Samara Heisz/Alamy Stock Photo
The National Institute for Health and Care Excellence (NICE) has recommended an immunotherapy to treat advanced head and neck cancer for use on the NHS in England.
In final draft guidance, published on 24 March 2026, NICE approved pembrolizumab (Keytruda; MSD), an IV infusion for patients with resectable locally advanced head and neck squamous cell carcinoma (LA HNSCC).
Commenting on the recommendation, a spokesperson for MSD said it was the “first time a new treatment option has shown 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”.
NICE recommended the treatment for use before surgery, after surgery with radiotherapy and with or without chemotherapy. It also approved pembrolizumab as a monotherapy in patients who express the programmed death-ligand 1 protein, which cancer cells can use to switch off the body’s immune response.
Head and neck cancer is the ninth most common cancer in the UK, with 12,800 new cases annually.
Of all head and neck cancers, 90% of these are squamous cell carcinomas, which means they develop from epithelial cells that line areas of the head and neck, such as the mouth, throat and voice box.
Standard treatments for the head and neck cancer include surgery, radiotherapy and/or chemotherapy.
Tamara Kahn, chair of the Head and Neck Cancer Coalition, a group of 15 members comprising charities, support groups, healthcare associations and other stakeholders, said: “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.
“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, said: “I am delighted to hear of the recent decision from NICE supporting the use of pembrolizumab before and after surgery for head neck cancer patients with locally advanced disease. This represents a significant advance and will be welcomed by patients, their families and the head neck community.”
On 30 May 2025, the results of a phase III trial revealed that pembrolizumab helped patients with head and neck cancers to live extra years disease free when compared with standard treatment. The results were presented at the American Society of Clinical Oncology annual meeting.
In August 2025, NICE approved enfortumab vedotin and pembrolizumab combination therapy for advanced bladder cancer and pembrolizumab with chemotherapy (i.e. carboplatin and paclitaxel) for endometrial cancer.
Final NICE guidance on the use of pebrolizumab in LA HNSCC is expected to be published on 20 April 2026.
