Goetz J W, Rabinowits G, Kalman N, Villa A. A Review of Immunotherapy for Head and Neck Cancer. J Dent Res 2024; DOI: 10.1177/00220345241271992.

Guidelines are required to standardise dental care during immunotherapy.

The introduction of immune checkpoint inhibitors (ICIs) to oncological care has transformed the management of various malignancies, including head and neck squamous cell carcinoma (HNSCC), offering improved outcomes. The first-line treatment of recurrent and malignant HNSCC for many years was combined platinum, 5-fluorouracil, and cetuximab. Recently, the ICI pembrolizumab was approved as a first-line treatment, with or without chemotherapy, based on tumour and immune cell percentage of programmed-death ligand 1 (PD-L1). Immunotherapy regimens may be personalised by tumour biomarker. However, further clinical trials are needed to refine biomarker-driven protocols and standardise pathological methods to guide combined regimen timing, sequencing, and de-escalation. Gaps remain for protocols using immunotherapy to reverse oral premalignant lesions, particularly high-risk leukoplakias. A phase II non-randomised controlled trial, using the ICI nivolumab, showed a two-year cancer-free survival of 73%, although larger trials are needed. Guidelines are also needed to standardise the role of dental care, specifically regarding oral immune-related adverse events and their impact on cancer recurrence.