Immunotherapy in head and neck squamous cell carcinoma: oncologic and functional outcomes

This review summarizes the evidence supporting the use of immunotherapy across the full disease spectrum of head and neck squamous cell carcinoma (HNSCC) from early-stage, curative-intent settings to recurrent/metastatic disease. It also examines emerging data on swallowing outcomes and outlines the incidence and management of immune-related adverse events (irAEs).

Immunotherapy has become integral to the management of advanced HNSCC, and recent trials demonstrated promising benefits in resectable disease, although overall survival data remain immature. Early evidence also suggests that peri-operative immunotherapy may confer functional advantages by reducing the proportion of patients requiring postoperative chemoradiation, an important consideration given the well established impact of cisplatin-based chemoradiation on swallowing outcomes. As the use of immunotherapy widens, irAEs become more prevalent, necessitating early detection and refined management strategies.

A robust and growing evidence base supports the use of immunotherapy in HNSCC across both curative-intent and advanced settings. Further research is required to optimize patient selection, define optimal sequencing and combination strategies in early-stage disease, and incorporate functional outcomes, particularly swallowing, into future trial designs.