884P - Real-world treatment patterns and survival outcomes associated with locally advanced squamous cell carcinoma of the head and neck (LA SCCHN): A German claims data analysis

Background

Treatment of patients (pts) with LA SCCHN depends on tumor site and resectability. Standard treatment options include surgery followed by radiotherapy (RT) or chemoradiotherapy (CRT) or, for pts not undergoing surgery, definitive CRT.

Methods

This was a retrospective cohort study using the WIG 2 benchmark database, a representative German claims database to describe real-world (RW) treatment patterns in pts with LA SCCHN and associated outcomes in Germany. Adult pts newly diagnosed with head and neck cancer between 2016 and 2020 were included. Information on therapeutic procedures and the sequence of therapies were then used to identify LA SCCHN pts within head and neck cancer pts. Pts were followed up for ≥12 months. RW overall survival (OS) was estimated from the start of initial treatment using the Kaplan-Meier estimator.

Results

A total of 1,010 pts with LA SCCHN with a mean age of 62.5 years were identified, the majority were male (81.9%). Oropharyngeal cancer was most common (38.5%), followed by cancer of the oral cavity (25.0%), larynx (23.6%), and hypopharynx (12.9%). Overall, 402 pts (39.8%) had primary resection and 608 pts (60.2%) received definitive nonsurgical treatment. The latter pt group was slightly older (proportion aged >65 years: 30.8% vs 39.3%, respectively). Adjuvant treatment included CRT (47.8%), RT (47.8%), and other treatment combinations (4.4%). Definitive nonsurgical therapy consisted of CRT (57.1%), RT (32.7%), and other treatment combinations (10.2%). The 3- and 5-year OS rates were 68.2% (95% CI, 63.4%–73.4%) and 55.8% (95% CI, 48.8%–63.7%) in pts with primary resection followed by adjuvant treatment. Pts with definitive nonsurgical treatment had 3- and 5-year OS rates of 54.6% (95% CI, 50.5%–59.1%) and 43.8% (95% CI, 38.9%–49.4%).

Conclusions

RW management of pts with LA SCCHN included resection followed by adjuvant CRT or RT and, for pts who did not undergo tumor resection, definitive CRT or RT. Although the majority of patients received standard-of-care treatment, half of the patients died within 5 years after treatment, highlighting the urgent unmet need for better treatment options.

Clinical trial identification

Editorial acknowledgement

Editorial support was provided by Aaron Runkle of Nucleus Global and was funded by Merck Healthcare KGaA (CrossRef Funder ID: 10.13039/100009945).

Legal entity responsible for the study

This study was sponsored by Merck Healthcare KGaA (CrossRef Funder ID: 10.13039/100009945).

Funding

This study was sponsored by Merck Healthcare KGaA (CrossRef Funder ID: 10.13039/100009945).

Disclosure

T. Kuhnt: Financial Interests, Personal, Advisory Role: Merck; Financial Interests, Personal, Funding: Merck. N. Kossack, L. Richter: Financial Interests, Personal, Full or part-time Employment, WIG2 GmbH conducted study on behalf of Merck: WIG2 GmbH. M. Schultze: Financial Interests, Personal, Full or part-time Employment, ZEGBerlin received funding from Merck to conduct this study. As part of the implementation of the study, medical writing support was provided by ZEGBerlin for a first draft of the abstract, funded by Merck as well: ZEGBerlin. U. Osowski: Financial Interests, Institutional, Full or part-time Employment: Merck Healthcare Germany GmbH, Weiterstadt, Germany, an affiliate of Merck KGaA. L. Henkel: Financial Interests, Personal, Full or part-time Employment: Merck Healthcare Germany GmbH, Weiterstadt, Germany. A. Gaupel: Financial Interests, Personal, Full or part-time Employment: Merck Healthcare KGaA. N. Schoenherr: Financial Interests, Institutional, Full or part-time Employment: Merck Healthcare KGaA.