Endometrial Cancer: An Integrated View of LEAP-001, KEYNOTE-775, RUBY and NRG-GY018 for Treatment Strategy

The differing results of LEAP 001 and KEYNOTE 775 help clarify how lenvatinib plus pembrolizumab should be used within the treatment landscape for endometrial cancer. LEAP 001 did not show superiority to chemotherapy in the first line setting, which limits routine upfront use. In contrast, KEYNOTE 775 demonstrated clear benefit after progression on prior chemotherapy, reinforcing the regimen as an important second line option and as a suitable choice when patients cannot receive standard chemotherapy.RUBY and NRG GY018 strengthened the role of adding PD 1 therapy to chemotherapy, particularly for dMMR tumors, which show the most pronounced improvement. In pMMR disease, benefit is present but more modest. This raises questions about whether lenvatinib plus pembrolizumab may be considered for selected pMMR patients, although current evidence supports its use mainly in later lines or when chemo immunotherapy is not feasible.