How do you approach your choice of systemic therapy for relapsed/metastatic H&N cancer (failed definitive concurrent chemoRT) not amenable to further locoregional therapies?

If patients fail CRT with a platinum-based regimen within 6 month of the completion of treatment, I generally give them I/O therapy. If > 6 months, the SOC right now is to treat with a platinum based regimen, i.e. EXTREME regimen or a platinum doublet. I will often give a modified version of EXTREME...