Endometrial Cancer: Interpreting dMMR and Post-Adjuvant Activity from LEAP-001

LEAP 001 was designed to evaluate whether a chemo free regimen of lenvatinib plus pembrolizumab could outperform standard carboplatin and paclitaxel in the frontline setting. Although the study did not meet its co primary endpoints, meaningful activity signals emerged within key subgroups. Patients with dMMR tumors showed stronger responses to the combination, consistent with the well established sensitivity of this molecular group to immunotherapy. Patients who had previously received adjuvant carboplatin and paclitaxel, often a more difficult population to treat, also demonstrated encouraging benefit. These trends do not alter the overall trial interpretation but highlight subgroups that may benefit more than others. As experts noted, the findings support individualized consideration of the regimen, particularly for patients who are not suitable candidates for standard frontline chemotherapy.