Lenvatinib plus pembrolizumab for advanced or recurrent endometrial cancer: a retrospective multi-institutional survey in the Kinki district of Japan

BACKGROUND: Lenvatinib plus pembrolizumab therapy has recently attracted attention as a new treatment option. However limited information is currently available based on large-scale clinical experience in Japanese patients. The present study examined patients with advanced or recurrent endometrial cancer who were treated with lenvatinib and pembrolizumab in the Kinki district of Japan. METHODS: A total of 161 patients with advanced or recurrent endometrial cancer who received lenvatinib and pembrolizumab were enrolled from 13 hospitals in the Kinki district between December 2021 and July 2024. We retrospectively reviewed their medical records. RESULTS: In the overall patient population, median overall survival (OS) was 27 months and median progression-free survival (PFS) was 9 months. In patients with proficient mismatch repair (pMMR), median OS was 21 months and median PFS was 8 months. The cohort included 14 patients with carcinosarcoma, for whom median OS was 20 months and median PFS was 9 months. A univariate analysis showed that the histological subtype and MMR status correlated with PFS, while the histological subtype, MMR status, and platinum-free interval correlated with OS. A multivariate analysis identified age and the histological subtype as significant factors for PFS, while the histological subtype, MMR status, and platinum-free interval correlated with OS. CONCLUSION: The combination of lenvatinib and pembrolizumab showed favorable treatment outcomes for patients with advanced or recurrent endometrial cancer in the Kinki district. This regimen appeared to be more effective for patients with a longer platinum-free interval (>6 months), or endometrioid carcinoma, or deficient MMR.