Absence of impact of direct acting antivirals for hepatitis C virus on recurrent hepatocellular carcinoma tumor growth in the AFEF/ANRS CO22 Hepather cohort

Corréas, Jean-Michel; Dorival, Céline; Zoulim, Fabien; Tran, Albert; Bourlière, Marc; Calès, Paul; Guyader, Dominique; Bronowicki, Jean–Pierre; Larrey, Dominique; Hézode, Christophe; Loustaud‐Ratti, Véronique; Gournay, Jérôme; Lédinghen, Victor de; Asselah, Tarik; Ganne, Nathalie; Métivier, Sophie; Chazouillères, Olivier; Leroy, Vincent; Rosa, Isabelle; Samuel, Didier; Maury, Philippe; Cagnot, Carole; Fontaine, Hélène; Carrat, Fabrice; Pol, Stanislas; Bonnet, Delphine; Payssan-Sicart, Virginie; Pomes, Chloe; Bailly, François; Beaudoin, Marjolaine; Giboz, Dominique; Hartig‐Lavie, Kerstin; Maynard, Marianne; Billaud, Éric; Boutoille, David; Cavellec, M; Cheraud‐Carpentier, Marjorie; Hubert, I.; Benhida, Jaouad; Lannes, Adrien; Lunel, F.; Oberti, Frédéric; Boyer, Nathalie; Giuily, Nathalie; Castelnau, Corinne; Scoazec, Giovanna; Chibah, Aziza; Keser, Sylvie; Bonardi, Karim; Vallet-Pichard, Anaı̈s; Sogni, Philippe; Foucher, Juliette; Hiriart, Jean‐Baptiste; Wilson, Amy; Shili, Sarah; Chermak, Faïza; Ansaldi, Christelle; Chouquet, Laëtitia; Luca, Emilie De; Oulès, Valérie; Anty, Rodolphe; Gelsi, Ève; Truchi, Régine; Luckina, Elena; Messaoudi, Nadia; Moussali, Joseph; Dieuleveult, Barbara De; Labarrière, Damien; Poter, Pascal; Ahmed, Si Nafa Si; Grando‐Lemaire, Véronique; Nahon, Pierre; Bourcier, Valérie; Brulé, Séverine; Stalhberger, Thomas; Jézéquel, Caroline; Brener, Audrey; Laligant, Anne; Rabot, Aline; Renard, Isabelle; Baumert, Thomas F.; Doffoël, Michel; Mutter, Catherine; Simo-Noumbissie, Pauline; Razi, Esma; Barraud, Hélène; Bensenane, Mouni; Nani, Abdelbasset; Hassani-Nani, Sarah; Bernard, Marie-Albertine; Pageaux, Georges‐Philippe; Bismuth, Michaël; Caillo, Ludovic; Faure, Stéphanie; Ripault, Marie–Pierre; Bureau, Christophe; Péron, Jean Marie; Robic, Marie‐Angèle; Tarallo, Léa; Faure, Marine; Froissart, Bruno; Hilleret, Marie‐Noëlle; Zarski, Jean–Pierre; Goria, Odile; Grard, Victorien; Montialoux, Hélène; François, Muriel; Ouedraogo, Christian; Pauleau, Christelle; Varault, Anne; Andréani, Tony; Angoulevant, Bénédicte; Chevance, Azeline; Serfaty, Lawrence; Antonini, Térésa; Coilly, Audrey; Vallée, Jean‐Charles Duclos; Tateo, Mariagrazia; Bonny, Corinne; Brigitte, Chanteranne; Lamblin, Géraldine; Muti, Leon; Babouri, Abdenour; Filipe, Virginie; Barrault, Camille; Laurent, Alexis; Hagège, Hervé; Merbah, Soraya; Carrier, Paul; Debette‐Gratien, Maryline; Jacques, Jérémie; Lassailly, Guillaume; Artu, Florent; Canva, V.; Dharancy, Sébastien; Louvet, Alexandre; Latournerie, Marianne; Bardou, Marc; Mouillot, Thomas; Bacq, Yannick; Barbereau, Didier; Nicolas, Charlotte; Chevalier, Caroline; Archambeaud, Isabelle; Habes, Sarah; Amara, Nisserine Ben; Botta-Fridlund, Danièle; Saillard, Eric; Lafrance, Marie-Josée

doi:10.1016/j.clinre.2020.04.022

Cited by 4 publications

(4 citation statements)

References 30 publications

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“…In this situation, external criteria from predominantly Western or other developed countries may not be suitable for Indian patients in the current scenario. The availability and use of direct-acting antivirals did not have any impact on the incidence or recurrence of HCC; however, extensive data are lacking in this regard[ 34 - 36 ].…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

