复功能完整(pMMR)的患者,其治疗效果更差,有效的治疗方法更少。幸运的是,最近的 Ib/II 期和 III 期试验表明,与该治疗环境中目前使用的治疗方法相比,联合 pembrolizumab 和 lenvatinib 可提高客观缓解率(ORR)、无进展生存期(PFS)和总生存期(OS)。
本文回顾了导致高级别子宫内膜癌治疗选择进展的历史和重要临床试验。最重要的是,我们回顾了最近发表的关于 pembrolizumab 和 lenvatinib 联合治疗高级别和复发性子宫内膜癌的疗效、安全性和耐受性的数据。
对于先前铂类治疗后进展或复发的 MSS 或 pMMR 高级别和复发性子宫内膜癌患者,pembrolizumab 和 lenvatinib 联合治疗是一种有效的治疗方案。对于接受过系统铂类和紫杉烷化疗后疾病进展或复发的患者,应常规提供这种联合治疗方案。尽管该方案安全有效,但临床医生应注意已知的毒性,并定期评估患者,以确定是否需要调整剂量或中断治疗。