Introduction:
Monoclonal antibody (mAb) therapies, including immune checkpoint inhibitors and anti-epidermal growth factor receptor (EGFR) agents, are increasingly used in oral squamous cell carcinoma (OSCC) [1]. Response rates vary, highlighting the need for predictive biomarkers to guide patient selection [2,3]. This review summarises current evidence linking biomarker profiles with mAb outcomes in OSCC.

Methods:

A PRISMA-guided search of PubMed, ScienceDirect, and Web of Science identified English-language studies published within the past five years on adult OSCC treated with mAbs, reporting biomarker associations with clinical outcomes. Of the 502 records screened, 5met inclusion criteria.

Results:

Analysis of recent evidence highlights several biomarkers with predictive value for mAb and immunotherapy response in OSCC. In recurrent disease treated with nivolumab (n = 64), Tachinami et al. found that a post-treatment neutrophil-to-lymphocyte ratio (NLR) ≥ 5 was associated with poorer survival [4]. Dou et al. reported that EGFR mutations and chromosome 11q13 amplification correlated with reduced progression-free survival (PFS) and a lack of clinical benefit in patients receiving anti-PD-1 therapy [5]. In locally advanced OSCC, Xiang et al. achieved a major pathological response (MPR) rate of 69.0% and pathological complete response (pCR) rate of 41.4% with camrelizumab plus chemotherapy, with higher rates in programmed death-ligand 1 (PD-L1)-positive patients [6]. Huang et al. reported MPR 60% and pCR 30% with toripalimab plus chemotherapy, with a PD-L1 combined positive score (CPS) > 10 and increased tertiary lymphoid structures predicting response [7]. Ju et al. observed MPR 40% with camrelizumab and the vascular endothelial growth factor receptor 2 (VEGFR2) inhibitor apatinib, with all PD-L1 CPS > 10 patients responding [8].

Conclusion:
PD-L1 expression, tertiary lymphoid structures, NLR, and genomic alterations may guide mAb therapy selection in OSCC. Evidence is limited by few studies and heterogeneity; larger prospective trials are needed to confirm clinical utility.