Background/Aim: Head and neck squamous cell carcinoma (HNSCC) is one of the most common types of cancer worldwide. Our study focused on the axon guidance receptor roundabout guidance receptor 1 (ROBO1) as a target for monoclonal antibody therapy of HNSCC. We previously showed that saporin-conjugated anti-ROBO1 (B5209B) immunotoxin (IT-ROBO1) enhanced cytotoxic effects on HNSCC cells in combination with the photosensitizer aluminum phthalocyanine disulphonate (AlPcS2a) and illumination. We examined the effects of this combination therapy in a mouse xenograft model. Materials and Methods: IT-ROBO1 was intraperitoneally administered to HSQ-89 (derived from Japanese maxillary sinus squamous carcinoma, RCB0789; RIKEN, Tsukuba, Japan) xenografted mice. After 3 days, AlPcS2a was injected subcutaneously around the tumor and the area was illuminated at 650 nm for 30 min. The growth of the tumor was evaluated and the effects on the tumor were examined. Results: Pronounced anti-tumor effects were elicited by the administration of IT-ROBO1 and AlPcS2a with light illumination on tumor size and pathological characteristics. Conclusion: The results showed that photosensitizer treatment with illumination robustly enhanced the antitumor effect of the IT-ROBO1 immunotoxin.The annual number of deaths from head and neck cancer worldwide was recently reported to be 300,000 (1, 2). Triple therapy has been the standard treatment for Head and neck squamous cell carcinoma (HNSCC), i.e. the combination of surgery, radiation therapy and chemotherapy. Various complications, however, such as postoperative aesthetic issues, masticatory disorders, dysphagia, articulatory disorders, respiratory disorders, mucositis, and long-term osteomyelitis have been matters of concern with regard to quality of life. As the number of patients suffering from HNSCC is increasing with the aging of society, the development of new treatments with less functional impairment and higher therapeutic effect is an urgent issue.Monoclonal antibody treatment is one of the approaches expected to afford improved care. Cetuximab and nivolumab have been approved for HNSCC treatment by the Food and Drug Administration (FDA) (3). Several methods to enhance antitumor effects have been tried, such as antibody drug conjugates, immunotoxin (IT), and radioimmunotherapy (RIT) (4). Trastuzumab-emtansine as an antibody drug conjugate was approved for inoperable or recurrent breast cancer that is human epidermal growth factor receptor 2 (HER2)-positive by the FDA in 1988 (5). IT was also approved for CD25-positive T-cell lymphoma (6) by the FDA in 2019. We demonstrated that a radioactive antibody 3793