Role of immunotherapy in the management of oral squamous cell carcinoma – A systematic review

Abstract

Background

Oral squamous cell carcinoma (OSCC) is an aggressive malignancy with high recurrence rates and limited survival benefits from conventional treatments. Immunotherapy has emerged as a promising therapeutic approach, but its role in OSCC remains to be clearly defined.

Objectives

To systematically review and synthesize available evidence on the use of immunotherapy in OSCC, focusing on treatment regimens, clinical outcomes, and adverse effects.

Methods

A systematic search of PubMed, MEDLINE, Web of Science, Cochrane Library, and Google Scholar was conducted for studies published between January 2000 and December 2024. Eligible studies were case reports or case series involving OSCC patients treated with immunotherapy. Data extraction and quality assessment were performed using Joanna Briggs Institute (JBI) critical appraisal tools.

Results

Seventeen studies comprising 20 individual OSCC cases were included. The most common tumor sites were the tongue (30%) and gingiva (30%), with 60% presenting at stage IV. Immunotherapy was used more often as adjuvant therapy (55%) than monotherapy (45%). Pembrolizumab (n = 7) and nivolumab (n = 5) were the most frequently administered agents. complete responses occurred in 50%, partial responses in 20% of cases and progressive disease in 15%. Adverse effects, reported in 75% of cases, ranged from mild dermatologic reactions to severe immune-mediated events.

Conclusions

Immunotherapy shows promising clinical activity in OSCC, particularly in combination with conventional treatments, but its optimal use requires further high-quality research.