علاج سرطان البلعوم السفلي الحرشفي المتكرر أو المنتشر مع ورم إيجابي لـ PD-L1

References

DOI: 10.1016/j.annonc.2020.07.011

• No platinum-based ChT during the last 6 months and PD-L1-positive tumour
• A 'chemo-free' approach with pembrolizumab monotherapy in patients with CPS 1 SCCHN should be considered, especially when a rapid tumour shrinkage is not needed [I, A].
• Pembrolizumab monotherapy [I, A; MCBS 4]
• Pembrolizumab plus platinum/5-FU [I, A; MCBS 4]
• Platinum/5-FU/cetuximab if contraindication to immunotherapy and fit for platinum-based therapy [I, A; MCBS 3]
• Methotrexate or taxane or cetuximab and/or BSC if contraindication to immunotherapy and unfit for platinum-based therapy [III, C]
• A second option, independent of PD-L1 status, is the combination of pembrolizumab and ChT (cisplatin or carboplatin plus 5-FU), particularly in symptomatic patients or when a rapid tumour shrinkage is needed [I, A].