A retrospective database analysis to understand treatment patterns and outcomes of intermediate and advanced hepatocellular carcinoma in Alberta, Canada (A-CAPTAIN study).

Background: With the emergence of new systemic therapies there has been a substantial change in treatment options for hepatocellular carcinoma (HCC). The aim of this study was to assess treatment patterns and outcomes in real-world Canadian HCC patients with intermediate and advanced stage disease who have received systemic treatments prior to 2021. Methods: All HCC patients with intermediate or advanced disease who received at least one dose of systemic therapy between January 1, 2008 to December 31, 2020 in the Canadian province of Alberta were included. Patient characteristics, treatment patterns, overall survival (OS), real-world progression-free survival (rwPFS), clinician-assessed response rates (RRs), and reasons for treatment discontinuation were retrospectively analyzed in all patients. Results: Of the 321 total patients included, 33 (10%) were intermediate and 288 (90%) were advanced stage. With respect to intermediate and advanced HCC patients, most were Eastern Cooperative Oncology Group (ECOG) 0-1 (94%, 85%, respectively) and Child-Pugh A (82% for both). For intermediate and advanced patients, RRs to first-line systemic therapy were 13% and 19%, median rwPFS was 7.4 and 4.2 months, and median OS was 13.5 and 10.9 months, respectively. Conclusions: This study characterized the systemic treatment patterns and outcomes of intermediate and advanced HCC patients treated prior to 2021 and can serve as a baseline for future comparison with HCC patients who predominantly receive first-line immunotherapy.