From the Research
Pembrolizumab maintenance therapy for metastatic endometrial cancer should be continued for up to 2 years (35 cycles) in patients who demonstrate clinical benefit and do not experience unacceptable toxicity, as supported by the most recent and highest quality study 1.
Rationale for Duration
The duration of pembrolizumab maintenance therapy is based on the design of clinical trials that established its efficacy in this setting. The study by 1 demonstrated that the addition of pembrolizumab to standard chemotherapy resulted in significantly longer progression-free survival than with chemotherapy alone in patients with advanced or recurrent endometrial cancer.
Treatment Administration
Each cycle of pembrolizumab consists of 200 mg administered intravenously every 3 weeks. Treatment may be discontinued earlier if disease progression occurs or if the patient experiences intolerable side effects that cannot be managed with dose interruptions or supportive care.
Considerations for Extended Treatment
Some patients may continue treatment beyond 2 years if they are still deriving benefit, though this would be considered on a case-by-case basis. The decision to extend treatment should be based on individual patient factors, including response to therapy, toxicity, and overall health status.
Mechanism of Action
Pembrolizumab works by enhancing T-cell responses against tumor cells, with evidence suggesting that these immunologic effects may persist even after discontinuation of the drug. This mechanism of action supports the use of pembrolizumab as a maintenance therapy to sustain clinical benefit in patients with metastatic endometrial cancer.
Key Points
- Pembrolizumab maintenance therapy should be continued for up to 2 years (35 cycles) in patients with clinical benefit and no unacceptable toxicity.
- Each cycle consists of 200 mg administered intravenously every 3 weeks.
- Treatment may be discontinued earlier due to disease progression or intolerable side effects.
- Extended treatment beyond 2 years may be considered on a case-by-case basis.
- Pembrolizumab's mechanism of action supports its use as a maintenance therapy to sustain clinical benefit.