With regard to this and considering the differences in the toxicity profile of pembrolizumab alone versus in combination with chemotherapy, prioritizing discussion in a multidisciplinary team as well as patient preference should be prioritized in this treatment setting (recurrent/metastatic non-nasopharyngeal HNSCC expressing PD-L1), whereas the EXTREME regimen, including platinum, 5-fluoruracil and cetuximab, is still recommended for patients with recurrent/metastatic HNSCC not expressing PD-L1. The gene discussed is CD274; the disease is head and neck squamous cell carcinoma.