On the other hand, immunotherapy response differs between malignancies and within cancer Cohorts.[30] As a result, TMB levels were established to predict cancer patients’ response to immunotherapy, and high TMB has been demonstrated to correlate with immunotherapy efficacy.[31] CD4+, CD8 + T-cells and other antitumor immune cells were in negatively correlation with score, while cancer-associated fibroblasts (CAF) and the score were positive correlation, which may have interpreted the poor prognosis of HNSCC suffers. This evidence concerns the gene CD4 and head and neck squamous cell carcinoma.