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Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
Published on: April 22, 2019
Pembrolizumab Plus Quad-Shot Radiotherapy for Recurrent, Unresectable, or Metastatic Head and Neck Cancer: A
Ryan T Hughes1, Sydney Smith2, Thomas W Lycan3
1Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
JAMA Otolaryngology-- Head & Neck Surgery
|June 18, 2026
Summary
This study found that combining pembrolizumab with quad-shot radiotherapy (QSRT) is feasible and shows promise for treating recurrent, unresectable, or metastatic head and neck squamous cell carcinoma (RUM HNSCC). Further randomized trials are needed to confirm these findings.
Area of Science:
- Oncology
- Radiation Oncology
- Immunotherapy
Background:
- Immune checkpoint inhibitor (ICI) monotherapy offers limited benefit for patients with recurrent, unresectable, or metastatic head and neck squamous cell carcinoma (RUM HNSCC).
- Low-dose, hypofractionated, quad-shot radiotherapy (QSRT) is an emerging technique that may enhance ICI efficacy.
Purpose of the Study:
- To assess the efficacy and safety of combining ICIs with QSRT in patients with RUM HNSCC.
- To evaluate the potential of this combination therapy for RUM HNSCC amenable to QSRT.
Main Methods:
- A single-arm, phase 2, nonrandomized clinical trial involving patients with RUM HNSCC.
- Patients received pembrolizumab every 3 weeks combined with cyclical QSRT (14.8 Gy in four fractions).
- Outcomes included overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs).
Main Results:
- The overall response rate (ORR) was 47% (95% CI, 21%-73%) among evaluable patients.
- Median progression-free survival (PFS) was 11.5 months (95% CI, 5.1 to not estimable), and median overall survival (OS) was 15.3 months (95% CI, 6.3 to not estimable).
- Grade 3 and 4 adverse events occurred in 6 and 2 patients, respectively; patient-reported AEs remained stable.
Conclusions:
- Pembrolizumab plus QSRT is a feasible treatment for RUM HNSCC.
- The combination therapy shows preliminary evidence of clinical benefit.
- Further investigation in randomized clinical trials is warranted.
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