Immunotherapy Prescribing Patterns and Immune-Related Adverse Events in Patients With Head and Neck Cancer

Area of Science:

• Oncology
• Pharmacology
• Clinical Research

Background:

• Immunotherapy is an approved first-line treatment for recurrent/metastatic head and neck cancer (HNC).
• Prescribing patterns and immune-related adverse events (irAEs) in HNC patients remain underreported.
• Assessing irAEs in HNC patients receiving immunotherapy is crucial for clinical management.

Purpose of the Study:

• To evaluate immunotherapy prescribing trends in HNC patients.
• To determine the incidence and risk factors associated with irAEs in this population.
• To analyze the market share of different immunotherapeutic agents.

Main Methods:

• Retrospective cohort study using MarketScan Commercial and Medicaid databases (2016-2022).
• Inclusion of patients with HNC (ICD-10-CM codes), excluding those aged 65 and older.
• Analysis of immunotherapy prescription rates, irAE incidence, and risk factors for irAEs.

Main Results:

• 4.8% of 47,365 HNC patients received immunotherapy; prescription rates slightly increased from 2.3% (2017) to 2.8% (2022).
• Pembrolizumab dominated the market, holding 87% share by 2022.
• The 90-day overall irAE rate was 41.2%, severe irAE rate was 2.7%. Hypothyroidism and liver disease were associated with irAEs.

Conclusions:

• Pembrolizumab is the leading immunotherapy for HNC, but overall immunotherapy use has seen minimal growth in patients under 65.
• irAEs are frequent in HNC patients, with specific comorbidities like hypothyroidism and liver disease increasing risk.
• Severe irAEs are infrequent and associated with overall comorbidity burden.