Pembrolizumab plus lenvatinib in advanced endometrial cancer: case report and systematic review of lung toxicity.

BACKGROUND: The optimal strategy for the treatment of recurrent and/or advanced
endometrial cancer is still undefined. Recently, despite the lack of any
predictive biomarker, the combination of pembrolizumab with lenvatinib has
improved survival outcomes. We here report the long-term management of lung
toxicity in a patient with endometrial cancer, and we critically review the
current therapeutic options for this disease.
RESULTS: A patient with heavily pretreated endometrial cancer took pembrolizumab
plus lenvatinib for 1 year, achieving a persistent partial response with a time
to treatment failure of 18 months, despite relevant lung toxicity that did not
affect the remarkable overall clinical benefit. A systematic review of this
combination underlines the efficacy outcome despite toxicity. Interestingly, the
literature review on lung toxicity suggested the role of anti-angiogenetic
agents in the pathogenesis of lung cavitation, probably related to direct
treatment activity, and disclosed a potential radiological sign predictive of
the activity of anti-angiogenetic agents.
CONCLUSION: We underline the efficacy of pembrolizumab plus lenvatinib in the
current treatment landscape of endometrial cancer, underscoring the relevance of
a correct management of toxicity.