Trends in the use of neoadjuvant systemic therapy for head and neck squamous cell carcinoma

Recent trials have demonstrated potential effectiveness of neoadjuvant systemic therapy (NST), including chemotherapy and immunotherapy, for head and neck squamous cell carcinoma (HNSCC). A retrospective study using the National Cancer Database evaluated trends in the use of NSTin patients with HNSCC from 2004 to 2022. In this cohort study if 312,748 patients with HNSCC undergoing definitive surgery, 0.6% received NST. Neoadjuvant immunotherapy use significantly increased over time, whereas neoadjuvant chemotherapy use decreased. Neoadjuvant immunotherapy recipients were more likely to have private insurance and stage IV disease and less likely to be of Black race. The authors conclude that these findings suggest that increasing neoadjuvant immunotherapy use reflects evolving treatment practices in HNSCC and highlights disparities.