OBJECTIVES: HCC is the 6^th most common cancer and 4^th leading cause of cancer deaths in the world, with more than 70% of cases diagnosed in Asia.

METHODS: Primary research was conducted amongst key HCC prescribers in Hong Kong (HK), Singapore (SG) and Thailand (TH) in 2019. A total of 18 Oncologists, Hepatologists and Gastrointestinal Specialists (6 HK; 6 SG; 6 TH) participated in Qualitative phase and a total of 55 (15 HK; 20 SG; 20 TH) in the Quantitative phase. We present data from key prescribers on their perception of the challenges, unmet needs and burden of advanced HCC.

RESULTS: Based upon the feedback from prescribers, advanced stage HCC patients comprise 76% (HK), 63% (SG) and 45% (TH) of their HCC patient load. Of those advanced stage patients, the proportion receiving an active treatment vs. palliative care varied across countries [88% vs. 9% HK, 63% vs. 35% SG, 65% vs. 30% TH]. 48% (HK), 59% (SG) and 20% (TH) of advanced HCC patients who received 1L therapy went on to receive 2L therapy. Prescribers identified challenges in managing advanced HCC patients due to poor performance status upon presentation, residual side effects from targeted therapies and lack of efficacious options (OS, PFS and ORR were lower). Patients with advanced HCC experience a range of emotions from onset of symptoms to disease progression. Through the course of disease, patients experience symptoms yet delay consulting a doctor, receive a diagnosis and begin treatment, experience side effects and evaluate further treatment options.

CONCLUSIONS: Despite experiencing uncertainty in their future and a myriad of emotions patients remain persistent and hopeful in managing their condition. The challenges identified in managing advanced HCC patients, highlights the real-world research perspective that is valuable to health policymakers, pharmaceutical companies and prescribers to improve public health policies and patient treatment outcomes.