OBJECTIVES: HCC is the fifth-most common cancer worldwide and third-leading cause of cancer-related deaths. Patients with advanced HCC have a particularly poor prognosis and limited treatment options. This study examined treatment patterns and HCRU in patients who initiated first (1L) or second line (2L) systemic therapy for HCC.

METHODS: A retrospective, non-interventional study was conducted among 278 physicians in Canada, France, Germany, Italy, Spain and UK between February-March 2018. Patient characteristics and treatment-related data were collected from medical charts of the 2-3 most recent patients.

RESULTS: Of the 706 patients treated with 1L therapy for HCC, 88% patients had advanced disease, with a median age of 63 years at 1L treatment, 79% were male, and 47% had severe fibrosis or cirrhosis (23% with status unknown). Comorbidities included alcoholism (33%), Hepatitis C (14%), Hepatitis B (10%), nonalcoholic steatohepatitis and/or nonalcoholic fatty liver disease (9%). Most patients (71%) received sorafenib at 1L therapy, 22% of patients received 2L systemic therapy and 3% received best supportive care following 1L therapy at chart abstraction. 89% of patients visited an oncologist at least once a month, with 39% visiting ≥2 times. 19% of patients received ≥1 scans/month. Most commonly reported grade 3-4 adverse events (AEs) at 1L were asthenia/fatigue (66 reports), diarrhoea (34), and hand-foot skin reaction (25). 46 1L patients were hospitalised for an AE, with median length of stay being 5.0 days as inpatient and 5 days as outpatient.

CONCLUSIONS: In Canada and Europe, the most common 1L treatment in advanced HCC was sorafenib. HCRU for these patients was high. Prevalence of HBV/HCV and cirrhosis were lower than expected but this may be due to under-diagnosis or limitations of chart review. Poor treatment outcomes suggest a high unmet need for these patients.