OBJECTIVES: With the advent of new immunotherapies for recurrent/metastatic (R/M) head and neck squamous cell cancers (HNSCCs), the current study examined real-world treatment patterns in HNSCC by relevant demographic/clinical factors to understand current standard of care and inform the potential role/utilization of the new therapies.

METHODS: Patient characteristics, clinical profiles, and current antitumor treatments were reported from case report forms collected by physicians in the cross-sectional Kantar Health French Cancerology database. Corresponding data were extrapolated to the whole of France using projection coefficients based on hospital activity level and type of hospital. Analyses focused on representative 2015 data for patients with primary R/M HNSCC.

RESULTS: Patients (n=8,579) were predominantly male (79%), receiving 1^st line treatment (88%), having oropharynx tumor (26%), and with mean age of 61 years. Most patients who underwent 1^st-line treatment had Eastern Cooperative Oncology Group (ECOG) score of 0 or 1 (80%), and were treated with chemotherapy or targeted therapy alone (68%). Other treatment options included combining chemotherapy/targeted therapy with surgery and/or radiation. Cetuximab was the predominate regimen prescribed as 1^st line monotherapy. Similarly for all locations, combination therapies involving platinum/5FU/cetuximab/taxane were preferred to monotherapy in 1^st line. The majority (66%) of patients received a regimen with a cycle length of 3 weeks. Across all lines, toxicities occurred to more than three quarters of patients; diarrhea, leucopenia, skin rash, nausea/vomit, and/or mucositis were the most occurring toxicities, each affecting ≥20% patients with varying severity. Among patients with tumor response evaluated/specified (n=5,182), 11% and 45% had a completely and partial remission, respectively.

CONCLUSIONS: Chemotherapy/targeted therapy alone is the most commonly used regimen for HNSCC, with a variety of combinations used more often than monotherapy. Current treatment options for HNSCC remain limited for all lines, especially 2^nd line. Immunotherapies are expected to fill part of this umet need.