OBJECTIVES

Sorafenib is indicated for the first-line (1L) treatment of HCC. This study examined physician attitudes towards treatment based on preferred 1L systemic therapy for advanced HCC.

METHODS

A retrospective, non-interventional study was conducted among 278 physicians in Canada, France, Germany, Italy, Spain, and the UK between February-March 2018. Physician attitudes, patient characteristics and treatment-related data were collected from medical charts of the 2-3 most recent HCC patients. Descriptive, bivariate, and Chi-Square Automatic Interaction Detection (CHAID) analyses were used to examine physician and patient data.

RESULTS

The study surveyed physicians primarily from Europe (93%), aged 45.6±9.3 years with 72% male, and 89% hospital-based who provided information on 706 patients (n=504 sorafenib; n=202 other [83% chemotherapy; 10% targeted therapy; 7% checkpoint inhibitors]). Most physicians (80%) reported 1L sorafenib use regardless of country. Physician-reported attitudes indicated that 27% prescribed based on personal experience rather than clinical data, 90% agreed on an unmet need for more efficacious HCC treatments, 85% prescribed based on guidelines, and 54% were motivated to prescribe new therapies. Attitudes differed by physician group (sorafenib treaters vs. other only) regarding reasons for prescribing and an unmet need (p≤0.002). The most common primary treatment rationale was efficacy (58%) regardless of physician group, however guideline-based rationale was a stronger driver among physicians reporting patients with sorafenib 1L use compared to those reporting non-sorafenib 1L use only (24% vs. 8%, p<0.001). CHAID analysis supported these findings that physician characteristics and attitudes, in addition to patient characteristics, such as portal vein invasion and Child-Pugh score at diagnosis, predict treatment choice.

CONCLUSIONS

HCC treatment choices appear to be influenced by physician and patient characteristics as well as physician attitudes. Understanding 1L HCC therapy determinants is important as the treatment landscape evolves to address unmet needs.