Journal Article

First-line pembrolizumab with or without chemotherapy for recurrent or metastatic head and neck squamous cell carcinoma: 5-year follow-up of the Japanese population of KEYNOTE‑048

Nakayama, Masahiro, Ueda, Tsutomu, Hanai, Nobuhiro, Yasumatsu, Ryuji, Takahashi, Masanobu, Mitsugi, Kenji, Takahashi, Shunji, Yoshizaki, Tomokazu, Yamaguchi, Hironori, Nohata, Nijiro, Yokota, Tomoya, Fujii, Takashi, Hara, Hiroki, Shimizu, Yasushi, Shiga, Kiyoto, Gumuscu, Burak, Matsumoto, Koji, Yamazaki, Tomoko, Fujimoto, Yasushi, Lerman, Nati, Tahara, Makoto, Oridate, Nobuhiko, Tanaka, Kaoru, Takahashi, Kenichi

2024

Overview

BackgroundPreviously reported results from phase III KEYNOTE-048 demonstrated similar or improved overall survival (OS) with pembrolizumab or pembrolizumab-chemotherapy versus cetuximab-chemotherapy (EXTREME) in Japanese patients with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). We report results in Japanese patients from KEYNOTE-048 after 5 years of follow-up.MethodsPatients with R/M HNSCC of the oropharynx, oral cavity, hypopharynx, or larynx were randomly assigned 1:1:1 to pembrolizumab, pembrolizumab-chemotherapy, or EXTREME. Primary endpoints were OS and progression-free survival. Efficacy was evaluated in the programmed cell death ligand 1 (PD-L1) combined positive score (CPS) ≥ 20, PD-L1 CPS ≥ 1, and total Japanese populations.ResultsIn Japan, 67 patients were enrolled (pembrolizumab, n = 23; pembrolizumab-chemotherapy, n = 25; EXTREME, n = 19). Median follow-up was 71.0 months (range, 61.2–81.5); data cutoff, February 21, 2022. 5-year OS rates with pembrolizumab versus EXTREME were 35.7% versus 12.5% (hazard ratio [HR] 0.38; 95% CI 0.13–1.05), 23.8% versus 12.5% (HR 0.70; 95% CI 0.34–1.45), and 30.4% versus 10.5% (HR 0.54; 95% CI 0.27–1.07) in the PD-L1 CPS ≥ 20, CPS ≥ 1, and total Japanese populations, respectively. 5-year OS rates with pembrolizumab-chemotherapy versus EXTREME were 20.0% versus 14.3% (HR 0.79; 95% CI 0.27–2.33), 10.5% versus 14.3% (HR 1.18; 95% CI 0.56–2.48), and 8.0% versus 12.5% (HR 1.11; 95% CI 0.57–2.16) in the PD-L1 CPS ≥ 20, CPS ≥ 1, and total Japanese populations, respectively.ConclusionAfter 5 years of follow-up, pembrolizumab and pembrolizumab-chemotherapy showed long-term clinical benefits; results further support these treatments as first-line options for Japanese patients with R/M HNSCC.Clinical trial registrationNCT02358031.

• Publisher: Springer Nature B.V
• Subject: Apoptosis / Cell death / Cell survival / Chemotherapy / Head & neck cancer / Head and neck carcinoma / Hypopharynx / Immunotherapy / Larynx / Metastases / Metastasis / Monoclonal antibodies / Oral cavity / Oropharynx / PD-L1 protein / Pembrolizumab / Squamous cell carcinoma / Targeted cancer therapy