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This phase 2 nonrandomized trial suggests that combining pembrolizumab, an immune checkpoint inhibitor, with low-dose hypofractionated quad-shot radiotherapy (QSRT) is feasible and may enhance anti-tumor efficacy in patients with recurrent, unresectable, or metastatic head and neck squamous cell carcinoma (RUM HNSCC). Among evaluable patients, an overall response rate of 47% was observed, with median progression-free survival (PFS) of 11.5 months and overall survival (OS) of 15.3 months. The regimen had a manageable safety profile without substantial increases in patient-reported adverse events over time, supporting further exploration in randomized trials.
