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Peer-reviewedCC BY-NC-ND 4.0In Vivo

Salvage Chemotherapy After Pembrolizumab for Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

  • CHIHIRO FUSHIMI1,2
  • ISAKU OKAMOTO3
  • TAKASHI MATSUKI4,5
  • TAKURO OKADA3
  • YURI UEDA3
  • HIDEAKI TAKAHASHI2,6
  • HIROKI SATO3
  • TAKAHITO KONDO3
  • KUNIHIKO TOKASHIKI3
  • KENJI HANYU3
  • TATSUYA ITO3
  • YUKIOMI KUSHIHASHI7
6 more authors
  • TATSUO MASUBUCHI7
  • YUICHIRO TADA1,8
  • GO OMURA2
  • TAKU YAMASHITA4
  • NOBUHIKO ORIDATE6
  • KIYOAKI TSUKAHARA3
8 affiliations
  1. 1Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
  2. 2Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
  3. 3Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
  4. 4Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan
  5. 5Department of Head and Neck Surgery, Kanagawa Cancer Center, Kanagawa, Japan
  6. 6Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University, Kanagawa, Japan
  7. 7Department of Head and Neck Surgery, Chibanishi General Hospital, Chiba, Japan
  8. 8Department of Otorhinolaryngology-Head and Neck Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
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Abstract

Background/Aim: Pembrolizumab-based therapy is widely used for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, clinical outcomes after subsequent salvage chemotherapy (SCT) remain insufficiently defined. This study evaluated the efficacy of SCT after pembrolizumab in patients with R/M HNSCC.

Patients and Methods: This multicenter retrospective study included 36 evaluable patients with R/M HNSCC who received SCT after pembrolizumab between December 2019 and February 2022. The primary endpoint was the objective response rate. Secondary endpoints included the disease control rate, progression-free survival, overall survival, and exploratory clinical factors associated with treatment outcomes.

Results: The best overall response to SCT was a complete response in 2 patients, partial response in 8, stable disease in 12, and progressive disease in 14. The overall response rate was 27.8%, and the disease control rate was 61.1%. Median progression-free and overall survival were 4.6 months and 11.5 months, respectively. The overall response rate was significantly higher (>4-fold) in patients with prior surgery and in platinum-naive patients. A combined positive score of 20 or higher for tumor programmed cell death-ligand 1, initial M1 status, and prior surgery were associated with longer progression-free survival in exploratory analyses.

Conclusion: SCT after pembrolizumab showed clinically meaningful activity in selected patients with R/M HNSCC. These findings support SCT as a reasonable post-pembrolizumab option, although prospective validation is warranted.

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Cite

BibTeXRIS
BibTeX
@article{fushimi2026salvage,
  title = {{Salvage Chemotherapy After Pembrolizumab for Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma}},
  author = {CHIHIRO FUSHIMI and ISAKU OKAMOTO and TAKASHI MATSUKI and TAKURO OKADA and YURI UEDA and HIDEAKI TAKAHASHI and HIROKI SATO and TAKAHITO KONDO and KUNIHIKO TOKASHIKI and KENJI HANYU and TATSUYA ITO and YUKIOMI KUSHIHASHI and TATSUO MASUBUCHI and YUICHIRO TADA and GO OMURA and TAKU YAMASHITA and NOBUHIKO ORIDATE and KIYOAKI TSUKAHARA},
  journal = {In Vivo},
  year = {2026},
  month = oct,
  doi = {10.21873/invivo.14503},
  url = {https://doi.org/10.21873/invivo.14503},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Salvage Chemotherapy After Pembrolizumab for Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma
AU  - CHIHIRO FUSHIMI
AU  - ISAKU OKAMOTO
AU  - TAKASHI MATSUKI
AU  - TAKURO OKADA
AU  - YURI UEDA
AU  - HIDEAKI TAKAHASHI
AU  - HIROKI SATO
AU  - TAKAHITO KONDO
AU  - KUNIHIKO TOKASHIKI
AU  - KENJI HANYU
AU  - TATSUYA ITO
AU  - YUKIOMI KUSHIHASHI
AU  - TATSUO MASUBUCHI
AU  - YUICHIRO TADA
AU  - GO OMURA
AU  - TAKU YAMASHITA
AU  - NOBUHIKO ORIDATE
AU  - KIYOAKI TSUKAHARA
PY  - 2026
DA  - 2026/10/29
JO  - In Vivo
DO  - 10.21873/invivo.14503
UR  - https://doi.org/10.21873/invivo.14503
AB  - Background/Aim: Pembrolizumab-based therapy is widely used for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, clinical outcomes after subsequent salvage chemotherapy (SCT) remain insufficiently defined. This study evaluated the efficacy of SCT after pembrolizumab in patients with R/M HNSCC.  Patients and Methods: This multicenter retrospective study included 36 evaluable patients with R/M HNSCC who received SCT after pembrolizumab between December 2019 and February 2022. The primary endpoint was the objective response rate. Secondary endpoints included the disease control rate, progression-free survival, overall survival, and exploratory clinical factors associated with treatment outcomes.  Results: The best overall response to SCT was a complete response in 2 patients, partial response in 8, stable disease in 12, and progressive disease in 14. The overall response rate was 27.8%, and the disease control rate was 61.1%. Median progression-free and overall survival were 4.6 months and 11.5 months, respectively. The overall response rate was significantly higher (>4-fold) in patients with prior surgery and in platinum-naive patients. A combined positive score of 20 or higher for tumor programmed cell death-ligand 1, initial M1 status, and prior surgery were associated with longer progression-free survival in exploratory analyses.  Conclusion: SCT after pembrolizumab showed clinically meaningful activity in selected patients with R/M HNSCC. These findings support SCT as a reasonable post-pembrolizumab option, although prospective validation is warranted.
SN  - 0258-851X
SN  - 1791-7549
ER  -