Effectiveness Outcomes in Patients With Recurrent or Refractory Head and Neck Cancers: Retrospective Analysis of Data From a Community Oncology Database

Fisher, Mary L.; Fernandes, Ancilla W.; Olufade, Temitope; Miller, Paul J.; Walker, Mark S.; Fenton, Moon J.

doi:10.1016/j.clinthera.2018.07.016

Cited by 5 publications

(4 citation statements)

References 31 publications

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“…We did not found that age affects PFS (RR 0.90; 95% CI 0.64–1.25; p = 0.52). This result was consistent with previous studies from Pytynia et al [ 20 ] and Fisher et al [ 21 ]. A reasonable explanation for this was because most patients had no comorbidities and good performance status regardless of their age.…”

Section: Discussionsupporting

confidence: 94%

Factors that Influence 2-Year Progression-Free Survival Among Head and Neck Cancer Patients

Irawan

Benbella

Rachman

et al. 2021

J Epidemiol Glob Health

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Objectives The majority of patients with head and neck cancer (HNC) come to the hospital at advanced stages. This research was conducted to determine the mortality, 2-year progression-free survival (PFS) and factors that influenced PFS of HNC patients. Methods A retrospective cohort study was conducted among locally advanced HNC patients who underwent chemoradiation for the first time at RSCM from January 2015 to December 2017. Data were retrieved through medical records. Laboratory data were taken 2–4 weeks prior and 2–4 weeks after chemoradiation. PFS observation started from the first day of chemoradiation until disease progression or death. PFS data were recorded in two groups: ≤ 2 years and > 2 years. The Chi-square test was used for bivariate analysis with the Fischer-exact test as an alternative. Variables will be further tested using multivariate logistic regression tests. Results Among 216 subjects, there were 103 (47.69%) patients who did not reach overall survival (OS) > 2 years. There were 108 (50%) patients who had PFS > 2 years. Based on the results of multivariate analysis, it was found that smoking, hemoglobin level ≤ 12 g/dl, ECOG (Eastern Cooperative Oncology Group) 1–2, and negative therapeutic response were associated with poor PFS. Hazard ratio (HR) for 2-year PFS for Brinkman index > 250 was 1.36 (95% CI 0.93–2.00; p = 0.02); HR for Hb ≤ 12 g/dl was 1.65 (95% CI 1.13–2.42; p = 0.01); HR for ECOG 1–2 was 4.05 (95% CI 1.49–11.00; p < 0.01); and HR for negative therapeutic response was 2.37 (95% CI 1.43–3.94; p < 0.01). Conclusion Mortality of HNC patients within 2 years is 47.69%, with a 2-year PFS reaching 50%. Cigarette smoking, low hemoglobin levels, poor performance status, and negative therapeutic response (non-responders) negatively affect the 2-year PFS.

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Section: Discussionsupporting

confidence: 94%

Factors that Influence 2-Year Progression-Free Survival Among Head and Neck Cancer Patients

Irawan

Benbella

Rachman

et al. 2021

J Epidemiol Glob Health

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“…This is much longer than other recently published German real-world data from 2011 to 2013 in sample with comparable treatment regimens: 102 patients with probably lower general health status (ECOG performance status ≥ 2: 41%) than in the present study showed a median overall survival of only 7 months (Grunwald et al 2020 ). In contrast, a retrospective data collection of 462 patients from a network of community oncology practices in the United States from 2007 to 2015 on effectiveness of systemic therapy for R/M HNC estimated a median overall survival of 21.0 months, i.e., even longer than in the present study (Fisher et al 2018 ). In contrast, in trials on first-line systemic therapy, typically patients with an ECOG performance status > 1 are not included.…”

Section: Discussioncontrasting

confidence: 74%

Systemic therapy for recurrent and/or metastatic head and neck cancer: a population-based healthcare research study in Thuringia, Germany

