Abstract

Background. Endometrial cancer is the most common malignancy of the female reproductive system. Patients with metastatic endometrial cancer have the overall 5-year survival rate of less than 20 %. The efficacy of treatment of advanced endometrial cancer remains low; therefore, the search for novel approaches for treating endometrial cancer is of great importance.Case description. We report a case of a 68-year-old female who presented with advanced endometrial cancer with metastatic lesions found in the axillary and lumbar lymph nodes, liver and lungs. The disease progressed after third-line chemotherapy, with no deficiency in the DNA repair system. The patient was successfully treated with lenvatinib and pembrolisumab. The treatment was characterized by controlled minimal toxicity and a satisfactory quality of life. At 5 months, the patient is alive with stable disease.Conclusion. Despite the progress in treating endometrial cancer including chemotherapy and hormone therapy, the prognosis of patients with metastatic endometrial cancer is poor. The discovery of new molecular markers (MSI , PD -L1) made it possible to develop a clinical approach using a combination of pembrolizumab and lenvatinib for patients with no deficiency in the repair system, for whom, the standard chemotherapy is ineffective. The presented case gives hope for the treatment of this category of patients.

Highlights

  • Endometrial cancer is the most common malignancy of the female reproductive system

  • The efficacy of treatment of advanced endometrial cancer remains low; the search for novel approaches for treating endometrial cancer is of great importance

  • We report a case of a 68-year-old female who presented with advanced endometrial cancer with metastatic lesions found in the axillary and lumbar lymph nodes, liver and lungs

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Summary

ПРАКТИКЕ У БОЛЬНОЙ С РАСПРОСТРАНЕННЫМ РАКОМ ЭНДОМЕТРИЯ

Поэтому проблема поиска новых клинических подходов к такой категории больных остается актуальной. Представлено клиническое наблюдение успешного применения ленватиниба с пембролизумабом у пациентки 68 лет с распространенным раком эндометрия, вовлекающим аксиллярные, поясничные лимфоузлы и прогрессирующим после III линии химиотерапии, с множественным поражением печени и легких и отсутствием дефицита в системе репарации ДНК. До настоящего времени прогноз больных с метастатическим раком эндометрия, несмотря на проводимые стандартные методы лечения (химиотерапия и гормонотерапия), оставался неутешительным. Открытие новых молекулярных маркеров (MSI, PD-L1) позволило разработать клинический подход с использованием комбинации пембролизумаба и ленватиниба для больных с отсутствием дефицита в системе репарации, для которых не существует эффективной стандартной химиотерапии. Представленный случай вселяет надежду на возможность лечения данной категории больных. Ключевые слова: рак эндометрия, микросателлитная нестабильность, MSI, нарушение в системе репарации, MMR, химиотерапия, ленватиниб, пембролизумаб. COMBINATION OF LENVATINIB AND PEMBROLISUMAB IN THE TREATMENT OF ADVANCED ENDOMETRIAL CANCER:

Pelvic and lumbar lymph node dissection
ВКЛАД АВТОРОВ
Findings
AUTHOR CONTRIBUTION

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