A cocktail of immunotherapy drugs has saved the lives of some terminally ill cancer patients in a large trial against head and neck cancer, surpassing the performance of aggressive chemotherapies that significantly decrease patients’ quality of life.
In patients with aggressive head and neck cancer, the therapy enabled them to live longer, and the results were the best that have ever been produced for patients with relapsed or metastatic head and neck cancer.
“Our findings point towards a positive trend in survival when using a new immunotherapy combination for patients with head and neck cancer whose tumours are positive for the PD-L1 immune marker. In this group of patients, combining the immunotherapies nivolumab and ipilimumab could be a better option than the standard ‘Extreme’ treatment, especially as it has fewer side effects," said Professor Kevin Harrington, Professor of Biological Cancer Therapies at The Institute of Cancer Research and oncologist involved in the Checkmate 651 trial, in a statement.
Their results, which involved almost 1,000 patients, were presented to European Society for Medical Oncology Virtual Congress (ESMO) last month. While the survival rates did not reach statistical significance, there was a positive trend in survival of a specific type of head and neck cancer and some patients experienced their tumor completely disappear, despite being told they were likely to die years earlier. The patients also experienced far fewer side-effects compared to "extreme" chemotherapy, offering a "kinder" approach to extending the lives of terminally ill patients.
“Our trial shows the immunotherapy combination achieved the longest median overall survival ever seen in patients with relapsed or metastatic head and neck cancer. Despite the lack of statistical significance, these results are clinically meaningful. We will need to do longer follow-up to see whether we can demonstrate a survival benefit across all patients in the trial,” Harrington continued.
The cocktail involves a combination therapy of nivolumab and ipilimumab, which blocks proteins that prevent the immune system from attacking cancer cells, allowing the body to identify and prevent tumors from growing. Both drugs have been used previously, with success, against melanoma and kidney cancer, and now show great promise against head and neck cancers that are high in PD-L1.
When treated with the combination therapy, patients with high levels of PD-L1 lived for an average of 17.6 months, 3 months longer than those on aggressive chemotherapy, and the longest ever reported in this group of patients.
The results are promising, but require much more validation before it can be known when best to use the therapy. All cancers are different, and – as seen in this trial – only some will respond to specific treatments. However, for one man, it gave him his life back.
Barry Ambrose (77, Suffolk) was diagnosed with throat cancer in 2017, and offered only palliative care. Not long after, he was offered the opportunity to join the Checkmate 651 trial, and after almost two years on the trial and subsequent treatment, now has no signs of cancer.
“When I was told about the trial by Professor Harrington, I didn’t hesitate to join – what did I have to lose? It turned out to be a lifeline. Although I had to make bi-weekly trips from Suffolk to the hospital for the treatment, I had virtually no side effects and was able to carry on as normal doing the things I love - sailing, cycling, and spending time with my family,” he said in a statement.
“When the research nurses called to tell me that, after two months, the tumour in my throat had completely disappeared, it was an amazing moment. While there was still disease in my lungs at that point, the effect was staggering. In fact, I was doing so well on the trial I was allowed to pause it in November 2018 to go on a Caribbean cruise with my wife. The treatment I’ve received at The Royal Marsden has been second to none and I’m so fortunate they’ve continued to find treatment that works for me – they’re the gift that keeps on giving.”