Cancers & treatments·Regimen libraryFirst line

Pembrolizumab + platinum + fluorouracil

Checked 2026-09-09

Recurrent or metastatic head and neck squamous cell carcinoma, first line

One cycle

every 21 days

21-day cycle, chemotherapy 6; pembrolizumab up to 35Intravenous Continuous infusion

Components

Drug	Dose	Route	Days	Note
Pembrolizumab Monoclonal antibody (anti-PD-1)	200 mg	IV	D1	or 400 mg every 6 weeks
Cisplatin 100 mg/m² or carboplatin AUC 5 Cytotoxic chemotherapy (platinum)	day 1	IV	D1
Fluorouracil infusion Fluoropyrimidine antimetabolite	1,000 mg/m² per day	IV	D1-4 (96 h infusion)

Cycles

chemotherapy 6; pembrolizumab up to 35

21-day cycle

Emetogenicity

High (>90%)

G-CSF

Not routine

Notes

Pembrolizumab alone for CPS 1 or above (or 20 or above) when a chemotherapy-free start is preferred. EXTREME (cetuximab + platinum + 5-FU) is the older standard.

Used in

Head and neck squamous cell carcinoma

Trials

KEYNOTE-048 EXTREME

Products

PembrolizumabCisplatinFluorouracil (5-FU)

Source

KEYNOTE-048, Lancet 2019

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.

Other regimens for these cancers

Weekly cisplatin chemoradiation (with pembrolizumab for high-risk disease)

Locally advanced cervical cancer (FIGO IB2-IVA); pembrolizumab for FIGO 2014 III-IVA or node-positive

weekly × 5-6

Pembrolizumab monotherapy

Adjuvant melanoma stage IIB-IV (1 year); PD-L1 TPS 50% or above NSCLC; MSI-high tumours; recurrent head and neck (CPS 1 or above)

every 21 days

High-dose cisplatin chemoradiation

Locally advanced head and neck squamous cell carcinoma, definitive or postoperative (positive margins or extranodal extension)

every 21 days × 3

TPF induction

Locally advanced head and neck cancer where induction is chosen (larynx preservation, bulky nodes)

every 21 days × 3-4

All regimens Gemcitabine + cisplatin (nasopharyngeal) →