Optimal treatment for head and neck tumours
Does a combination of radiotherapy and immunotherapy improve chances of recovery?
A nationwide patient study led by the Department of Radiation Oncology at Universitätsklinikum Erlangen is investigating how effective radioimmunotherapy is as the primary method for treating locally advanced head and neck tumours. Patients are selected for the innovative treatment on the basis of the immunological status of their tumour. When deciding who is suitable, the Institute of Pathology and the Department of Otorhinolaryngology – Head and Neck Surgery at Universitätsklinikum Erlangen work in close collaboration with the Deutsches Zentrum Immuntherapie (DZI – German Centre for Immune Therapy), also based in Erlangen.
The multicentre CheckRad-CD8 study is the first of its kind to investigate how effective radiotherapy can be when used in combination with two antibodies capable of reversing the inhibiting effects the tumour has on the patient’s immune system. The immunologists James P. Allison and Tasuku Honjo won the Nobel prize for physiology or medicine for this type of immune therapy in 2018.
The first step towards identifying patients suited for the innovative radiotherapy is to give all patients induction chemoimmunotherapy. Thereafter, a further sample of tumour tissue is taken and analysed by pathologists. If the number of cytotoxic t-cells in the tumour has increased, the patients are given radioimmunotherapy. If the number of immune cells capable of eradicating the tumour does not increase, patients are offered standard treatment. In addition, detailed immune screening is carried out by the radioimmunology working group under the leadership of Prof. Dr. Udo Gaipl and PD Dr Benjamin Frey at the Department of Radiation Oncology. In future, this will make it even easier to identify patients who are particularly likely to benefit from radioimmunology. The CheckRad-CD 8 study is receiving funding from the company AstraZeneca.
Radiotherapy is a conventional method of treating tumours used in over 60 percent of all cancer patients, aimed in particular at controlling the tumour locally and killing cancer cells. As we are learning more and more about the immunological effects of radiation, and new options for combining radiotherapy with immune therapy are being discovered, the scope of radiotherapy is currently expanding rapidly.
Six other radiation oncology centres in Germany are involved alongside Universitätsklinikum Erlangen in the CheckRad-CD8 study. One essential difference between this study and other studies investigating immunotherapy is that the aim is not only to increase the life expectancy of the patients, but to heal them entirely of the tumour. Patients are currently still being accepted for the study if they meet the criteria. CheckRad-CD8 is coordinated by the secretary’s office responsible for studies at the Department of Radiation Oncology at Universitätsklinikum Erlangen, which coordinates several nationwide studies. Previous studies from Erlangen (e.g. CAO/ARO/AIO-94) have already led to considerable improvements in concepts for treating cancer.
PD Dr. Benjamin Frey
Phone: +49 9131 8544258