Do you offer patients with advanced endometrial cancer lower starting doses of lenvatinib when used in combination with pembrolizumab given high adverse event rates with 20 mg daily?
Is there a role for using pembrolizumab alone in microsatellite stable endometrial cancer if patients are unable to tolerate lenvatinib?
Answer from: Medical Oncologist at Community Practice
For the first part of the question, "Do you offer patients with advanced endometrial cancer lower starting doses of lenvatinib when used in combination with pembrolizumab given high adverse event rates with 20 mg daily?" The strategy of administering lenvatinib therapy by starting at the established...
The dosing of lenvatinib has been greatly debated since the initial FDA approval of the combination regimen in the endometrial cancer space. I start at 20 mg unless the patient has an existing medical comorbidity that mandates a lower starting dose (i.e. hepatic disease). Importantly, however, I rem...
I start at 20 mg for most patients but monitor for side effects closely in the first couple of months and am quick to dose reduce. I do give strict blood pressure monitoring instructions as well as strict precautions regarding diarrhea. If severe renal or hepatic impairment, the starting dose is 10 ...