*The use of this product has EMA authorisation and funding conditions from the HNS. †The TECENTRIQ® indication in combination with bevacizumab is funded by the HNS for the treatment of adult patients with advanced or unresectable hepatocellular carcinoma who have not received prior systemic therapy, with liver function (Child-Pugh stage A), an ECOG score of 0 or 1, in the absence of untreated or undertreated oesophagogastric varices and in the absence of autoimmune diseases. ‡The reflected information refers to the Avastin® data sheet; in case of administering another bevacizumab, the corresponding data sheet should be consulted. §In China only. ‖The use of this product has EMA authorisation but is pending for obtaining funding conditions from HNS. ¶Does not currently have EMA authorisation. This figure contains research data from products without EMA authorisation, with the only purpose of medical education. SEARCH study: sorafenib + erlotinib vs sorafenib + placebo. Trials in bold supported an approval.
HCC is a global disease that affects 1.5 billion people worldwide15
|20% of people with liver cancer are alive at 5 years following diagnosis16||This estimate significantly drops to 3% of people alive at 5 years for advanced liver cancer16|
The recurrence rate remains as high as 70% within 5 years after curative surgery or ablation.17 In this scenario, adjuvant therapy is essential to improve the prognosis of curative treatments for HCC18,19
Although most patients are not amenable to curative therapies because they are diagnosed at an advanced tumour stage or complicated with advanced liver disease, curative treatment is available and represents the first choice for HCC19
Clinical studies of adjuvant therapies conducted to date, investigating vitamin K, retinoids and sorafenib, did not yield the expected positive outcomes20
Phase III research is ongoing. There are currently 4 global Phase 3 trials ongoing for adjuvant HCC:21-24
Adjuvant treatments could help reduce the risk of recurrence after curative surgery or ablation and improve patient outcomes21-24
HCC is characterised by a high degree of heterogeneity accompanied by the underlying CLD, making no single provider equipped to deal with all the patients’ needs adequately25,26
Limited access to:
Multiple studies have shown that the lack of an MDT can significantly impact stage at diagnosis, referral patterns, the selection of treatment and survival for patients with HCC27-30
Selection of treatment-based biomarkers is still far away from its clinical applicability in the clinical decision-making processes31
Disparities in the treatment of HCC are often related to sex, race, ethnicity and socioeconomic status32
Recent data suggest that women are more likely to undergo liver resection or liver ablation and less likely to undergo liver transplantation compared with men33,34
Hispanic patients are less likely to receive HCC-directed, curative therapy at BCLC stage 0/A HCC;35 in addition these group of patients are less likely to receive liver resection and liver ablation36
HCC has been shown to disproportionately affect individuals of low socioeconomic status, with lower observed surveillance and survival rates in those with the lowest income37,38
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3. Zhu AX, et al. J Clin Oncol 2015;33:559–66.
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6. Yau C, et al. Lancet Oncol 2022;23:149–60.
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8. Ren Z, et al. Lancet Oncol 2021;22:977–90.
9. Qin S, et al. J Clin Oncol 2021;39:3002–11.
10. Kelley RK, et al. Lancet Oncol 2022;23:995–1008.
11. Abou-Alfa GK, et al. N Engl J Med Evidence 2022;1:EVIDoa2100070.
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13. Kudo M, et al. Ann Oncol 2022;33(Suppl 7):S808–69.
14. Qin S, et al. Ann Oncol 2022;33(Suppl 7):S808–69.
15. Cheemerla S. and Balakrishnan M. Clin Liver Dis (Hoboken) 2021;17:365–370.
16. Siegel RL, et al. CA Cancer J Clin 2021;71:7–33.
17. Bruix J. and Sherman M. Hepatology 2011;53:1020–1022.
18. Liu Y, et al. Front Oncol 2021;11:709278.
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20. Kudo M. Liver Cancer 2021;10:399–403.
21. ClinicalTrial.gov NCT04102098. Available at: https://clinicaltrials.gov/ct2/show/NCT04102098; accessed April 2023.
22. ClinicalTrial.gov NCT03383458. Available at: https://clinicaltrials.gov/ct2/show/NCT03383458; accessed April 2023.
23. ClinicalTrial.gov NCT03867084. Available at: https://www.clinicaltrials.gov/ct2/show/NCT03867084; accessed April 2023.
24. ClinicalTrial.gov NCT03847428. Available at: https://clinicaltrials.gov/ct2/show/NCT03847428; accessed April 2023.
25. Chan SL, et al. J Gastroenterol Hepatol 2022;37:1197–1206.
26. Naugler WE, et al. Clin Gastroenterol Hepatol 2015;13:827–835.
27. Yopp AC, et al. Ann Surg Oncol 2014; 21:1287–95.
28. Villadsen GE, et al. J Gastrointestin Liver Dis 2019;28:83–88.
29. Sinn DH, et al. PLoS One 2019;14:e0210730.
30. Duininck G, et al. J Surgical Oncology 2019;120:1365–1370.
31. Piñero F, et al. Cells 2020;9:1370;2.
32. Guo A, et al. Clin Liver Dis (Hoboken) 2021;17:353–358.
33. Wu EM, et al. Hepatoma Res 2018;4:66.
34. Sobotka L, et al. World J Hepatol 2017;9:1346–1351.
35. Rich NE, et al. Clin Gastroenterol Hepatol 2019;17:551–559.e1.
36. Peters NA, et al. J Surg Res 2017;210:253–260.
37. Ladhani S, et al. J Clin Gastroenterol 2020;54:218–226.
38. Harris PS, et al. World J Gastroenterol 2019;25:1550–1559.
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