Pembrolizumab /-化疗是治疗 r/m HNSCC 的标准疗法。尽管监管机构批准了铂/5FU/pembrolizumab，但出于便利性和耐受性的考虑，紫杉烷通常会替代 5FU。我们的目的是描述全国范围内的使用模式，并比较铂类/紫杉烷/派姆单抗与铂类/5FU/派姆单抗之间的结果。美国全国数据库中纳入了 2017 年至 2022 年接受派姆单抗加铂类化疗治疗的复发性 HNSCC 患者。总结了人口统计学和癌症特异性特征。使用 Kaplan-Meier 方法估计总生存期 (OS)，并使用对数秩检验和多变量 Cox 回归进行组间比较。比较各组之间的治疗时间、周期数、接受二线治疗以及毒性。在 438 名患者中，320 名 (73%) 接受 5FU，118 名 (27%) 接受紫杉烷。随着时间的推移，紫杉烷的使用变得更加频繁，并且在学术实践和社区实践中使用率更高（51% vs 23%，p < 0.001）。紫杉烷组和 5FU 组之间的 OS 没有差异（mOS 12.2 个月与 13.4 个月，p = 0.662）。在多变量 Cox 回归中，紫杉烷与 5FU 相关的死亡 HR 为 0.99 (95% CI 0.71-1.38)。 5FU 患者 (46%) 接受 2L 治疗的比例高于紫杉烷类患者 (35%, p = 0.071)。紫杉烷类患者中 ≥ 3 级贫血更为常见（33% vs 20%，p = 0.003），而 5FU 患者中 ≥ 3 级淋巴细胞减少症和血小板减少症数量较高。 在接受化学免疫治疗的 r/m HNSCC 患者中，紫杉烷类药物与 5FU 的使用因实践环境和地理区域而异。铂/紫杉烷/派姆单抗与铂/5FU/派姆单抗的生存率相似；这些结果表明紫杉烷化学免疫疗法是 5FU 的合理替代方案。版权所有 © 2024 Elsevier Ltd。保留所有权利。

Pembrolizumab +/- chemotherapy is standard therapy for r/m HNSCC. Despite regulatory approval of platinum/5FU/pembrolizumab, a taxane is often substituted for 5FU for convenience and tolerability. We aimed to characterize nationwide use patterns and compare outcomes between platinum/taxane/pembrolizumab vs platinum/5FU/pembrolizumab.Patients in a US nationwide database with r/m HNSCC treated from 2017 to 2022 with pembrolizumab plus platinum chemotherapy were included. Demographic and cancer-specific characteristics were summarized. Overall survival (OS) was estimated using Kaplan-Meier methodology, and compared between groups using log-rank test and multivariable Cox regression. Time on treatment, number of cycles, receipt of second-line therapy, and toxicities were compared between groups.Of 438 patients, 320 (73 %) received 5FU and 118 (27 %) received a taxane. Taxane use became more frequent over time and was higher in academic vs community practices (51 % vs 23 %, p < 0.001). OS did not differ between taxane and 5FU groups (mOS 12.2 vs 13.4 months, p = 0.662). On multivariable Cox regression, HR for death associated with taxane vs 5FU was 0.99 (95 %CI 0.71-1.38). Receipt of 2L therapy was numerically higher for 5FU patients (46 %) compared to taxane patients (35 %, p = 0.071). Grade ≥ 3 anemia was more common in taxane patients (33 % vs 20 %, p = 0.003), whereas grade ≥ 3 lymphopenia and thrombocytopenia were numerically higher in 5FU patients.In patients with r/m HNSCC undergoing chemoimmunotherapy, taxane vs 5FU use varies by practice setting and geographical region. Platinum/taxane/pembrolizumab was associated with similar survival as platinum/5FU/pembrolizumab; these results suggest that chemoimmunotherapy with taxane is a reasonable alternative to 5FU.Copyright © 2024 Elsevier Ltd. All rights reserved.