Spotlight on Australians diagnosed with a genetically complex and sometimes difficult to treat cancer
July 27, 2022 6:00 am Australia/Sydney
Around 550 eligible Australians with head and neck squamous cell carcinoma (HNSCC) could receive funded access to immuno-oncology therapy KEYTRUDA (pembrolizumab) as a first-line treatment option.1
KEYTRUDA as a first-line treatment option for certain eligible patients with HNSCC, was recommended for listing on the Pharmaceutical Benefits Scheme (PBS) by the independent Pharmaceutical Benefits Advisory Committee (PBAC) in March this year.2 KEYTRUDA is not currently listed on the PBS for this indication.
Nadia Rosin, CEO, Head and Neck Cancer Australia says, “Many people haven’t even heard of head and neck cancer until they, or someone they love, is diagnosed. The reality of head of neck cancer in Australia is that it is a life-altering and for some a life-limiting cancer.”
Head and neck squamous cell carcinomas (HNSCCs) are an aggressive, genetically complex, and difficult to treat group of cancers – and in some cases a debilitating and symptomatic disease.3,4,5 Approximately 50% of patients relapse after treatment in the locally advanced setting, and may require further treatment.4
Patients may require intensive treatment that is often disfiguring – leaving them with poor speech articulation, difficulties in chewing and swallowing, and cosmetic disfigurement, as well as loss of taste.3 This can lead to serious psycho-social impacts including low self-esteem and a sense of isolation with patients anxious about interacting with others.6 Their caregivers can also experience high rates of psychological distress.7
Furthermore, given that HNSCC survivors can be disabled as a result of their condition and treatment and unable to return to work, the economic and societal costs associated with this type of cancer can be significant.3
Professor Michael Boyer, Chief Clinical Officer, Chris O’Brien Life House says, “Patients with advanced head and neck cancer can have a poor prognosis. An additional first-line treatment option for head and neck cancer could give oncologists an opportunity to help manage this complex and sometimes difficult to treat cancer.”
In 2021, an estimated 5,104 Australians were diagnosed with head and neck cancer and approximately 1,201 died from the disease.8 There are 18 different cancer sites categorised as head and neck cancers – including mouth, throat, voice box, nasal, and sinus cancers. It is not uncommon that a patient may have multiple cancers in different regions of the head and neck.9
TGA Indication: Squamous Cell Carcinoma of the Head and Neck (SCCHN) indication: KEYTRUDA (pembrolizumab), as monotherapy or in combination with platinum and 5-fluorouracil (5-FU) chemotherapy, is indicated for the first-line treatment of patients with metastatic or unresectable recurrent HNSCC, and whose tumours express PD-L1 [Combined Positive Score (CPS) ≥1] as determined by a validated test.
KEYTRUDA contains the active ingredient pembrolizumab.10 KEYTRUDA works by helping your immune system fight your cancer.10 Adults may get KEYTRUDA if their cancer has spread or cannot be taken out by surgery.10 Before using KEYTRUDA check with your doctor if you have a disease of your immune system like Crohn’s, ulcerative colitis, or lupus; had an organ transplant (like a kidney transplant) or a bone marrow (stem cell) transplant that used donor stem cells (allogeneic); have pneumonia or swelling of your lungs (called pneumonitis); have liver damage.10 Check with your doctor if you are pregnant or intend to become pregnant.10 You must use effective contraception while you are being treated with KEYTRUDA and for at least 4 months after the last dose of KEYTRUDA if you are a woman who could become pregnant. Talk to your doctor if you are breastfeeding or intend to breastfeed.10 Like all medicines, KEYTRUDA can cause side effects.10 Common side effects include diarrhoea, nausea, itching, rash, joint pain, back pain, feeling tired, cough, patches of skin which have lost colour, stomach pain, decreased sodium levels in the blood, fever, infections of the upper respiratory tract, a decreased number of white blood cells (which are important in fighting infection) in patients with primary mediastinal B-cell lymphoma.10
For additional information refer to the Consumer Medicine Information and/or speak to your doctor.
PBS information: KEYTRUDA for HNSCC is not listed on the Pharmaceutical Benefits Scheme.
- MSD Data on file.
- Australian Government. Department of Health. Pharmaceutical Benefits Scheme. https://www.pbs.gov.au/pbs/industry/listing/elements/pbac-meetings/pbac-outcomes/recommendations-made-by-the-pbac-march-2022 Accessed April 2022
- Jethwa AR, Khariwala SS. Tobacco-related carcinogenesis in head and neck cancer. Cancer Metastasis Rev. 2017 Sep;36(3):411-423. doi: 10.1007/s10555-017-9689-6. PMID: 28801840; PMCID: PMC5709040.
- Borel C, Jung AC, Burgy M. Immunotherapy Breakthroughs in the Treatment of Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma. Cancers (Basel). 2020;12(9):2691. Published 2020 Sep 21. doi:10.3390/cancers12092691
- Alsahafi, E., Begg, K., Amelio, I. et al. Clinical update on head and neck cancer: molecular biology and ongoing challenges. Cell Death Dis 10, 540 (2019). https://doi.org/10.1038/s41419-019-1769-9
- Lo Nigro C, Denaro N, Merlotti A, Merlano M. Head and neck cancer: improving outcomes with a multidisciplinary approach. Cancer Manag Res. 2017 Aug 18;9:363-371. doi: 10.2147/CMAR.S115761. PMID: 28860859; PMCID: PMC5571817.
- Badr H, Gupta V, Sikora A, Posner M. Psychological distress in patients and caregivers over the course of radiotherapy for head and neck cancer. Oral Oncol. 2014 Oct;50(10):1005-11. doi: 10.1016/j.oraloncology.2014.07.003. Epub 2014 Aug 3. PMID: 25091150; PMCID: PMC4165786.
- Australian Government. Cancer Australia. Head and neck cancer in Australia statistics www.canceraustralia.gov.au/cancer-types/head-and-neck-cancer/statistics Accessed June 2022
- Australian Institute of Health and Welfare. Head and neck cancers Australia. Cancer series. Number 83. www.aihw.gov.au/reports/cancer/head-neck-cancers-australia/summary Accessed June 2022
10 KEYTRUDA (pembrolizumab) Consumer Medicine Information. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2015-CMI-01640-1 Accessed June 2022