Despite rapid advances in systemic regimens, reirradiation technology, and an expanding pipeline of therapies for recurrent/metastatic HNSCC, we need evidence-based frameworks to select appropriate candidates and plan safe re-irradiation, reassess resectability and coordinate timing of surgery after response to modern chemo-immunotherapy, and stratify and sequence emerging treatments using contemporary trial data and biomarkers. These gaps drive heterogeneous decision making, inconsistent tolerance mitigation, underutilization of clinical trials and variable patient outcomes. Focused education is needed to align day-to-day practice with current evidence and ongoing trials across these domains.

Practicing clinicians need up-to-date understanding of rapidly evolving domains in recurrent/metastatic HNSCC-specifically, modern re-irradiation paradigms, criteria for surgical conversion after systemic response and new systemic options in HPV-negative disease. This activity closes knowledge gaps by synthesizing current evidence and ongoing trials across these topics. Clinicians must translate the latest evidence into day-to-day decisions: for example, selecting candidates for re-irradiation, coordinating timing of salvage surgery after immuno-/chemotherapy response, and integrating emerging therapeutics into individualized care pathways. The presentations provide practical, case-focused guidance on when and how to apply these strategies. To improve outcomes, teams need to consistently implement multidisciplinary, evidence-based workflows, such as standardizing toxicity mitigation in re-irradiation, aligning surgical decision making with systemic responses, and ensuring timely adoption of new therapies. This session is structured to drive consistent practice change across these interfaces.

Faculty walk participants through patient selection criteria for salvage local and systemic therapy, then model pathways that coordinate systemic therapy response with salvage surgery/RT.