The currently preferred first-line treatment for recurrent, unresectable or metastatic HNSCC is pembrolizumab as monotherapy or in combination with platinum and 5-fluorouracil chemotherapy, per the results of KEYNOTE-048 [15], in which pembrolizumab alone improved overall survival (OS) by 4.2, 2 and 0.9 months in the PD-L1 combined positive score (CPS) ≥20 group, CPS ≥1 group and total population, respectively, compared with the control arm (treatment with cetuximab chemotherapy) [16]. The gene discussed is CD274; the disease is head and neck squamous cell carcinoma.