Introduction
As the seventh most common tumor (1), head and neck cancer (HNC)
consists of four major anatomical sites: the oral cavity, oropharynx,
larynx, and nasopharynx (2), and almost 90% of it is head and neck
squamous cell carcinoma (HNSCC)(3). HNSCC associates with the human
papillomavirus (HPV) (HPV16/18) and tobacco (4), and the overall
incidence rate of HNSCC in males is higher than in females (4).
HPV-positive (HPV+) patients have a more favorable
prognosis and more favorable responses to chemotherapy and radiotherapy
than patients with HPV-negative (HPV-)(5).
Conventional treatments for HNC involve surgery and chemoradiotherapy.
Cetuximab, the antibody of epidermal growth factor receptor (EGFR), is
also applied to the HNC treatment combined with cisplatin-based
chemotherapy (6, 7). However, the
efficiency of conventional treatments and cetuximab is limited(8). One
of the first and most characterized immune evasion mechanisms is the PD
pathway (9). Overwhelming evidence demonstrated that PD-1/PD-L1 immune
inhibitors could reduce escaping tumor immune surveillance (T cell
suppression)(10), enhance endogenous anti-tumor immunity (11). We first
identified the suitable population for PD-1/PD-L1 inhibitors, compared
the overall survival rate of the patients with different
characteristics, analyzed the incidence of various adverse events in
detail according to the classification, and included studies about
PD-1/PD-L1 inhibitors with conventional therapy to guide clinical
practice, which has not been studied(12-14).