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SYSTEMATIC REVIEW article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1404669

Efficacy and safety of lenvatinib plus pembrolizumab in patients with advanced and recurrent endometrial cancer: A systematic review and meta-analysis

Provisionally accepted
Guangwei Yan Guangwei Yan Yanmin Du Yanmin Du *Huanhuan Zhang Huanhuan Zhang *Jinxiang Yan Jinxiang Yan *Yixuan Liu Yixuan Liu *Zhenying Ban Zhenying Ban *Yong-Zhen Guo Yong-Zhen Guo Xianxu Zeng Xianxu Zeng *
  • Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China

The final, formatted version of the article will be published soon.

    Background: Various trials have demonstrated the clinical benefits of lenvatinib plus pembrolizumab in patients with advanced or recurrent endometrial cancer, regardless of mismatch repair (MMR) status or histologic subtype. The majority of the previously published trials had small sample sizes. Here, we aimed to assess the reported efficacy and safety profile of lenvatinib plus pembrolizumab in patients with advanced and recurrent endometrial cancer. Methods: We utilized the Cochrane Library, PubMed, Web of Science and Embase databases to identify clinical trials evaluating the efficacy and safety of lenvatinib plus pembrolizumab in patients with advanced and recurrent endometrial cancer. The outcomes analyzed were progression-free survival (PFS), overall survival (OS), the objective response rate (ORR), the disease control rate (DCR) and the incidence of adverse events (AEs). Subgroup analysis was conducted on the basis of MMR status (deficient, dMMR or proficient, pMMR). Results: Four trials (582 patients) were included. The pooled ORR was 32.7% [95% confidence interval (CI): 28.9-36.5]. Subgroup analysis revealed an ORR of 48.1% (95% CI: 26.1-70.2) for dMMR group and 33.1% (95% CI: 25.7-40.6) for pMMR group. The pooled DCR was 74.9% (95% CI: 71.3-78.4%). Subgroup analysis revealed a DCR of 81.0% (95% CI: 64.5-97.6) for the dMMR group and 76.3% (95% CI: 66.3-86.3) for the pMMR group. Follow-up was reported in all included studies. The median range time of PFS and OS was 5.3 months-258 days and 17.2 months-not reached, respectively. Regarding safety, the overall pooled proportions of any-grade AE and AEs ≥ grade 3 were 95.8% (95% CI: 89.5-100.0) and 80.2% (95% CI: 59.9-100.0), respectively. Conclusion: Lenvatinib plus pembrolizumab showed a relevant clinical benefit and significant toxicity in patients with advanced and recurrent endometrial cancer. Further studies encompassing long-term outcomes are warranted.

    Keywords: Lenvatinib, Pembrolizumab, Immunotherapy, endometrial cancer, Meta-analysis

    Received: 21 Mar 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Yan, Du, Zhang, Yan, Liu, Ban, Guo and Zeng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yanmin Du, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
    Huanhuan Zhang, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
    Jinxiang Yan, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
    Yixuan Liu, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
    Zhenying Ban, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
    Xianxu Zeng, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.