Pembrolizumab + 5-FU + platinum (HNSCC R/M, 1L; PD-L1 CPS ≥1)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.
| Components | DRUG-PEMBROLIZUMAB DRUG-5-FLUOROURACIL DRUG-CISPLATIN DRUG-CARBOPLATIN |
|---|
| ID | REG-PEMBRO-CHEMO-HNSCC-1L |
|---|---|
| Type | Regimen |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-HNSCC-2025 |
Notes
KEYNOTE-048 (Burtness Lancet 2019): in PD-L1 CPS ≥1 R/M HNSCC, pembrolizumab + 5-FU + platinum vs EXTREME (cetuximab + 5-FU + platinum) improved OS 13.6 vs 10.4 mo (HR 0.65). In CPS <1 the benefit is smaller; in CPS ≥20 monotherapy pembrolizumab is preferred (less chemo-toxicity, equivalent OS). Cisplatin preferred over carboplatin when feasible; carboplatin is the practical default in elderly / comorbid / renal-impaired. EXTREME (cetuximab + 5-FU + platinum) remains an alternative for IO-contraindicated patients.
Used By
Algorithms
ALGO-LARYNGEAL-1L- ALGO-LARYNGEAL-1L
Indication
IND-HNSCC-RM-1L-PEMBRO-CHEMO- IND-HNSCC-RM-1L-PEMBRO-CHEMOIND-LARYNGEAL-RM-1L-PEMBRO-CHEMO- IND-LARYNGEAL-RM-1L-PEMBRO-CHEMO