Clinical trial: Monoclonal antibody may be an effective alternative to cisplatin in treatment of head and neck cancers (Cetuximab)

Medical Xpress / University of California - San Diego / The Lancet Oncology ^ | Nov. 22, 2024 | Susanne Clara Bard / Loren K Mell et al

[ConservativeMind]

Head and neck cancers are the seventh most common type of cancer worldwide.

The chemotherapy drug cisplatin is the gold standard for treating these malignancies. However, more than 30% of patients, including some older adults and those with pre-existing kidney disease or hearing loss, cannot take cisplatin due to severe side effects.

The monoclonal antibody cetuximab, while not as effective as cisplatin, is often used as an alternative in these patients.

Durvalumab, an immune checkpoint inhibitor, has shown promise for treating a wide range of cancers, and has been proposed as a potentially safer and more effective option than cetuximab, according to Loren Mell, MD.

In a clinical trial, Mell compared the effectiveness of durvalumab and cetuximab—in combination with radiation therapy—in 186 patients with advanced squamous cell carcinoma of the head or neck who were ineligible for cisplatin.

They report that contrary to expectations, cetuximab performed better than durvalumab, with a similar rate of adverse events. As a result, the researchers discontinued the study early.

"We found that the probability of being alive and free of disease at two years was approximately 64% for cetuximab versus 51% for durvalumab, indicating no evidence of a benefit of durvalumab over cetuximab," said Mell.

Monoclonal antibodies like cetuximab bind to proteins on the surface of cancer cells, halting their growth and proliferation. In contrast, durvalumab, an immune checkpoint inhibitor, blocks a protein on cancer cells called PDL1, which allows tumors to thrive, allowing the immune system's T cells to attack cancer cells directly.

The results have significant implications for the treatment of head and neck cancers.

Mell said the drug is likely to become the new standard of care for these patients. The study also revealed that cetuximab showed similar efficacy whether or not a patient's cancer was associated with HPV.

[ConservativeMind]

“We found that the probability of being alive and free of disease at two years was approximately 64% for cetuximab versus 51% for durvalumab.”

Cetuximab is currently available, but was not known to be as good a choice as durvalumab.

[ConservativeMind]

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