Treatment could ‘change the world’ for head and neck cancers

Head and neck cancer patients lived twice as long cancer-free after a immunotherapy treatment regime, a clinical trial has found.

Patients in the trial had a “dramatically” decreased chance of their cancer returning, living for an average of five years cancer-free when the immunotherapy was added to their treatment.

Those on the trial who did not receive the drug alongside their treatment lived just 30 months without any cancer returning, according to a results presented by the American Society of Clinical Oncology in Chicago.

The immunotherapy, pembrolizumab, primes the immune system to detect and attack cancer. It is already approved for use on its own or alongside chemoradiotherapy in head and neck cancers that have returned or metastasised.

Previous trials testing the drug for patients with newly diagnosed advanced cancer were not as successful. However, the current trial’s “excellent” results for this group of patients were due to its use in combination with surgery, researchers said.

Three years after treatment, patients given the immunotherapy alongside surgery also had a ten per cent reduced risk of their cancer returning elsewhere in their body.

A team of researchers from 24 different countries, including those from the Institute of Cancer Research (ICR) and the Royal Marsden NHS Foundation Trust, said they believed the drug “primes” the immune system to attack the cancer before it is surgically removed.

This means the immune system is ready to continue fighting cancer around the body when it is targeted after surgery with chemotherapy or radiotherapy.

Of the 714 patients in the Keynote-689 trial, which was funded by the global healthcare company MSD, 363 received pembrolizumab followed by the current treatment schedule, and 351 received the current treatment regime of surgery followed by radiotherapy or chemotherapy.

The immunotherapy treatment significantly decreases the chances of cancer spreading around the body in newly diagnosed patients

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The researchers, led by Washington University‘s School of Medicine, also found that the treatment worked “particularly well” for those with the immune marker PD-L1, but “dramatically” decreased cancer resurgence for all types of cancers.

Professor Kevin Harrington, a consultant oncologist at the Royal Marsden NHS Foundation Trust and professor at the ICR, said that treatment options for some patients had not changed in “two decades”.

He added that until now, the treatment had been effective for patients with returning or metastasized cancer, but had not been successful at treating patients who were newly diagnosed.

Harrington said: “This research shows that immunotherapy could change the world for these patients — it significantly decreases the chance of cancer spreading around the body, at which point it’s incredibly difficult to treat.

“The results of this trial show that pembrolizumab dramatically increases the duration of disease remission — for years longer than the current standard treatments.”

‘Knowing I was in the best hands was really reassuring’

Marston, with her husband, was diagnosed with stage four tongue cancer in 2019

Laura Marston, 45, from Derbyshire took part in the trial six years ago after being diagnosed with stage four tongue cancer in 2019 after an ulcer on her tongue didn’t heal.

She was later referred to the Royal Marsden hospital where she joined the Keynote-689 trial.

“I was so excited to be on a clinical trial and knowing I was in the best hands was really reassuring,” she said. “As part of the trial I underwent two rounds of immunotherapy before undergoing surgery.

“In the months following my surgery I had to relearn how to eat and talk again while also having ten more infusions of immunotherapy, chemotherapy and radiotherapy. My clinical team were amazing and went above and beyond for anything I needed.

“I am amazed I am still here six years later — this treatment has given me the gift of life.”