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Head and Neck SCC — SCE Medical Oncology MCQ

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HardHead & Neck CancerHead and Neck SCCSCE Medical Oncology

A patient has untreated, unresectable recurrent laryngeal squamous-cell carcinoma, PD-L1 combined positive score 8, ECOG 1 and low-volume asymptomatic disease. Which funded regimen precisely matches NICE TA661?

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Correct answer: D — Pembrolizumab monotherapy with uninterrupted treatment capped at 2 years

TA661 recommends pembrolizumab only as monotherapy for untreated metastatic or unresectable recurrent HNSCC with CPS at least 1, with a 2-year uninterrupted-treatment cap. Although pembrolizumab plus chemotherapy is licensed and trial-supported, it is not the TA661 recommendation. Nivolumab is not the relevant untreated-disease appraisal, and the NICE threshold is CPS 1 rather than 20.

Reference: NICE TA661 pembrolizumab for untreated metastatic or unresectable recurrent HNSCC (Published November 2020): https://www.nice.org.uk/guidance/ta661/chapter/1-Recommendations