Pembrolizumab and lenvatinib in the treatment of recurrent ovarian carcinoma: A single institution experience

Background: Advanced stage ovarian carcinoma has a poor prognosis with recurrence rates of over 80%, 5-year survival of 36–45%, and limited response to standard therapy. Pembrolizumab and lenvatinib are FDA approved for treatment of microsatellite stable (MSS)/mismatch repair proficient (pMMR) endom...

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Main Authors: Helen Toma, Rebeca Kelly, Chelsea Katz, Hannah Hong, Hannah Diasti, David P. Warshal, Lauren Krill
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Gynecologic Oncology Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2352578925001365
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Summary:Background: Advanced stage ovarian carcinoma has a poor prognosis with recurrence rates of over 80%, 5-year survival of 36–45%, and limited response to standard therapy. Pembrolizumab and lenvatinib are FDA approved for treatment of microsatellite stable (MSS)/mismatch repair proficient (pMMR) endometrial and renal cell cancers. Early phase II studies have shown promising results in a variety of advanced solid tumors, including ovarian cancer. We report on the clinical outcome of recurrent MSS/pMMR ovarian cancer patients treated with this therapy. Methods: For this retrospective cohort study, patients with a diagnosis of ovarian cancer treated with pembrolizumab and lenvatinib from January 2020 to April 2024 at MD Anderson Cancer Center at Cooper were identified. Demographic data, tumor characteristics, germline/somatic genetic testing, treatment duration, and toxicity were collected. Response rate by RECIST criteria, progression free survival (PFS), and clinical benefit rate were calculated. Results: Sixteen patients were identified. Most had high-grade serous (n = 11, 68.75 %) or clear cell histologies (n = 4, 25 %) and FIGO stage III/IV disease (n = 15, 93.75 %). Eighty-one percent had platinum resistant recurrent disease. Three patients discontinued therapy after one cycle, unrelated to drug toxicity, and were non-evaluable for response. Of 13 patients evaluable for response, 54 % had a partial response and 31 % had stable disease. The 6-month clinical benefit rate was 69 %. The median PFS for all evaluable patients was 7.9 months. At the time of data analysis, 2 patients remained on treatment. Conclusion: Pembrolizumab-lenvatinib therapy demonstrated favorable clinical benefit in recurrent, platinum resistant MSS/pMMR ovarian cancer, a group of patients in need of more therapeutic options.
ISSN:2352-5789