Head and Neck Cancer Randomized Phase II Study of Concurrent Versus Sequential Pembrolizumab in Combination With Chemoradiation in Locally Advanced Head and Neck Cancer
Sequential pembrolizumab administered after chemoradiation provides better long‑term disease control than concurrent administration in locally advanced head and neck squamous cell carcinoma.
This randomized phase‑II trial evaluated concurrent versus sequential administration of pembrolizumab with concurrent chemoradiation (CRT) for locally advanced head and neck squamous cell carcinoma (HNSCC). Both arms met the primary trivariate endpoints, but the sequential arm demonstrated superior 1‑year progression‑free survival (84% vs 71%) and a markedly higher 4‑year locoregional control (96% vs 64%). The study selected the sequential schedule for further testing, suggesting that delayed pembrolizumab following CRT may enhance long‑term outcomes.
Optimizing the timing of immune checkpoint blockade with definitive radiation–chemotherapy could improve survival in high‑risk HNSCC. These findings support administering pembrolizumab after completion of chemoradiation to achieve better disease control, informing future trial design and clinical practice.
Evidence level: Sejtvonalas. Laboratóriumi sejtekben vizsgálták.
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