What Were the Top Head and Neck Cancer Highlights at ASCO 2026?

The head and neck cancer treatment landscape continues to evolve with practice-changing data and promising early-phase developments. Reflecting on recent advancements, Sivraj Muralikrishnan, MD, highlighted the lasting impact of the KEYNOTE-689 trial (NCT03765918) presented at 2025 American Society of Clinical Oncology Annual Meeting in an interview with CancerNetwork®.¹ The study established a new standard approach for resectable head and neck cancers with a PD-L1 combined positive score of 1 or higher, representing a major therapeutic milestone that resuled in the approval of the regimen in head and neck squamous cell carcinoma in June 2025.²

Transitioning to the ASCO 2026 Annual Meeting, Muralikrishnan identified a notable "sleeper" hit in a historically difficult-to-treat patient population. A phase 1/2 trial (NCT06118086) of REM-422, a novel MYB mRNA degrader, demonstrated an impressive objective response rate (ORR) of approximately 43% in recurrent or metastatic adenoid cystic carcinoma.³ For a rare disease lacking effective FDA-approved systemic options, these data offer a highly encouraging signal, even as KEYNOTE-689 remains the foundational cornerstone of recent progress in the broader head and neck space.

Muralikrishnan is a medical oncologist and assistant professor of medicine at Rutgers Robert Wood Johnson Medical School.

Transcript:

CancerNetwork: Which specific data set or oral abstract in the head and neck track did you find most clinically impactful, and how might it alter your multidisciplinary management strategy for locally advanced or metastatic disease moving forward?

Muralikrishnan: Dating back to ASCO 2025, we had the KEYNOTE-689 study, which was the biggest advance in the head and neck space that we utilize today for resectable head and neck cancers with PD-L1 [combined positive] scores over 1%. That has now been adopted as a fairly standard approach for many of our [patients with] head and neck [cancer].

In the head and neck area, there are also a lot of other rare cancers for which we might not have any good treatments, and one thing that stood out as a sleeper this year was REM-422, an MYB mRNA degrader studied in recurrent or metastatic adenoid cystic carcinoma. It was a phase 1/2 study, but it showed [ORRs] of [around 43%]. This [is a] difficult-to-treat patient population, especially when we do not have any good FDA-approved systemic treatments and the treatments we do have available show low response. That was more of a standout specifically for ASCO 2026, but overall, in the head and neck space, KEYNOTE-689 remains the newest and most exciting [practice-changing] study.

References

1. Adkins D, Haddad RI, Tao Y, et al. Neoadjuvant and adjuvant pembrolizumab plus standard of care in resectable locally advanced head and neck squamous cell carcinoma: exploratory efficacy analyses of the phase 3 KEYNOTE-689 study. J Clin Oncol. 2025;43(16_suppl):6012. doi:10.1200/JCO.2025.43.16_suppl.6012
2. FDA approves neoadjuvant and adjuvant pembrolizumab for resectable locally advanced head and neck squamous cell carcinoma. News release. FDA. June 12, 2025. Accessed July 1, 2026. https://tinyurl.com/yt9p66xz
3. Ferrarotto R, Swiecicki P, Ho AL, et al. Clinical activity of REM-422, a MYB mRNA degrader, in recurrent/metastatic adenoid cystic carcinoma: final results from the phase 1/2 dose-escalation cohort. J Clin Oncol. 2026;44(suppl 16):6009. doi:10.1200/JCO.2026.44.16_suppl.6009