Post Hoc Analysis of Pembrolizumab Versus Standard of Care in Head and Neck Cancer
Posted: Tuesday, December 4, 2018
Based on the results of a post hoc analysis of the KEYNOTE-040 trial, patients with recurrent head and neck squamous cell carcinoma whose disease progressed during or after platinum-based treatment appear to experience clinical benefits when treated with pembrolizumab compared with other standard-of-care options. Christophe Le Tourneau, MD, PhD, of Institut Curie, Paris, and colleagues observed improvements in overall survival among those treated with pembrolizumab regardless of prior treatment with cetuximab. Progression-free survival and overall response rates also tended to improve among those with no prior cetuximab therapy. These findings were presented at the European Society for Medical Oncology (ESMO) 2018 Congress in Munich (Abstract 1047PD).
The investigators randomly assigned 495 patients with recurrent and/or metastatic head and neck squamous cell carcinoma to receive pembrolizumab or methotrexate, docetaxel, or cetuximab (standard of care). Post hoc analyses evaluated each of the standard-of-care choices, prior cetuximab use, and time to disease progression after beginning new anticancer therapy.
Survival benefits were observed among patients who received pembrolizumab compared with those who received the standard-of-care options regardless of prior cetuximab treatment (8.4 months vs. 6.0 months with methotrexate; 7.1 months with docetaxel; 7.7 months with cetuximab). Overall response rates and progression-free survival improved among those with no prior cetuximab use (n = 210). The time from randomization to disease progression after initiation of anticancer therapy was significantly longer in patients treated with pembrolizumab than in those treated with the standard of care (6.6 vs. 5.4 months, P = .0002).