{"id":657455,"date":"2026-10-26T10:12:09","date_gmt":"2026-10-26T10:12:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/657455\/"},"modified":"2026-10-26T10:12:09","modified_gmt":"2026-10-26T10:12:09","slug":"smart-key-at-esmo-2026-pembrolizumab-based-strategy-achieves-65-1-laryngectomy-free-survival-in-advanced-laryngeal-cancer","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/657455\/","title":{"rendered":"SMART-KEY at ESMO 2026: Pembrolizumab-Based Strategy Achieves 65.1% Laryngectomy-Free Survival in Advanced Laryngeal Cancer"},"content":{"rendered":"<p>At the ESMO Congress 2026, Thiago B. Oliveira (S\u00e3o Paulo, Brazil) presented results from the phase II SMART-KEY (LACOG 0720) trial (NCT04943445), evaluating a pembrolizumab-based, cisplatin-free organ preservation strategy in patients with locally advanced laryngeal squamous cell carcinoma.<\/p>\n<p>The investigational regimen achieved a 2-year laryngectomy-free survival (LFS) rate of 65.1%, with an 86% larynx preservation rate and 74.4% overall survival at two years. These outcomes were numerically comparable to historical results from established cisplatin-based organ preservation strategies.<\/p>\n<p>Methods<\/p>\n<p>SMART-KEY was a multicenter, single-arm phase II study evaluating whether <a href=\"https:\/\/oncodaily.com\/oncolibrary\/immune-oncology\/head-and-neck-io\" rel=\"nofollow noopener\" target=\"_blank\">pembrolizumab<\/a> could support <a href=\"https:\/\/oncodailyjournal.com\/head-and-neck-cancer\/\" target=\"_blank\" rel=\"noopener nofollow\">laryngeal<\/a> preservation without concurrent cisplatin-based chemoradiotherapy.<\/p>\n<p>The trial enrolled patients with newly diagnosed stage III\u2013IVB glottic or supraglottic squamous cell carcinoma.<\/p>\n<p>A total of 43 patients from nine centers received a three-phase treatment strategy:<\/p>\n<p>Induction therapy: Carboplatin (AUC 6), paclitaxel (175 mg\/m\u00b2), and pembrolizumab (200 mg) for three 21-day cycles.<br \/>\nConcurrent treatment: Intensity-modulated radiation therapy (IMRT) with pembrolizumab, without concurrent chemotherapy.<br \/>\nConsolidation therapy: Fourteen additional 21-day cycles of pembrolizumab.<\/p>\n<p>The primary endpoint was 2-year laryngectomy-free survival. Secondary outcomes included larynx preservation, laryngeal dysfunction-free survival, overall survival, recurrence, and treatment-related toxicity.<\/p>\n<p><a href=\"http:\/https:\/\/oncodaily.com\/oncolibrary\/immune-oncology\/head-and-neck-io\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-518338 size-full\" src=\"https:\/\/www.newsbeep.com\/il\/wp-content\/uploads\/2026\/10\/IMAGE-2026-06-10-164533.webp\" alt=\"Immunotherapy in head and neck cancer\" width=\"1242\" height=\"828\" title=\"SMART-KEY at ESMO 2026: Pembrolizumab-Based Strategy Achieves 65.1% Laryngectomy-Free Survival in Advanced Laryngeal Cancer 2\"  \/><\/a><\/p>\n<p>Key Takeaways<\/p>\n<p>Between February 2022 and August 2023, 43 patients were enrolled. The median age was 61.1 years, 86% were male, and 83.7% were former or current smokers.<\/p>\n<p>Laryngectomy-free survival: The 2-year LFS rate was 65.1% (80% CI, 54.9\u201373.5%), compared with 64.9% reported in the historical RTOG 9111 trial.<br \/>\nLarynx preservation: The 2-year larynx preservation rate was 86%, compared with 88% in RTOG 9111 and 75.8% in GORTEC 2000-01.<br \/>\nLaryngeal dysfunction-free survival: The 2-year rate was 83.7%, compared with 70.3% in GORTEC 2000-01.<br \/>\nOverall survival: The 2-year OS rate was 74.4%, compared with 74% in RTOG 9111 and 73% in GORTEC 2000-01.<br \/>\nLocoregional recurrence: The 2-year cumulative incidence was 18.8%.<br \/>\nDistant recurrence: The 2-year cumulative incidence was 7.4%.<br \/>\nTreatment-related toxicity: Grade \u22653 treatment-related adverse events occurred in 41.9% of patients, including one grade 5 event.<br \/>\nImmune-related toxicity: Grade \u22653 immune-mediated treatment-related adverse events occurred in 16.3% of patients.<\/p>\n<p>At two years, 65.1% of patients were alive with their larynx preserved, while 9.3% were alive following laryngectomy.<\/p>\n<p>Conclusion<\/p>\n<p>The phase II SMART-KEY trial demonstrated that a pembrolizumab-based, cisplatin-free strategy achieved encouraging oncologic and functional outcomes in patients with locally advanced laryngeal cancer.<\/p>\n<p>The 65.1% 2-year laryngectomy-free survival rate, together with an 86% larynx preservation rate, was numerically comparable to outcomes reported in historical cisplatin-based trials. The regimen also demonstrated a relatively low incidence of distant recurrence.<\/p>\n<p>However, the single-arm design and small sample size prevent definitive conclusions about comparative efficacy or safety. Cross-trial comparisons should be interpreted cautiously, and the occurrence of severe treatment-related adverse events, including one treatment-related death, remains clinically important.<\/p>\n<p>Further follow-up is needed to determine whether this cisplatin-free approach can reduce the long-term morbidity and mortality associated with conventional chemoradiotherapy while maintaining effective disease control.<\/p>\n<p>Source: <a href=\"https:\/\/cslide.ctimeetingtech.com\/esmo2026\/attendee\/confcal\/show\/session\/278\" target=\"_blank\" rel=\"noopener nofollow\">ESMO Congress 2026, Abstract 1537RO; SMART-KEY\/LACOG 0720 (NCT04943445)<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"At the ESMO Congress 2026, Thiago B. Oliveira (S\u00e3o Paulo, Brazil) presented results from the phase II SMART-KEY&hellip;\n","protected":false},"author":2,"featured_media":657456,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[163,85,46],"class_list":["post-657455","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-health","tag-il","tag-israel"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/657455","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=657455"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/657455\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/657456"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=657455"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=657455"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=657455"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}