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一名复发性子宫内膜癌患者接受二线帕博利珠单抗联合乐伐替尼治疗期间的长期持续缓解:病例报告

Long sustained response during second-line pembrolizumab plus lenvatinib in a patient with recurrent endometrial carcinoma: a case report.

作者信息

Fabbri Laura, Galvani Linda, Zamagni Claudio

机构信息

Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy.

IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.

出版信息

Drugs Context. 2025 Jun 24;14. doi: 10.7573/dic.2025-4-3. eCollection 2025.

Abstract

The combination of the immune-checkpoint inhibitor pembrolizumab plus lenvatinib, an angiogenesis inhibitor targeting VEGFR/FGFR, has been approved as standard second-line treatment for patients with recurrent or metastatic endometrial cancer progressed to first-line platinum-based chemotherapy regardless of mismatch repair status and based on the results of the KEYNOTE-775 trial. This article reports on the case of a middle-aged woman with advanced microsatellite stable, p53-mutant endometrial cancer who achieved a meaningful and sustained partial response, with good tolerability, to second-line treatment with pembrolizumab plus lenvatinib. This favourable outcome was compared with efficacy and toxicity data available in the current literature. Pembrolizumab plus lenvatinib can significantly prolong progression-free survival, especially in patients with a negative prognostic molecular profile, who at most can benefit from combining different therapeutic strategies. The heterogeneous treatment-related adverse events landscape should not discourage therapy prescription because most adverse events are easily manageable following simple precautions. This article is part of the Special Issue: https://www.drugsincontext.com/special_issues/new-treatment-options-for-advanced-endometrial-carcinoma.

摘要

免疫检查点抑制剂帕博利珠单抗联合血管生成抑制剂乐伐替尼(一种靶向VEGFR/FGFR的药物)的组合,已被批准作为复发或转移性子宫内膜癌患者的标准二线治疗方案。这些患者在接受一线铂类化疗后病情进展,无论错配修复状态如何,这是基于KEYNOTE-775试验的结果。本文报道了一名中年女性,患有晚期微卫星稳定、p53突变的子宫内膜癌,她接受帕博利珠单抗联合乐伐替尼二线治疗后,获得了有意义且持续的部分缓解,耐受性良好。将这一良好结果与当前文献中的疗效和毒性数据进行了比较。帕博利珠单抗联合乐伐替尼可显著延长无进展生存期,尤其是对于预后分子特征为阴性的患者,这类患者最多可从联合不同治疗策略中获益。与治疗相关的不良事件情况各异,但这不应该阻碍治疗处方的开具,因为大多数不良事件在采取简单预防措施后很容易控制。本文是《药物背景》特刊的一部分:https://www.drugsincontext.com/special_issues/new-treatment-options-for-advanced-endometrial-carcinoma

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