QoL Improved for Patients With Head and Neck Cancer After Immunotherapy

An immunotherapy agent drastically improved patient-reported quality of life (QoL) in short and long-term analyses compared with conventional chemotherapy for patients with head and neck cancer, according to research published in The Lancet Oncology (published online June 23, 2017; doi:10.1016/S1470-2045(17)30421-7).


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Patients with platinum-refractory recurrent or metastatic squamous cell carcinoma of the head and neck have limited treatment options and a poor prognosis. The immunotherapy drug nivolumab has shown in a previous trial to significantly improve survival for patients with such disease when compared with standard single-agent chemotherapy (methotrexate, docetaxel, or cetuximab).

Kevin J Harrington, PhD, professor of biological cancer therapies, Institute of Cancer Research (London, England), and colleagues conducted a follow-up study to this previous trial that surveyed patient-reported outcomes of nivolumab versus chemotherapy for comparisons of QoL at baseline, nine weeks, and every six weeks thereafter. Researchers used the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30, the EORTC head and neck cancer-specific module, and the three-level European Quality of life-5 Dimensions questionnaire.

Among the 361 patients from the original trial, 129 patients (93 in the nivolumab group, 36 in the chemotherapy group) completed any of the patient-reported outcomes questionnaires at baseline and at least one other assessment.

Survey results showed that while patients in the chemotherapy group reported their QoL to be lower at nine and 15 weeks into the trial, patients in the nivolumab group reported consistently better ratings. After nine weeks, patients in the nivolumab group reported higher ratings for a range of symptoms, including pain, sensory problems, appetite loss, tiredness, and breathing problems. After 15 weeks, the list of beneficial effects grew to include better ratings for nausea, insomnia, and weight loss.

“In view of the major unmet need in this population and the importance of maintaining or improving quality of life for patients with recurrent or metastatic squamous cell carcinoma of the head and neck, these data support nivolumab as a new standard-of-care option in this setting,” authors of the study concluded.

"Using the body's own immune system to attack cancer continues to find wider application across the spectrum of cancers we have to treat in the clinic,” said David Cunningham, MD, FRCP, Institute of Cancer Research (June 23, 2017). “Head and neck cancer is a particularly challenging disease and these results are an important step in improving outcomes for our patients.”—Zachary Bessette