{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:22:13Z","timestamp":1792783333973,"version":"4.5.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Leipzig","id":[{"id":"https:\/\/ror.org\/028hv5492","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J CARS"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Recurrent and metastatic head and neck squamous cell carcinoma (RM-HNSCC) is a challenging malignant disease due to limited treatment options and heterogeneous therapeutic responses. Despite Immunotherapy with PD-1 inhibitors such as Nivolumab and Pembrolizumab has become a standard of care, it is still complex and multifactorial to make a clinical decision in giving the patient its best individualized therapy. This study refines the use of Bayesian networks (BN) in application of supporting therapy selection in RM-HNSCC, integrating clinical, pathological, and molecular features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The previously introduced immune-oncologic BN for head and neck cancer was rechallenged by clinical data from 82 patients with RM-HNSCC. Therapy decisions (Nivolumab vs. Pembrolizumab) were calculated from the primary patient data. Model performance was assessed by comparing predicted versus actual therapy using retrospective data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The reevaluation of the immune-oncologic BN revealed an inconsistency in the conditional probabilities of the initial model leading to a correction. Consequently, the model achieved 94.7% predictive accuracy for Nivolumab administration (18\/19 cases) and 95.2% (60\/63) for Pembrolizumab, yielding an overall prediction accuracy of 95.1% with a Cohens Kappa of 0.859. The model provided transparent reasoning paths for therapy selection and enabled hypothetical simulations in clinical scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The immune-oncologic BN offers a promising approach to enhance personalized immunotherapy selection in RM-HNSCC patients by integrating diverse clinical variables into an interpretable decision support framework. The results support further prospective validation and clinical integration. Given the increasing complexity of biomarker-driven therapy, probabilistic models may contribute to more consistent and evidence-aligned treatment decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11548-026-03803-z","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T12:17:35Z","timestamp":1790338655000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reevaluation of the Bayesian network model to support immunotherapy decision-making in recurrent\/metastatic head and neck squamous cell carcinoma"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4219-4459","authenticated-orcid":false,"given":"Matthaeus","family":"Stoehr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Stoehr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Dietz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Gaebel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"3803_CR1","unstructured":"World Health Organization, International Agency for Research on Cancer. https:\/\/gco.iarc.fr\/today\/en\/dataviz\/bars?types=0&mode=cancer&group_populations=1&sort_by=value0&key=total. 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