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ESMO GI 2025 | Elucidating optimal second-line treatments in hepatocellular carcinoma
Julien Edeline, MD, PhD, Centre Eugene Marquis, Rennes, France, comments on the need for real-world data to inform treatment decisions in hepatocellular carcinoma (HCC), particularly in the second-line setting where prospective trials are limited. Currently, there is focus on adding immunotherapies to first-line treatments, leaving a significant gap in research for second-line options. Real-world data, including data from patients with comorbidities such as Child-Pugh B cirrhosis, can provide valuable insights and comparisons that are not available through clinical trials. This interview took place at the European Society for Medical Oncology (ESMO) Gastrointestinal Cancer 2025 Congress in Barcelona, Spain.
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Transcript
First of all, we need to see that currently there are very few ongoing prospective trials in the second line. Most of the pharma companies are trying to add immunotherapy compounds in the first-line setting, and very limited research is done for the second-line treatment. So, real-world data are obviously more available than clinical trials data. So, it’s an important gap...
First of all, we need to see that currently there are very few ongoing prospective trials in the second line. Most of the pharma companies are trying to add immunotherapy compounds in the first-line setting, and very limited research is done for the second-line treatment. So, real-world data are obviously more available than clinical trials data. So, it’s an important gap. We provide data in this setting where prospective trials are difficult to do. Also, prospective data comparing TKIs will certainly not be done due to limited interest for funding of such trials. So real-world evidence is important to provide some comparisons. And real-world evidence also provides evidence in some populations that are excluded from clinical trials. In our analysis, close to a quarter of the population have, for example, Child-Pugh B cirrhosis, which is underrepresented in clinical trials.
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