SynthesisFrontiers in oncology2026
Lenvatinib starting doses below 20 mg versus 20 mg with pembrolizumab in advanced or recurrent endometrial cancer: a systematic review and meta-analysis of comparative observational evidence.
Synthesis in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Lenvatinib plus pembrolizumab is an established treatment for patients with previously treated advanced or recurrent endometrial cancer. In routine practice, clinicians may select a lenvatinib starting dose below 20 mg for patients expected to have limited tolerance, but the comparative effectiveness and tolerability of that strategy remain uncertain. Methods: We searched PubMed/MEDLINE, Web of Science Core Collection, and Cochrane CENTRAL from inception to 11 July 2026, with source-specific updates completed on 13-14 July 2026. Comparative observational studies of adults receiving lenvatinib plus pembrolizumab were eligible. The primary estimand compared starting doses below 20 mg with 20 mg; a 10-mg threshold contrast and first-8-week relative dose intensity were kept separate. Binary outcomes were summarized as risk ratios (RRs) and time-to-event outcomes as hazard ratios (HRs). Risk of bias was assessed with ROBINS-I, missing-evidence bias with ROB-ME, and certainty with GRADE. Results: Ten studies representing 10 independent cohorts and 1,000 patients were included. Five cohorts (703 patients in total) informed the primary starting-dose comparison, with outcome-specific analysis denominators. For starting doses below 20 mg versus 20 mg, the pooled RR was 0.97 for objective response (95% confidence interval [CI], 0.70-1.34; I²=11.9%) and 0.96 for disease control (95% CI, 0.83-1.11; I²=0%). The RR for subsequent lenvatinib dose reduction was 0.66 (95% CI, 0.34-1.27; I²=27.4%). Estimates for interruption, permanent discontinuation, grade 3 or higher adverse events, and progression-free survival were imprecise; hospitalization and treatment persistence were not poolable. Every evaluated result had serious overall risk of bias, and certainty was very low for all pooled comparisons. Conclusion: Comparative observational evidence does not establish that starting lenvatinib below 20 mg preserves antitumor effectiveness or improves tolerability relative to a 20 mg starting dose. Prospective, confounder-aware comparative studies are needed before a reduced starting-dose strategy can be recommended broadly.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.