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  • PR023/#503  Evaluation of the combination lenvatinib and pembrolizumab in endometrial cancer; a real world multi-institutional review of practice patterns, efficacy and tolerability

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Featured Posters: Poster Rounds with the Professors
AS04. Endometrial/Uterine corpus cancers
PR023/#503  Evaluation of the combination lenvatinib and pembrolizumab in endometrial cancer; a real world multi-institutional review of practice patterns, efficacy and tolerability
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  1. Bradley Corr1,
  2. Samantha Thomas2,
  3. Paulina Haight3,
  4. Elizabeth Stock4,
  5. Jessica Floyd1,
  6. Lindsay Borden5,
  7. Irina Tunnage6,
  8. Angeles Alvarez Secord7,
  9. Rebecca Arend8,
  10. Amanda Jackson9,
  11. Jason Wright10,
  12. Gottfried Konecny11,
  13. Tara Castellano12,
  14. Emily Ko13,
  15. Sarah Podwika14,
  16. Floor Backes3,
  17. Daniel Spinosa1,
  18. Margaret Mullen4,
  19. Christina Washington5,
  20. Bhavana Pothuri6,
  21. Carsen Smitherman2,
  22. Alfonsus Harsono8,
  23. Hanaa Khadraoui9,
  24. Yukio Suzuki10,
  25. Ritu Salani15,
  26. Kristina Powell13,
  27. Shalini Subbarao14 and
  28. Stephanie Gaillard16
  1. 1University of Colorado, Obstetrics and Gynecology, Aurora, USA
  2. 2Duke University, Biostatistics, Durham, USA
  3. 3The Ohio State University, Obstetrics and Gynecology, Columbus, USA
  4. 4Washington University, Obstetrics and Gynecology, St. Louis, USA
  5. 5The University of Oklahoma, Obstetrics and Gynecology, Oklahoma city, USA
  6. 6New York University, Obstetrics and Gynecology, New York City, USA
  7. 7Duke University, Gynecologic Oncology, Durham, USA
  8. 8University of Alabama, Obstetrics and Gynecology, Birmingham, USA
  9. 9University of Cincinnati, Obstetrics and Gynecology, Cincinnati, USA
  10. 10Columbia University, Obstetrics and Gynecology, New York City, USA
  11. 11UCLA, Obstetrics and Gynecology, Los Angeles, USA
  12. 12LSU, Obstetrics and Gynecology, New Orleans, USA
  13. 13University of Pennsylvania, Obstetrics and Gynecology, Philaldelphia, USA
  14. 14University of Virginia, Obstetrics and Gynecology, Charlottesville, USA
  15. 15UCLA, Ob/gyn, Los Angeles, USA
  16. 16Johns Hopkins University, Obstetrics and Gynecology, Baltimore, USA

Abstract

Introduction Keynote-775 defined the SOC for MMRp recurrent EC. AEs with recommended dosing of lenvatinib/pembrolizumab led to dose reductions in 66.5% of patients. Real world prescription patterns vary significantly from clinical trial. We describe prescribing patterns and outcomes across a multi-institutional consortium.

Methods A national multidisciplinary consortium was utilized to study patients with advanced/recurrent EC treated with lenvatinib/pembrolizumab. Treatment decisions were based on the physician’s recommendation.

Results 217 patients across 14 institutions were identified. Histologic subtypes were 34.1% endometrioid, 39.6% serous, 9.7% carcinosarcoma, 10.1% mixed, and 2.8% clear cell. 82.9% were MMRp and 4.6% were MMRd. Median dose intensity of lenvatinib was 14 mg. Lenvatinib starting dose was 20 mg in 17.1%, 18 mg in 12.9%, 14 mg in 41%, 10 mg in 15.7%. Rates of any grade >=3 AE related to lenvatinib were 20 mg (13.5%), 18 mg (17.9%), 14 mg (7.9%), 10 mg (17.6%) (p=0.31). Pembrolizumab dosing was 200 mg Q3W in 85.6% and 400 mg Q6W in 6.5%. ORR (p=0.38), PFS (p=0.97) & OS (p=0.31) were similar in White vs. Black patients. ORR in relation to Lenvatinib starting dose 20 mg, 18 mg, 14 mg, 10 mg was 27%, 35.7%, 39.3%, 44.1% (p=0.08). In relation to Lenvatinib starting dose, 12-month PFS rates were 40%, 35%, 35%, 47% respectively (p=0.92), 12-month OS were 59%, 66%, 56%, 51% respectively (p=0.79), and median duration of therapy was 5.1, 4.1, 4.8, 4.6 months respectively (p=0.52).

Conclusion/Implications In a real-world analysis, the predominant starting dose is 14 mg lenvatinib and 200 mg pembrolizumab. Grade >=3 AE’s, 12-month PFS/OS, ORR & duration of therapy related to lenvatinib starting dose were not statistically different.

Abstract PR023/#503 Figure 1
Abstract PR023/#503 Figure 1
Abstract PR023/#503 Figure 2
Abstract PR023/#503 Figure 2

https://doi.org/10.1136/ijgc-2023-IGCS.65

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