Real-world systemic therapy treatment patterns for squamous cell carcinoma of the head and neck in Canada

Background In the present study, we examined real-world treatment patterns for squamous cell carcinoma of the head and neck (SCCHN) in Canada, which are largely unknown. Methods Oncologists across Canada provided data for disease history, characteristics, and treatment patterns during May-July 2016 for 6-8 consecutive patients receiving first-line or second-line drug treatment for SCCHN (including locally advanced and recurrent or metastatic disease). Results Information from 16 physicians for 109 patients receiving drug treatment for SCCHN was provided; 1 patient was excluded from the treatment-pattern analysis. Median age in the cohort was 63 years [interquartile range (IQR): 57-68 years], and 24% were current smokers, with a mean exposure of 26.2 +/- 12.7 pack-years. The most common tumour site was the oropharynx (48%). Most patients (84%) received platinum-based regimens as first-line treatment (44% received cisplatin monotherapy). Use of cetuximab-based regimens as first-line treatment was limited (17%). Of 53 patients receiving second-line treatment, 87% received a first-line platinum-based regimen. Median time between first-line treatment with a platinum-based regimen and initiation of second-line treatment was 55 days (IQR: 20-146 days). The most common second-line regimen was cetuximab monotherapy (43%); platinum-based regimens were markedly infrequent (13%). Conclusions Our analysis provides real-world insight into SCCHN clinical practice patterns in Canada, which could inform reimbursement decision-making. High use of platinum-based regimens in first-line drug treatment was generally reflective of treatment guidelines; cetuximab use in the second-line was higher than anticipated. Additional real-world studies are needed to understand the effect of novel therapies such as immuno-oncology agents on clinical practice and outcomes, particularly for recurrent or metastatic SCCHN.