Pembrolizumab monotherapy versus chemotherapy in platinum-pretreated, recurrent or metastatic nasopharyngeal cancer (KEYNOTE-122): an open-label, randomized, phase III trial

•No difference was observed in efficacy between pembrolizumab and chemotherapy in advanced platinum-pretreated NPC.•Median OS was 17.2 months with pembrolizumab versus 15.3 with chemotherapy (median PFS, 4.1 versus 5.5 months.•Pembrolizumab had manageable safety and a lower incidence of treatment-related adverse events (AEs) than chemotherapy.•Grade 3-5 treatment-related AEs occurred in 10.3% of participants treated with pembrolizumab versus 43.8% with chemotherapy.