OBJECTIVES

: HCC is the 9th most common cancer in Spain, with an incidence of 5,878 new cases per year. Patient with HCC has significant unmet medical need, poor quality of life and low survival rates.

METHODS

: A retrospective, non-interventional survey of 52 Spanish physicians was conducted between February-March 2018. Clinical and treatment data were collected from medical charts for patients aged ≥18 (with Child-Pugh A/B status at 1L initiation), who initiated and completed systemic 1L treatment for HCC within 2y of data collection. Descriptive statistics compared 1L systemic therapy, sorafenib vs. other.

RESULTS

The 52 physicians surveyed were aged.46.0±10.4y (mean±SD), 65.4% male, 14.3±5.6y in practice, 94.2% hospital-based, and treated a median of 30 aHCC patients in the past 2 years.

125 patients were included, with mean age at 1L of 65.3±10.4y and 84.0% male. Patients presented as follows at diagnosis: 62.4% portal vein invasion, 56.8% severe fibrosis or cirrhosis and 46.4% distant metastasis. Comorbidities: alcoholism (32.8%), Hepatitis C (16.0%), Hepatitis B (5.6%), nonalcoholic steatohepatitis or nonalcoholic fatty liver disease (7.4%).

Physicians based HCC treatment decisions on: personal experience (38.5%), guidelines (78.9%), and over 90% believe there is a great unmet need for more efficacious aHCC treatment. Of these patients, 75.2% received with sorafenib and 24.8% were offered other treatments.

Dose or schedule intensity was reduced significantly in 33.0% of patients receiving sorafenib vs. others 6.5% (p<0.001), and a difference was also shown for treatment duration (p=0.005).

The most common grade 3 or 4 adverse events were fatigue (9.6%), hypertension (4.8%), and diarrhea (4.8%).

CONCLUSIONS

: In this Real World chart survey of Spanish physicians, sorafenib remains the most commonly used 1L systemic therapy for aHCC. Understanding determinants of 1L therapy is important as the treatment landscape of HCC is evolving to address unmet need.