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Pembrolizumab and nivolumab which have also been in a category of immune checkpoint inhibitors are approved by FDA as a first line therapy in patients having cisplatin insensitive recurrent or metastatic HNSCC [19,20,21]

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TLR4 activation in platelets whether by pathogen- (viremia) or damage-associated molecular patterns induces a prothrombotic and proinflammatory state (Schattner, 2019)