Keytruda as Perioperative Treatment for Head and Neck Cancer

Keywords

Pembrolizumab (Keytruda)
Head and neck squamous cell carcinoma (HNSCC)
Perioperative treatment
Disease recurrence reduction
Event-free survival
Practice-changing results
Immunotherapy
PD-1 inhibitor

Key Facts

Merck's cancer drug Keytruda (pembrolizumab) has shown significant promise as a perioperative treatment for head and neck cancer. Recent pivotal trial data revealed that adding Keytruda before and after surgery reduced the risk of disease recurrence or death by 27% in patients with resected, locally advanced head and neck squamous cell carcinoma1.

The KEYNOTE-689 trial represents the first positive trial in two decades for patients with this condition, with results described as "statistically significant and clinically meaningful"1. Dr. Marjorie Green from Merck Research Laboratories noted that these findings have the potential to change clinical practice for treating earlier stages of head and neck cancer1.

Keytruda works as an immune checkpoint inhibitor (ICI) that activates T cells' immune surveillance by preventing programmed cell death-1 (PD-1) from binding to its targets, enhancing the immune system's ability to detect and fight cancer cells2.

Beyond this new perioperative application, Keytruda has already established itself in the head and neck cancer treatment landscape. It's approved in 61 countries for second-line treatment of recurrent or metastatic HNSCC5. In the first-line setting for recurrent or metastatic disease, Keytruda has demonstrated superior overall survival compared to the EXTREME regimen (the previous standard of care), both as monotherapy and in combination with chemotherapy5.

The standard Keytruda dosing for HNSCC is 200 mg administered intravenously over 30 minutes every 3 weeks until disease progression3. It is also recognized as the only NCCN Category 1 preferred first-line systemic therapy option for recurrent, unresectable, or metastatic head and neck squamous cell carcinoma4.