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Pembrolizumab Promising in Treatment of Head and Neck Skin Cancer
New findings suggest that pembrolizumab used in the neoadjuvant and adjuvant setting causes anti-tumour activity in patients with locally advanced squamous cell carcinoma of the head and neck.
Ravindra Uppaluri, director of Head and Neck Surgical Oncology at the Dana Farber Cancer Institute in Boston, presented the early findings of an ongoing trial at the American Society of Clinical Oncology 2017 Annual Meeting.
The initial stages of the study indicate potential clinical efficacy. Researchers saw a pathologic response in 42 percent of patients with just a single dose of pembrolizumab. There were no local regional relapses or distant metastases for 14 patients at one year after surgery, in a very high-risk subgroup of patients. No serious drug-related adverse events or unexpected surgical delays or complications occurred.
Previous studies have supported the use of adjuvant chemoradiotherapy in patients with resected, high-risk, locally advanced squamous cell carcinoma of the head and neck. But despite this, 35 percent of patients develop recurrent and metastatic disease within a year after post-operative adjuvant chemoradiotherapy. Researchers hope that the addition of pembrolizumab can improve these outcomes.
In the current phase two trial, patients receive a single dose of neoadjuvant pembrolizumab and then undergo surgery two to three weeks later. Twenty-five patients have thus far been accrued, and most of these have tumours in the oral cavity, larynx or oropharynx.
The primary endpoint of the study is to reduce the rate of local regional relapse and distant metastasis from 35 percent to 15 percent.
Nelson, R. (June 21, 2017) Neoadjuvant Pembrolizumab Promising in Head and Neck Cancer. Medscape. Article 881911.