Head and neck tumors, with the addition of immunotherapy the risk of recurrence and death decreases

In patients with head and neck cancer, pembrolizumab immunotherapy before and after surgery in addition to standard of care reduces the risk of recurrence or death by 27% compared to standard of care of radiation therapy alone (with or without chemotherapy) following surgery, according to results from the Phase 3 Keynote-689 study, which evaluated pembrolizumab as a perioperative treatment regimen for patients with locally advanced, resected stage III or IVA squamous cell carcinoma of the head and neck. The data were presented during the Plenary Session of the American Association for Cancer Research (AACR) 2025 Annual Meeting.

"In 2024, in Italy, approximately 6,000 new cases of head and neck cancer were estimated - explains Lisa Licitra, Head of Medical Oncology 3 Head and Neck Cancer at the Fondazione IRCCS Istituto Nazionale dei Tumori in Milan -. They can affect different sites, including the oral cavity, pharynx, larynx. The main risk factors are smoking, alcohol and papilloma virus infection. Immunotherapy is already the standard of care in metastatic disease. In light of the data from the Keynote-689 study, immunotherapy can change clinical practice even in earlier stages eligible for surgery. It is in fact the first positive study in over twenty years in patients with locally advanced squamous cell carcinoma of the head and neck. These results are significant and represent a turning point for these patients and for clinicians. We are faced with a new therapeutic regimen capable of offering the possibility of reducing the risk of recurrence and progression of the disease".

"The addition of immunotherapy with pembrolizumab to standard-of-care surgery and adjuvant radio(chemo)therapy has led to a significant reduction in the risk of events compared to standard-of-care - continues Licitra -. In addition, thanks to the effect of preoperative therapy with pembolizumab, a reduction in the number of cases destined to receive postoperative treatment based on chemoradiotherapy has been observed. This effect of de-escalation of postoperative treatment is important because we know it has an impact on toxicities and, therefore, a favorable impact on the quality of life of patients".