CHICAGO — What if the trick to getting cancer immunotherapy to parts of the world that can’t access it is simply lowering the dose?
A lower-cost immunotherapy approach could extend survival for patients with advanced head and neck squamous cell carcinoma in resource-limited countries, according to results presented Sunday at the annual meeting of the American Society of Clinical Oncology.
Immune checkpoint inhibitors have transformed cancer treatment in wealthier countries, but in many parts of the world, their cost — potentially tens of thousands of dollars a year in India — keeps them out of reach.
In India, where the phase 3 trial took place, head and neck squamous cell carcinoma is the second most commonly diagnosed cancer. Despite its prevalence, less than 3% of eligible patients receive a checkpoint inhibitor. Researchers led by Minit Jalan Shah of Tata Memorial Centre in Mumbai tested whether an ultra-low dose of the PD1 inhibitor nivolumab in combination with chemotherapy could offer a more affordable alternative.
The study enrolled 422 adults with advanced platinum-sensitive disease. Participants were randomly assigned to receive either paclitaxel-carboplatin, a standard platinum-based chemotherapy, or triple-oral metronomic chemotherapy combined with ultra-low-dose nivolumab, known as TMC-I, which costs about $230 a month.
