Besides, substantial infiltration of pro-inflammatory immune cells, such as tumor-associated macrophages (TAM), natural killer (NK) cells, and CD8+ T cells, HNSCC TME is immunosuppressive.34 Expression of pro-inflammatory mediators, such as IL-1α, IL-1β, IL-6, IL-8, TNF-α, TGF-β, granulocyte–macrophage colony-stimulating factor (GM-CSF), vascular endothelial growth factor (VEGF), monocyte chemoattractant protein 1 (MCP-1), RANTES (CCL5), and prostaglandin E2 (PGE2) are found to be upregulated in the premalignant lesions of HNSCC38,39 and are involved in progression and metastasis. This evidence concerns the gene CCL5 and head and neck squamous cell carcinoma.