Treating advanced endometrial cancer (which is not deficient in MMR or high in microsatellite instability) with a mixture of lenvatinib and pembrolizumab has been effective and successful after the patient received earlier systemic therapy in any setting in the single-arm, open-label, phase Ib/II Study 111/KEYNOTE-146. The safety profile of this mixture was quite similar to each monotherapy except for hypothyroidism. Health care specialists can be aided through more specification of the treatment’s adverse reactions (AR) so that they can enhance the combination therapy of lenvatinib and pembrolizumab.
In Study 111/KEYNOTE-146, a beginning dosage of 20 mg lenvatinib was orally given to patients once per day while 200 mg of pembrolizumab was administered through their veins at intervals of three weeks. Detailed in the post hoc analyses were some of the selected ARs of the treatment such as fatigue, hypertension, hypothyroidism, diarrhea, nausea/vomiting, palmar-plantar erythrodysesthesia syndrome, decreased appetite/weight loss, musculoskeletal pain, proteinuria, and stomatitis.
In this analysis, the ARs of the treatment from the median times first affected the patients within the initial 10 weeks. More than or equal to 5% of the patients experienced seriousness of hypertension, nausea, and fatigue, in grade 3 and above, out of all of the chosen ARs. Hypothyroidism, which mainly had the seriousness of grade 2 (46%), was faced by an overall 51% of the patients. Changes were made in the dosage of the study drug and some concomitant medications were received by the patients in order for them to tackle most of the ARs that were assessed.
Recognition of new safety signals was not made. Moreover, a decrease in lenvatinib dose, supportive medications as well as disruptions in doses were able to handle the toxic ARs in this study. This analysis works as a guideline for handling ARs in patients who are diagnosed with endometrial cancer and are being treated through the mixed therapy of lenvatinib and pembrolizumab.
Link:theoncologist.onlinelibrary.wiley.com/doi/10.1002/onco.13883
