Continuing Nivolumab After Progression of Head and Neck Cancer May Improve Survival

FDA-approved nivolumab blocks a molecule that prevents immune system T-cells from targeting tumor cells.
FDA-approved nivolumab blocks a molecule that prevents immune system T-cells from targeting tumor cells.

Continued immunotherapy after tumor progression may improve survival in patients with head and neck cancers, according to a poster presented at the American Association for Cancer Research (AACR) Annual Meeting 2017.

The findings highlight the idea that for some immunotherapy drugs, “the benefit is often seen with increased survival, not necessarily tumor shrinkage and response rate," said study lead investigator Robert Haddad, MD, leader of the Head and Neck Oncology Program at Dana-Farber Cancer Institute in Boston, Massachusetts.

The US Food and Drug Administration (FDA)-approved immune therapy drug nivolumab blocks a molecule that prevents immune system T-cells from attacking tumor cells. In a phase 3 clinical trial, 139 patients with recurrent or metastatic squamous cell cancer of the head and neck whose tumors had progressed during nivolumab treatment were given the option of continuing treatment or not; 57 patients chose to continue treatment and 82 did not. The patients who continued treatment had a median overall survival of 12.7 months, whereas patients who did not had a median overall survival of 6.1 months. Approximately one-third of the patients who continued treatment had tumor shrinkage. Both groups experienced similar adverse events, with a higher incidence of skin disorders seen in those patients who chose to continue treatment.

"Our findings suggest that for patients with head and neck cancer who are doing well enough, continuing nivolumab therapy after disease progression can often lengthen survival. For such patients, it can be a mistake to give up on these drugs too early, and clinical judgment should be exercised to determine whether it would be beneficial to continue therapy," said Dr Haddad. The study is the first to show that prolonging the use of an immunotherapy drug after disease progression lengthens survival.

Reference

1. Haddad R, Robert LF, Blumenschein G Jr, et al. Treatment beyond progression with nivolumab in patients with recurrent or metastatic squamous cell carcinoma of the head and neck in the phase 3 Checkmate 141 study. Poster presented at: American Association for Cancer Research Annual Meeting 2017; April 1-5, 2017; Washington, DC. Abstract CT157/23.

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