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Scientific Oral Presentation

Rhinology/Allergy

Immune Profiles and Immunotherapy Efficacy in Sinonasal Malignancies: A Scoping Review

Sunday, October 18, 2026
8:36 AM - 8:42 AM PT
Location: Theatre 411

    Presenting Author(s)

  • AA

    Ayad Ali, MD, PhD

    Resident Physician
    Duke University Hospital System
    Durham, NC, United States

    • Senior Author(s)

  • RA

    Ralph Abi Hachem, MD, MBA, MSc

    Associate Professor
    Duke University Hospital System
    Durham, North Carolina, United States

Disclosure(s):
Ayad Ali, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Sinonasal malignancies are rare, diverse tumors with high mortality and recurrence rates despite multimodal treatment strategies. Little is understood about the efficacy of immunotherapeutic strategies against them or their immunologic profiles. This review summarizes key immune markers within sinonasal cancers and underscores known data on the efficacy of checkpoint inhibitors.

Methods: The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Web of Science were searched (July 28, 2025) from database inception to present using PRISMA guidelines to identify studies on sinonasal malignancies, including sinonasal squamous cell carcinoma (SNSCCa), adenocarcinoma (SNAC), undifferentiated carcinoma (SNUC), and olfactory neuroblastoma (ONB), and immunotherapy. Included studies were those that either investigated the immune profile (cellular or molecular) or reported findings following the use of immune checkpoint inhibitors. Four reviewers performed dual, independent screening of references by title and abstract, and full-text review in the Covidence software. Conflicts were resolved by a third person arbitrator.

Results: After completing dual, independent screening of 631 studies, 48 were included in the final analysis. Anti-programmed cell death protein-1 (PD-1) immunotherapy is the most investigated immune checkpoint inhibitor against SN malignancies. Checkpoint inhibitor efficacy showed the most promise for SNSCCa with comparatively few studies in SNAC, SNUC, and ONB. The prognostic value of tumor-infiltrating lymphocytes (TIL) density and programmed death ligand-1 (PD-L1) expression vary greatly between sinonasal tumor subtypes. TIL, not PD-L1 expression, most consistently correlates with survival in SNSCCa, SNAC, and SNUC, and are largely absent in ONBs. ONBs appear to be predominantly immune-cold.

Conclusions: Sinonasal tumor rarity and heterogeneity limits research in immunotherapy efficacy and prognostic biomarkers. Further research is needed to understand SN tumor immune microenvironment and identify reliable prognostic biomarkers.