QS-immunotherapy trial
pembrolizumab
In this single-center study, 15 patients will be treated with pembrolizumab at a dose of 200 mg every 3 weeks.QS RT (14.8 Gy in four twice-daily fractions) will be delivered at least once prior to cycle four of pembrolizumab and up to three times (before cycles eight and 13).Overall response, target and nontarget lesion response, durability of response, progression-free survival, overall survival and tolerability will be measured.Integrative multiomics, including proteomics, metabolomics, immunoregulatory miRNA expression, oral microbiome analysis and single-cell RNA sequencing, will be performed on blood and saliva samples collected before and during treatment to evaluate the effect of QS RT on the immune response to pembrolizumab.