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Ferris RL, Blumenschein G Jr et al. N Engl J Med 2016; 10.1056/NEJMoa1602252

Those with platinum-refractory recurrent squamous-cell carcinoma of the head and neck (about 70% of such cancers – J Clin Oncol 2015; 33: 3305–3313) have a median survival of only 6 months. 'No therapeutic options prolong survival among these patients.' Nivolumab, a fully human monoclonal antibody, blocks signals that prevent activated T cells from attacking the cancer thereby facilitating the immune system to clear the tumour. In this randomised, open-label, phase 3 trial, nivolumab resulted in longer overall survival than treatment with standard, single-agent therapy (hazard ratio for death, 0.70). In addition, side-effects were considerably less in those patients who received nivolumab. Also, patient-reported quality-of-life measures receiving nivolumab appeared to show a marginal improvement. Those who received conventional therapy, experienced a worsening of physical and social functioning (QLQ-C30) as well as pain and sensory problems (QLQ-H&N35). In the nivolumab group there were two treatment-related deaths ascribed to pneumonitis and hypercalcemia.