Recently, pembrolizumab, which blocks the programmed-death-1 (PD-1)/programmed death-ligand 1 (PD-L1) axis, was approved as a first-line therapy for patients with R/M HNSCC either as monotherapy for PD-L1 positive patients (combined positive score, CPS ≥ 1) or in combination with platinum and 5-fluorouracil [4]. This evidence concerns the gene CD274 and head and neck squamous cell carcinoma.