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4

Indication details

Control Arm
Cisplatin or carboplatin/5-FU/cetuximab
Therapeutic Indication
As monotherapy is indicated for the first‑line treatment of metastatic or unresectable recurrent head and neck squamous cell carcinoma in adults whose tumours express PD‑L1 with a CPS ≥ 1
Tumour Type
Head and neck cancer
Tumour Sub-type
Squamous cell
Tumour Stage
Recurrent or metastatic
Tumour Sub-Group
CPS PD-L1 expression ≥20
Trial Name
KEYNOTE-048
NCT Number
NCT02358031
Trial Phase
Phase III

Approval details

FDA Approval
FDA approval June 2019
EMA Approval
EMA (CHMP) August 2019 EC decision October 2019

Primary Outcome(s)

Primary Outcome(s)
PFS/OS
Evaluated Outcome
OS
Form(s)
Form 2a

Outcome Data

OS Control
10.8 months 2-year OS: 19.7%
OS Gain
4.1 months 2-year OS gain: 15.6%
OS HR
0.61 (0.46-0.81)

Adjustments

QoL Comment
No QoL benefit
Toxicity Comment
Toxicity was reduced for pembro vs control in the whole population. No information is provided for the cohorts of interest. Thus, no upgrade should be implemented

Final Score (after adjustments)

Preliminary non-curative score

4

Final non-curative score

4

Comment
The licensed indication is for CPS PD-L1 expression ≥1. This score relates to a planned subgroup illustrating enhanced benefit among a subset of the approved cohort with CPS PD- L1 expression ≥20.

Three-arm trial comparing chemotherapy plus cetuximab versus chemotherapy plus pembrolizumab versus pembrolizumab monotherapy.

Scorecard details

ESMO-MCBS version
ESMO-MCBS v1.1
Scorecard ID
196
Scorecard version
1
Issue date
17.07.2020
Last update
07.08.2023
Pembrolizumab KEYNOTE-048

PRELIMINARY SCORE

OS

ADJUSTMENTS

No QoL benefit
Pembrolizumab KEYNOTE-048

FINAL SCORE

Overall Survival / Disease-Free Survival / Pathological Complete Response
4
Overall Survival
Progression-Free Survival
Non-inferiority (Improved Quality of Life or Reduced Adverse Events) / Response Rate
Overall Response Rate / Duration of Response
Head and neck cancer
As monotherapy is indicated for the first‑line treatment of metastatic or unresectable recurrent head and neck squamous cell carcinoma in adults whose tumours express PD‑L1 with a CPS ≥ 1
Pembrolizumab
Cisplatin or carboplatin/5-FU/cetuximab

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    Legend

    Information about symbols, abbrevations and color codes

    Red = negative
    Green = positive
    Grey = neutral
    ? Grey + ? = neutral with pending data
    DFS
    Disease-Free Survival
    DoR
    Duration of Response
    EFS
    Event-Free Survival
    HR
    Hazard Ratio
    NEB
    No evaluable benefit
    NI
    Non-inferiority Study
    ORR
    Overall Response Rate
    OS
    Overall Surival
    pCR
    Pathological Complete Response/Remission
    PFS
    Progression-Free Survival
    QoL
    Quality of Life
    RFS
    Relapse-Free Survival
    RR
    Response Rate

    QoL adjustments

    Other adjustments*

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    QoL adjustments

    Red = negative / deterioration

    Green = positive / improvement

    Other adjustments*

    Red = negative / deterioration

    Green = positive / improvement

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    * Other adjustments include:

    - Long-term plateau in the survival curve
    - Long-term plateau in the PFS curve
    - Early stopping or crossover
    - Only improved PFS mature data shows no OS advantage and no improved Qol.

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