Treatment patterns and outcomes in US patients with unresectable HCC treated with embolization
Year: 2026
Type: article
Study design: Observational Study
Abstract: To describe treatment patterns and outcomes in patients with unresectable hepatocellular carcinoma (uHCC) treated with embolization. This retrospective observational study used Optum’s de-identified Market Clarity Data. US adults with HCC treated with embolization between July 2016–September 2022 were followed from first embolization following diagnosis until death and end of enrollment or study period. Of 1,458 patients, 41.9%, 33.5%, and 24.6% received transarterial radioembolization (TARE), transarterial chemoembolization (TACE), and transarterial embolization (TAE), respectively, as initial embolization therapy; TARE use increased over time. Most were male (74.6%), white (66.5%), with a median age at index of 65.0 years, and 63.1% required ≥1 subsequent treatment (median treatment pattern follow-up: 16.3 months). Median (95% CI) time to first follow-up treatment or death was 5.9 (5.5–6.4) months. Compared with TARE, risk of death was lower with TACE (HR [95% CI] 0.82 [0.69–0.97]; P = 0.0242], non-significant in missingness sensitivity analysis) and higher with TAE (HR [95% CI] 1.25 [1.05–1.49]; P = 0.0135]). TARE was the most common initial embolization therapy and its use increased over time. Time to first follow-up treatment or death was relatively short. Future studies are needed to identify optimal treatment approaches. Between July 2016 and September 2022, transarterial radioembolization (TARE) was the most common therapy received at index among patients with unresectable hepatocellular carcinoma (uHCC) treated with embolization in the US, reflecting a notable shift in real-world practice toward increased use of TARE over transarterial chemoembolization (TACE) during the study period.Nearly two-thirds of patients (63.1%) received ≥1 follow-up treatment post-index embolization, highlighting a potential unmet need.Median time to first follow-up treatment or death was <7 months regardless of the embolization modality, highlighting the limited durability of initial embolization and the need for early treatment sequencing.In exploratory survival analyses, TACE was associated with a lower risk of death compared with TARE and risk of death was significantly higher with transarterial embolization (TAE); however, in the complete case sensitivity analysis, which did not include patients with missing covariate data, mortality differences were not statistically significant between TACE and TARE and were less pronounced between TAE and TARE.These findings emphasize the importance of early treatment sequencing and the continued need for more effective treatment strategies for uHCC treated with embolization. Between July 2016 and September 2022, transarterial radioembolization (TARE) was the most common therapy received at index among patients with unresectable hepatocellular carcinoma (uHCC) treated with embolization in the US, reflecting a notable shift in real-world practice toward increased use of TARE over transarterial chemoembolization (TACE) during the study period. Nearly two-thirds of patients (63.1%) received ≥1 follow-up treatment post-index embolization, highlighting a potential unmet need. Median time to first follow-up treatment or death was <7 months regardless of the embolization modality, highlighting the limited durability of initial embolization and the need for early treatment sequencing. In exploratory survival analyses, TACE was associated with a lower risk of death compared with TARE and risk of death was significantly higher with transarterial embolization (TAE); however, in the complete case sensitivity analysis, which did not include patients with missing covariate data, mortality differences were not statistically significant between TACE and TARE and were less pronounced between TAE and TARE. These findings emphasize the importance of early treatment sequencing and the continued need for more effective treatment strategies for uHCC treated with embolization. Hepatocellular carcinoma (HCC) is the most common form of liver cancer. For patients with cancer that is restricted to the liver but cannot be safely removed by surgery (known as unresectable), treatments are delivered through the artery feeding the tumor. These are called embolization therapies. There are three main types: transarterial radioembolization (TARE), which delivers radiation directly to the tumor, transarterial chemoembolization (TACE), which delivers chemotherapy directly to the tumor while also blocking its blood supply, and transarterial embolization (TAE), which blocks the blood supply without using radiation or chemotherapy. This study assessed real-world medical records from 1,458 adults in the United States who received embolization for HCC between 2016 and 2022. TARE was the most frequently chosen first treatment, used in about 4 in 10 patients. Most patients went on to receive at least one more treatment or died after this, typically within about 6 months, suggesting that the disease often progresses quickly. Over half of patients died during the follow-up period. These real-world findings can help patients and their doctors better understand what to expect from the different embolization types and help plan their treatments for unresectable HCC.
Source: Figshare
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7222920740