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Giving pembrolizumab before surgery and continuing it afterwards alongside radiotherapy reduced recurrences in resectable locally advanced head and neck cancer, the first improvement in surgical treatment of the disease in two decades.
Phase 3 trial of 714 patients with resectable stage III to IVA head and neck squamous cell carcinoma (excluding HPV-positive oropharynx in most analyses) randomised to two cycles of neoadjuvant pembrolizumab followed by surgery and adjuvant pembrolizumab with radiotherapy or chemoradiotherapy, or surgery and adjuvant radiotherapy or chemoradiotherapy alone.
Event-free survival was improved in patients with a PD-L1 combined positive score of 10 or more (median 59.7 versus 26.9 months; hazard ratio 0.66) and of 1 or more (hazard ratio 0.70), and major pathological responses occurred in 9.3 percent after neoadjuvant treatment.
Perioperative pembrolizumab is a new standard for resectable head and neck cancer with PD-L1 expression, adding immunotherapy to a treatment pathway that had not changed since postoperative chemoradiation was defined.
Shares KEYNOTE-689, Pembrolizumab.
Shares HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares KEYNOTE-689, Pembrolizumab.
Shares HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), New England Journal of Medicine.
Shares HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), Pembrolizumab.
Shares HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer), Pembrolizumab.