Pembrolizumab monotherapy (HNSCC R/M, 1L; PD-L1 CPS ≥20)

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.

Source YAML: complete record

Components	`DRUG-PEMBROLIZUMAB`

ID	`REG-PEMBRO-MONO-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 ≥20 R/M HNSCC, pembrolizumab monotherapy vs EXTREME improved OS 14.9 vs 10.7 mo (HR 0.61) with substantially less toxicity. Preferred over chemo-IO in CPS ≥20 for fitness-limited patients. Median DOR ~22 mo; long-tail responders. Switch to chemo-IO or cetuximab-based regimen if rapid progression / visceral crisis at 1L assessment.

Used By

Algorithms

ALGO-LARYNGEAL-1L - ALGO-LARYNGEAL-1L

Indication

IND-HNSCC-RM-1L-PEMBRO-MONO-CPS-HIGH - IND-HNSCC-RM-1L-PEMBRO-MONO-CPS-HIGH
IND-LARYNGEAL-RM-1L-PEMBRO-MONO-CPS-HIGH - IND-LARYNGEAL-RM-1L-PEMBRO-MONO-CPS-HIGH