OBJECTIVES: To describe treatment patterns and HCU among patients who experienced progression during or after platinum-based chemotherapy for HNSCC in the United Kingdom (UK).
METHODS: Physicians in the UK recruited by convenience sampling reviewed medical records of adult patients who experienced 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 197 patients (median age 59.6 years) were extracted by 47 physicians. At least 1 additional (second-line) systemic therapy was received by 144 (73.1%) patients, of whom 19 (13.2%) also had third line therapy; the other 53 (26.9%) received best supportive care only. The most common second-line treatments were docetaxel alone (n=72, 50.0%), cisplatin+5-fluorouracil (n=13, 9.0%), and single-agent cetuximab (n=11, 7.6%). During second-line treatment, 79 (54.9%) patients had ≥1 hospital outpatient encounter (median 0.8 visits per month), and community health and emergency department visits were reported for 8 (5.6%) and 13 (9.0%) patients, respectively; 17 (11.8%) patients had ≥1 hospitalisation (median length of stay 4 days), and the most common reasons for hospitalisation were palliative care (n=6, 35.3%), treatment- or procedure-related complications (n=5, 29.4%), and disease progression (n=4, 23.5%).
CONCLUSIONS: In this study in the UK, 26.9% of patients received best supportive care only for R/M HNSSC. Of the 144 (73.1%) patients receiving second-line therapy, only 19 (13.2%) had third-line treatment for R/M HNSCC. Hospital-based outpatient services were used more frequently than community health, and 11.8% of patients required inpatient hospitalisation. These findings emphasise the need for new treatments for R/M HNSCC after initial platinum therapy that are effective and have improved safety.
