Frontiers in Hepatocellular Carcinoma
Survey Results

In collaboration with Ipsen

  • Quantify the change in treatment selection across the lines of treatment
  • Identify how physicians think public health coverage for Hepatocellular Carcinoma (HCC) treatments will change in the coming months.
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    In late June and early July, twenty medical oncologists across Canada who treat HCC answered the survey. Below are some key findings.
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First line HCC therapy distribution today and anticipated distribution six months from now

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Some provinces will start covering Atezo/bev in 1L HCC, fueling its increase in use over Lenvatinib.
Comparison of now vs. future in anticipated second line HCC therapy distribution. Cabozantinib now and 28% and 38% in the future. Lenvatinib at 28% and 38% in the future. Sorfenib now at 16% and 12% in the future. Regorafenib now at 16% and 8% in the future. Other treatments today at 10% and will decrease to 7% in the future.
Second line HCC therapy distribution today and anticipated distribution six months from now was compared.
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As Lenvatinib use is expected to decline in 1L, respondents expect to use it more in 2L. Cabozantinib, which is not approved in 1L, is also expected to be used more in 2L.
Comparison of now vs. future in anticipated second line HCC therapy distribution. Cabozantinib now and 28% and 38% in the future. Lenvatinib at 28% and 38% in the future. Sorfenib now at 16% and 12% in the future. Regorafenib now at 16% and 8% in the future. Other treatments today at 10% and will decrease to 7% in the future.
Comparison of third line HCC therapy distribution today and anticipated distribution six months from now.
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Cabozantinib was approved for HCC 2Ltreatment late last year, it is interesting to see its anticipated use increasein 3L. ‘Other’ treatments are anticipated to be used more often in 3L.

Comparison of now vs. future in anticipated third line HCC therapy distribution. Cabozantinib now and 28% and 38% in the future. Lenvatinib at 0% and 4% in the future. Sorafenib 0% now and 6% in the future. Regorafenib 28% now and 26% in the future. Other therapies at 44% today and 25% in the future.

What are 'Other' treatments do you think your colleagues
intend to use more often in 3L?

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Given recent reimbursement decisions and availability of new therapies, physicians report a fair increase in the demand for third line therapies.

Bar demonstrating 3.5 of 5 increase in the demand for third line therapies. 1 = no increase, 5 = large increase.

When oncologists were asked about their sentiment on the prospect of improved provincial health plan coverage of 3L HCC therapy, 25% said "I'm not sure".

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Public health plan coverage for 3L HCC treatment is uneven across provinces, and physicians struck a nihilistic tone when asked if reimbursement policy will improve in their province in the coming months. This finding, along with the expected increase in demand for 3L treatment, suggests that advocacy may be necessary to improve treatment access for 3L HCC patients.

Physician sentiment on prospect of improved provincial coverage of 3L HCC therapy: 25% said I'm not sure, 20% said will evolve accordingly, 20% said no coverage will be provided, and 10% said it will not change.
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