Real-World Data on the Diagnosis, Treatment, and Management of Hepatocellular Carcinoma in the Asia-Pacific: The INSIGHT Study
Issued Date
2023-10-09
Resource Type
ISSN
22351795
eISSN
16645553
Scopus ID
2-s2.0-85178113051
Journal Title
Liver Cancer
Volume
13
Issue
3
Start Page
306
End Page
321
Rights Holder(s)
SCOPUS
Bibliographic Citation
Liver Cancer Vol.13 No.3 (2023) , 306-321
Suggested Citation
Sim Y.K., Chong M.C., Gandhi M., Pokharkar Y.M., Zhu Y., Shi L., Lequn L., Chen C.H., Kudo M., Lee J.H., Strasser S.I., Chanwat R., Chow P.K.H., Tse E., Strasser S.I., Lequn L., Li J., Jia F., Xu Z., Bai Y., Shu-Kui Q., Yau T., Furuse J., Shimada K., Hasegawa K., Takemura N., Bartlett A., Chow P.K.H., Lim K., Seng T.P., Young D.Y., Goh B., Yoon H.K., Hwan K.Y., Sungbum C., Lee J.H., Han H.S., Jin-Mo Y., Young C.J., Wang H.J., Kim D.Y., Hospital S., Yuan P.C., Chao Y., Hu T.H., Cheng P.N., Chen C.H., Chanwat R., Nimanong S. Real-World Data on the Diagnosis, Treatment, and Management of Hepatocellular Carcinoma in the Asia-Pacific: The INSIGHT Study. Liver Cancer Vol.13 No.3 (2023) , 306-321. 321. doi:10.1159/000534513 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/99230
Title
Real-World Data on the Diagnosis, Treatment, and Management of Hepatocellular Carcinoma in the Asia-Pacific: The INSIGHT Study
Author(s)
Sim Y.K.
Chong M.C.
Gandhi M.
Pokharkar Y.M.
Zhu Y.
Shi L.
Lequn L.
Chen C.H.
Kudo M.
Lee J.H.
Strasser S.I.
Chanwat R.
Chow P.K.H.
Tse E.
Strasser S.I.
Lequn L.
Li J.
Jia F.
Xu Z.
Bai Y.
Shu-Kui Q.
Yau T.
Furuse J.
Shimada K.
Hasegawa K.
Takemura N.
Bartlett A.
Chow P.K.H.
Lim K.
Seng T.P.
Young D.Y.
Goh B.
Yoon H.K.
Hwan K.Y.
Sungbum C.
Lee J.H.
Han H.S.
Jin-Mo Y.
Young C.J.
Wang H.J.
Kim D.Y.
Hospital S.
Yuan P.C.
Chao Y.
Hu T.H.
Cheng P.N.
Chen C.H.
Chanwat R.
Nimanong S.
Chong M.C.
Gandhi M.
Pokharkar Y.M.
Zhu Y.
Shi L.
Lequn L.
Chen C.H.
Kudo M.
Lee J.H.
Strasser S.I.
Chanwat R.
Chow P.K.H.
Tse E.
Strasser S.I.
Lequn L.
Li J.
Jia F.
Xu Z.
Bai Y.
Shu-Kui Q.
Yau T.
Furuse J.
Shimada K.
Hasegawa K.
Takemura N.
Bartlett A.
Chow P.K.H.
Lim K.
Seng T.P.
Young D.Y.
Goh B.
Yoon H.K.
Hwan K.Y.
Sungbum C.
Lee J.H.
Han H.S.
Jin-Mo Y.
Young C.J.
Wang H.J.
Kim D.Y.
Hospital S.
Yuan P.C.
Chao Y.
Hu T.H.
Cheng P.N.
Chen C.H.
Chanwat R.
Nimanong S.
Author's Affiliation
Korea University Anam Hospital
Ajou University Hospital
Siriraj Hospital
Kindai University Hospital
Severance Hospital
Duke-NUS Medical School
National Cheng Kung University Hospital
National Taiwan University Hospital
Asan Medical Center
Chang Gung Memorial Hospital
National Cancer Centre, Singapore
Royal Adelaide Hospital
National University Hospital
National Cancer Institute Thailand
Zhejiang University School of Medicine
The University of Tokyo
Harbin Medical University
Seoul National University Hospital
Samsung Medical Center, Sungkyunkwan university
Kyorin University Faculty of Medicine
Royal Prince Alfred Hospital
Singapore General Hospital
Taipei Veterans General Hospital
Auckland City Hospital
Tampere University
Fudan University
Beijing Cancer Hospital
Guangxi Medical University
St. Vincent's Hospital Melbourne
Royal College of Surgeons in Ireland
Samsung Medical
Queen Mary Hospital
Consortium for Clinical Research and Innovation
National Cancer Centre Japan
National Centre for Global Health and Medicine
China Medical University Hospital
Nanjing Bayi Hospital
St. Mary’s Hospital
Ajou University Hospital
Siriraj Hospital
Kindai University Hospital
Severance Hospital
Duke-NUS Medical School
National Cheng Kung University Hospital
National Taiwan University Hospital
Asan Medical Center
Chang Gung Memorial Hospital
National Cancer Centre, Singapore
Royal Adelaide Hospital
National University Hospital
National Cancer Institute Thailand
Zhejiang University School of Medicine
The University of Tokyo
Harbin Medical University
Seoul National University Hospital
Samsung Medical Center, Sungkyunkwan university
Kyorin University Faculty of Medicine
Royal Prince Alfred Hospital
Singapore General Hospital
Taipei Veterans General Hospital
Auckland City Hospital
Tampere University
Fudan University
Beijing Cancer Hospital
Guangxi Medical University
St. Vincent's Hospital Melbourne
Royal College of Surgeons in Ireland
Samsung Medical
Queen Mary Hospital
Consortium for Clinical Research and Innovation
National Cancer Centre Japan
National Centre for Global Health and Medicine
China Medical University Hospital
Nanjing Bayi Hospital
St. Mary’s Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
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.