The humanistic burden reported by first-line (1L) head and neck cancer patients diagnosed with recurrent/metastatic squamous cell carcinoma (R/M SCCHN) in europe: A real-world study.

Abstract

e18514 Background: R/M SCCHN is associated with substantial humanistic burden and limited tolerable treatment options that are able to preserve heath-related quality of life (HRQoL). Real world evidence is lacking to characterize and quantify burden in these patients by geographic region and treatment. Methods: A cross-sectional study was conducted in France, Germany, Italy, Spain and the UK from Jan to May 2019. Physicians (n = 184) recruited patients to complete a survey assessing the impact of their SCCHN and completed medical charts for corresponding patients. Patient burden and HRQoL was captured through the patient survey, which included the Functional Assessment of Cancer Therapy Head and Neck Cancer (FACT H&N) (range: 0-148; sub scores physical/social/functional: 0-28, emotional 0-24). Higher scores for instruments indicate better HRQoL. Patients were identified as 1L platinum eligible according to clinical characteristics and treatments captured in the medical charts. Results: Physicians recruited 577 (99 UK, 114 France, 117 Germany, 117 Spain, and 130 Italy) 1L platinum eligible patients of mean age 62.8 years, most were male (72%) and had ECOG score 0-1 (79%) or 2 (21%). Over half (52%) received the EXTREME regimen, 9% received a separate cetuximab-based regimen. Patients experienced a high symptom burden, most commonly fatigue (43%), weight loss (40%), pain (35%), and difficulty swallowing (32%). Dry mouth and persistent sore throat were reported by 19% patients. Most patients reported at least some problems with performing usual activities (62%), at least moderate pain/discomfort (79%), and at least moderate anxiety/depression (71%). Patients had a diminished HRQoL in every FACT-H&N domain: total score, 73.2; physical, 15.0; social, 16.5; emotional, 11.7; functional well-being, 10.7. Conclusions: In Europe, patients treated for 1L R/M SCCHN experience considerable humanistic burden and diminished HRQoL. These data suggest an unmet need in this patient population for novel treatments that are able to maintain or even improve HRQoL.