The humanistic burden reported by patients diagnosed with recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) in Europe

Abstract

Background: R/M SCCHN is associated with poor prognosis and low survival rate. Further, there is a lack of evidence of how the disease impacts patients’ quality of life (QoL) and ability to perform activities of daily living (ADL). This study examines patients’ experience of living with R/M SCCHN. Methods: A cross-sectional study was conducted in the EU5 from Jan to May 2019. Medical oncologists recruited patients to complete a survey, including the Functional Assessment of Cancer Therapy – Head and Neck Cancer (FACT-H&N), a 39-item instrument evaluating patients’ QoL (score range 0-148; higher scores indicating better QoL), the European Quality of Life – 5 Dimension Questionnaire (EQ-5D-3L; utility scores range -0.59-1, VAS scores 0-100; with higher scores indicating better health status) and questions on daily life impact using a 7-point scale (7= extremely high impact). Physicians also completed a case report form (CRF) for each patient. This analysis is based on interim data. Results: 191 patients completed the survey. Median age was 66 years (45% < 65, 55% ≥ 65), 77% were male, the majority (82%) had an ECOG score 0-1 and 39% required caregiver support for daily needs (mean 32.7 hours per week). At data capture, 9% of patients were in paid work, 21% on sick leave and 48% retired. Most patients (93%) received at least one therapy line following R/M. Patients reported diminished health status, with a mean EQ-5D utility score of 0.62 and a mean VAS score of 58. Mean FACT-H&N score was low at 74.0. Almost half of patients reported high impact (score 5-7) on ADL and family/social life (43% and 46%, respectively). For patients with a lower FACT-H&N score (lowest score quartile [26–60.2]), 75% reported high impact on ADL, versus 15% patients in the highest FACT-H&N score quartile (87.5–120). 81% patients in the lowest FACT-H&N quartile reported high family/social life impact, versus 15% patients in the highest quartile. Conclusions: In addition to considerable impact on health status and QoL, patients report high impact on ability to perform ADL, with a high caregiving burden. There is a clear relationship between reduced QoL and restricted ADL and social life, highlighting the need to consider novel approaches to improve QoL in R/M SCCHN. Legal entity responsible for the study: Bristol-Myers Squibb. Funding: Bristol-Myers Squibb. Disclosure: P. Singh: Full / Part-time employment: Bristol-Myers Squibb. B. Bennett: Full / Part-time employment: Bristol-Myers Squibb. M.C. Contente: Full / Part-time employment: Bristol-Myers Squibb. All other authors have declared no conflicts of interest.