{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:28:25Z","timestamp":1778858905564,"version":"3.51.4"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82272735, 82203510"],"award-info":[{"award-number":["82272735, 82203510"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018542","name":"Natural Science Foundation of Sichuan Province","doi-asserted-by":"publisher","award":["2025ZNSFSC0648"],"award-info":[{"award-number":["2025ZNSFSC0648"]}],"id":[{"id":"10.13039\/501100018542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>PD-1 inhibitors are first-line treatments for recurrent or metastatic head and neck squamous cell carcinoma (R\/M HNSCC). However, previous trials included few participants from mainland China and other Asian regions and differed from real-world practice. PD-L1 expression alone has limited predictive value. This study aimed to systematically evaluate efficacy and survival differences in diverse clinical scenarios and identify associated peripheral blood markers (PBMs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were retrospectively collected from 105 R\/M HNSCC patients treated with first-line immunotherapy alone or in combination across 3 hospitals in China (2020.01-2022.12). Primary endpoints were overall survival (OS) and progression-free survival (PFS). We assessed efficacy, survival, and safety, and developed predictive models. Data analyses were performed using SPSS 26.0 and GraphPad Prism 8.0.1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median follow-up was 21 months. The objective response rate was 37.14%. Median OS was 21 months (1-year OS: 81.02%), and median PFS was 11 months (1-year PFS: 39.47%). Immunotherapy was more effective for distant metastasis (DM) than local recurrence (LR). For patients with LR, DM, or both, median PFS was 12, 14, and 7.5 months, respectively (P = 0.0029). Higher combined positive score (CPS) predicted better outcomes. Median OS for CPS \u2265 20, 1 \u2264 CPS &amp;lt; 20, and CPS &amp;lt; 1 was 32, 20, and 12 months, respectively (P = 0.0008). In the comparison of combination versus single-agent immunotherapy, median PFS was 12 versus 9 months (P = 0.0044). Combining taxanes with immunotherapy yielded favorable results, with a median OS of 27 months. No survival difference was found between domestic and imported PD-1 inhibitors. Secondary radiotherapy did not improve survival. Increased peripheral blood lymphocyte subsets and decreased peripheral blood inflammatory markers were associated with superior immunotherapy outcomes. Key predictive PBMs included baseline CD8\n                      <jats:sup>+<\/jats:sup>\n                      T cells, CD3\n                      <jats:sup>+<\/jats:sup>\n                      T cells at 12 weeks post-treatment (12w pt), CD4\n                      <jats:sup>+<\/jats:sup>\n                      T cells at 6w pt, and CD8\n                      <jats:sup>+<\/jats:sup>\n                      T cells at 12w pt.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study focused on evaluating immunotherapy efficacy and survival differences in R\/M HNSCC patients across various clinical background. Dynamic PBMs correlated closely with immunotherapy response and survival prognosis. These findings expanded treatment options and supported personalized decisions. R\/M HNSCC, Immunotherapy, Real-world study, Efficacy and survival differences, Predictive markers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1720838","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T06:45:49Z","timestamp":1770187549000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Multicenter real-world data on immunotherapy for R\/M HNSCC from China: comprehensive analysis of efficacy and survival differences across diverse clinical backgrounds, and identification of predictive peripheral blood biomarkers"],"prefix":"10.3389","volume":"17","author":[{"given":"Feifan","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Xijing Hospital, The Fourth Military Medical University (Air Force Medical University)","place":["Xi\u2019an, China"]},{"name":"Department of Oncology, The General Hospital of Western Theater 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