Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Oct 15, 2026; 18(10): 121745
Published online Oct 15, 2026. doi: 10.4251/wjgo.121745
Published online Oct 15, 2026. doi: 10.4251/wjgo.121745
Evolving practices, treatment decisions, and unmet needs in intermediate-stage hepatocellular carcinoma: An Asia Pacific perspective
Suebpong Tanasanvimon, Division of Medical Oncology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
Pin-Nan Cheng, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
Wonseok Kang, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
Gwo-Fuang Ho, M Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kuala Lumpur 43000, Malaysia
Tuan-Anh Pham, Department of Medical Oncology, National Cancer Hospital, Hanoi 100000, Viet Nam
Michael Cabato, Department of Medical Imaging and Therapeutic Radiology, National Kidney and Transplant Institute, Quezon City 1101, Philippines
Ryan Edbert Husni, East Asia Global South Region, Eisai Co Ltd, Tokyo 112-8088, Japan
Bo-Young Kim, Medical Department, Eisai Korea Inc, Seoul 06163, South Korea
Pierce Chow, Department of Hepato-Pancreato-Biliary Surgery and Transplantation, National Cancer Centre Singapore, Singapore General Hospital, Singapore 169608, Singapore
Pierce Chow, Surgery Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore
Author contributions: Tanasanvimon S, Cheng PN, Kang W, Ho GF, Pham TA, Cabato M, Husni RE, Kim BY, and Chow P were responsible for conceptualization and writing - review and editing; Husni RE and Kim BY were responsible for methodology and writing - original draft; Chow P was responsible for supervision. All authors read, approved, and agreed to submit the final manuscript for publication.
AI contribution statement: AI tools (specifically, Microsoft Copilot) were used solely for linguistic refinement. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions.
Supported by Eisai Co Ltd, Tokyo, Japan. Medical writing/editorial assistance was provided by Fay Pickering, at Amiculum, funded by Eisai Co Ltd, and carried out in compliance with the Good Publication Practice 2022 guidelines.
Institutional review board statement: As this study comprised an anonymous and voluntary survey addressed to physicians and did not involve patients or the collection of patient-level or identifiable personal data, ethics committee or institutional review board approval was not required.
Informed consent statement: All study participants provided written informed consent prior to completion of the survey.
Conflict-of-interest statement: Kang W has received personal fees (honoraria) from Eisai, Roche, and AstraZeneca during the conduct of the study; Ho GF has received research grants from Merck, Sharpe & Dohme, Novartis, Roche, AstraZeneca, Boehringer Ingelheim, Pfizer, Astellas Pharmaceuticals, Regeneron Pharmaceuticals, Eli Lilly, AB Science, Arcus Bioscience, Daiichi Sankyo, Janssen Research & Development, Mira Therapeutics, Amgen, and the Fundamental Research Grant Scheme (FRGS), personal compensation for acting in an advisory role, as an invited speaker, or as a local principal investigator from Merck, Sharpe & Dohme, Novartis, Roche, AstraZeneca, Boehringer Ingelheim, Pfizer, Astellas Pharma, Takeda, Merck & Co, Inc, and Eisai, and non-financial support from Merck, Sharpe & Dohme, AstraZeneca, Pfizer, Ipsen, Bristol-Meyers Squibb, Regeneron Pharmaceuticals, Dr Reddy’s, Roche Sequencing Solutions, Servier, and Zuellig Pharma; Cheng PN has received personal compensation for acting in an advisory role, as an invited speaker, or as a local principal investigator from Merck, Sharpe & Dohme, AstraZeneca, Boehringer Ingelheim, Gilead Sciences, and Eisai; Husni RE is an employee of Eisai Co Ltd; Kim BY is an employee of Eisai Korea Inc; Chow P has received personal compensation for acting in an advisory role from Sirtex Medical, Ipsen, Bristol-Myers Squibb, Oncosil, Bayer, New B Innovation, Merck, Sharpe & Dohme, BTG Plc, Guerbet, Roche, AUM Bioscience, LEK Consulting, AstraZeneca, Eisai, Genentech, IQVIA, and Abbott and research grants from Sirtex Medical, Ipsen, New B Innovation, Roche, IQVIA, AMiLi, Perspectum, and MiRXES. All other authors have no conflicts of interest to disclose.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: All data generated or analysed during this study are included in this published article.
Corresponding author: Pierce Chow, Department of Hepato-Pancreato-Biliary Surgery and Transplantation, National Cancer Centre Singapore, Singapore General Hospital, Singapore 169608, Singapore. pierce.chow@duke-nus.edu.sg
Received: April 1, 2026
Revised: July 9, 2026
Accepted: August 25, 2026
Published online: October 15, 2026
Processing time: 169 Days and 20.2 Hours
Revised: July 9, 2026
Accepted: August 25, 2026
Published online: October 15, 2026
Processing time: 169 Days and 20.2 Hours
Core Tip
Core Tip: The integration of systemic therapy with locoregional therapy (LRT) for the treatment of intermediate-stage hepatocellular carcinoma (iHCC) is rapidly becoming an area of interest. In this physician-targeted survey, 98.1% of prescribers had experience using a systemic therapy in combination or sequence with LRT for the treatment of iHCC. Patients with Barcelona Clinic Liver Cancer stage B2 and B3 iHCC were seen as ideal candidates for such combinations; however, barriers to access included lack of evidence for combination-therapy use and cost/reimbursement status of approved treatments.