DigiCon

In a post hoc analysis of REFLECT trial, Lenvatinib was shown to offer superior outcomes [ORR, PFS and OS] over Sorafenib in patients who progressed to Child Pugh B. Does this hold true in your clinical practice as well? *

Yes

No

As you would agree, most of the systemic therapies are indicated for Child Pugh A advanced HCC patients. In your clinical practice, what is your treatment strategy for Child Pugh B patients? *

Treat with recommended dose

Treat with lower dose

Start with lower dose and then escalate based on tolerability

Do not treat

What is the starting dose of Lenvatinib that you would recommend for advanced HCC patients with Child Pugh B status? *

4mg

8mg

Do you recommend TACE for advanced HCC patients? *

Yes

No

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If yes

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As per the LAUNCH trial published in Journal of Clinical Oncology (J Clin Oncol. 2023 Jan 1;41(1):117-127), Lenvatinib plus TACE combination has shown a survival benefit of 17.8 months in advanced HCC patients. Do you think this combination would be a good alternative to immunotherapy? Please mention reasoning for answer. *

Yes

No

Need more data

Which is your preferred choice of drug for first line management of in-operable viral HCC? *

ATEZOLIZUMAB+BEVACIZUMAB

SORAFENIB

LENVATINIB

Any other

Which is your preferred choice of drug for first line management of in-operable non-viral HCC? *

ATEZOLIZUMAB+BEVACIZUMAB

SORAFENIB

LENVATINIB

Any other

Please mention the duration of therapy in case of first line treatment. *

IO
Lenvatinib
Sorafenib

As per a recent data published in ESMO (ESMO Open. 2022 Dec;7(6):100591), non-viral HCC patients benefited less from immunotherapy compared to Lenvatinib/Sorafenib. Is it the same in your clinical practice as well? *

Yes

No

In your clinical practice what is the commonly used staring dose with Lenvatinib for First line HCC management based on patient weight? *

Patient weight above 60 kg	Patient weight below 60 kg
8 mg 4 mg Any Other Please Specify	12 mg 8 mg 4 mg Any Other Please Specify

In your clinical practice which drug is your preference for first line management of in-operable HCC based on AFP levels. *

AFP levels 0-200ng
AFP levels 200-400mg
AFP levels above 400ng

Amongst the following which is a commonly seen side effect in your patients with Lenvatinib? What is the grade seen with all the adverse events? *

ADVERSE EVENT	OBSERVATION	GRADE
Hypertension	Very Common Common Rare
Hand foot skin reaction	Very Common Common Rare
Diarrhea	Very Common Common Rare
Nausea/Vomiting	Very Common Common Rare
ANY OTHER	Very Common Common Rare

In your clinical practice what is the common method applied by you to manage grade 3 or 4 hypertension with Lenvatinib? (Please tick your choice) *

Dose reduction

Treatment discontinuation

Treatment free interval, followed by return to normal dose upon ADE reduction.

Effectively manage with available drugs

Any other

In Your Clinical Practice how many patients receive second line treatment for HCC? *

< 20%

20-30%

30-40%

40-50%

50-60%

>60%

For the patients who receive second line therapy, what is your drug of choice for second line management of HCC based on First line therapy? *

For patients who received IO in first line
For patients who received TKI in first line

What is the average duration of second line therapy in case of relapsed HCC patients? *

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HCC Survey 2