Morkramer

Geitner

Boeger

et al. 2021

J Cancer Res Clin Oncol

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Purpose Systemic therapy choice for patients with recurrent and/or metastatic head and neck cancer (R/M HNC) is a challenge. Not much is known about systemic therapies used in daily clinical routine and their outcome. Methods Data of all 283 patients with R/M HNC (89.4% male, median age: 60 years) registered for first-line systemic therapy between 2015 and 2018 in the cancer registries of Thuringia, a federal state in Germany, were included. Patient characteristics and treatment patterns were summarized. Exploratory univariate and multivariate analyses were conducted on select of systemic therapy and prognostic factors for overall survival. Results The most frequent first-line regimens were platinum-based combinations (71.4%), mainly cetuximab + platinum + 5-fluorouracil (32.5%). 32.5, 13.1, 4.9, and 1.1%, respectively, received, a second, third, fourth, and fifth line of systemic therapy. Median follow-up was 5.5 months. Median real-world overall survival was 16.8 months [95% confidence interval (CI) 11.1–22.6]. Alcohol drinking [hazard ratio (HR) 2.375, CI 1.471–3.831; p < 0.001], no second-line therapy (HR 3.425, CI 2.082–5.635, p < 0.001), and application of three agents compared to one agent in first-line therapy (HR 2.798, CI 1.374–5.697; p = 0.005) were associated to decreased overall survival after start of first-line systemic therapy. Termination of second-line treatment because of deterioration of the general condition was the only independent negative prognostic factor (HR 4.202, CI 1.091–16.129; p = 0.037) after start of second-line systemic therapy. Conclusions This study offers useful information, mainly prior to the availability of immunotherapy, on patient characteristics, treatment patterns, and survival in a German real-world population.

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“…Our median time to next treatment estimates of 6.1 months pre-IO and 7.4 months post-IO are consistent (marginally longer) than that observed in a prior EMR-based analysis (5.0 months for chemotherapy only treated patients). 24 Our estimates are also longer than the median PFS observed in CheckMate-141: nivolumab-treated ¼ 2.0 months, standard therapy ¼ 2.3 months. 6 Indirect comparison of these results is difficult.…”

Section: Discussionmentioning

confidence: 57%

Real-world treatment patterns, cost of care and effectiveness of therapies for patients with squamous cell carcinoma of head and neck pre and post approval of immuno-oncology agents

Abraham

Kish

Korytowsky

et al. 2019

Journal of Medical Economics

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Aims: In 2016, nivolumab and pembrolizumab were approved for the treatment of squamous cell carcinoma of the head and neck (SCCHN) following progression after initial platinum-based therapy. We sought to explore the uptake, effectiveness, and impact on healthcare resource utilization (HRU) and total costs of care pre and post introduction of immuno-oncology (IO) agents. Materials and Methods: Recurrent/metastatic SCCHN patients were identified from a healthcare claims clearinghouse by selecting patients with a claim for distant metastases or who initiated systemic therapy at least 120 days following discontinuation of platinum-based therapy. Two cohorts were created according to the date of post-platinum therapy (PPT) initiation: pre-IO ¼ 08/01/2014-07/ 31/2015; post-IO ¼ 08/01/2016-07/31/2017. Treatment patterns and effectiveness (duration of treatment, time to next treatment) during first-line (1 L) PPT, HRU, and costs were compared between propensity-score matched patients from each cohort. Results: Of 716 patients identified (pre-IO ¼ 265, post-IO ¼ 451) 46.3% of post-IO patients received IO post-platinum. In 229 matched patients 20.0% of the post-IO compared to 10.7% of the pre-IO (p¼.

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Effectiveness Outcomes in Patients With Recurrent or Refractory Head and Neck Cancers: Retrospective Analysis of Data From a Community Oncology Database

Abstract: This study of data from clinical practice shows that there remains a large unmet need for effective therapeutic options in advanced HNC. Patients' characteristics such as alcohol use and performance status were statistically significant predictors of PFS and OS in Stage III-IVc HNC.

Cited by 5 publications

References 31 publications

Factors that Influence 2-Year Progression-Free Survival Among Head and Neck Cancer Patients

Factors that Influence 2-Year Progression-Free Survival Among Head and Neck Cancer Patients

Systemic therapy for recurrent and/or metastatic head and neck cancer: a population-based healthcare research study in Thuringia, Germany

Real-world treatment patterns, cost of care and effectiveness of therapies for patients with squamous cell carcinoma of head and neck pre and post approval of immuno-oncology agents

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