Head and Neck Squamous Cell Carcinoma

If you or someone you know has been diagnosed with head and neck squamous cell carcinoma, you may be trying to learn as much as possible about the disease and its treatments. Read on to find out more.

The information on this website should be discussed with your healthcare professional and does not replace their advice.

What is head and neck squamous cell carcinoma?

Head and neck cancer is a general term for cancers that start in the head and neck area. Most of these cancers begin in the moist lining of the mouth, nose or throat and are known as squamous cell carcinomas.

Head and neck cancers are more common in men than in women. They are named according to the area in which they start.

Head and neck cancers include:

Mouth cancers. Cancer that starts in the mouth (lips and oral cavity).
Throat (pharyngeal) cancers. Cancer that starts in the throat or pharynx.
Voice box (laryngeal) cancers. Cancer that starts in the voice box or larynx.

Nose cancers. Cancer that starts in the nasal cavity and sinuses.
Salivary gland cancers. Cancer that starts in the glands which make saliva.

Cancers that start in the brain, eyes, oesophagus (food pipe), trachea (windpipe) or thyroid (a gland producing hormones) are not considered head and neck cancers.

Treatment with KEYTRUDA® (pembrolizumab)

Your doctor will plan your treatment according to your individual circumstances. These include your type and stage of cancer, its location and your general health and life priorities.

Click here to read about cancer staging

KEYTRUDA is an immunotherapy that may be used to treat head and neck squamous cell carcinoma when it has spread or returned and cannot be removed by surgery:

If your tumour tests positive for PD-L1 and KEYTRUDA is your first treatment; or
In combination with chemotherapy as your first treatment; or
When you have received chemotherapy that contains platinum and it did not work or is no longer working.

Talk to your doctor to see if KEYTRUDA may be right for you.

KEYTRUDA is not funded in New Zealand for the treatment of patients with head and neck squamous
cell carcinoma.

Click here to learn more about KEYTRUDA

Glossary

Expand for more information on terms and definitions related to head and neck squamous cell carcinoma.

Terms you may find useful:

Carcinoma
The most common type of cancer. It is formed by epithelial cells. These cells cover the inside and outside of our body – for example, the lining of the mouth, nose or throat.

Larynx or voice box
This contains the vocal cords and connects the throat and windpipe.

Nasal cavity
The hollow space behind the nose.

Oral cavity
The mouth (including gums, cheek linings, mouth roof and floor, most of the tongue and the area behind the wisdom teeth).

Oncologist
A doctor who specialises in treating cancer with drug therapies – for example, chemotherapy and immunotherapy.

PD-L1
A protein that may protect cancer cells from being detected by the immune system.

Prognosis
The expected outcome of your cancer, which is best discussed with your doctor who can tell you your general outlook but is unable to predict the course of your disease exactly.

Pharynx or throat
Hollow tube that connects the mouth and nose with the windpipe (trachea) and food pipe (oesophagus).

Tumour
A new or abnormal growth of tissue on or in the body. Tumours can be benign (not cancerous) or malignant (cancerous).

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Questions to ask your doctor

KEYTRUDA® (pembrolizumab) 100 mg/4 mL concentrate solution for infusion is a Prescription Medicine. KEYTRUDA has risks and benefits. The KEYTRUDA Consumer Medicine Information (CMI) is available at www.medsafe.govt.nz or by clicking the 'Consumer Medicine Information' button at the top of this page.

IMPORTANT SAFETY INFORMATION

You should not be given KEYTRUDA if you are allergic to pembrolizumab or to any of the following inactive ingredients: histidine, histidine monohydrochloride monohydrate, sucrose, polysorbate-80, water for injection.

Tell your doctor if you have a disease of your immune system such as Crohn’s disease, ulcerative colitis, or lupus; have had an organ transplant or have had a bone marrow (stem cell) transplant that used donor stem cells (allogeneic); have pneumonia or swelling of your lungs (called pneumonitis); or have liver problems.

If you are pregnant, think you may be pregnant or are planning to have a baby, tell your doctor. KEYTRUDA can cause harm or death to your unborn baby. Effective contraception must be used during treatment with KEYTRUDA and for at least 4 months after the last dose of KEYTRUDA for woman who could become pregnant.

