Parikh RC, Kurosky S, Kaye JA, Levine C, Hettle R, Shire N, Sawyer W, Wang H. Treatments and health care utilisation (HCU) following initial platinum therapy in patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC): a medical record review in Germany. Poster presented at the ISPOR 21st Annual European Congress; November 14, 2018. Barcelona, Spain.


OBJECTIVES: To characterise treatment patterns and assess HCU among patients with R/M HNSCC in Germany who experienced progression during or after platinum-based chemotherapy.

METHODS: Physicians in Germany 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: Physicians (n=84) reviewed data for 206 eligible patients (median age 58.3 years). Most patients (n=162, 78.6%) received second-line chemotherapy or biologic therapy and the remaining 44 (21.4%) received only best supportive care. Docetaxel alone (n=40, 24.7%), carboplatin+cetuximab+5-fluorouracil (n=22, 13.6%), and cetuximab+cisplatin+5-fluorouracil (n=20, 12.3%) were the most common second-line regimens. Only 25.9% (n=42) of patients who received second-line treatment also received third-line treatment, most frequently with single-agent cetuximab (n=23, 54.8%) or docetaxel (n=11, 26.2%). Among patients receiving second-line treatment, 134 (82.7%) had at least 1 hospital outpatient visit, with a median of 1.1 visits per month; community health and emergency department visits were reported for few patients (2.5% and 0.6%, respectively). At least 1 hospitalisation encounter was reported for 8.0% of patients during second-line treatment; the median duration of hospitalisation was 4 days, and the most common reasons for admission were chemotherapy administration (30.7%), treatment- or procedure-related complications (23.1%), and disease progression (23.1%).

CONCLUSIONS: Only 25.9% of patients in Germany who received second-line treatment also received third-line treatment, indicating the importance of improving treatment options for this population. Furthermore, most patients were reported to have used hospital-based services (inpatient and outpatient), highlighting that treatments with improved safety profiles are needed.

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