New cancer treatment could 'change the world' for newly diagnosed head and neck cancer patients by adding several years to their life
By XANTHA LEATHAM EXECUTIVE SCIENCE EDITOR
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An immunotherapy treatment has been found to ‘change the world’ for head and neck cancer patients by giving them an extra two and a half years before the disease worsens or comes back.
During a major phase III trial, pembrolizumab combined with standard treatment kept cancer at bay for an average of 60 months - five years - compared to the typical 30 months.
The worldwide trial involved 192 sites in 24 countries and experts tested the drug on 714 patients with newly-diagnosed head and neck cancers.
Hundreds of thousands of patients are diagnosed with the disease around the world each year and it includes cancer of the tongue and the throat.
A total of 363 patients received pembrolizumab followed by standard-of-care and 351 received only the current standard-of-care - surgery to remove the tumour, followed by radiotherapy with or without chemotherapy.
Results showed the immunotherapy treatment ‘dramatically’ increased the chance of remaining well without the disease progressing or coming back for all tumour types.
After three years, 58 per cent of patients given pembrolizumab were alive and free of disease, compared with 46 per cent given standard treatment.
Pembrolizumab works by taking the brakes off the immune system’s ability to attack cancer cells.
Immunotherapy uses our immune system to fight cancer. It works by helping the immune system recognise and attack cancer cells (stock image)
It is already approved for use on its own or in combination with chemotherapy in head and neck cancer that has come back or spread around the body.
The researchers believe the drug has been so effective in this current trial because of its use prior to surgery and then as part of the post-operative treatment.
The drug primes the immune system to attack the cancer before it is surgically removed, and the immune system is then ready to continue fighting it when it is targeted with post-surgery chemotherapy or radiotherapy.
Kevin Harrington, Professor of Biological Cancer Therapies at The Institute of Cancer Research in London, and Consultant Oncologist at The Royal Marsden NHS Foundation Trust, said: ‘For patients with newly-diagnosed, locally-advanced head and neck cancer, treatments haven’t changed in over two decades.
‘Immunotherapy has been amazingly beneficial for patients with cancer that has come back or spread around the body but, until now, it hasn’t been as successful for those presenting for the first time with disease which has spread to nearby areas.
‘This research shows that immunotherapy could change the world for these patients - it significantly increases the chance of remaining free of disease.
‘The results of this trial show that pembrolizumab dramatically increases the duration of disease remission - for years longer than the current standard treatments.
‘It works particularly well for those with high levels of immune markers, but it’s really exciting to see that the treatment improves outcomes for all head and neck cancer patients, regardless of these levels.’
The results were presented at the American Association for Cancer Research annual meeting in Chicago.
It works by harnessing the immune system recognise and attack cancer cells. It is normally given via an IV drip.
Some types of immunotherapy are also called targeted treatments or biological therapies.
One might have immunotherapy on its own or with other cancer treatments.
The immune system works to protect the body against infection, illness and disease. It can also protect from the development of cancer.
The immune system includes the lymph glands, spleen and white blood cells.
Normally, it can spot and destroy faulty cells in the body, stopping cancer developing. But a cancer might develop when:
- the immune system recognises cancer cells but it is not strong enough to kill the cancer cells
- the cancer cells produce signals that stop the immune system from attacking it
- the cancer cells hide or escape from the immune system
Types of immunotherapy
Cancer treatments do not always fit easily into a certain type of treatment.
This is because some drugs or treatments work in more than one way and belong to more than one group.
For example, a type of immunotherapy called checkpoint inhibitors are also described as a monoclonal antibody or targeted treatment.
CAR T-cell therapy
This treatment changes the genes in a person’s white blood cells (T cells) to help them recognise and kill cancer cells.
Changing the T cell in this way is called genetically engineering the T cell.
It is available as a possible treatment for some children with leukaemia and some adults with lymphoma.
People with other types of cancer might have it as part of a clinical trial.
Monoclonal antibodies (MABs)
MABs recognise and attach to specific proteins on the surface of cancer cells.
Antibodies are found naturally in our blood and help us to fight infection. MAB therapies mimic natural antibodies, but are made in a laboratory.
Monoclonal means all one type. So each MAB therapy is a lot of copies of one type of antibody.
MABs work as an immunotherapy in different ways. They might do one of the following:
- trigger the immune system
- help the immune system to attack cancer
MABs trigger the immune system by attaching themselves to proteins on cancer cells.
This makes it easier for the cells of the immune system to find and attack the cancer cells.
This process is called antibody dependent cell mediated cytotoxicity (ADCC).
Checkpoint inhibitors are MABs that work by helping the immune system attack cancer cells.
Cancer can sometimes push a stop button on the immune cells, so the immune system won’t attack them.
Checkpoint inhibitors block cancers from pushing the stop button.
Cytokines
Cytokines are a group of proteins in the body that play an important part in boosting the immune system.
Interferon and interleukin are types of cytokines found in the body. Scientists have developed man made versions of these to treat some types of cancer.
Source: Cancerresearchuk.org
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