pembrolizumab and lenvatinib metastatic endometrial cancer

Dear Barb, hope you don’t mind me calling you by your name, I hope this treatment works for you, you’ve given me more hope that there are still some other treatments available. My oncologist said I could only have immunotherapy if I had the MMR gene which I don’t so I now have some ammunition to challenge this.

thankyou again and the very best of love and luck xxx

marilyn

Hi Barb. Thank you so much for your reply. The initial research on this combination of immunotherapy is encouraging. I will post some references below. Can I check if you are on a clinical trial? I ask because I can’t see approval from the cancer drugs fund list ( https://www.england.nhs.uk/wp-content/uploads/2017/04/national-cdf-list-v1.229.pdf) for this combination for endometrial cancer although it is being looked at for renal cancer. NICE are currently evaluating it’s effectiveness and cost effectiveness, due to report January 4, 2023. See https://www.nice.org.uk/guidance/indevelopment/gid-ta10692.

here are some quotes and other references. Unfortunately, I don’t think all of the references are publicly available but if you know someone who can access a University library you should be able to find all the articles. Let’s keep each other informed on developments as the oncologist told me to stop reading the Daily Mail wonder drug stories and chemo was the only way to go. This is the current position as a first line of treatment in the NHS. Some research is going on in the US to look at it as a first line of treatment/alternative to chemotherapy (see https://clinicaltrials.gov/ct2/show/NCT03884101) 

Onto the quotes and references

The combination of pembrolizumab and lenvatinib has emerged as an effective treatment for advanced, previously treated endometrial cancer. Pembrolizumab is an anti-programmed death 1 monoclonal antibody that blocks the interaction between programmed death 1 and programmed death ligands 1 and 2, and has been shown to be effective in the treatment of a variety of solid tumor types, including mismatch repair-deficient endometrial cancer. (https://ijgc.bmj.com/content/32/1/93)

Lenvatinib plus pembrolizumab led to significantly longer progression-free survival and overall survival than chemotherapy among patients with advanced endometrial cancer. (https://www.nejm.org/doi/full/10.1056/NEJMoa2108330) 

Lenvatinib plus pembrolizumab showed promising antitumor activity in patients with advanced endometrial carcinoma who have experienced disease progression after prior systemic therapy, regardless of tumor MSI status. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479759/)

Pembrolizumab and lenvatinib, an oral multikinase inhibitor targeting vascular endothelial growth factor and platelet growth factor receptors, received accelerated approval by the FDA in 2019 for relapsed or advanced endometrial cancer that is not MMRd. (www.thelancet.com Vol 399 April 9, 2022).

Stay strong!

Hi, just looking at your message Marilyn. Please find references in my reply to Barb. I think you can find some ammunition there to challenge you’re oncologist, or at least ask them to explain why this is not an option.

Dostarlimab Looks promising for those who have an MMRd but for those who do not pembrolizumab and lenvatinib seems to offer an alternative. 

Don’t hesitate to ask for any help.

Hi JamesF22  All I know is I signed the treatment of the Patient Agreement for Pembrolizumab form and the part where it states proposed course of treatment for NSCLC (Non small cell lung cancer) has been deleted and Endometrial Cancer has been put in. 

My Oncologist thought after my chemo finished at the end of March I wouldn't need more chemo until next January, however by July it had started to come back.

Hugs, Barb xx

Hi JamesF22,

thankyou for all that, I will certainly look it all up. It’s seems a bit scientific but the outcome reports suggest it could be effective.

fingers crossed 

Thanks again Barb for this information. I’m wishing you all the best and as noted above the initial signs for this treatment are good.

Hi JamesF22 I received a copy letter from my Oncologist to my GP which mentions there is compassionate access at the moment for NHS patients for this drug. So I suppose I must be deemed to be on my last legs. I am humbly grateful to our wonderful NHS and my Oncologist. I'll seize whatever's offered and pray it work for me.

Hugs, Barb xx

Best of luck Barbs. You are a trooper and will be fine.  You’ve got this!  Lots of love always    Ps mum still on the trial.  Next scan on 22nd of this month xx. Lots of love xxx

Hi, for anyone that is interested. NICE Will be holding a technical meeting on the 11 Oct, 09:30 on the use of Lenvatinib plus pembrolizumab. Theoretically members of the public can register. I’ve put my name in and hopefully they will allow me to attend. Will report back any findings on this thread. For anyone wishing to register you can do so here:
www.nice.org.uk/.../taca-october-2022

Thank you JamesF22 for all the helpful info.

MrsBLJ, I sincerely wish you all the best, you have been such a support on here, for all of us. Thank you. X