Patients with recurrent or metastatic head and neck cancer showing high expression of PD-L1 (programmed cell death ligand 1) could soon be treated with Keytruda (Pembrolizumab) instead of the current standard chemotherapy courses.
A panel of experts has reached this conclusion while discussing the results of KEYNOTE-048, the first study evaluating immunotherapy as first-line medical care, at the 2018 European Society of Medical Oncology conference. This might prove to be one of the most significant moments in cancer treatment strategy.
“KEYTRUDA is the first anti-PD-1 therapy to show superior overall survival as first-line treatment compared to the EXTREME regimen, the current standard of care in patients with recurrent or metastatic head and neck cancer,” said in a press release Dr. Roy Baynes, senior vice president and head of Global Clinical Development, chief medical officer, Merck Research Laboratories.
Clinical trials involved nearly 900 patients and showed Pembrolizumab monotherapy improved overall survival (OS) by 39 percent in patients with PD-L1 expression ≥ 20 percent and extended OS by 22 percent in those with PD-L1 expression ≥ 1 percent. Furthermore, Keytruda combined with chemotherapy exhibited an improvement of 23 percent over the EXTREME regimen (cetuximab with carboplatin or cisplatin plus 5-fluorouracil).
Dr Tanguy Seiwert, Assistant Professor of Medicine at the University of Chicago Medicine, Chicago, US, said: “This is the first study to show superior overall survival over the decade-old standard of care, platinum-based chemotherapy and cetuximab, and establishes PD-L1 CPS as a valid marker for head and neck cancer that should be routinely measured in these patients”.
Barbara Burtness, MD, Yale School of Medicine and Yale Cancer Center, New Haven, Connecticut, also praised the new therapy: “Pembrolizumab appears to prolong life even when the cancer continues to grow, suggesting that it should be a first line therapy in recurrent and metastatic head and neck cancer”.
Patients can be hopeful in avoiding the adverse effects of chemotherapy and look forward to better overall outcomes.