Factors such as female gender (HR=4.022, 95%CI: 1.417-10.710, P=0.006), presence of CDKN2A LOF (HR=4.389, 95%CI: 1.782-11.460, P=0.002), and a CPS score below 1 (HR=17.20, 95%CI: 4.134-79.550, P<0.0001) emerged as independent associated factors of mortality in patients with recurrent or metastatic HNSCC undergoing immunotherapy (Table 4). The gene discussed is CDKN2A; the disease is head and neck squamous cell carcinoma.