Combination Immunotherapy in Head and Neck Cancer—Checkmate or a Draw?

Mené dans 21 pays sur 425 patients atteints d'un carcinome épidermoïde de la tête et du cou de stade métastatique ou récidivant, cet essai de phase II évalue l'efficacité, du point de vue du taux de réponse objective, et la toxicité de l'ajout d'ipilimumab au nivolumab, selon que la maladie est réfractaire ou sensible aux sels de platine (241 cas de cancer réfractaire aux sels de platine, 184 cas de cancer sensible aux sels de platine)

Résumé en anglais

In this issue of JAMA Oncology, Harrington and colleagues report on the results of CheckMate 714, a double-blind, phase 2 randomized clinical trial comparing immunotherapy with nivolumab and ipilimumab vs nivolumab alone as first-line therapy for patients with recurrent or metastatic squamous cell carcinoma of the head and neck. Combination immunotherapy targeting cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed death 1 (PD-1) has shown success in improving survival in other tumor types, especially melanoma, and represents an exciting and important goal in head and neck cancer. In addition to this trial, and of great importance, is the previously reported CheckMate 651 study, which compared this combination to the EXTREME regimen (cetuximab plus cisplatin/carboplatin plus fluorouracil for ≤6 cycles, then cetuximab maintenance), the standard of care for initial treatment of recurrent or metastatic head and neck cancer. These 2 studies, together, explored the efficacy of monotherapy and combination immunotherapy with PD-1 inhibitors alone and with CTLA-4 targeting in recurrent and metastatic head and neck cancer.