Treatment patterns and outcomes in US patients with unresectable HCC treated with embolization

Aims To describe treatment patterns and outcomes in patients with unresectable hepatocellular carcinoma (uHCC) treated with embolization.Materials & methods This retrospective observational study used Optum’s de-identified Market Clarity Data. US adults with HCC treated with embolization between July 2016–September 2022 were followed from first embolization following diagnosis until death and end of enrollment or study period.Results Of 1,458 patients, 41.9%, 33.5%, and 24.6% received transarterial radioembolization (TARE), transarterial chemoembolization (TACE), and transarterial embolization (TAE), respectively, as initial embolization therapy; TARE use increased over time. Most were male (74.6%), white (66.5%), with a median age at index of 65.0 years, and 63.1% required ≥1 subsequent treatment (median treatment pattern follow-up: 16.3 months). Median (95% CI) time to first follow-up treatment or death was 5.9 (5.5–6.4) months. Compared with TARE, risk of death was lower with TACE (HR [95% CI] 0.82 [0.69–0.97]; P = 0.0242], non-significant in missingness sensitivity analysis) and higher with TAE (HR [95% CI] 1.25 [1.05–1.49]; P = 0.0135]).Conclusion TARE was the most common initial embolization therapy and its use increased over time. Time to first follow-up treatment or death was relatively short. Future studies are needed to identify optimal treatment approaches.