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

PURPOSE

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.

METHODS/PATIENTS: 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.

RESULTS

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%).

CONCLUSIONS

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.