However, most data are from clinical trials with less heavily pretreated patients, and uncertainty remains about efficacy in platinum-resistant, p53-mutated, high-grade tumors and the optimal starting dose of lenvatinib given its toxicity.What this study adds:In a real-world cohort enriched for platinum-resistant, high-grade, p53-mutated, heavily pre-treated endometrial cancers, lenvatinib plus pembrolizumab achieved an objective response rate consistent with prior trials. Here, TP53 is linked to endometrial cancer.