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  • RESET FILTERS

    Unmet Need and Opportunity Assessment in Recurrent or Metastatic SCCHN: Are Immune Checkpoint Inhibitors the Answer?

    Decision Resources Group finds in a survey of U.S. and European oncologists, that in contrast to many other oncology indications, incidence of grade 3/4 toxicities and quality of life (QOL) are highly important attributes for making prescribing decisions in recurrent or metastatic non-nasopharyngeal squamous cell carcinoma of the head and neck (SCCHN).

    Current treatment approaches are aggressive and can have long-lasting impact on a patient’s physiological and sensory function, and often result in severe and frequent side effects. The importance of QOL assessments in SCCHN clinical practice and in trial protocols is increasingly being recognized. The high value that surveyed oncologists place on the incidence of grade 3/4 toxicities and QOL is also evident in our conjoint analysis.

    In one scenario where we test the sensitivity to grade 3/4 toxicities and QOL, we find that prescribing likelihood is higher for target product profiles (TPPs) that offer a lower incidence of grade 3/4 toxicities and improved QOL. It is striking that surveyed oncologists are willing to trade-off efficacy improvements and accept a therapy with the same efficacy as the current first-line standard of care (EXTREME regimen), even at higher price points, if there are improvements in grade 3/4 toxicities and QOL.

    Other key findings from the Unmet Need report for Recurrent or metastatic non-nasopharyngeal SCCHN:

    • Our derived importance analysis reveals that OS holds a lower derived importance score than progression free survival (PFS), objective response rate (ORR), duration of response, and QOL; therefore, while surveyed oncologists recognize the importance of OS, there are other efficacy attributes that are key influencers of treatment decisions.
    • Frequency of administration is a hidden drug development opportunity, according to to our analysis. Frequent administration of therapy is inconvenient for patients and negatively impacts QOL. While the market impact of focusing on this opportunity may be be low, it could be an important differentiator for emerging therapies with comparable efficacy and tolerability profiles.
    • Surveyed oncologists from the United States perceive the 2016 PD-1 inhibitors entrants, Opdivo and Keytruda, to outperform all other current regimens. Given that the efficacy data for Opdivo and Keytruda are not as numerically high as those of the first-line EXTREME regimen (these agents were evaluated for heavily pretreated patients), our findings are revealing.