A low Prognostic Nutritional Index (PNI), defined as serum albumin (g/dL) multiplied by ten plus total lymphocyte count multiplied by 0.005 (11) and reflecting poor nutritional status, has been shown to predict reduced progression-free survival (PFS) and overall survival (OS) in advanced head and neck squamous cell carcinoma (HNSCC) patients receiving immunotherapy (12). Here, ALB is linked to head and neck squamous cell carcinoma.