Real-world management and outcomes of patients with hepatocellular carcinoma treated with systemic therapy in Spain: a patient cohort from the RETUD gastrointestinal registry

TL;DR

This study examines how patients with liver cancer in Spain are treated and their outcomes using real-world data from a registry.

Contribution

The study provides real-world insights into HCC treatment and outcomes in Spain, highlighting the effectiveness of immunotherapy combinations.

Findings

Most patients received sorafenib as first-line treatment, while atezolizumab/bevacizumab showed the best survival outcomes.

Median overall survival was 9.8 months, with immunotherapy combinations showing longer survival and higher response rates.

Over a third of patients received locoregional treatment alongside systemic therapy.

Abstract

Characterization of the management and outcomes of patients diagnosed with hepatocellular carcinoma (HCC) and treated with systemic therapy who were included in the Spanish gastrointestinal RETUD registry.

This is a retrospective, registry-based, non-interventional, multicenter study conducted in Spain (NCT06711211, retrospectively registered in Dec-2024). This cohort from the RETUD registry includes adult patients diagnosed with HCC and treated with systemic therapy between Jan-2017 and Feb-2024. Sociodemographic, clinical, therapeutic and survival data are analyzed descriptively.

Four hundred and sixty nine patients were included (median age: 65.8 years; 90.2% males; 98.1% Caucasian). At diagnosis, 51.8% presented a clinical stage of Barcelona Clinic Liver Cancer (BCLC)-C. At the start of systemic treatment, 34.5% and 30.3% of the patients showed extrahepatic spread of the disease and main portal vein invasion, respectively. The most frequently administered first-line systemic therapies were sorafenib (57.1%), atezolizumab/bevacizumab (27.7%) and lenvatinib (7.5%). More than a third of the cohort (37.1%) received locoregional treatment at any time (before, concurrent and/or after systemic treatment). Overall, the median progression-free survival (PFS) and overall survival (OS) were 5.1 and 9.8 months, respectively. Patients receiving atezolizumab/bevacizumab showed the longest PFS (10.6 months) and OS (14.0 months) of all treatment groups and a numerically higher objective response rate (ORR) compared to the overall population (31.0% vs 12.5%).

This study offers valuable insights into the clinical characteristics, management, and outcomes of HCC patients in Spain in a real-world setting. Our results suggest potential benefits of immunotherapy-based combinations over other available alternatives, supporting findings from interventional and real-world studies.

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