Pembrolizumab and Quality of Life in Recurrent or Metastatic Head and Neck Cancer

This study aimed to evaluate longitudinal changes in the quality of life (QOL) of patients with recurrent or metastatic head and neck cancer treated with pembrolizumab in real-world clinical practice.

We retrospectively analyzed the data of patients with recurrent or metastatic head and neck cancer who underwent pembrolizumab treatment at our institution between 2020 and 2023. QOL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 at baseline and at nine and 18 weeks after treatment initiation. Changes in Global Health Status (GHS) were defined as the primary endpoint and analyzed over time using least-squares mean estimates.

In total, 68 patients were included in the analysis. The mean GHS score increased from 57.0 at baseline to 62.5 at nine weeks, indicating a trend toward improvement (p=0.051). The GHS score remained higher at 18 weeks (58.7) than at baseline, although the difference was not statistically significant. No significant deterioration was observed in other functional or symptom scales. The objective response and disease control rates were 36.8% and 77.9%, respectively.

With the use of pembrolizumab, QOL tended to be maintained or improved from the early phase of treatment in patients with recurrent or metastatic head and neck cancers. These findings are consistent with the results of the KEYNOTE-048 trial and other real-world studies, suggesting that immune checkpoint inhibitor therapy may preserve patients' QOL without compromising treatment efficacy.