Researchers launched and reported on OPTIM, a randomized Phase II strategy in recurrent or metastatic squamous cell carcinoma of the head and neck that escalates therapy based on early results. The trial tests nivolumab first, then shifts to either nivolumab-ipilimumab or docetaxel depending on response and predefined selection criteria. The design reflects a move toward adaptive oncology pathways—using initial immunotherapy exposure to route patients toward the next best option. Published in British Journal of Cancer, the approach aims to improve outcomes while limiting unnecessary toxicity from broad upfront combination regimens. For clinicians and development teams, OPTIM provides a template for response-adaptive escalation that can be adapted to other tumor types and immunotherapy combinations.