PMID- 37664029
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230905
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 13
DP  - 2023
TI  - Real-world study of patients with locally advanced HNSCC in the community 
      oncology setting.
PG  - 1155893
LID - 10.3389/fonc.2023.1155893 [doi]
LID - 1155893
AB  - INTRODUCTION: There is a need to understand the current treatment landscape for 
      LA HNSCC in the real-world setting. METHODS: This retrospective study assessed 
      real-world outcomes and treatment patterns of 1,158 adult patients diagnosed with 
      locally advanced (stage III-IVB) HNSCC initiating chemoradiotherapy (CRT) within 
      the period January 2015 to December 2017 in a large network of US community 
      oncology practices. Structured data were abstracted from electronic health 
      records. Demographic, clinical and treatment characteristics were analyzed 
      descriptively overall and stratified by index treatment (cisplatin + radiotherapy 
      [RT], cisplatin + other chemotherapy + RT, or cetuximab + RT). Time to next 
      treatment (TTNT) and overall survival (OS) were measured using the Kaplan-Meier 
      method, and median duration of treatment was assessed. OS was compared across 
      treatment cohorts using multinomial logistic regression with inverse probability 
      treatment weighting. To identify covariates associated with OS, a multivariable 
      adjusted Cox proportional hazard model was used. RESULTS: This study examined 
      22,782 records, of which 2124 had stage III to stage IVB and no other cancers, 
      and 1158 met all eligibility criteria. Among the treatment cohorts analyzed 
      (cisplatin + RT, cisplatin + other chemotherapy + RT, or cetuximab + RT), 
      cisplatin + RT was the most common concurrent chemotherapy (65.8%). Among 1158 
      patients, 838 (72.4%) did not initiate subsequent treatment and 139 (12.0%) died. 
      The median TTNT and median OS were only reached by the cetuximab + RT cohort. 
      Among patients with oropharynx primary tumor location, patients with human 
      papilloma virus (HPV) positive status had the longest time on treatment and 
      highest survival at 60 months. Covariates associated with improved survival were 
      never/former tobacco use, HPV positive status, and overweight or obese body mass 
      index. Covariates associated with poorer survival were age of 60+ years, primary 
      tumor location of hypopharynx or oral cavity and Eastern Cooperative Oncology 
      Group performance status score of 2+. CONCLUSION: These data describe real-world 
      treatment patterns in locally advanced head and neck squamous cell cancer and 
      sets the baseline to assess outcomes for future studies on the community oncology 
      population.
CI  - Copyright (c) 2023 Black, Ramakrishnan, Nadler, Tseng, Wentworth, Murphy, Fulcher, 
      Wang, Alexander and Patton.
FAU - Black, Christopher M
AU  - Black CM
AD  - Center for Observational and Real-World Evidence, Merck & Co., Inc., Rahway, NJ, 
      United States.
FAU - Ramakrishnan, Karthik
AU  - Ramakrishnan K
AD  - Center for Observational and Real-World Evidence, Merck & Co., Inc., Rahway, NJ, 
      United States.
FAU - Nadler, Eric
AU  - Nadler E
AD  - Texas Oncology, Medical Oncology, Dallas, TX, United States.
AD  - Real World Research, Ontada, Boston, MA, United States.
FAU - Tseng, Wan-Yu
AU  - Tseng WY
AD  - Real World Research, Ontada, Boston, MA, United States.
FAU - Wentworth, Chuck
AU  - Wentworth C
AD  - Real World Research, Ontada, Boston, MA, United States.
FAU - Murphy, John
AU  - Murphy J
AD  - Real World Research, Ontada, Boston, MA, United States.
FAU - Fulcher, Nicole
AU  - Fulcher N
AD  - Real World Research, Ontada, Boston, MA, United States.
FAU - Wang, Liya
AU  - Wang L
AD  - Center for Observational and Real-World Evidence, Merck & Co., Inc., Rahway, NJ, 
      United States.
FAU - Alexander, Melannie
AU  - Alexander M
AD  - Epidemiology, Merck & Co., Inc., Rahway, NJ, United States.
FAU - Patton, Gregory
AU  - Patton G
AD  - Real World Research, Ontada, Boston, MA, United States.
LA  - eng
PT  - Journal Article
DEP - 20230817
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC10472134
OTO - NOTNLM
OT  - CRT
OT  - HPV
OT  - cancer treatment patterns
OT  - concurrent chemotherapy with radiation therapy
OT  - head and neck cancer
OT  - locally advanced
OT  - outcomes
OT  - real world
COIS- CB, KR, LW, and MA are employees of Merck Sharp & Dohme LLC, a subsidiary of 
      Merck & Co., Inc., Rahway, NJ, USA. EN, W-YT, CW, JM, NF, and GP are employees of 
      Ontada. The remaining authors declare that the research was conducted in the 
      absence of any commercial or financial relationships that could be constructed as 
      a potential conflict of interest.
EDAT- 2023/09/04 06:43
MHDA- 2023/09/04 06:44
PMCR- 2023/01/01
CRDT- 2023/09/04 05:09
PHST- 2023/01/31 00:00 [received]
PHST- 2023/07/21 00:00 [accepted]
PHST- 2023/09/04 06:44 [medline]
PHST- 2023/09/04 06:43 [pubmed]
PHST- 2023/09/04 05:09 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2023.1155893 [doi]
PST - epublish
SO  - Front Oncol. 2023 Aug 17;13:1155893. doi: 10.3389/fonc.2023.1155893. eCollection 
      2023.