A phase 2 study found that combining pembrolizumab (Keytruda) with docetaxel and cisplatin before surgery works very well for patients with locally advanced head and neck squamous cell carcinoma that can still be removed.
In the study of 49 patients, 87.8% responded to treatment. Among those who had surgery, 44.4% had no remaining cancer found (complete response), and 55.6% had a major reduction in tumor cells. After 18 months, 72.7% of patients had no disease progression, and 84.9% were still alive. As of October 2024, none of the patients who underwent surgery had cancer recurrence or died, and no surgeries were delayed due to side effects.
The treatment was considered manageable. The most common side effects were nausea or vomiting (12.2%), fatigue (10.2%), and rash (8.2%). More serious side effects occurred in about 24.5% of patients, while very severe events were rare (4.1%). Patients received two 3-week treatment cycles before surgery. These results support using immunotherapy earlier, following the FDA’s June 2025 approval of pembrolizumab for similar cases.