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.
