Prior to 2016, the therapeutic landscape for recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) had only benefited from the introduction of one novel treatment, Erbitux, in 2011. However, after years of dormancy, the immune checkpoint inhibitors, Keytruda and Opdivo, are beginning to transform the recurrent or metastatic SCCHN treatment paradigm.

The understanding of unmet need is crucial for identifying opportunities in SCCHN drug development, particularly because not all unmet needs are worth pursuing. We focus on the commercially important recurrent and metastatic population, the setting for which two PD-1 inhibitors Opdivo and Keytruda gained FDA approval in 2016. We assess how PD-1 inhibitors and other therapies perform on key drug attributes and measure the impact of drug attributes on physicians’ prescribing behavior. We identify potential hidden opportunities and consider which emerging therapies (e.g., durvalumab), if any, may be poised to capitalize. Using conjoint analysis, we determine the trade-offs across key drug attributes (including duration of response and quality of life) and price that surveyed physicians are willing to make when considering the first-line recurrent and metastatic treatment setting; these results allow us to simulate physician and prescribing likelihood across different SCCHN target product profiles.

Questions answered:

  • What are the treatment drivers and goals for recurrent or metastatic non-nasopharyngeal SCCHN?
  • What attributes are key influencers that have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals for recurrent or metastatic non-nasopharyngeal SCCHN?
  • What are the prevailing areas of unmet need and opportunity in recurrent or metastatic non-nasopharyngeal SCCHN?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European medical oncologists for a hypothetical new recurrent or metastatic non-nasopharyngeal SCCHN drug?

Markets covered: United States, United Kingdom, France, and Germany

Primary research: Survey of 60 U.S. and 31 European medical oncologists, fielded in December 2016

Key companies: Merck & Co., Bristol-Myers Squibb, AstraZeneca, Eli Lilly

Key drugs: Erbitux, Keytruda, Opdivo, durvalumab, docetaxel, paclitaxel


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