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Head & Neck

OMS and Other Dental Specialists

Session: Late Breaking Clinical Topics

SSOD55 - Perioperative Immunotherapy for the Treatment of Locally Advanced Head and Neck Cancer: A New Standard of Care

On-demand

    Speaker(s)

  • R. Bryan Bell, DDS, MD, FACS, FRCS(Ed)

    Executive Medical Director Medical Director, Providence Head and Neck Cancer Program, Providence Cancer Institute- Oregon Member and Director, Surgical Oncology Research, Earle A. Chiles Research Institute
    Providence Cancer Institute
    Portland, Oregon

    Handouts
Synopsis : Locally advanced head and neck squamous cell carcinoma (LA HNSCC) is a deadly disease in which fewer than half of all patients survive longer than 5 years and for which there has been no improvement in survival for decades. However, in June 2025, the FDA approved perioperative pembrolizumab (pembro) for the treatment of patients with resectable LA HNSCC, based upon the results of KEYNOTE-689 (NCT03765918), which was a randomized phase 3 clinical trial that tested neoadjuvant (preoperative) pembro, surgery and adjuvant (postoperative) pembro plus (chemo)radiotherapy versus surgery plus (chemo)radiotherapy alone, establishing a new standard-of-care. The FDA approval was based upon significant differences in the pre-specified endpoint of event-free survival that was observed in the study, resulting primarily from a 10% reduction in distant metastasis and fewer high-risk features amongst the pembro-treated group. Therefore, oral and maxillofacial surgeons should be aware of these practice-changing results. The purpose of this late-breaking session is to: 1) review the rationale for neoadjuvant and adjuvant immunotherapy for patients with LA HNSCC, especially oral cancer; 2) present the results of KEYNOTE-689, recently published in the New England Journal of Medicine; 3) discuss recommendations for multidisciplinary assessment and treatment; and 4) highlight future directions in the field.

Learning Objectives:

At the conclusion of this presentation, participants should be able to:
  1. Describe the randomized phase 3 KEYNOTE-689 study that established neoadjuvant (preoperative) pembrolizumab, surgery and postoperative pembrolizumab plus (chemo)radiotherapy as a new standard-of-care for patients with resectable locally advanced oral cancer.
  2. Understand the rationale for perioperative, neoadjuvant and adjuvant immunotherapy for patients with locally advanced oral squamous cell carcinoma.
  3. Describe proper multidisciplinary assessment and proper work up for patients with locally advanced oral squamous cell carcinoma.
  4. Be aware of new and evolving guidelines for diagnostic imaging and biomarker testing prior to treatment of patients with locally advanced oral squamous cell carcinoma.
  5. Describe future directions in the field to further improve outcomes for patients with locally advanced oral squamous cell carcinoma.