Dr. Saba on the Investigation of Pembrolizumab Plus Cabozantinib in HNSCC

Nabil Saba, MD, FACP, professor, vice chair, Quality and Safety, Department of Hematology and Medical Oncology, adjunct professor, Department of Otolaryngology, Emory University School of Medicine, the Lynne and Howard Halpern chair, Head and Neck Cancer Research, co-director, Head and Neck Cancers, Multi-Disciplinary Program, Winship Cancer Institute, Emory University, discusses the evaluation of pembrolizumab (Keytruda) plus cabozantinib (Cabometyx) in patients with recurrent metastatic head and neck squamous cell carcinoma (HNSCC).

An open-label, single-arm phase 2 trial (NCT03468218) is investigating the combination of pembrolizumab and cabozantinib in patients with recurrent metastatic HNSCC who have not received prior treatment with an immune checkpoint inhibitor.

Historically, the overall response rate (ORR) with single-agent pembrolizumab is approximately 20% for patients with recurrent metastatic HNSCC, prompting the investigation of the combination with cabozantinib in an effort to improve response, Saba says. Data presented at the 2022 ASCO Annual Meeting showed that among 33 evaluable patients, the combination elicited an ORR of 54%, Saba explains.

The combination of pembrolizumab and another multitargeted TKI, lenvatinib (Lenvima), previously produced responses in HNSCC, Saba says, noting that the findings for pembrolizumab/cabozantinib add further credence to investigating checkpoint inhibitor and TKI combinations in HNSCC. Studies evaluating these regimens could change the standard of care for patients with HNSCC, Saba concludes.