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Would development of a rectovaginal fistula mid-treatment with second line pembrolizumab/lenvatinib for endometrial cancer cause you to change regimens, eliminate lenvatinib, or continue current therapy?
The patient has a history of pelvic radiation and progressed through first line carboplatin/taxol. She has had a partial response to pembro/lenvatinib. Tumor is MMR proficient.
Answer from: at Academic Institution
These complications are always difficult situations. Given she is having a response to therapy and her disease is not curable, I would have a discussion with her about the option of diversion with a colostomy after imaging and discuss holding therapy perioperatively but would consider restarting aft...
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