A Podcast Discussion on Medical Treatment in R/M-SCCHN in the Year 2025-Standard and Considerations for an...

Recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) remains a disease with limited treatment options. Once salvage surgery or radiotherapy is no longer feasible, systemic medical therapy becomes the mainstay of treatment. This article discusses the general principles of systemic therapy, with a focus on key phase 3 clinical trials such as KEYNOTE-048 and EXTREME. The strengths and limitations of these studies are evaluated, and in the context of additional phase 2 trials, considerations are made regarding individualized treatment strategies based on patient-specific characteristics when selecting first-line therapy. Although there is limited evidence to define an ideal second-line therapy, switching the mechanism of action from the first-line treatment remains a reasonable approach. In conclusion, as of 2025, for fit patients, the choice of first-line therapy should be guided by PD-L1 combined positive score (CPS) and the clinical need for rapid remission, as well as other patients individual parameters. Second-line treatment decisions should be based on the mode of action used in the first-line setting-pending further clinical trials to establish optimal treatment sequencing. However, upcoming innovation within the landscape of medical treatment, with introduction of PD1 inhibition into the neoadjuvant setting, will need within the near future a reconsideration of hole treatment journey in head and neck. Podcast Audio (MP4 285072 KB).