Endometrial Cancer: Sequencing Lenvatinib–Pembrolizumab - Alignment with Trials, Post-Adjuvant Potential, and Dose Flexibility

Clinical experience with lenvatinib plus pembrolizumab is generally consistent with results observed in major studies, although real world practice often presents additional challenges related to tolerability. Many patients require careful monitoring, early intervention and dose adjustments in order to remain on therapy. Lenvatinib reductions are common, and clinicians frequently rely on individualized dosing strategies to maintain treatment continuity.

Interest in bringing the regimen earlier into the treatment sequence has grown, supported by post adjuvant analyses from LEAP 001 and KEYNOTE 775. These findings suggest potential benefit in earlier settings, although broader evidence is still needed. The flexibility to reduce and later re escalate lenvatinib makes it possible to personalize therapy and support long term adherence. This adaptability is an important component of optimizing treatment benefit.