Patient-Reported Quality of Life in Patients With Endometrial Cancer Treated With Lenvatinib Plus Pembrolizumab

Recently, Domenica Lorusso, MD, PhD, from the Fondazione Policlinico Universitario Agostino Gemelli IRCCS and Catholic University of Sacred Heart, Rome, Italy, and colleagues researched the effects on overall quality of life for patients with endometrial cancer who are treated with a combination therapy of lenvatinib and pembrolizumab. The combination has shown significant results in previous studies on progression-free survival (PFS) rates, and this analysis used data from the KEYNOTE-775 study to evaluate the treatment’s impact on quality of life.

In the KEYNOTE-775 study, patients were randomly assigned at a 1:1 ratio to receive 20 mg of lenvatinib once daily plus 200 mg of pembrolizumab once every 3 weeks or treatment of physician’s choice (TPC; doxorubicin or paclitaxel). Researchers used three different instruments to assess patients’ health-related quality of life (HRQoL): the EORTC QLQ-C30, the EORTC QLQ-EN24, and the EQ-5D-5L. The primary goals of this analysis were to find the impact of combination therapy on quality of life, as the KEYNOTE-775 study was already able to prove the therapy’s safety. To evaluate quality, the researchers based their estimations on the original study’s overall survival (OS) and PFS rates.

In their results, Dr Lorusso and colleagues found that the instruments (QLQ-C30, QLQ-EN24) showed greater deterioration in diarrhea and muscular pain in patients in the control arm as well as deterioration in dyspnea and lymphoedema. When the researchers evaluated the symptom scales, they found that patients significantly preferred lenvatinib+pembrolizumab over the control when exhibiting symptoms such as dyspnea, poor body image, numbness, and hair loss. However, for symptoms such as appetite loss, diarrhea, and muscular pain they preferred the TPC.

“Differences could be seen on individual scales: appetite loss, diarrhea, and muscular pain all appeared worse with lenvatinib+pembrolizumab compared with TPC; whereas dyspnea, poor body image, and hair loss appeared worse with TPC compared with lenvatinib+pembrolizumab," the authors wrote. “Together, these differences in individual PRO outputs can help explain how scores on the more broad GHS/QoL instrument were generally similar between treatment arms, while patients’ HRQoL on individual symptom scales varied depending on the specific study treatment.”

In conclusion, Dr Lorusso and colleagues found that even though the TPC (control) arm and the lenvatinib+pembrolizumab arm showed deterioration in different symptoms for patients with endometrial cancer, the differences were minor. Overall, the data found showed statistically significant improvements in patients’ PFS, OS, and safety profile. The data suggest that lenvatinib+pembrolizumab is favorable overall in comparison to TPC and should be considered as a first option for patients with endometrial cancer when looking for care.

Reference:

doi:10.1016/j.ejca.2023.03.015

Lorusso D, Colombo N, Antonio Casado Herráez, et al. Health-Related Quality of Life in Patients With Advanced Endometrial Cancer Treated With Lenvatinib Plus Pembrolizumab or Treatment of Physician’s Choice. Eur J Cancer. 2023;186:172-184. doi:10.1016/j.ejca.2023.03.015