Real-world treatment patterns and survival outcomes in patients with locally advancedsquamous cell carcinoma of the head and neck (LA SCCHN) in Germany using claims data

Kathrin Hering¹Thomas Kuhnt¹Nils Kossack²Lena Richter²Michael Schultze³Ulrike Osowski⁴Luisa Henkel⁴Ann-Christin Gaupel⁴Marie-Noelle Solbes⁵Bernard Zolyniak⁵Nancy Schoenherr^5*

• ¹Department of Imaging and Radiation Medicine, Clinic of Radiooncology, University of Leipzig, Leipzig, Germany
• ²WIG2 Institute for Health Economics and Health System Research, Leipzig, Germany
• ³ZEG – Berlin Center for Epidemiology and Health Research GmbH, Berlin, Germany
• ⁴Merck Healthcare Germany GmbH, an affiliate of Merck KGaA, Weiterstadt, Germany
• ⁵Merck Healthcare KGaA, Darmstadt, Hesse, Germany

Introduction: Standard of care treatment for locally advanced squamous cell carcinoma of the head and neck (LA SCCHN) is surgery with consolidation chemoradiotherapy (CRT) or definitive CRT. There is a paucity of real-world evidence regarding current treatment patterns and downstream outcomes for LA SCCHN in German clinical practice.Methods: This study was a non-interventional, observational, retrospective cohort study of newly diagnosed patients with LA SCCHN using routinely collected claims data from a health insurance claims database in Germany (2016)(2017)(2018)(2019)(2020)(2021). Claim records were used to describe the cohort, including incidence, characteristics, treatment patterns and survival. As permitted by the data, descriptive analyses were stratified by index treatment (surgical resection or definitive non-surgical treatment), tumor site (oral cavity, oropharynx, hypopharynx or larynx) and sex. The study was descriptive in nature; as such, no statistical comparisons were made.Results: The LA SCCHN cohort comprised 1,010 patients (827 male and 183 female), of which 39.8% (402/1,010) received surgical resection and 60.2% (608/1,010) received definitive nonsurgical treatment as part of index treatment. Patients with surgical resection as part of index treatment were characterized by a younger mean age and lower comorbidity indices. After index treatment, three-quarters (74.8%) of the study population received no subsequent SCCHN treatment. Index treatment was similar for male and female patients. The rate of surgical resection and definitive non-surgical treatment was similar in patients with oral cavity cancer (50.6% [128/253] and 49.4% [125/253], respectively); all other tumor sites were treated more frequently (>60%) with definitive non-surgical treatment. The 5-year probability of survival for the overall population was 48.5% (95% CI: 44.4-53.1%). Survival probabilities varied across tumor sites and by index treatment.Conclusion: Despite index treatment being broadly aligned to guideline recommendations, most patients did not receive a subsequent line of treatment and almost half of patients had died within 5 years. This highlights the urgent unmet need for improved treatment options for LA SCCHN.