KEYNOTE-412
KEYNOTE-412 tested adding pembrolizumab to standard chemoradiotherapy for locally advanced head and neck cancer; the improvement in keeping patients free of disease fell short of statistical significance, so chemoradiotherapy alone remains the standard.
Overview
KEYNOTE-412 randomised 804 patients with newly diagnosed locally advanced head and neck squamous cell carcinoma (oropharynx, larynx or hypopharynx, and oral cavity) to pembrolizumab or placebo given as a priming dose before, concurrently with and for a year after cisplatin-based chemoradiotherapy. The primary endpoint was event-free survival.
Event-free survival favoured pembrolizumab but the difference did not reach the prespecified threshold for statistical significance, with a larger effect in PD-L1-high tumours in exploratory analysis. Together with the negative JAVELIN Head and Neck 100 trial of avelumab, it showed that concurrent checkpoint blockade does not reliably add to definitive chemoradiotherapy, in contrast to the success of neoadjuvant and adjuvant pembrolizumab around surgery in KEYNOTE-689.
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