Introduction Hepatocellular carcinoma (HCC) is the sixth most commonly diagnosed cancer and the third leading cause of cancer death worldwide. While there has been rapid evolution in the treatment paradigm of HCC across the past decade, the extent to which these newly approved therapies are utilized in clinical practice in the real world is, however, unknown. The INSIGHT study was an investigator-initiated, multi-site longitudinal cohort study conducted to reflect real-world epidemiology and clinical practice in Asia-Pacific in the immediate 7-year period after the conclusion of the BRIDGE study. Methods Data were collected both retrospectively (planned 30% of the total cohort size) and prospectively (planned 70%) from January 2013 to December 2019 from eligible patients newly diagnosed with HCC from 33 participating sites across 9 Asia-Pacific countries. Results A total of 2,533 newly diagnosed HCC patients (1,052 in retrospective cohort and 1,481 in prospective cohort) were enrolled. The most common risk factor was hepatitis B in all countries except Japan, Australia, and New Zealand, where the prevalence of hepatitis C and diabetes were more common. The top three comorbidities reported in the INSIGHT study include cirrhosis, hypertension, and diabetes. We observe high heterogeneity in the first-line treatment recorded across countries and across disease stages, which significantly affects survival outcomes. Stratification by factors such as etiologies, tumor characteristics, the presence of extrahepatic metastases or macrovascular invasion, and the use of subsequent lines of treatment were performed. Conclusion The INSIGHT study describes a wide spectrum of clinical management practices in HCC, where patient demographics, differential costs, and patient access to therapies may lead to wide geographical variations through the patient's treatment cycle, from diagnosis to clinical outcome. The high heterogeneity in patient outcomes demonstrates the need for more robust and clinical management strategies to be designed and adopted to bring about better patient outcomes.

中文翻译：

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亚太地区肝细胞癌诊断、治疗和管理的真实世界数据：INSIGHT 研究。


简介 肝细胞癌 (HCC) 是全球第六大最常见癌症和第三大癌症死亡原因。尽管过去十年 HCC 的治疗模式发生了快速发展，但这些新批准的疗法在现实世界临床实践中的应用程度尚不清楚。 INSIGHT 研究是一项由研究者发起的多中心纵向队列研究，旨在反映 BRIDGE 研究结束后 7 年内亚太地区的真实流行病学和临床实践。方法 从 2013 年 1 月至 2019 年 12 月期间，对来自 9 个亚太国家 33 个参与地点的新诊断为 HCC 的合格患者进行回顾性（计划占队列总规模的 30%）和前瞻性（计划占 70%）收集数据。结果 共有 2,533 名新诊断 HCC 患者入组（回顾性队列 1,052 例，前瞻性队列 1,481 例）。除日本、澳大利亚和新西兰以外的所有国家中，最常见的危险因素是乙型肝炎，而日本、澳大利亚和新西兰的丙型肝炎和糖尿病的患病率更为常见。 INSIGHT 研究报告的前三种合并症包括肝硬化、高血压和糖尿病。我们观察到不同国家和不同疾病阶段记录的一线治疗存在高度异质性，这显着影响生存结果。根据病因、肿瘤特征、肝外转移或大血管侵犯的存在以及后续治疗方案的使用等因素进行分层。 结论 INSIGHT 研究描述了 HCC 的广泛临床管理实践，其中患者人口统计、差异成本和患者接受治疗的机会可能导致患者治疗周期（从诊断到临床结果）的广泛地域差异。患者结果的高度异质性表明需要设计和采用更稳健的临床管理策略以带来更好的患者结果。