If you are breastfeeding, tell your doctor. Do not breastfeed while taking KEYTRUDA.

Tell your doctor if you are taking any other medicines, including medicines that can be bought without a prescription from a pharmacy, supermarket or health food shop, or other medicines that make the immune system weak. Examples of these may include steroids, such as prednisone.

What are the possible side effects of KEYTRUDA?

KEYTRUDA can have some serious side effects. These side effects can sometimes become life-threatening and can lead to death. These side effects may happen any time during treatment or even after treatment has ended. More than one side effect can be experienced at the same time.

Call or see your doctor right away if you develop any of the following symptoms:

Lung problems:
Signs and symptoms of lung problems may include shortness of breath, chest pain, or coughing.

Intestinal problems:
Signs and symptoms of problems with your intestines may include diarrhoea or more bowel movements than usual, stools that are black, tarry, sticky, or have blood or mucus, or severe stomach pain or tenderness.

Liver problems:
Signs and symptoms of liver problems may include nausea or vomiting, feeling less hungry, pain on the right side of your stomach, your skin looks yellow, the whites of your eyes look yellow, dark urine or you bleed or bruise more easily than normal.

Hormone gland problems (especially the thyroid, pituitary, adrenal glands):
Signs and symptoms of hormone gland problems may include rapid heartbeat, weight loss or weight gain, increased sweating, hair loss, feeling cold, constipation, your voice gets deeper, muscle aches, dizziness or fainting, or headaches that will not go away or unusual headache.

Kidney problems:
Signs and symptoms of kidney problems may include change in the amount or colour of your urine.

Blood sugar problems:
Signs and symptoms of blood sugar problems may include feeling more hungry or thirsty, needing to urinate more often or weight loss.

Skin problems:
Signs and symptoms of skin problems may include rash, itching, blisters, peeling or skin sores, or ulcers in mouth or in lining of nose, throat, or genital area.

Problems in other organs:
Signs and symptoms of problems in other organs may include muscle pain or weakness; changes in eyesight; stomach area pain with nausea and vomiting (pancreatitis); shortness of breath, irregular heartbeat, feeling tired, or chest pain (myocarditis, pericarditis); confusion, fever, memory problems, or seizures (encephalitis); swollen lymph nodes, rash or tender lumps on skin, cough, or eye pain (sarcoidosis); pain, numbness, tingling, or weakness in the arms or legs, bladder or bowel problems including needing to urinate more frequently, urinary incontinence, difficulty urinating and constipation (myelitis); inflammation of the blood vessels (vasculitis); decreased function of the parathyroid gland, which may include muscle cramps or spasms, fatigue and weakness (hypoparathyroidism); inflammation of the stomach lining, which may include severe stomach pain or tenderness, nausea or vomiting (gastritis); destruction of red blood cells, which may include dark urine, pale or yellow skin/eyes, lightheadedness, feeling tired, rapid heartbeat, or shortness of breath (haemolytic anaemia), or pain in the upper right part of the stomach, swelling of the liver or spleen, fatigue, itching or yellowing of the skin or whites of eyes (sclerosing cholangitis) ; or decreased ability of the pancreas to make digestive enzymes, which may include diarrhoea with loose and oily stools, weight loss, metabolic bone disease, and vitamin or mineral deficiencies (exocrine pancreatic insufficiency).

Infusion (IV) reactions:
Signs and symptoms of infusion reactions may include shortness of breath, itching or rash, dizziness or fever.

Rejection of a transplanted organ:
People who have had an organ transplant may have an increased risk of organ transplant rejection. Your doctor should tell you what signs and symptoms you should report and monitor you, depending on the type of organ transplant that you have had.

Graft-versus-host-disease (GVHD) in people with bone marrow (stem cell) transplant that uses donor stem cells (allogeneic):
GVHD may occur if you had this transplant in the past. Your doctor will monitor you for the following signs and symptoms: skin rash, liver inflammation, abdominal pain, and diarrhoea.

