Keytruda (Pembrolizumab) in Perioperative Treatment of Locally Advanced Head and Neck Squamous Cell Carcinoma: A Paradigm Shift in Event-Free Survival?

Head and neck squamous cell carcinoma (HNSCC) represents a heterogeneous group of malignancies originating in the mucosal linings of the oral cavity, pharynx, and larynx. Despite advancements in multimodal treatment strategies, including surgery, radiotherapy, and chemotherapy, a significant portion of patients with locally advanced HNSCC (LA-HNSCC) experience disease recurrence, leading to poor prognosis and diminished quality of life. The persistent challenge of managing LA-HNSCC has fueled the exploration of novel therapeutic approaches, particularly the integration of immunotherapy into standard treatment regimens. Recent findings from the Phase III KEYNOTE-689 trial, evaluating the efficacy of Keytruda (pembrolizumab) as a perioperative treatment, have shown promising results, suggesting a potential shift in the management of resected LA-HNSCC. This essay will delve into the significance of the KEYNOTE-689 trial outcomes, scrutinizing the implications of pembrolizumab’s role in enhancing event-free survival (EFS) and evaluating the potential for a paradigm shift in the therapeutic landscape of LA-HNSCC.