NICE Recommends Keytruda for Advanced Head and Neck Cancer Treatment
The National Institute for Health and Care Excellence (NICE) has recommended pembrolizumab (Keytruda; MSD) as a treatment for resectable locally advanced head and neck squamous cell carcinoma (LA HNSCC) for use within the National Health Service (NHS) in England. The final guidance was published on March 24, 2026.
This recommendation marks the first time a new treatment option has demonstrated improved outcomes above the standard of care in LA HNSCC in over 20 years, and is the first recommended perioperative immunotherapy for LA HNSCC in the UK, according to MSD.
How Will Keytruda Be Used?
NICE recommends pembrolizumab for use before surgery, and after surgery with radiotherapy, and with or without chemotherapy. It also approves pembrolizumab as a monotherapy for patients who express the programmed death-ligand 1 protein (PD-L1), which cancer cells can utilize to suppress the body’s immune response.
Understanding Head and Neck Cancer
Head and neck cancer is the ninth most common cancer in the UK, with approximately 12,800 new cases diagnosed annually. The vast majority – 90% – of these cancers are squamous cell carcinomas, originating from the epithelial cells lining the mouth, throat, and voice box.
Current standard treatments for head and neck cancer include surgery, radiotherapy, and/or chemotherapy.
Impact on Patients
Tamara Kahn, chair of the Head and Neck Cancer Coalition, emphasized the significance of this recommendation, stating, “This recommendation is an important moment for people living with head and neck cancer in England. Treatment can be gruelling, and many people are left dealing with lasting challenges in speaking, eating and everyday interaction long after treatment ends.”
Kahn added, “Today’s decision introduces an immunotherapy option earlier in the pathway and widens the choices available to patients and clinicians. For the head and neck cancer community, this brings real hope, not just in treating the cancer but in the possibility that fewer people may face the most severe long-term effects after treatment.”
Chris Nutting, consultant clinical oncologist at the Royal Marsden Hospital in London, expressed his delight with the NICE decision, stating it “represents a significant advance and will be welcomed by patients, their families and the head neck community.”
Clinical Trial Results
Phase III trial results presented at the American Society of Clinical Oncology annual meeting in May 2025 demonstrated that pembrolizumab helped patients with head and neck cancers live longer without disease progression when compared to standard treatment.
Recent NICE Approvals
In August 2025, NICE also approved enfortumab vedotin and pembrolizumab combination therapy for advanced bladder cancer, and pembrolizumab in combination with chemotherapy (carboplatin and paclitaxel) for endometrial cancer.
Final NICE guidance on the use of pembrolizumab in LA HNSCC is expected to be published on April 20, 2026.