A landmark clinical trial offers new hope for hundreds of thousands facing advanced head and neck cancer. For the first time in two decades, researchers report a significant breakthrough: an immunotherapy drug, pembrolizumab, administered before and after surgery, has effectively doubled the length of time patients remain free from their cancer returning. This finding marks a pivotal moment in treating this notoriously challenging disease.
A Persistent Challenge in Cancer Treatment
Head and neck cancers are particularly difficult to manage, and unfortunately, treatment approaches have seen little substantial change over the past two decades. This is critical because for patients diagnosed with advanced head and neck cancers, the prognosis can be grim, with more than half tragically passing away within five years of diagnosis. This underscores the urgent need for more effective therapies.
The Keynote Trial: A Novel Approach
The promising results come from the international Keynote clinical trial. Researchers enrolled over 350 patients diagnosed with locally advanced head and neck cancers – cancers that were significant but had not yet spread widely to distant parts of the body. These patients received the immunotherapy drug, pembrolizumab, both before and after undergoing surgery to remove the tumor. A control group of similar patients received standard care involving surgery alone or other conventional treatments.
Dramatic Improvement in Cancer-Free Survival
The findings were highly encouraging. The new immunotherapy strategy effectively doubled the average length of time patients remained free of cancer recurrence. Specifically, the median time without the cancer returning increased from approximately 2.5 years for the control group to an impressive 5 years for patients treated with pembrolizumab. The trial also showed a 10% lower risk of the cancer returning elsewhere in the body after three years for those on the new regimen.
Training the Immune System to Fight Back
Researchers believe a key factor in the success of this approach is the timing of the immunotherapy. By giving pembrolizumab before surgery, the treatment allows the patient’s immune system to interact with the tumor and “learn” to recognize the cancer cells. As explained by Prof Kevin Harrington, who led the UK arm of the trial at the Institute of Cancer Research in London, this pre-surgical step helps “generate anti-tumour immunity.” Continuing the drug for up to a year after surgery then serves to “amplify that immune response,” essentially training the body to hunt down and destroy any remaining cancer cells or potential micro-metastases, significantly reducing the chance of the cancer spreading or returning.
Real-World Impact: Laura’s Story
The profound impact of this treatment is vividly illustrated by patients like Laura Marston, a 45-year-old who was diagnosed with advanced tongue cancer six years ago. Facing a “dire” prognosis with only a 30% chance of surviving five years, Laura enrolled in the trial and received pembrolizumab before and after extensive surgery that involved removing part of her tongue and lymph nodes. Despite a challenging recovery, she is now doing well six years later, working full-time, and describes herself as “amazed she’s still here.” Laura credits the immunotherapy with giving her “my life back again,” stating she wasn’t expected to live this long given her initial chances.
“Could Change the World”: Expert Optimism
Prof Kevin Harrington expressed significant optimism about the trial results, stating that this immunotherapy approach “could change the world” for patients with locally advanced head and neck cancer. He highlighted its critical ability to significantly decrease the chance of the cancer spreading throughout the body, a stage where treatment becomes exceptionally difficult. While the therapy worked particularly well for some patients, Prof Harrington noted the excitement that it provided benefits across the entire trial group. With approximately 12,800 new head and neck cancer cases diagnosed in the UK alone each year, there is a strong call for this treatment to be made available on national health services like the NHS.
Part of a New Era in Cancer Treatment
This breakthrough in head and neck cancer is not an isolated event but rather reflects an exciting period of rapid advancement in cancer research. Recent clinical trials across other cancer types are also demonstrating unprecedented results, often achieving significant improvements in patient outcomes through innovative drug combinations, particularly involving immunotherapy and targeted therapies. For example, a recent trial for advanced bladder cancer showed a combination including pembrolizumab doubled overall survival for patients compared to standard chemotherapy, marking the first major advance in decades for upfront treatment of that disease. Similarly, a new three-drug regimen for a specific type of advanced breast cancer has been shown to effectively double the time patients live without their cancer progressing. These parallel successes underscore the power of these novel therapeutic strategies to significantly extend and improve lives for patients facing various cancers.
Global Collaboration, Promising Future
The Keynote trial itself is a testament to global collaboration, involving 192 hospitals across 24 countries. Led by Washington University Medical School in St Louis and funded by the drug company MSD, the full findings of this groundbreaking study are being presented at the prestigious American Society of Clinical Oncology (ASCO) annual meeting, bringing worldwide attention to this significant step forward for head and neck cancer treatment.
This breakthrough in treating advanced head and neck cancer, alongside similar advancements in other cancer types, signals a new era of possibilities for patients. The ability to double the time patients live free from recurrence offers tangible hope and represents a critical step towards improving long-term outcomes for this challenging disease.
References
- https://www.bbc.com/news/articles/ce82gderpl9o
- https://www.bbc.co.uk/news/articles/ce82gderpl9o
- https://www.cancer.gov/news-events/cancer-currents-blog/2023/bladder-cancer-padcev-keytruda-doubles-survival
- https://www.icr.ac.uk/about-us/icr-news/detail/powerful-new-therapy-doubles-progression-free-survival-in-advanced-breast-cancer
- https://www.independent.co.uk/news/health/breast-cancer-treatment-drugs-research-uk-b2638468.html
