Pembrolizumab (Keytruda) for the treatment of advanced head and neck cancer in adults who have had previous treatment
In 2018, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into whether pembrolizumab has any advantages or disadvantages compared to individual treatment for advanced squamous cell carcinoma of the head and neck with high levels of the protein PD-L1 in people who have had treatment before.
The manufacturer gave IQWiG one study involving a small number of participants (37 people) that provided at least preliminary answers to some questions. 16 people in the study had treatment with pembrolizumab, and another 21 were given methotrexate. Despite the advanced stage of the disease, all patients involved were otherwise in good general health. This is what was found:
What are the advantages of pembrolizumab?
Life expectancy: The study suggests that pembrolizumab has an advantage here: People in the pembrolizumab group passed away within 17 months on average (median value), while those in the methotrexate group already passed away after an average of only 6 months (median value).
What are the disadvantages of pembrolizumab?
Immune-mediated side effects: Immune-mediated side effects are medical conditions in which someone’s immune system attacks their own body. The study suggests that pembrolizumab has a disadvantage here. These side effects typically occurred within about 3 years and 7 months on average (median value) in people who had treatment with pembrolizumab. They occurred later in those who received methotrexate.
No difference was found regarding a number of disease-related symptoms, including:
- Nausea and vomiting
- Shortness of breath
- Sleep problems
- Loss of appetite
- Trouble swallowing
- Abnormal sensations
- Speech problems
- Dental (tooth) problems
- Trouble opening your mouth
- Dry mouth
- Sticky saliva
- Generally feeling ill
Health-related quality of life: No difference was found between the treatments in terms of various aspects of quality of life either, such as performing daily tasks or problems socializing.
Severe side effects and stopping treatment due to side effects: There was no difference here either.
Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Pembrolizumab (head and neck squamous cell carcinoma) – Benefit assessment according to §35a Social Code Book V. Dossier assessment; Commission A18-67. January 11, 2019. (IQWiG reports; Volume 711).
IQWiG health information is written with the aim of helping
people understand the advantages and disadvantages of the main treatment options and health
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.
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