Real-World Utilization of Lenvatinib and Pembrolizumab Combination Therapy for the Treatment of Endometrial Cancer in the USA

Abstract

Aim:

Describe treatment and dosing patterns of lenvatinib and pembrolizumab combination therapy (lenva+pembro) among endometrial cancer (EC) patients in US clinical practice.

Materials & methods:

Retrospective cohort study among adults with EC initiating lenva+pembro in second line (2L) or third line and later (≥3L) between 17 September 2019 and 30 June 2021.

Results:

110 patients initiated lenva+pembro in 2L and 135 patients in ≥3L. Majority of patients initiated lenva+pembro at label-recommended starting doses/interval. Less than half changed lenvatinib dose over time. At median follow-up of 7.3 and 8.7 months, median (95% CI) duration of therapy was 5.1 (4.7–6.1) and 5.8 (4.2–7.3) months for patients in 2L and ≥3L, respectively.

Conclusion:

Lenva+pembro was mostly initiated at label-recommended dose.

Plain language summary

This study looked at details of lenvatinib and pembrolizumab combination treatment among patients with endometrial cancer (EC) in the USA. Specifically, these patients had received prior chemotherapy or hormone therapy before starting lenvatinib and pembrolizumab. Most patients started lenvatinib and pembrolizumab at the dose recommended by the product label and received the next pembrolizumab injection within the recommended timeframe. Over time, more than half of the patients did not change the dose of lenvatinib, and most patients had the same dose of pembrolizumab. On average, patients were treated with lenvatinib and pembrolizumab for 5–6 months. This study showed that in general, patients were taking lenvatinib and pembrolizumab for treatment of EC as recommended by product labels.

Tweetable abstract

Our retrospective study of lenvatinib and pembrolizumab using IQVIA’s claims database shows that most patients initiated at label-recommended dose, and majority did not have a dose change. At median follow-up of 7.3 and 8.7 months, the median (95% CI) duration of therapy was 5.1 (4.7–6.1) and 5.8 (4.2–7.3) months for patients in 2L and ≥3L, respectively.

Keywords::

• dose
• endometrial carcinoma
• lenvatinib
• pembrolizumab
• real-world evidence
• retrospective database analysis
• treatment patterns

Author contributions

K Wada: conceptualization, investigation, methodology, project administration, validation, writing – original draft, writing – review & editing. J Zhang: conceptualization, investigation, methodology, supervision, writing – review & editing. I Lee: conceptualization, investigation, methodology, project administration, validation, writing – original draft, writing – review & editing. Y Wang: data curation, formal analysis, software, validation, writing – review & editing. A Near: conceptualization, investigation, methodology, supervision, writing – review & editing. VS Prabhu: conceptualization, funding acquisition, investigation, methodology, supervision, writing – review & editing.

Financial disclosure

This study was co-funded by Merck Sharp & Dohme (MSD) LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA and Eisai Inc., Nutley, NJ, USA. I Lee, Y Wang and A Near are employees of IQVIA Inc., which received funding from MSD to conduct this study. K Wada was an employee of IQVIA Inc. at the time of study execution. J Zhang was an employee of Eisai, Inc., Nutley, NJ, USA, at the time of study execution. VS Prabhu is an employee of MSD and owns shares of Merck & Co., Inc., Rahway, NJ, USA. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

All data are de-identified and Health Insurance Portability and Accountability Act (HIPAA)-compliant to protect patient privacy, thus Institutional Review Board approval or waiver was not required for this study.

Previous Presentations

Part of this research was presented at the National Comprehensive Cancer Network (NCCN) 2022 Annual Conference [18].