OBJECTIVES: We assessed the real-world treatment patterns and overall survival (rwOS) of patients receiving pembrolizumab + platinum + taxane in 1L R/M HNSCC, a national guideline supported treatment option. This study provides real-world evidence to complement the ongoing phase IV KEYNOTE-B10 trial evaluating pembrolizumab + carboplatin + paclitaxel in 1L R/M HNSCC.

METHODS: A retrospective cohort study was conducted using the Flatiron Health Advanced Head and Neck database. The study cohort included adult R/M HNSCC patients who initiated 1L pembrolizumab + platinum + taxane between 07/01/19 and 12/31/21 with follow-up until 06/30/22. Patients were excluded if they received prior platinum treatment ≤6 months of 1L pembrolizumab therapy, had other primary cancers before R/M HNSCC diagnosis, or were treated with protocol therapy. Real-world time on treatment (rwToT), time-to-next treatment (rwTTNT), and rwOS were assessed using the Kaplan-Meier method.

RESULTS: A total of 63 patients initiated 1L pembrolizumab + platinum + taxane, mostly with carboplatin (93.7%) and paclitaxel (92.1%). Median age was 64 years (range: 39 - 84). Most were male (77.8%) and had an Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1 (66.6%). The most common tumor site was oropharynx (50.8%), followed by larynx (28.6%), oral cavity (15.9%), and hypopharynx (4.8%). P16-positivity was documented in 78.1% (25/32) of oropharyngeal cancers. The median rwTOT was 6.3 months (95% CI: 3.9 - 10.3) with a median rwTTNT of 6.6 months (95% CI: 5.8 - 8.3). The median rwOS was 14.9 months (95% CI: 6.2 - not reached [NR]) with 35.9% (95% CI: 18.7 - 53.5%) of patients alive at 24 months. These rwOS results were consistent with the KEYNOTE-B10 interim analysis (12.1 months, 95% CI: 10 - NR).

CONCLUSIONS: Treatment patterns and overall survival among patients treated with pembrolizumab + platinum + taxane in the real-world were consistent with data reported in clinical trials.