Fig. 2

Treatment Algorithm 2: Second-line treatment for R/M HNSCC patients. Immunotherapy treatment algorithm for platinum-refractory recurrent/metastatic HNSCC based on current FDA approvals for pembrolizumab and nivolumab as second-line therapies. All treatment options shown may be appropriate. The final selection of therapy should be individualized based on patient eligibility and therapy availability based on the treating physician’s discretion. The goal of these algorithms are to provide advice as the consensus recommendations of the Subcommittee. 1) Nivolumab and pembrolizumab have been FDA approved only in patients with R/M HNSCC and who are refractory to platinum-based chemotherapy. If patient experiences disease progression on or after prior Platinum Based chemotherapy, patient should receive Immune Checkpoint Inhibitor monotherapy or be enrolled in an appropriate clinic trial. 2) Clinical trials, including those that are immunotherapy-based, should be considered in all HNSCC patients, in all lines of therapy