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P-10 PATTERNS OF PROGRESSION AND TREATMENT DISCONTINUATION IN A REAL LIFE LATIN AMERICAN PROSPECTIVE COHORT STUDY OF INTERMEDIATE-ADVANCED HEPATOCELLULAR CARCINOMA: SECOND INTERIM ANALYSIS
Federico Piñero1, Margarita Anders2, Carla Bermudez3, Ezequiel Demirdjian4, Adriana Varón5, Ana Palazzo6, Jorge Rodriguez7, Oscar Beltrán5, Leonardo Gomes da Fonseca8, Ezequiel Ridruejo9, Pablo Caballini10, Norberto Tamagnone10, Virginia Reggiardo10, Hugo Cheinquer11, Diego Arufe4, Juan Ignacio Marín12, Natalia Ratusnu13, Estela Manero14, Daniela Perez6, Marina Villa15..., Federico Orozco2, Dolores Murga6, Sebastián Marciano3, Fernando Bessone10, Marcelo Silva1, Manuel Mendizabal1Ver más
1 Austral University Hospital, Pilar, Argentina
2 Germany Hospital, Buenos Aires, Argentina
3 Buenos Aires Italian Hospital, Buenos Aires, Argentina
4 Sacred Heart Sanatorium, Buenos Aires, Argentina
5 LACARDIO/ Cardioinfantil Foundation. Bogotá, Colombia
6 Padilla Hospital, Tucumán, Argentina
7 San Juan Regional Hospital, San Juan, Argentina
8 Clinic Hospital, Sao Paulo University, Sao Paulo, Brasil
9 Education and Clinical Research Medical Center (CEMIC), Buenos Aires, Argentina
10 Centenario Hospital of Rosario, Santa Fe. Argentina
11 Porto Alegre Clinic Hospital, Federal University Rio Grande do Sul. Rio Grande do Sul, Brasil
12 Pablo Tobón Uribe Hospital, Medellín. Colombia
13 Ushuaia Regional Hospital, Ushuaia, Argentina
14 Pablo Soria Hospital, San Salvador de Jujuy, Argentina
15 Comarcal de Blanes Hospital, Córdoba, Argentina
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        "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0001">Introduction and Objectives</span><p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Previously published regional real-world results of overall survival &#40;OS&#41; in Barcelona Clinic Liver Cancer &#40;BCLC&#41; B and C patients demanded a prospective cohort study nested in a systematic and continuous medical educational networking group&#46; This study aimed to describe and evaluate the treatment decisions in patients with hepatocellular carcinoma &#40;HCC&#41; within BCLC B and C stages&#46;</p></span> <span id="abss0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Materials and Methods</span><p id="spara002" class="elsevierStyleSimplePara elsevierViewall">A multicenter prospective cohort study&#44; conducted in different Latin American centers from Argentina&#44; Brazil and Colombia&#44; started on 15<span class="elsevierStyleSup">th</span> May 2018 &#40;delayed recruitment during COVID locked-down period&#41;&#46; Patients within BCLC B or C stages were included&#46; Survival&#44; tumor progression and patterns of treatment suspension were evaluated&#46;</p></span> <span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Results</span><p id="spara003" class="elsevierStyleSimplePara elsevierViewall">At this second interim analysis &#40;projected final analysis March 2023&#41;&#44; 390 HCC BCLC-B or C patients were included &#40;n&#61;15 excluded&#41;&#59; mean age 65 years&#44; 75&#46;6&#37; males and 89&#46;5&#37; cirrhotic&#46; Median OS since HCC diagnosis was 27&#46;2 months&#46; Among BCLC-B patients&#44; the most frequent therapy was transarterial chemoembolization &#40;TACE&#44; 42&#46;3&#37;&#41;&#59; 51&#46;8&#37; using drug-eluting beads and 47&#46;4&#37; conventional TACE&#59; with a median OS since 1<span class="elsevierStyleSup">st</span> TACE of 41&#46;9 months&#46; Similar radiological responses after 1<span class="elsevierStyleSup">st</span> TACE were observed between both modalities&#46; Overall&#44; 48&#46;2&#37; of the cohort received systemic therapy for HCC &#40;n&#61;188&#41;&#44; 23&#46;7&#37; still on BCLC-B stage&#46; The most frequent systemic treatments were Sorafenib &#40;74&#46;5&#37;&#41;&#44; atezolizumab bevacizumab &#40;17&#46;5&#37;&#41;&#44; and lenvatinib &#40;12&#46;2&#37;&#41;&#44; with a median OS since systemic therapy of 15&#46;7 months&#46; Lenvatinib or atezolizumab bevacizumab was used as the second line following sorafenib in 5 and 3 patients&#44; respectively&#46; The most common causes of systemic treatment discontinuation were tumor progression and liver function deterioration &#40;15&#37; to 36&#46;4&#37;&#41;&#46; Patterns of tumor progression were not specifically associated with prognosis or treatment discontinuation&#46;</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Conclusions</span><p id="spara004" class="elsevierStyleSimplePara elsevierViewall">Liver function deterioration occurs in a third of patients following systemic therapies&#46; The complexity of treatment decisions underly the need for a multidisciplinary team and the role of hepatologists&#46;</p></span>"
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Article information
ISSN: 16652681
Original language: English
DOI:10.1016/j.aohep.2023.100914
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