Immunotherapy is better than aggressive chemo as a first-line treatment of head and neck cancer

Immunotherapy used alone or in chemotherapy is a better first-line treatment for people with recurrent head and neck cancer than standard aggressive chemotherapy, according to new clinical trial results .

At the time of diagnosis, people with head and neck cancer who have returned or who have spread are currently being given an "extreme" badtail of two chemotherapy drugs and an antibody treatment target.

But the new trial showed that pembrolizumab in immunotherapy, combined with platinum chemotherapy, prolonged survival, while immunotherapy alone also worked well for some patients with much lower side-effect rates.

The new clinical trial results offer strong evidence in favor of pembrolizumab, alone or in combination with chemotherapy, becoming the first treatment of choice for people with head and neck cancer who have returned and it's spread.

NICE has begun an badysis to determine if pembrolizumab is profitable for use on the NHS and is expected to announce its decision in February 2020.

The trial was conducted in the UK by a team from the London Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, and involved 206 research centers around the world.

The scientists found that patients were living longer when they received pembrolizumab in combination with platinum chemotherapy as a first step, instead of the current standard of aggressive chemotherapy.

Patients with high levels of PD-L1 immune marker who received pembrolizumab with chemotherapy experienced an average of 14.7 months compared to 11.0 months in patients who received aggressive chemotherapy.

Remarkably, one-third of patients treated with pembrolizumab and chemotherapy were alive three years after the start of treatment, compared to only one in twelve of those treated with extreme chemotherapy.

Individuals with lower levels of PD-L1 also benefited from the combination of immunotherapy and chemotherapy, with an average survival of 13.6 months compared to 10.4 months with chemotherapy "Extreme" standard.

The final results of the test were presented at the annual meeting of the ASCO in Chicago on Saturday. The trial was sponsored by Merck & Co., Inc., known as MSD outside the United States and Canada.

Pembrolizumab alone prolonged its survival in patients with the PD-L1 immune marker – the majority of patients – compared to the standard combination of aggressive chemotherapy.

Immunotherapy alone was less important (16.9% versus 36% on chemotherapy), but this did not prevent pembrolizumab from obtaining significantly improved survival rates compared to chemotherapy. extreme. For people for whom pembrolizumab worked, the treatment was extremely effective – the average response time was 22.6 months, compared to only 4.5 months under aggressive chemotherapy.

Importantly, compared to chemotherapy, treatment with pembrolizumab resulted in much lower rates of serious adverse events, which only occurred in 55% of people treated with immunotherapy alone.

Adverse events were observed in 85% of people treated with pembrolizumab with platinum chemotherapy and in 83% of people who received the aggressive chemotherapy combination.

The research follows the ICR's recent announcement of a £ 15 million fundraising for the construction of a new Cancer Drug Research Center, has a budget of 75 million pounds sterling. The new center will focus on new drugs and anti-evolution combinations, including the use of targeted drugs alongside immunotherapies.

Professor Kevin Harrington, professor of cancer biotherapy at the Cancer Institute, London and clinical oncology consultant at the Royal Marsden Foundation Trust, said:

"We have shown that pembrolizumab, alone or in combination with platinum chemotherapy, is effective as a first-line treatment in patients with advanced head and neck cancer – for whom the treatment of first choice is currently aggressive chemotherapy.

"We had begun to see strong indications of the promise of pembrolizumab as a first – line treatment while the trial was underway and I am pleased to see the preliminary results of the trial confirmed during the trial. final badysis.

"Patients with advanced head and neck cancer are currently receiving extremely aggressive chemotherapy, so I hope the results of our study will soon be translated into approval of pembrolizumab by the NHS so that Patients can benefit from this at the beginning of the treatment We can imagine that many patients could be treated with pembrolizumab alone, which would give them a double survival: prolonged survival and fewer side effects.If necessary, a combination of pembrolizumab and chemotherapy could prove to be very beneficial. "

Professor Paul Workman, director of the London Cancer Institute, said:

"Immunotherapy has already revolutionized the outlook for patients with melanoma and is also very promising for other types of cancer." According to the results of the new clinical trial, pembrolizumab should do the same for people with recurrent cancer of the head and neck.

"Until now, immunotherapy has only been tested in patients with cancer of the head and neck at an advanced stage of treatment, whereas Other treatments had stopped working, I'm looking forward to new innovative treatments being evaluated earlier in the course of treatment, where the potential for benefit may be greater, and it's great news that in this case, pembrolizumab is actually effective at the first-line stage. "