ASCO 2026 | Cytokine dynamics and metronomic chemo-immunotherapy in R/M HNSCC
Marcelo Bonomi, MD, The Ohio State University, Columbus, OH, examines a Phase II trial (NCT04862650) evaluating metronomic carboplatin and paclitaxel combined with cemiplimab in recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). The regimen demonstrated clinically meaningful antitumor activity. Cytokine profiling revealed that specific immune markers at baseline and early on-treatment timepoints were associated with therapeutic response and overall survival, supporting the hypothesis that immune-mediated mechanisms play a role in treatment outcomes. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
This is a phase two study that we were looking at the immune effects of adding metronomic chemotherapy, which is basically using very low dose chemotherapy once a week for six months in combination with cemiplimab, which is a checkpoint inhibitor. The idea was to see if we can potentiate the anticancer effects of cemiplimab by using this approach without the toxicity of the high-dose chemotherapy...
This is a phase two study that we were looking at the immune effects of adding metronomic chemotherapy, which is basically using very low dose chemotherapy once a week for six months in combination with cemiplimab, which is a checkpoint inhibitor. The idea was to see if we can potentiate the anticancer effects of cemiplimab by using this approach without the toxicity of the high-dose chemotherapy. In this study, we showed that this is an active regimen. You know, the overall response rate was 43%, and the median survival, in this difficult-to-treat population, was 16 months. What is interesting from the correlative analysis of the cytokine dynamics, we saw that patients who respond to these therapies, usually you see that many of these immunosuppressive cytokines drop within the first six weeks of treatment in those who are going to respond. And also there is a reduction in patients who are going to live longer. So this is hypothesis generating because clearly we identify a subset of patients that probably will need some extra treatments. You know, we’re looking into newer combinations like inflammasome inhibitors adding to this backbone of checkpoint inhibitors with low-dose chemotherapy.
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