A descriptive epidemiological study on the treatment options for head and neck cancer: Transition before and after approval of cetuximab

• Published in: Pharmacoepidemiology and drug safety 2019-03, Vol.28 (3), p.330-336
• Main Authors: Yamada, Shuhei, Sato, Izumi, Kawakami, Koji
• Format: Article
• Language: English
• Subjects: Aged; Antineoplastic Agents - supply & distribution; Antineoplastic Agents - therapeutic use; Antineoplastic drugs; Antitumor agents; Cancer; Cetuximab - therapeutic use; chemoradiation; Chemoradiotherapy; Cisplatin; Cisplatin - therapeutic use; Cohort Studies; Drug Approval; Drug Substitution; Drugs; Female; Head & neck cancer; head and neck cancer; Head and Neck Neoplasms - drug therapy; Humans; Immunotherapy; Japan; Japanese patient; Male; Monoclonal antibodies; Patients; Pharmacoepidemiology; Platinum; prescription trends; Regression analysis; Targeted cancer therapy
• ISSN: 1053-8569; 1099-1557
• DOI: 10.1002/pds.4703

Purpose Chemoradiotherapy is among the effective treatment modalities for head and neck cancer (HNC). We aimed to elucidate the factors affecting drug selection by describing the actual situation of chemoradiotherapy for HNC in Japan and the transition in treatment selection before and after the approval of cetuximab. Method We used a claims database involving multiple hospitals nationwide. The study included patients diagnosed with HNC between April 2008 and August 2015 who underwent chemoradiotherapy. The anticancer drugs used were categorized into four groups, namely, cetuximab, cisplatin, other platinum agents, and other agents. After assessing patient background and transition in concomitant drugs, we performed multinomial logistic regression analysis to determine factors that affect patient drug selection. Results This study analyzed 2777 patients whose median age was 66 years. A cisplatin‐based regimen remained the most commonly used concomitant drug even after cetuximab approval. In multinomial logistic regression analysis, the odds ratio and 95% confidence interval (CI) in terms of age (66 y or older vs less than 65 y) relative to the cisplatin group were 3.01 (95% CI, 2.26‐4.02) for the cetuximab group; 1.76 (95% CI, 1.22‐2.48) for the other platinum agent group; and 3.09 (95% CI, 2.39‐3.99) for the other agent group. Conclusion This study showed the current practices in concomitant medication used in chemoradiotherapy for HNC patients in Japan, the transition in anticancer drugs used before and after cetuximab approval, and the factors affecting the selection of concomitant drugs.