Clinical update

New drug available for head and neck cancer patients not responding to chemotherapy

The National Institute for Health and Care Excellence recommends nivolumab is made available for head and neck cancer that has progressed following chemotherapy.


Picture: Jim Varney

Essential facts

Nivolumab is an immunotherapy drug and belongs to a group of drugs called monoclonal antibodies. It is used in the treatment of several cancers, including advanced melanoma, advanced non-small cell lung cancer and advanced renal cell carcinoma. It is also used in clinical trials for other types of cancer.

What’s new

In October, the National Institute for Health and Care Excellence (NICE) recommended nivolumab to be made available through the Cancer Drugs Fund (CDF) to treat patients with head and neck cancer who have not responded to platinum-based chemotherapy in six months, and the cancer has spread to other parts of the body.

Trials have shown that the drug significantly improves survival for this group of patients, with 22% still alive after 18 months, compared to only 8.3% of those receiving chemotherapy. Research by Harrington K et al (2017), cited by NICE, shows that nivolumab is kinder to patients than traditional chemotherapies, helping them maintain a better quality of life for longer. The drug will be available on the CDF for two years while more evidence is collected about its benefits, including identifying those patients more likely to respond positively. NICE estimates that around 900 patients will receive nivolumab during the two years.

How you can help your patient

Nurses can play a key role in helping patients understand more about the drug, who can be considered to take it, how it will be administered and the most common side effects. For the most part, these are relatively minor, but may include fatigue, diarrhoea, a skin rash, and vomiting or feeling nauseous.

Expert comment

 Sarah Orr is lead Macmillan clinical nurse specialist in head and neck cancer at University College London Hospitals NHS Foundation Trust and vice chair of the British Association of Head and Neck Oncology Nurses

‘It’s great that this is available for patients with head and neck cancer who have disease progression and are no longer responding to the usual chemotherapy.

'Essentially, it improves survival significantly for a number of months. It’s been around for a while for lung cancer patients, with head and neck cancer patients asking why can’t they have it too. Now it’s available to them and people are excited about the impact this may have. I think it will change the way we deal with palliative treatments.

‘Not every patient will respond to it, but those that do, respond well. Another key aspect is that it’s an easy drug both to administer and take. Any drug has side effects but this doesn’t have as much toxicity as others. There is a lot of discussion around prolonging life, but at what cost. With nivolumab, patients can have a good quality of life, relatively speaking, and that’s what matters.’

 

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