Analysis of peripheral blood T-cell levels for predicting immunotherapy response sensitivity in squamous cell carcinoma of the head and neck.

Authors

Nuan Li, Lifei Feng, Gaofei Yin, Shuo Ding, Wei Guo

Published in

Frontiers in molecular biosciences. Volume 13. Pages 1896236. Epub Aug 06, 2026.

Abstract

To investigate the correlation between peripheral blood immune cell subsets and pathological response to neoadjuvant therapy in locally advanced head and neck squamous cell carcinoma (HNSCC), and to evaluate their predictive value.
A total of 57 patients with locally advanced HNSCC were retrospectively enrolled. Patients were divided into a chemotherapy group (TPF regimen, n = 25) and a chemoimmunotherapy group (TPK regimen, n = 32). Peripheral blood percentages and absolute counts of CD4⁺CD25⁺CD127low Treg cells, CD3⁺PD-1⁺, CD3⁺CD28⁺, CD4⁺PD-1⁺, CD4⁺CD28⁺, CD8⁺PD-1⁺, and CD8⁺CD28⁺ cells, as well as CPS scores, were collected before and after treatment. Primary tumor and lymph node responses were assessed by RECIST 1.1 and histopathology.
In the chemoimmunotherapy group, primary tumor and dual pCR rates were 75.0% (24/32) and 37.0% (10/27), respectively; subsequent surgery was significantly reduced. Post-chemoimmunotherapy, CD3⁺CD28⁺ (P = 0.014) and CD8⁺CD28⁺ (P = 0.034) percentages were lower in the primary tumor pCR group vs. non-pCR; in the pCR group, CD3⁺CD28⁺ (P = 0.026) and CD8⁺CD28⁺ (P = 0.041) percentages significantly declined from baseline. In lymph node pCR, similar trends were observed, with an additional decrease in CD4⁺CD28⁺ percentage (P = 0.030). In dual pCR, CD3⁺CD28⁺ percentage trended downward after treatment (P = 0.052). In the chemotherapy group, post-treatment Treg count (P = 0.013) and CD3⁺CD28⁺ percentage (P = 0.038) were lower in primary tumor pCR vs. non-pCR, with no significant associations at nodal or composite levels. Representative cases confirmed that benefit was associated with a sustained decline in peripheral CD3⁺CD28⁺ percentage, whereas non-beneficiaries showed stable or rebounding levels.
Chemoimmunotherapy can induce a significant decrease in peripheral blood CD28⁺ T cell subsets in HNSCC patients, and this dynamic change is closely associated with pathological complete response in the primary tumor, lymph nodes, and dual sites, with its predictive performance being superior to that of traditional CPS scoring. The migratory response of peripheral blood activated T cells holds promise as a novel non-invasive biomarker to guide individualized neoadjuvant therapy in locally advanced HNSCC.

PMID:
42625566
Bibliographic data and abstract were imported from PubMed on 21 Aug 2026.

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