Role of Surgical Pathologist for Detection of Immunooncologic Predictive Factors in Head and Neck Cancer

Abstract

Immunotherapy has shown promising results in the treatment of recurrent and metastatic head and neck cancers. Antiprogrammed cell death (PD)-1 therapies have been recently approved in this setting and they are currently tested also in the treatment of locally advanced diseases and in the neoadjuvant setting. However, the clinical benefits of these treatments have been quite variable, hence the need to select those patients who may obtain the maximal efficacy through the identification of predictive biomarkers. Currently, PD-L1 immunohistochemical expression by tumor and immune cells is the most widely used predictive biomarker for immunotherapy in head and neck squamous cell carcinoma. Nevertheless, patients with PD-L1− tumors may still respond to treatments, thereby emphasizing the need for the identification of other predictive biomarkers. In this review, we summarize the current data on histologic and molecular parameters that can be used to select patients with head and neck cancers for immunotherapy, with a focus on squamous cell carcinoma and salivary gland carcinomas.

Effects of immune inflammation in head and neck squamous cell carcinoma: Tumor microenvironment, drug resistance, and clinical outcomes

“…T_cells_CD4_memory_resting, Macrophages_M0, Mast_cells_activated, and Dendritic_cells_activated expression levels were elevated. At the same time, T_cells_follicular_helper, T_cells_CD8, T_cells_CD4_memory_activated, Macrophages_M1, T_cells_ regulatory_(Tregs), and B_cells_naive decreased, suggesting that when the risk scores are higher, specific immune function activation in the tumor tissue is reduced and that this is associated with a poor prognosis ( Taverna and Franchi, 2022 ). The relationship between the model genes and drug sensitivity (GSDC and CTRP) was analyzed using the GSCALite database.…”

The Histological Background of Recurrence in Laryngeal Squamous Cell Carcinoma: An Insight into the Modifications of Tumor Microenvironment

“…It has been found in the tumor microenvironment of several solid cancers, including a significant subset of HNSCCs, where it has been detected both on tumor cells and tumor infiltrating mononuclear cells (TIMCs) [ 65 ]. Following the approval of immune checkpoint inhibitors pembrolizumab and nivolumab by FDA and EMA in the treatment of recurrent and metastatic HNSCCs, PD-L1 evaluation gained a pivotal importance in the diagnostic algorithm of HNSCCs, but its assessment still suffers from a lack of solid standardization [ 66 , 67 ]. This weakness is due to several reasons, including intratumoral heterogeneity, modifications occurring along the course of the disease, differences among the cutoffs, and exogenous modifications induced by local and systemic therapies [ 40 , 67 , 68 ].…”