Research background
death, Pembrolizumab, tumour, head and neck squamous cell carcinomas, HNSCC
TUMOUR
Over 60% of head and neck squamous cell carcinomas (HNSCCs) were diagnosed at advanced stage, which raises therapeutic challenge and results in poor prognosis (In recent years, the value of immune checkpoint inhibitors, especially anti-programmed cell death-1 (PD-1) and anti-programmed cell death ligand-1 (PD-L1) monoclonal antibodies in the treatment of recurrent/metastatic HNSCCs has received increasing recognition among the academic community. Pembrolizumab is a PD-1 blocker that minimises the inhibitory effects of PD-1 on T cells, thereby enhancing the anti-tumour action of T cells. A phase III clinical trial (KeyNote-048 study) compared treatment with pembrolizumab, both alone and in combination with chemotherapy, versus the EXTREME regimen (combination therapy consisting of a platinum agent, 5-fluorouracil and cetuximab) for recurrent/metastatic HNSCCs. Both alone and in combination with chemotherapy, pembrolizumab was found to be significantly superior to cetuximab combined with chemotherapy and to effectively prolong overall survival (OS) (The efficacy of immune checkpoint inhibitors promises improved outcomes in the treatment of HNSCCs. The lower tumour heterogeneity, fewer drug-resistant clones and better immune status of patients before surgery makes them more responsive to neoadjuvant immunotherapy, with higher compliance than recurrent/metastatic patients (Neoadjuvant immunotherapy is known to improve the postoperative pathological response in a proportion of HNSCC patients. Our previous trial (