Introduction

The advent of immune checkpoint inhibition has improved survival for patients with recurrent or metastatic platinum-resistant head and neck squamous cell carcinoma (HNSCC). In this setting, nivolumab has shown significantly improved outcome in comparison to chemotherapy (1). Evidence from pre-clinical studies suggests the addition of radiotherapy to immunotherapy may improve disease control (2). However, uncertainty remains as to whether combination treatment translates to improved outcomes in this clinical setting of recurrent or metastatic HNSCC. Currently, the decision to administer radiotherapy alongside systemic therapy in the palliative setting is made for selected patients on a case-by-case basis. However, there remains a need to define the additional clinical benefit of administration of radiotherapy alongside immunotherapy in this patient group.