Common side effects:
Common side effects (may affect more than 1 in 10 people) include: diarrhoea, nausea, itching, rash, joint pain, back pain, feeling tired, cough, patches of skin which have lost colour, stomach pain, decreased sodium levels in the blood and low levels of thyroid hormone.

Common side effects (reported in more than 1 in 5 people) when KEYTRUDA was given in combination with chemotherapy include: hair loss, feeling tired, diarrhoea, vomiting, rash, fever, decrease in white blood cell count, decreased appetite, joint pain, swelling of the lining of the digestive system (for example mouth, intestines), mouth sores, decrease in number of red blood cells and decrease in number of platelets in the blood.

The most common side effects when KEYTRUDA is given in combination with axitinib are: diarrhoea, high blood pressure, fatigue, low levels of thyroid hormone, decreased appetite, blisters or rash on the palms of your hands or soles of your feet, nausea, increase in liver enzyme levels, hoarseness, cough and constipation.

The most common side effects when KEYTRUDA is given in combination with lenvatinib are: high blood pressure, diarrhoea, feeling tired, decreased appetite, low levels of thyroid hormone, nausea, vomiting, weight loss, joint pain, headache, constipation, hoarseness, urinary tract infection, stomach-area (abdominal) pain, blisters or rash on the palms of your hands and soles of your feet, rash, protein in your urine, increase in liver enzyme levels and feeling weak.

The most common side effects when KEYTRUDA is given alone to children are: fever, vomiting, headache, stomach pain, decrease in number of red blood cells, cough, and constipation.

Less common side effects can happen. KEYTRUDA may cause other side effects that are not listed. If you have any side effect that bothers you or that does not go away, tell your doctor.

For more information, please talk to your doctor.

KEYTRUDA may be used in adults to treat certain cancers when the cancer has spread (metastatic) or cannot be removed by surgery (unresectable), such as:

melanoma
non-small cell lung cancer
urothelial carcinoma
head and neck squamous cell carcinoma
renal cell carcinoma
oesophageal carcinoma
cervical cancer
endometrial carcinoma
gastric or gastroesophageal junction adenocarcinoma
triple-negative breast cancer
cutaneous squamous cell carcinoma
a kind of cancer that can occur in any part of the body and is shown by a laboratory test to be microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR)
colon or rectal cancer that is shown by a laboratory test to be MSI-H or dMMR

KEYTRUDA may also be used in adults:

after surgery to remove melanoma, non-small cell lung cancer, or renal cell carcinoma to help prevent the cancer from coming back
before surgery to treat triple-negative breast cancer and then continued after surgery to help prevent the cancer from coming back
to treat bladder cancer which has not spread to nearby tissues but is at high-risk of spreading and where bladder removal is not preferred
to treat classical Hodgkin Lymphoma (cHL) that has returned or when other treatments have not worked

KEYTRUDA may be used in children with cHL, MSI-H or dMMR cancer, or after surgery to remove melanoma. It is not known if KEYTRUDA is safe and effective in children with MSI-H or dMMR cancer of the brain or spinal cord (central nervous system cancers).

KEYTRUDA may sometimes be given in combination with other anti-cancer medicines.

Based on the KEYTRUDA Consumer Medicines Information and Data Sheet dated 6^th November 2024.

Ask your doctor if KEYTRUDA is right for you. If symptoms continue or you have side effects, see your doctor, pharmacist, or health professional.

KEYTRUDA is funded to treat certain patients with the following types of advanced cancers: melanoma, non-small cell lung cancer, MSI-H or dMMR colorectal cancer, triple-negative breast cancer, head and neck squamous cell carcinoma, urothelial carcinoma, and classical Hodgkin lymphoma - further restrictions apply. KEYTRUDA is not funded for the treatment of all other cancers listed above.

Ask your health professional about the cost of the medicine and any other medical fees that may apply.

Merck Sharp & Dohme (New Zealand) Limited, Level 3, 123 Carlton Gore Road, Newmarket, Auckland.

TAPS NP20132 TAPS DA 2419KN NZ-KEY-00885v11 Last updated December 2024