OBJECTIVES: To assess treatment patterns and HCU among patients with R/M HNSCC in Spain who experienced progression during or after platinum-based chemotherapy.
METHODS: Physicians in Spain recruited by convenience sampling reviewed medical records of adult patients who experienced disease progression between 1 January 2011 and 31 March 2016. Progression must have occurred during or after palliative platinum chemotherapy for R/M HNSCC or within 6 months after platinum chemotherapy as part of a multimodality therapy with curative intent. Disease characteristics, treatment patterns, and HCU (including drug administration encounters) were described.
RESULTS: Data for 196 patients (median age 58.6 years) were extracted by 43 physicians. Second-line systemic therapy was received by 154 (78.6 %) patients; 42 (21.4%) patients received best supportive care only. The most frequently received second-line regimens were cetuximab+paclitaxel (n=38, 24.7%), paclitaxel monotherapy (n=19, 12.3%), and single-agent cetuximab (n=18, 11.7%). Of patients receiving second-line treatment, only 38 (24.7%) received third-line treatment. During second-line treatment, hospital outpatient and community health visits were reported for 64 (41.6%) and 24 (15.6%) patients (median 0.9 and 0.7 visits/month, respectively); 33 (21.4%) patients required emergency department visits, and treatment- or procedure-related complications (n=15, 45.5%) were the most common reason for these visits. Hospitalisations during second-line treatment were reported for 35 (22.7%) patients; median length of stay was 10 days. Palliative care (n=18, 51.4%), disease progression (n=17, 48.6%), and treatment- or procedure-related complications (n=8, 22.9%) were common reasons for hospitalisation.
CONCLUSIONS: After progression on initial platinum therapy, 21.4% patients received best supportive care and, of the 154 (78.6%) receiving second-line therapy, only 24.7% received subsequent treatments. A considerable proportion of patients were hospitalised for disease- and treatment-related issues, highlighting the need for improved safety of new treatments.
