虽然最近对新辅助免疫检查点抑制剂进行的临床试验在部分患有头颈鳞状细胞癌（HNSCC）的患者中显示出了有希望的结果，但需要识别肿瘤活检中坚固的生物标记物以提高患者选择的精度。本文旨在揭示未经处理的同一HNSCC患者的配对样本之间的转录组异质性。根据以往的研究以及公开可用的配对肿瘤生物标本和手术切除物的基因表达谱分析，我们讨论了肿瘤活检在捕捉HNSCC患者靶向生物通路的总体活化中的可靠性。我们认为需要进一步研究肿瘤内部转录组异质性以及采样方法对基因表达的影响，以开发创新且相关的生物标记物驱动的新辅助策略。版权所有© 2023 Elsevier Ltd.。保留所有权利。

While recent clinical trials evaluating neoadjuvant immune checkpoint inhibitors showed promising results in a subset of patients with head and neck squamous cell carcinomas (HNSCC), there is a need for the identification of robust biomarkers in tumor biopsies to improve patient selection. This context suggests unravelling transcriptomic heterogeneity between untreated paired samples from same patient with HNSCC. Based on previous studies and the analysis of publicly available gene expression profiles of paired tumor biopsies and surgical resection specimens, we discuss the reliability of tumor biopsy to capture the overall activation of targetable biological pathways in patients with HNSCC. Further studies investigating intratumor transcriptomic heterogeneity as well as the effect of sampling methods on gene expression are needed in patients with HNSCC, in order to develop innovative and relevant biomarker-driven neoadjuvant strategies.Copyright © 2023 Elsevier Ltd. All rights reserved.