Pembrolizumab plus lenvatinib performs well in MPM

The combination of pembrolizumab plus lenvatinib displayed promising clinical activity in the second-line treatment of patients with malignant pleural mesothelioma (MPM) in the phase 2 PEMMELA study. According to the authors, the combination therapy showed remarkable but manageable toxicity [1].

“There is no standard second-line treatment for patients with MPM,” explained Dr Li-Anne Douma (Netherlands Cancer Institute - Antoni van Leeuwenhoek, the Netherlands). The current phase 2 study (NCT04287829) evaluated the safety and efficacy of pembrolizumab and lenvatinib in 38 patients with recurrent MPM. The included patients received up to 35 cycles of the combination therapy and objective response rate (ORR) was the primary endpoint of the trial.

The ORR was 58%, exceeding the expectations of the investigators. All of the 22 responses were partial, and all other patients had stable disease at the time of the analysis. Furthermore, ORR by independent central review was 42%.

In total, 13 serious adverse events (AEs) were reported, 76% of the patients required at least 1 dose reduction or discontinued from lenvatinib, and 3 patients discontinued permanently from pembrolizumab. The most common any-grade AEs were fatigue (n=21), hoarseness (n=21), anorexia (n=16), and diarrhoea (n=15). Hypertension was the most common grade 3 AE (n=2) and 2 cases of grade 4 myositis were observed. Dr Douma commented that the safety profile was remarkable but manageable, and that the assessed combination therapy showed the highest in-trial ORR in the second-line treatment of MPM.

1. Douma L-A, et al. Pembrolizumab plus lenvatinib in second and third line malignant pleural mesothelioma patients; a single arm phase 2 study (PEMMELA). OA04.06, WCLC 2022, Vienna, Austria, 06–09 August.

 

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Posted on 23 August, 202218 March, 2024