Management of metastatic head and neck Cancer: An all-in, kitchen-sink Approach?

•The role of first-line ICI alone vs chemo-ICI in CPS 1–19% r/mHNSCC is unclear.•Simpler, less toxic cancer therapy is generally favoured in the palliative setting.•We review evidence of potential benefit of chemo-ICI over ICI alone in CPS 1–19%•Many patients will not be fit enough to receive subsequent line of systemic therapy.•Careful patients-physicians discussions are warranted.