Low-dose cancer immunotherapy could open access for patients in poorer countries
A phase 3 trial conducted in India and presented at the ASCO 2026 meeting showed that using nivolumab at a low dose in patients with head and neck squamous cell carcinoma can extend survival. According to STAT News, the study is being viewed as a model that could be applied in countries without access to high-cost immunotherapies.
The trial was coordinated by Tata Memorial Centre in Mumbai and enrolled 151 patients. One group received standard chemotherapy, while another group received standard chemotherapy with low-dose nivolumab added at 40 milligrams a month. That dose is roughly 6 per cent of the typical retail price of the active product.
At two years of follow-up, overall survival in the low-dose nivolumab arm was reported at 43 per cent, while in the standard-care arm the rate stood at 32 per cent. STAT News reports that the result was found to be statistically significant and offers a replicable model for lower-income countries.
Lead investigator Dr Kumar Prabhash of the Tata Memorial Centre emphasised that the aim of the study was to adapt costly therapies that face access problems to health systems under permanent budget pressure. STAT News notes that the results were greeted with 'a genuine ovation' at the ASCO session.
The findings differ from the typical dosing recommendation of Bristol Myers Squibb, which markets the active product. The company has not commented on the methodology or results of the trial and has not changed its standard dosing guidance. STAT News notes that the sector's stance on low-dose protocols will require a wider discussion.
World Health Organization representatives said the study could be an important reference point for a 'minimum effective dose' approach, but would need to be tested again in different cancer types. Dr Madhuri Aggarwal, in commentary set to appear in Lancet Cancer Discovery, suggests this could be a 'value-based access' model.
According to IQVIA and Boston Consulting Group data, immunotherapy access rates remain below 10 per cent in low- and middle-income countries. STAT News reports that low-dose approaches are starting to be applied in India's public hospitals and could particularly widen treatment options in cities outside the capital.
Comments on primary patient-level data also draw a positive picture in terms of quality of life. Patients said that side-effect frequency in the low-dose arm remained similar to the standard arm. The rate of immune-related side effects was observed at lower levels.
Dr Prabhash said the results may open new horizons not only for head and neck cancer but also for lung and gastric cancers. According to STAT News, follow-up studies are already being registered for trials covering different cancer types.
Experts emphasise that this article should not be read as medical advice, and that cancer treatment decisions should always be planned with specialist oncologist input on a patient-by-patient basis. This piece is limited to summarising scientific findings and views reported by STAT News; health decisions for patients and families should be discussed with a qualified clinician.