Pahari,

Raj,

Sawant

et al. 2024

World J Transplant

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BACKGROUND Liver transplantation (LT) for hepatocellular carcinoma (HCC) has been widely researched and is well established worldwide. The cornerstone of this treatment lies in the various criteria formulated by expert consensus and experience. The variations among the criteria are staggering, and the short- and long-term outcomes are controversial. AIM To study the differences in the current practices of LT for HCC at different centers in India and discuss their clinical implications in the future. METHODS We conducted a survey of major centers in India that performed LT in December 2022. A total of 23 responses were received. The centers were classified as high- and low-volume, and the current trend of care for patients undergoing LT for HCC was noted. RESULTS Of the 23 centers, 35% were high volume center (> 500 Liver transplants) while 52% were high-volume centers that performed more than 50 transplants/year. Approximately 39% of centers had performed > 50 LT for HCC while the percent distribution for HCC in LT patients was 5%–15% in approximately 73% of the patients. Barring a few, most centers were divided equally between University of California, San Francisco (UCSF) and center-specific criteria when choosing patients with HCC for LT, and most (65%) did not have separate transplant criteria for deceased donor LT and living donor LT (LDLT). Most centers (56%) preferred surgical resection over LT for a Child A cirrhosis patient with a resectable 4 cm HCC lesion. Positron-emission tomography-computed tomography (CT) was the modality of choice for metastatic workup in the majority of centers (74%). Downstaging was the preferred option for over 90% of the centers and included transarterial chemoembolization, transarterial radioembolization, stereotactic body radiotherapy and atezolizumab/bevacizumab with varied indications. The alpha-fetoprotein (AFP) cut-off was used by 74% of centers to decide on transplantation as well as to downstage tumors, even if they met the criteria. The criteria for successful downstaging varied, but most centers conformed to the UCSF or their center-specific criteria for LT, along with the AFP cutoff values. The wait time for LT from downstaging was at least 4–6 wk in all centers. Contrast-enhanced CT was the preferred imaging modality for post-LT surveillance in 52% of the centers. Approximately 65% of the centers preferred to start everolimus between 1 and 3 months post-LT. CONCLUSION The current predicted 5-year survival rate of HCC patients in India is less than 15%. The aim of transplantation is to achieve at least a 60% 5-year disease free survival rate, which will provide relief to the prediction of an HCC surge over the next 20 years. The current worldwide criteria (Milan/UCSF) may have a higher 5-year survival (> 70%); however, the majority of patients still do not fit these criteria and are dependent on other suboptimal modes of treatment, with much lower survival rates. To make predictions for 2040, we must prepare to arm ourselves with less stringent selection criteria to widen the pool of patients who may undergo transplantation and have a chance of a better outcome. With more advanced technology and better donor outcomes, LDLT will provide a cutting edge in the fight against liver cancer over the next two decades.

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Section: Discussionmentioning

confidence: 99%

Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

Pahari,

Raj,

Sawant

et al. 2024

World J Transplant

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“…14 Model for end-stage liver disease score, liver stiffness, serum ALT levels and albumin levels were also significantly improved after HCV clearance by DAAs therapy. 33,34 In addition, DAAs therapy can improve extrahepatic symptoms. Eradicating HCV infection by DAAs therapy has beneficial impacts on glucose metabolism and renal profile.…”

Section: Discussionmentioning

confidence: 99%

“…36,37 The safety and efficiency of DAAs therapy has been confirmed by various studies, 38 as it has the advantage of shorter treatment duration, better response rates, and milder side effects. 33,39 Recently, the arrival of IFN-free DAAs has not only revolutionized the treatment of HCV infection, but also impacted the epidemiological landscape for HCV-related HCC. The cumulative incidence of HCV-related HCC has fallen in the IFN-free era, 40 and DAAs are replacing IFN as the first line therapy for HCV.…”

Section: Discussionmentioning

confidence: 99%

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Clinical benefits of direct‐acting antivirals therapy in hepatitis C virus patients with hepatocellular carcinoma: A systematic review and meta‐analysis

Liu

Yang

Dong

et al. 2022

J of Gastro and Hepatol

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Background and Aim:The purpose of the present study was to evaluate the effect of direct-acting antivirals (DAAs) therapy on the clinical outcomes of hepatitis C virus (HCV) patients with hepatocellular carcinoma (HCC). Methods: We searched multiple electronic databases from database inception to June 14, 2021. Meta-analyses were performed separately for HCC recurrence and overall survival (OS). Results: A total of 23 studies were identified for the primary analysis. Compared with no intervention, pooled data showed significant benefit from DAAs therapy in reducing recurrence (adjusted HR = 0.55, 95% CI 0.41-0.74, P < 0.001; I 2 = 66.6%, P < 0.001) and improving OS (adjusted HR = 0.36, 95% CI 0.16-0.83, P = 0.017; I 2 = 90.7%, P < 0.001) of HCV-related HCC patients. Compared with non-responders, patients with sustained virologic response (SVR) had greater benefit from DAAs therapy in reducing recurrence (HR = 0.37, 95% CI 0.16-0.84, P = 0.017; I 2 = 58.8%, P = 0.088) and improving OS (HR = 0.17; 95% CI 0.06-0.50; P = 0.001; I 2 = 56.4%, P = 0.130). Though DAAs did not show significant advantages over IFN in reducing recurrence (adjusted HR = 0.96, 95% CI 0.72-1.28, P = 0.784; I 2 = 0.0%, P = 0.805), there seems to be a trend toward OS benefit from DAAs therapy (adjusted HR = 0.11, 95% CI 0.01-1.19, P = 0.059). Conclusion: DAAs therapy can prevent recurrence and improve OS of HCV-related HCC patients, especially for patients with SVR. Further prospective randomized controlled trial is warranted to validate these results.

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Attach importance to antiviral therapy in patients with hepatocellular carcinoma caused by hepatitis virus

Liu

et al. 2023

Gastroenterology & Endoscopy

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Absence of impact of direct acting antivirals for hepatitis C virus on recurrent hepatocellular carcinoma tumor growth in the AFEF/ANRS CO22 Hepather cohort

Cited by 4 publications

References 30 publications

Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

Clinical benefits of direct‐acting antivirals therapy in hepatitis C virus patients with hepatocellular carcinoma: A systematic review and meta‐analysis

Attach importance to antiviral therapy in patients with hepatocellular carcinoma caused by hepatitis virus

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