Dr. Burtness on Promise of Frontline Pembrolizumab in Metastatic HNSCC

Barbara Burtness, MD, professor of Medicine (Medical Oncology); Disease Aligned Research Team Leader, Head and Neck Cancers Program; co-director, Developmental Therapeutics Research Program; of Yale Cancer Center, discusses the promise of frontline pembrolizumab (Keytruda) in the treatment of patients with metastatic head and neck squamous cell carcinoma (HNSCC).

Although the EXTREME regimen had previously been the best treatment option available in this setting, Burtness says no one actually liked using it due to its toxicity. Patients who receive it are at risk of neutropenia or they can develop rash, and there can be days where they just simply feel ill. The regimen has a response rate of approximately 36% and a median overall survival of about 10.7 months, Burtness says, which are not data that patients are particularly encouraged by. As such, the PD-1 inhibitor can really fill an unmet need.

Moreover, the field is anticipating forthcoming studies combining PD-1 inhibition with chemoradiation in early-stage disease, with the goal of preventing patients from reaching the recurrent metastatic setting. For now, however, it is important to see single-agent pembrolizumab have improved efficacy with no additional toxicity than what is observed with EXTREME. Burtness concludes that the next steps for research will be to generate even more durable responses.