Real-world treatment patterns, clinical outcomes, and health care resource utilization in advanced unresectable hepatocellular carcinoma.

Autor:	O'Sullivan DE; Department of Oncology, University of Calgary, Calgary, Alberta, Canada.; Oncology Outcomes Initiative, University of Calgary, Calgary, Alberta, Canada., Boyne DJ; Department of Oncology, University of Calgary, Calgary, Alberta, Canada.; Oncology Outcomes Initiative, University of Calgary, Calgary, Alberta, Canada., Syed IA; AstraZeneca Canada, Mississauga, Ontario, Canada., Shephard C; AstraZeneca Canada, Mississauga, Ontario, Canada., Clouthier DL; AstraZeneca Canada, Mississauga, Ontario, Canada., Yoshida EM; Canadian Liver Foundation, Markham, Ontario, Canada.; Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada., Spratlin JL; Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada.; Department of Oncology, University of Alberta, Edmonton, Alberta, Canada., Batra A; Department of Oncology, University of Calgary, Calgary, Alberta, Canada., Rigo R; Department of Oncology, University of Calgary, Calgary, Alberta, Canada., Hannouf M; Department of Oncology, University of Calgary, Calgary, Alberta, Canada., Yang Hu X; Department of Oncology, University of Calgary, Calgary, Alberta, Canada., N Jarada T; Department of Oncology, University of Calgary, Calgary, Alberta, Canada.; Oncology Outcomes Initiative, University of Calgary, Calgary, Alberta, Canada., Brenner DR; Department of Oncology, University of Calgary, Calgary, Alberta, Canada.; Oncology Outcomes Initiative, University of Calgary, Calgary, Alberta, Canada., Cheung WY; Department of Oncology, University of Calgary, Calgary, Alberta, Canada.; Oncology Outcomes Initiative, University of Calgary, Calgary, Alberta, Canada.
Jazyk:	angličtina
Zdroj:	Canadian liver journal [Can Liver J] 2022 Nov 07; Vol. 5 (4), pp. 476-492. Date of Electronic Publication: 2022 Nov 07 (Print Publication: 2022).
DOI:	10.3138/canlivj-2022-0001
Abstrakt:	BACKGROUND: The incidence of advanced unresectable hepatocellular carcinoma (HCC) is increasing in developed countries and the prognosis of advanced HCC remains poor. Real-world evidence of treatment patterns and outcomes can highlight the unmet clinical need. METHODS: We conducted a retrospective population-based cohort study of patients with advanced unresectable HCC diagnosed in Alberta, Canada (2008-2018) using electronic medical records and administrative claims data. A chart review was conducted on patients treated with systemic therapy to capture additional information related to treatment. RESULTS: A total of 1,297 advanced HCC patients were included of whom 555 (42.8%) were recurrent cases and the remainder were unresectable at diagnosis. Median age at diagnosis was 64 (range 21-94) years and 82.1% were men. Only 274 patients (21.1%) received first-line systemic therapy and, of those, 32 patients (11.7%) initiated second-line therapy. Nearly all of the patients received sorafenib (>96.4%) in first-line, and these patients had considerably higher median survival (12.23 months; 95% CI 10.72-14.10) compared with patients not treated with systemic therapy (2.66 months; 95% CI 2.33-3.12; log-rank p <0.001). Among patients treated with systemic therapy, overall survival was higher for recurrent cases, patients with Child-Pugh A functional status, and patients with HCV or multiple known HCC risk factors ( p <0.05). CONCLUSIONS: In a Canadian real-world setting, patients who received systemic therapy had greater survival than those who did not, but outcomes were universally poor. These results underscore the need for effective front-line therapeutic options. (Copyright © 2022 Canadian Association for the Study of the Liver.)
Databáze:	MEDLINE
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