Abstract 187P
Background
Recent data highlight the potential role of immunotherapy-based systemic therapy, with or without transarterial chemoembolisation (TACE), in patients with intermediate stage HCC (IS-HCC). Data on oncologists’ practice patterns and educational needs in this area are lacking.
Methods
Data were collected in Dec 2023 via a 14-item electronic survey administered to EU, Asia, and US oncologists using the LiMA network. The survey assessed practice patterns, CME exposure, knowledge gaps, and confidence related to systemic therapy in IS-HCC. Linear and logistic regression analyses were used to evaluate associations between CME participation frequency and oncologists’ confidence and practice patterns.
Results
Of 79 oncologist respondents (EU: 51, Asia: 15, US: 13), most (81%) had initiated systemic therapy for IS-HCC in the last 3 months. Most EU and US oncologists initiated systemic therapy upon progression after TACE (52%-67%), whereas those in Asia often initiated simultaneously with TACE (57%). Oncologists in all regions ranked guidelines as the most and patient preference as the least influential factor for recommending systemic therapy. A higher proportion in the EU reported moderate-large knowledge gaps and rated themselves as being not very confident in using systemic therapy for IS-HCC (Table). Participation in related CME was associated with confidence in selecting candidates (b = .21, β = .40, P < .001) and use of systemic therapy (OR 2.52; 95% CI 1.46 - 5.12). Table: 187P
Percentage of oncologists’ reporting knowledge and confidence gaps for use of systemic therapies in IS-HCC
| Europe | Asia | US | |
| % Who reported moderate or large gap in knowledge related to: | |||
| Safety and efficacy profiles of the various regimens | 47% | 20% | 38% |
| Patient candidate selection | 55% | 13% | 38% |
| Optimal timing to initiate the therapy | 61% | 33% | 38% |
| Adverse events | 51% | 20% | 31% |
| % Who did not rate themselves as “very/extreme confident” in: | |||
| Identifying optimal timing to initiate the therapy | 53% | 40% | 31% |
| Identifying patient candidates | 53% | 33% | 23% |
| Selecting appropriate regimens | 55% | 27% | 23% |
| Managing adverse events | 49% | 20% | 31% |
| Educating patients | 51% | 33% | 31% |
Conclusions
Self-reported practice patterns, knowledge, and confidence vary amongst EU, Asia, and US oncologists managing IS-HCC. Oncologists who participated in more CME had more confidence in selecting appropriate patients and reported greater use of systemic therapy. Cumulative CME exposure may reduce gaps in the application of systemic therapy in IS-HCC.
Legal entity responsible for the study
PeerVoice.
Funding
Has not received any funding.
Disclosure
A. Singal: Financial Interests, Personal, Advisory Board: Genentech/Roche, AstraZeneca, Eisai, Bayer, Exelixis, Elevar, Merck, Boston Scientific, Sirtex, Histosonics, FujiFilm Medical Sciences, Exact Sciences, Glycotest, GRAIL, Freenome, Delfi, Abbott, Universal Dx, Verve. All other authors have declared no conflicts of interest.