Susana M. Campos, MD, MPH, clinical director of the Division of Gynecologic Oncology and director of Educational Initiatives at Dana-Farber Cancer Institute, and assistant professor of medicine at Harvard Medical School, discussed the relationship between the platinum-free interval and outcomes with lenvatinib (Lenvima) plus pembrolizumab (Keytruda) in endometrial cancer. The platinum-free interval, the time between a patient’s last platinum-based chemotherapy and disease progression, has long been used to help predict how patients with recurrent endometrial cancer will respond to subsequent therapy.
While data suggest that a longer platinum-free interval is associated with better outcomes, Campos drew an important distinction that shapes treatment selection: the platinum-free interval is prognostic, meaning it signals how a patient is likely to do overall. However, it is not predictive of which specific therapy or immunotherapy-based or chemotherapy-based regimen will work best for that individual patient. That distinction has direct implications for treatment selection in patients who progress quickly after platinum-based chemotherapy.
Campos spoke with CancerNetwork as part of a
Transcript:
CancerNetwork: One of your colleagues noted that the data linking lenvatinib and pembrolizumab efficacy to the prior platinum-free interval were compelling. How does the duration of that platinum-free window alter the expected response rate of this combination?
Campos: It’s a great question, and one that’s been debated often. Does pembrolizumab and lenvatinib work better in patients who progress in less than 6 months? Does it work better in patients [who progress in] greater than 6 months vs chemotherapy? There have been some very interesting studies looking at the platinum-free interval in endometrial cancer, and what we can say with confidence is that the duration of the platinum-free interval is prognostic. What it is not is predictive. We know that if you have a short platinum-free interval, patients are probably not going to do as well. It doesn’t tell you how they’re going to do relative to one agent over the other. However, if a patient does have a very short platinum-free interval, I’m more keen to lean on something they have not been exposed to, as opposed to something they’ve already been exposed to, and pembrolizumab and lenvatinib is a very strong contender in that regard.