Lenvatinib Plus Pembrolizumab Promising for RCC and Other Solid Tumors

Study findings suggest that lenvatinib therapy plus pembrolizumab has promising antitumor activity and a manageable safety profile when used in patients with renal cell carcinoma (RCC) and other solid tumor types (J Clin Oncol. 2020 Jan 21. Epub ahead of print)

“Modulation of vascular endothelial growth factor–mediated immune suppression via angiogenesis inhibition may augment the activity of immune checkpoint inhibitors,” explained Matthew H. Taylor, MD, Knight Cancer Institute, Oregon Health and Science University, and co-investigators when describing the purpose of their dose-finding, phase 1B/2 study.

A total of 137 patients with metastatic RCC, endometrial cancer, squamous cell head and neck cancer, melanoma, non–small-cell lung cancer, or urothelial cancer were evaluated between the phase 1b and 2 expansion portions of the trial.

The primary end points were to determine the maximum tolerated dose of lenvatinib plus pembrolizumab (200 mg intravenously every 3 weeks)and to identify the 24-week objective response rate at the recommended dose in phase 1b and phase 2, respectively.

There were 2 dose-limiting toxicities reported in recipients of the initial dose of lenvatinib (24 mg daily). The maximum tolerated dose of lenvatinib was subsequently established as 24 mg daily.

The 24-week objective response rates were 63%, 52%, 48%, 33%, and 25% for patients with RCC, endometrial cancer, melanoma, non–small-cell lung cancer, and urothelial cancer, respectively.

Fatigue, diarrhea, hypertension, and hypothyroidism were the most frequently reported treatment-related adverse events.

“Lenvatinib plus pembrolizumab demonstrated a manageable safety profile and promising antitumor activity in patients with selected solid tumor types,” concluded Dr Taylor et al.—Kaitlyn Manasterski

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