Background OREIOS (NCT05239507) study determined the clinical characteristics, management patterns, and survival outcomes in patients with unresectable HCC (uHCC) from 12 countries across Asia, Latin America, and Middle East and Africa. Methods This non-interventional, retrospective study enrolled patients with Barcelona Clinic Liver Cancer (BCLC) stage B or C unresectable or advanced/metastatic HCC at index date, diagnosed between January 2017 and December 2019. The primary outcomes were median overall survival (mOS) and landmark survival (12 and 24 months) and secondary outcomes were clinicodemographic characteristics, treatment patterns, and median progression-free survival (mPFS). Results A total of 1116 patients (median range age: 63.0 18.0-97.0 years) were recruited; 83.2% (929/1116) were males, 49.5% (422/852) were current/ex-smokers, and 21.3% (122/572) consumed alcohol. At the index date, 22.3% (249/1116) and 77.7% (867/1116) of patients presented with BCLC stage B and C, respectively, with main portal vein invasion in 23.5% (263/1116), >50% liver involvement in 23.1% (250/1082), and extrahepatic metastases in 48.5% (541/1116). Transarterial chemoembolization was performed before and after the index dates in 22.9% (255/1112) and 20.8% (232/1116) of patients, respectively. In the first-line of therapy (LOT), majority of patients received tyrosine multikinase inhibitors (TKIs)─ sorafenib (68.3% 684/1002 and lenvatinib (10.2% 102/1002). Irrespective of LOT, the mPFS and mOS was 6.1 (95% CI: 5.5-6.7) and 13.1 (95% CI: 11.6, 14.1) months for the overall cohort. The survival rate at 12 and 24months for the overall cohort were52.1 % (95% CI: 49.1-55.1) and 30.6% (95% CI: 27.8-33.4). Conclusion Our study provides retrospective view of treatment strategies in patients with advanced uHCC prior to advent of immunotherapy and combination therapy. Majority of patients received TKIs, as per then recommended and available treatment options. The mOS in our study was similar to that observed in pivotal clinical trials for TKIs. With novel agents and combination therapies being approved for uHCC, integrating them into routine care is important to improve survival.
Chan et al. (Wed,) studied this question.