New treatments for head and neck cancer

Morgan Smith, PharmD, BCOP, clinical pharmacy specialist, hematology/oncology

In recent years, new treatments called immunotherapies have become widely available in the United States. Chemotherapy, a traditional type of treatment, destroys cancer cells as well as your healthy cells, while immunotherapies do not. These advanced treatments enhance your immune system to fight against your tumor without harming surrounding cells.

These new agents have been FDA-approved to treat many cancers, including melanomas, lymphomas and tumors of the kidney, lung and bladder. Recently, the two agents — nivolumab (Opdivo) and pembrolizumab (Keytruda) — are now available for use in squamous cell head and neck cancer, previously treated with ineffective cisplatin or carboplatin. It is exciting to now have safer and more effective alternatives for patients with recurrent disease!

In the past, outcomes in patients with recurrent head and neck cancer have been very poor. New studies with nivolumab and pembrolizumab for these cases have shown that 13 percent to 20 percent of patients’ tumors will shrink as a result of these immunotherapies. That compares to only about 5 percent of tumors in patients who received other standard therapies.

Additionally, responses with nivolumab and pembrolizumab were generally much more durable and long-lasting than those with chemotherapy. Furthermore, patients receiving nivolumab lived, on average, 2.4 months longer than those receiving other standard therapies.

Nivolumab and pembrolizumab are infused through your vein every two or three weeks. They are considered much easier to tolerate than chemotherapy. Plus they are much less likely to cause well-known treatment side effects such as severe nausea, hair loss, infections and drops in blood cell counts.

However, an overactive immune system can cause some uncomfortable side effects. These most often show up as diarrhea, rash, cough and trouble breathing, but in most cases, these symptoms are only mild and are easily treatable, according to the drug maker’s package inserts for nivolumab and pembrolizumab.

Our medical oncologists at Novant Health Cancer Specialists – Charlotte are excited that nivolumab and pembrolizumab have come to the market, and we look forward to offering these safe and effective options to our patients.