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799 Real-world use of pembrolizumab combination regimens in first-line recurrent/metastatic head and neck squamous cell carcinoma
  1. Christopher Black,
  2. Liya Wang,
  3. Karthik Ramakrishnan and
  4. Daisuke Goto
  1. Merck and Co., Inc., Rahway, NJ, USA


Background Based on KEYNOTE-048 results, pembrolizumab was approved for use as monotherapy and in combination with platinum+5FU in the first-line (1L) treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). Taxanes can help expand the available treatment options in the 1L R/M HNSCC, in place of 5-FU. NCCN guidelines recommend pembrolizumab + platinum + taxane as another treatment option for R/M HSCC patients. This study assessed the real-world treatment patterns of patients receiving pembrolizumab combination regimens in 1L R/M HNSCC.

Methods This retrospective cohort study assessed data from a US based de-identified EHR-derived database (Flatiron Health Advanced H&N database) of patients initiating pembrolizumab + platinum + taxane or platinum + 5-FU regimens between 07/01/19 – 6/30/21 with follow-up until 12/31/21. Real-world time on treatment (rwToT) was defined as length of time between first and last documented administration date pembrolizumab and assessed using Kaplan-Meier method.

Results A total of 225 patients received pembrolizumab combination therapy (Platinum+5-FU:176, Platinum+Taxane:49). Patient characteristics (age, gender, ECOG PS) were similar; differences were noted in oropharyngeal HPV+ cancer (50.0% vs 75.0%), and% treated at an academic center (6.3% vs 34.7% ) between pembrolizumab with platinum + 5-FU and platinum + taxane, respectively (table 1). Carboplatin use was similar among pembrolizumab + platinum + 5-FU (84.8%) and platinum + taxane (87.8%) patients, where paclitaxel was the most used taxane (87.8%). Patients remained on treatment longer with pembrolizumab + platinum + taxane compared to pembrolizumab + platinum + 5-FU .

Conclusions Substituting 5-FU with a taxane resulted in a longer median rwToT of 2.4 months. These results support guideline recommendations for the pembrolizumab + platinum + taxane combination as another treatment option for 1L R/M HNSCC patients.

Abstract 799 Table 1

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