Managing the Adverse Events Associated with the Combination Pembrolizumab and Lenvatinib Therapy in Endometrial Cancer

Endometrial cancer (EC) is the most common gynecological cancer. The combination of lenvatinib plus pembrolizumab has exhibited efficacy as the second line treatment for advanced EC, with a significant benefit in terms of progression free survival (PFS) and overall survival (OS), but the adverse effects (AE) profile is complex. AEs associated with the treatment may represent a limitation to this combination. Here, we report the case of a 38-year-old lady diagnosed with stage IV EC elsewhere, whose disease progressed after the first line of treatment, and was referred to our center in 2021. We treated her with the combination of lenvatinib and pembrolizumab. During the course of the treatment. she developed hand- foot syndrome (HFS) grade III, and hypothyroidism grade II. The AEs were managed with supportive medications, dose interruptions, dose reductions, and multidisciplinary care, which allowed us to continue the treatment. The patient achieved a good partial response, and an ongoing PFS of more than 12 months. Keywords: cancer, endometrial, lenvatinib, pembrolizumab, adverse drug events, hand foot syndrome, hypothyroidism, Oman.