Immune-scoring in head and neck squamous cell carcinoma: a scoping review

ABSTRACTIntroduction Head and neck squamous cell carcinomas (HNSCCs) have an increasing incidence, high recurrence, and an overall unfavorable prognosis despite numerous treatment options. The distinct immune landscape of HNSCC suggests a potential for immune-related biomarkers to aid classification and treatment planning.Areas covered Immunoscore, a multiplex measure of tumor-infiltrating immune cells, is currently approved in colorectal carcinoma and is under investigation in various other cancer types. Recent studies have tried to implement the immunoscore and other novel immune cell-based scoring systems in HNSCC as predictors of survival. This study provides an overview of tumor-infiltrating immune cells and their prognostic significance, as well as a comparative summary of studies introducing an immunoscore in HNSCC.Expert opinion With sufficient insight of the current literature, future studies could lead to the definition and validation of a new immune-based classification system for HNSCC. Such a classification strategy could be the basis for patient selection and, thus, optimize treatment outcomes and reduce unwanted complications. The heterogeneity of HNSCC subtypes, as well as the intratumoral variability of immune infiltrates, should be accounted for in the immunoscore.KEYWORDS: Head and neck squamous cell carcinomaHNSCCImmunoscoretumor microenvironmenttumor-infiltrating lymphocytes Article highlights Head and neck squamous cell carcinomas (HNSCC) are a heterogenous group of malignancies with a highly immune-suppressed tumor microenvironment.With the emerging therapeutic strategies for HNSCC and the need for patient selection, multiplexed immune-related biomarkers are brought into the focus of research.Recent studies have used numerous innovative technologies to create and validate a predictive immunoscore in HNSCC. Future research should focus on a cost-effective scoring system, which uses the least possible number of markers but quantifies them in more than one tumor compartment.Declaration of interestsThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.Reviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Supplemental dataSupplemental data for this article can be accessed online at https://doi.org/10.1080/1744666X.2023.2262140.Additional informationFundingThis paper was not funded.