Case Study

Evidence review to characterise the nature and burden of advanced hepatocelluar carcinoma


Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide and the third most common cause of cancer-related death.

Curative treatments including surgical resection, liver transplantation, local ablation or transarterial embolisation tend to be more effective in patients with early-stage HCC.

In patients with advanced HCC, prognosis remains poor and existing treatment options are limited.

Our client wanted to understand the epidemiology of advanced hepatocellular carcinoma and the clinical, humanistic and economic burden to patients and healthcare systems worldwide.


We conducted a series of systematic reviews characterising the nature (epidemiology) and clinical, humanistic and economic burden of advanced HCC.

A pragmatic literature review of treatment guidelines and HTAs was also undertaken to identify standard of care for advanced HCC.

A protocol was developed a priori, and the reviews’ methodology and reporting were in line with PRISMA guidelines and NICE recommendations.

Overall survival and response rates were estimated for the different recommended systemic therapies used in first- and second-line settings worldwide.


By including a wide range of study designs we were able to identify differences in standard of care between clinical trials and real-world evidence.

We collated published evidence characterising the nature and burden of disease in order to evaluate the clinical, patient and health economic gains that may be realised via new novel therapies for advanced HCC.

We identified current unmet needs in the field of advanced HCC that will drive targeted research in the future.