Besides, CAFs promote an immune suppressive TME through the induction of trans-differentiation or polarization of immune cells such as tumor-associated macrophages (TAMs) to pro-tumoral phenotype, as well as by suppressing T-cell infiltration in HNSCC, through secretion and activation of transforming growth factor–β (TGF-β), modulating multiple immune cells leading to a more suppressive phenotype (9, 19). This evidence concerns the gene TGFB1 and head and neck squamous cell carcinoma.