933P - Real-world patterns of immunotherapy utilization and outcomes in recurrent/metastatic head and neck cancer (R/M HNC) patients across European countries: A multicenter retrospective federated analysis

Background

Limited real-world data exists on treatment patterns and outcomes in R/M HNC pts receiving anti-PD-1 immunotherapy (IT). This study provides insights into contemporary IT use and sequencing. Preliminary results from five centers in four European countries (Italy, Poland, Portugal, Slovenia) are presented.

Methods

A retrospective federated analysis of R/M HNC pts who received IT between March 2017 and May 2022 was conducted. Data were analyzed at each center using a common R script. Overall survival (OS) and real-world progression-free survival (rwPFS) were calculated from IT start. Lines of systemic therapy (line) included concomitant chemotherapy (ChT) used with radiotherapy (CRT).

Results

A total of 224 pts with a median age of 58–67 yrs across countries were included. 43.8% of pts had metastatic disease as opposed to locoregional only at IT start, 64.7% had platinum refractory disease, and 19.2% were tested for PD-L1 expression. 9.8% of pts began their treatment with IT, whereas most pts. received anti-PD-1 after previous CRT or as a 2nd line (pembrolizumab 10.0%, pembrolizumab+ChT 4.4%, nivolumab 85.6%). In the first line, the most common systemic treatments beside platinum-based CRT (39.3%) were platinum-containing combination ChT without cetuximab (37.5%) and ChT+cetuximab (12.0%). The maximum number of lines in any patient was 10 and nivolumab was the most used agent overall (25.6%) followed by non-platinum monochemotherapy (21.4.%). Median overall survival from anti-PD-1 initiation across countries was 5.9–13.6 months (ms), and the median rwPFS ranged from 2.8–4.8 ms. The overall occurrence of irAEs ranged from 18.3–81.3% across countries, with the most common irAEs being gastrointestinal (25.8%) and endocrinal disorders (17.9%). There were 57.3% grade 2, 6.6% grade 3 and no grade 4 or 5 irAEs.

Conclusions

This real-world study across four European countries shows variable IT utilization and outcomes, irAEs occurrence, and treatment patterns in R/M HNC. Further research is needed to optimize IT use, considering pts characteristics and treatment-related factors.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

DIGICORE research network.

Disclosure

A. Kovac: Financial Interests, Personal, Writing Engagement: Novartis; Financial Interests, Personal, Invited Speaker: Ewopharma; Financial Interests, Personal, Other, Travel, accommodation, expenses: MSD; Non-Financial Interests, Member: ASCO, ESO. C. Vieira: Other, Personal, Speaker, Consultant, Advisor: Bristol Myers Squibb, Genentech/Roche, Grünenthal, Lilly, Merck Serono, MSD, Novartis, Pfizer. All other authors have declared no conflicts of interest.