OBJECTIVES: Recent data characterizing metastatic SCCHN treatment patterns in the UK are limited. The current study evaluated patterns of care and HCRU in UK patients with metastatic SCCHN who received greater than or equal to 3 lines of systemic therapy.
METHODS: Medical records of 220 patients with metastatic SCCHN who received greater than or equal to 3 lines of systemic therapy were abstracted. Clinical and demographic information at metastatic diagnosis as well as treatment and supportive care data were collected for patients greater than or equal to18 years initiating third-line systemic therapy between 1 January 2011 and 30 August 2014. Performance status (PS) was recorded prior to each line of therapy. SCCHN-related HCRU was captured until death or last medical record. All analyses were descriptive.
RESULTS: Most patients were Caucasian (90%), male (74%), current or former smokers (85%), with an initial SCCHN diagnosis of stage IVC (52%). Median age at metastatic diagnosis was 60 years and most patients had an Eastern Cooperative Oncology Group (ECOG) PS of 0 or 1 (208/217=96%). For patients with PS=0/1, the most common first-line treatment was cisplatin+5-FU (98/208=47%); docetaxel was the most common second-line (85/177=48%) and third-line treatment (30/117=26%). For patients with PS greater than or equal to 2, the most common first-, second-, and third-line treatments were carboplatin+5FU (5/9=56%), cetuximab (12/38=32%), and methotrexate (21/95=22%), respectively. Four patients (2%) received 4 therapy lines while no patient received greater than or equal to 5 lines. Seven patients (3%) received radiation and/or surgery for metastatic disease. Most patients received supportive care during therapy (85%) and after its discontinuation (89%). SCCHN-related hospitalizations and emergency department visits were reported for 27% and 20% of patients during therapy, respectively (vs. 10% and 16% after therapy discontinuation). Median survival after metastatic diagnosis was 25.6 months.
CONCLUSIONS: Patterns of care and HCRU varied among patients with repeatedly treated metastatic SCCHN; specific systemic therapies varied by PS. Factors associated with HCRU will be examined in future multivariate analyses.
