A case of recurrent endometrial cancer controlled by re-challenging of Lenvatinib plus Pembrolizumab combination therapy after onset of immune thrombocytopenia
2025 Volume 43 Issue 2 Pages 65-71
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2025 Volume 43 Issue 2 Pages 65-71
Synopsis: Lenvatinib plus Pembrolizumab combination therapy (LP) is indicated for patients with advanced or recurrent solid tumors that have progressed after prior chemotherapy. However, this treatment is associated with various treatment-emergent adverse events (TEAEs). We report a case of recurrent endometrial cancer that developed severe immune-related TEAEs after initiating LP therapy, which was successfully controlled by re-challenging with LP.
Case: A 70-year-old woman with endometrioid carcinoma, G1, stage IA. She experienced a recurrence at the vaginal stump and retroperitoneum 11 months post-surgery. Despite undergoing TC therapy, the tumors continued growing and LP was initiated. On day 21 of treatment, grade 4 thrombocytopenia developed, prompting the discontinuation of LP. Remission was achieved with prednisolone (PSL) 40 mg/day, platelet transfusion, and high-dose intravenous immunoglobulin therapy. However, tumor growth was observed during PSL tapering. LP therapy was re-initiated with 10 mg/day of PSL, and the patient has continued LP therapy without PSL, maintaining a partial response with no serious TEAE.
Re-challenging with LP after severe immune-related TEAEs may offer a favorable risk-benefit profile compared to cytotoxic chemotherapy. The effectiveness and safety of re-challenging of LP therapy warrant further investigation through additional case studies.
