Authors: Mike Gregg, Future Science Group
The KEYNOTE-040 trial has shown that Keytruda® (pembrolizumab) can extend the lives of some patients with advanced head and neck cancer for up to 3 years or more.The KEYNOTE-040 trial was carried out by a team at The Institute of Cancer Research (London, UK), and The Royal Marsden NHS Foundation Trust (London, UK), and included 97 medical centers in 20 different countries.
The drug used in the trial was pembrolizumab, which acts by increasing the immune system’s ability to attack cancer cells. The study was carried out on 500 patients with advanced head and neck cancer, which was resistant to platinum chemotherapy. The patients were divided into two groups, 247 patients were given pembrolizumab and 248 were on standard care which included chemotherapy or the targeted agent Erbitux® (cetuximab).
The study revealed that patients on pembrolizumab generally survived for a median of 8.4 months compared with 6.9 months with standard treatment. A minority of these patients responded exceptionally well to pembrolizumab. The cancer in these patients has either partially or completely disappeared; some are still cancer free 3 years after receiving the treatment.
“I would like to see pembrolizumab approved for use in the clinic, so that people with advanced head and neck cancer can be offered the chance of a longer life and improved quality of life. There is also an urgent need to work out how we can identify in advance which patients are likely to benefit, given that some of these people may do much better than they do on standard treatment,” concludes Kevin Harrington, The Institute of Cancer Research (London, UK).
• An interview with Kevin Harrington: what’s next for oncolytic virotherapy and immuno-oncology?
• KEYNOTE-048: pembrolizumab changes the rules for head and neck cancer patients </blockquote>
Researchers have also discovered that pembrolizumab has less serious side effects than current approved drugs. At present pembrolizumab is approved for use in some individuals with lung cancer, skin cancer and lymphoma. Researchers now want to use the results from this clinical trial to promote use of pembrolizumab and make it available to a wider range of patients.
“I was really lucky to get a place on The Royal Marsden’s pembrolizumab trial and started treatment in May 2015. I travelled down from Leicester every 3 weeks for 2 years. My tumor was shrinking all the time and I felt a bit better every time I went, it made a huge difference to my life and I was able to return to normality,” stated Derek Kitcherside who is alive and well after 2 years of treatment.
Sources: Cohen EW, Soulières D, Le Tourneau C et al. Pembrolizumab versus methotrexate, docetaxel, or cetuximab for recurrent or metastatic head-and-neck squamous cell carcinoma (KEYNOTE-040): a randomised, open-label, phase 3 study. The Lancet doi.org/10.1016/S0140-6736(18)31999-8 2018) [Epub ahead of print]; www.icr.ac.uk/news-archive/immunotherapy-keeps-some-patients-with-advanced-head-and-neck-cancer-alive-for-more-than-three-years