CD274 and neoplasm: Recently, the phase III Keynote 048 study led to the approval of pembrolizumab, either alone or in combination with platinum/5FU chemotherapy in first line in R/M HNSCCs expressing PD-L1, showing an advantage in terms of OS when compared to standard EXTREME regimen in patients with tumours expressing a combined proportion score (CPS) of 1 or higher 13. Pembrolizumab in monotherapy could be the first choice in frail patients, since they will not be able to receive chemo/immunotherapy due to the high toxicity rate of the combination.