The Pharmaceutical Benefits Scheme (PBS) listings for pembrolizumab and lenvatinib have been expanded. These agents are now listed for use in combination to treat advanced, metastatic, or recurrent endometrial carcinoma.
The safety and efficacy of this therapy was investigated in the KEYNOTE-775 trial. Patients with advanced endometrial cancer who had previously received at least one platinum-based chemotherapy regimen were randomly assigned to receive pembrolizumab plus lenvatinib or chemotherapy of the physician’s choice (doxorubicin or paclitaxel). Compared to the chemotherapy group, patients in the lenvatinib plus pembrolizumab group had significantly longer progression-free survival (7.2 months vs 3.8 months) and overall survival (18.3 months vs 11.4 months). The most common adverse effects experienced by patients in the pembrolizumab plus lenvatinib group included hypertension (64.0%), hypothyroidism (57.4%), diarrhoea (54.2%), and nausea (49.5%).
Lenvatinib is a tyrosine kinase inhibitor, and pembrolizumab is a monoclonal antibody. The usual doses for endometrial cancer are lenvatinib 20mg orally daily with pembrolizumab 200mg every three weeks or 400mg every six weeks administered as an intravenous infusion.
References:
- Keytruda® (Pembrolizumab) Australian approved product information. Macquarie Park: Merck Sharp & Dohme (Australia). Approved January 2023.
- Lenvima® (Lenvatinib mesilate) Australian product information. Melbourne: Eisai Australia. Approved May 2022.
- Makker V, Colombo N, Casado Herráez A, Santin AD, Colomba E, Miller DS, et al. Lenvatinib plus pembrolizumab for advanced endometrial cancer. N Engl J Med. 2022; 386(5): 437-8.
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