Association of low and intermediate combined positive score with outcomes of pembrolizumab for R/M HNSCC

The multinational phase 3 KEYNOTE-048 trial randomized patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) stratified by PD-L1 combined positive score (CPS) 1:1:1 to pembrolizumab monotherapy (pembro-mono), pembrolizumab plus chemotherapy (pembro-chemo), or cetuximab plus chemotherapy (cetux-chemo). A secondary analysis of the trial has now been published, evaluating outcomes in patients with intermediate CPS (1-19) and low CPS (<1). Among patients with intermediate CPS, pembro-chemo but not pembro-mono was associated with improved OS versus cetux-chemo. Among patients with low CPS, neither pembro-chemo nor pembro-mono was associated with improved OS versus cetux-chemo. The authors conclude that CPS was associated with OS for treatment with pembro-chemo and pembro-mono, but is not a general prognostic factor in R/M HNSCC.