鉴于其高患病率和相关死亡率，头颈鳞状细胞癌（HNSCC）构成了全球重要的癌症负担。尽管由于多学科治疗方法的增强，生存率取得了实质性进展，但这些方法常常导致严重的组织损伤、功能受损和潜在的毒性。因此，迫切需要新颖、有效且损伤最小的治疗方式。新辅助治疗是一种新兴的治疗策略，旨在在明确干预之前缩小肿瘤大小并减少远处转移。目前，新辅助化疗 (NACT) 已对部分 HNSCC 患者的治疗方法进行了微调，但尚未显着提高总生存期 (OS)。在当代癌症治疗领域，免疫疗法正在加速发展。值得注意的是，新辅助免疫疗法（NAIT）已显示出有希望的放射学和病理学反应，并且在多项临床试验中取得了令人鼓舞的疗效。这可能为 HNSCC 治疗降级的无数可能性铺平了道路，值得进一步探索。本文回顾了新辅助免疫检查点抑制剂（ICIs）的现有策略和功效，以及潜在的降级策略。此外，还探讨了 NAIT 降级战略中遇到的挑战。目的是为未来的研究方向提供信息，努力提高 HNSCC 患者的生活质量 (QoL)。版权所有 © 2024。由 Elsevier B.V. 出版。

Head and neck squamous cell carcinoma (HNSCC) constitutes a significant global cancer burden, given its high prevalence and associated mortality. Despite substantial progress in survival rates due to the enhanced multidisciplinary approach to treatment, these methods often lead to severe tissue damage, compromised function, and potential toxicity. Thus, there is an imperative need for novel, effective, and minimally damaging treatment modalities. Neoadjuvant treatment, an emerging therapeutic strategy, is designed to reduce tumor size and curtail distant metastasis prior to definitive intervention. Currently, neoadjuvant chemotherapy (NACT) has fine-tuned the treatment approach for a subset of HNSCC patients, yet it has not produced a noticeable enhancement in overall survival (OS). In the contemporary cancer therapeutics landscape, immunotherapy is gaining traction at an accelerated pace. Notably, neoadjuvant immunotherapy (NAIT) has shown promising radiological and pathological responses, coupled with an encouraging efficacy in several clinical trials. This potentially paves the way for a myriad of possibilities in treatment de-escalation of HNSCC, which warrants further exploration. This paper reviews the existing strategies and efficacy of neoadjuvant immune checkpoint inhibitors (ICIs), along with potential de-escalation strategy. Furthermore, the challenges encountered in the context of the de-escalation strategies of NAIT are explored. The aim is to inform future research directions that strive to improve the quality of life (QoL) for patients battling HNSCC.Copyright © 2024. Published by Elsevier B.V.