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REVIEW article

Front. Oncol.
Sec. Gynecological Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1511301

Efficacy and safety of pembrolizumab in patients with advanced endometrial cancer: a systematic review and meta-analysis

Provisionally accepted
Biqiong Pan Biqiong Pan Xiaojun Lai Xiaojun Lai Jiefang Lu Jiefang Lu Xiaoyan Bao Xiaoyan Bao Zengke Fan Zengke Fan Jie Sun Jie Sun *
  • Lishui City People's Hospital, Lishui, China

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

    Objective:This meta-analysis evaluated pembrolizumab monotherapy and combination therapy's efficacy and safety in recurrent or advanced endometrial cancer. Methods: We utilized PubMed, Embase, Cochrane Library, and Web of Science databases to identify clinical trials were used to search literature from July 2013 to July 2023 to evaluate efficacy and safety of pembrolizumab in patients with advanced endometrial cancer. Eight studies with 2,742 patients were included. Outcomes were progression-free survival (PFS), overall survival (OS), objective response rate (ORR), complete remission (CR), and adverse events (AEs), a subgroup analysis based on combination treatment regiments. Quality assessment of the studies included was conducted using Cochrane Risk of Bias Tool，the Newcastle–Ottawa Scale (NOS) and the Joanna Briggs Institute (JBI) critical appraisal checklist. Results: Pembrolizumab reduced progression risk (HR: 0.53; 95% CI: 0.44, 0.63; p < 0.00001) and death risk when combined with lenvatinib (HR: 0.67; 95% CI: 0.59, 0.76; p< 0.00001). Pembrolizumab monotherapy and lenvatinib combination achieved higher ORR (OR: 3.61; 95% CI: 2.12, 6.13; p < 0.00001) and CR rates (OR: 2.7; 95% CI: 1.59, 4.57; p < 0.05) than controls. Single-arm studies: 8% CR, 4% PR in pembrolizumab-treated patients. Pooled AE incidence: 86%, with 43% grade 3/4. Two RCTs found the pembrolizumab group had a higher incidence of grade 3 or 4 AEs compared to the control group (OR: 2.23; 95% CI: 1.23, 4.04; p=0.008). Conclusion: Pembrolizumab monotherapy or combination significantly improves survival in recurrent or advanced EC, and has manageable toxicity albeit with a relatively high incidence of treatment-related AEs.

    Keywords: Pembrolizumab, Monotherapy, endometrial cancer, Meta-analysis, Efficacy & safety

    Received: 14 Oct 2024; Accepted: 24 Dec 2024.

    Copyright: © 2024 Pan, Lai, Lu, Bao, Fan and Sun. 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: Jie Sun, Lishui City People's Hospital, Lishui, 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.