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Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
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Real-World Outcomes of Immune Checkpoint Inhibitors in Head and Neck Squamous Cell Carcinoma: Analyzing

Lena Huber1, Constanze Kohler2, Anne Lammert1

  • 1Department of Otolaryngology, Head and Neck Surgery, University Medical Center Mannheim, Heidelberg University, Germany.

Cancer Reports (Hoboken, N.J.)
|November 11, 2025
PubMed
Abstract

Insights

Immune checkpoint inhibitors (ICIs) show promise for head and neck squamous cell carcinoma (HNSCC). Tumor proportion score (TPS) ≥50% and healthy lifestyle factors improve outcomes, while female sex, high NLR, and elevated leukocytes are linked to worse survival.

Area of Science:

  • Oncology
  • Immunotherapy
  • Head and Neck Cancer Research

Background:

  • Head and neck squamous cell carcinoma (HNSCC) presents significant global health challenges with limited survival rates.
  • Immune checkpoint inhibitors (ICIs) like pembrolizumab and nivolumab have emerged as vital treatments, yet real-world effectiveness and influencing factors require further investigation.

Purpose of the Study:

  • To assess the real-world effectiveness of pembrolizumab and nivolumab in HNSCC patients.
  • To identify clinical and laboratory predictors of overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) in HNSCC treated with ICIs.

Main Methods:

  • Retrospective analysis of 45 HNSCC patients treated with ICIs.
  • Evaluation of patient-specific factors including tumor characteristics, PD-L1 expression, and laboratory parameters.
  • Statistical analysis using Kaplan-Meier estimation, log-rank tests, and multivariate regression models.

Main Results:

  • Median OS was 10.4 months and median PFS was 7.4 months, with an ORR of 22%.
  • Tumor proportion score (TPS) ≥50% and absence of smoking/alcohol abuse correlated with improved ORR.
  • Female sex, high neutrophil-to-lymphocyte ratio (NLR), and elevated leukocyte counts were associated with inferior OS and PFS.

Conclusions:

  • TPS and patient lifestyle factors (smoking, alcohol) are significant predictors of ICI treatment response in HNSCC.
  • Sex-specific differences, NLR, and leukocyte count may serve as prognostic indicators.
  • Further research with larger, diverse cohorts is necessary to validate these findings and optimize patient selection for ICI therapy.
Keywords:
head and neck squamous cell carcinomaimmune checkpoint inhibitorsimmunotherapy responsenivolumabpembrolizumabpredictive biomarkersprogression‐free survivalreal‐world outcomessurvival analysis

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