Application and Impact of Antiviral Therapy for Patients with HBV-Related Hepatocellular Carcinoma Receiving Sorafenib and Lenvatinib Treatment

Abstract

Overall survival (OS) in patients with advanced hepatocellular carcinoma (HCC) has improved in the era of multi-line sequential therapy. The application of antiviral therapy and its impact on survival for patients with HBV-related HCC needs to be reassessed. The aim of this study was to evaluate the application and impact of antiviral therapy on survival for patients with HBV-related HCC receiving tyrosine kinase inhibitor (TKI) therapy. Patients with advanced HBV-related HCC treated with sorafenib or lenvatinib as first-line therapy with (n = 377) and without (n = 182) nucleos(t)ide analogue (NUC) therapy were retrospectively enrolled. Prognostic factors of OS were evaluated. Secular trends in the increased application of NUC therapy and improved survival were observed in the last decade. The HBV reactivation rate in patients without NUC therapy was 6.6%. By multivariate analysis, baseline low HBV viral load, achieving undetectable HBV DNA after TKI therapy, and ability to receive second-line therapy were found to be independent predictors of OS. In subgroup patients with NUC therapy, starting NUC before TKI was associated with a better OS. In conclusion, the application of antiviral therapy for patients with HBV-related HCC receiving TKI therapy has increased over time. Achieving complete virological suppression may contribute to a better OS in patients with advanced HBV-related HCC.

Well‐controlled viremia reduces the progression of hepatocellular carcinoma in chronic viral hepatitis patients treated with lenvatinib

“…24 Lee et al enrolled 559 patients with tyrosine kinase inhibitor (518 with sorafenib use and 41 with lenvatinib use) as first-line treatment with results indicating that antiviral therapy might lead to better OS in patients with advanced HBV-HCC. 24 Casadei Gardini et al reported that there was better OS in HBV-HCC patients with lenvatinib treatment than with sorafenib treatment (HR 0.82 95% CI: 0.60-1.15), but there was no difference between lenvatinib and sorafenib efficacy (HR 0.91 95% CI 0.41-2.01) in HCV-HCC patients. 25 According to an analysis of two Phase III studies, HCV was predictive of a greater survival benefit with sorafenib.…”

“…Previous studies have discussed both virus etiology and suppression influence in patients with sorafenib treatment 16,17 ; however, studies of the virus influence in patients with lenvatinib treatment are less plentiful. In the patients treated with sorafenib, antiviral therapy use was one of the independent prognostic factors for overall survival of HBV‐HCC patients 24 . Lee et al enrolled 559 patients with tyrosine kinase inhibitor (518 with sorafenib use and 41 with lenvatinib use) as first‐line treatment with results indicating that antiviral therapy might lead to better OS in patients with advanced HBV‐HCC 24 .…”

“…In the patients treated with sorafenib, antiviral therapy use was one of the independent prognostic factors for overall survival of HBV‐HCC patients 24 . Lee et al enrolled 559 patients with tyrosine kinase inhibitor (518 with sorafenib use and 41 with lenvatinib use) as first‐line treatment with results indicating that antiviral therapy might lead to better OS in patients with advanced HBV‐HCC 24 . Casadei Gardini et al reported that there was better OS in HBV‐HCC patients with lenvatinib treatment than with sorafenib treatment (HR 0.82 95% CI: 0.60–1.15), but there was no difference between lenvatinib and sorafenib efficacy (HR 0.91 95% CI 0.41–2.01) in HCV‐HCC patients 25 …”

Tenofovir versus Entecavir on Outcomes of Hepatitis B Virus-Related Hepatocellular Carcinoma After FOLFOX-Hepatic Arterial Infusion Chemotherapy

“…For patients with TACE or targeted therapy, the OS in the antiviral group was better than that in the nonantiviral group as well. 3 , 7 , 9 , 32 As an alternative treatment for advanced HCC, HAIC can directly and continuously deliver chemotherapeutic drugs into the tumor-feeding artery, which can increase the local drug concentrations, enhance the antitumor effect and decrease the systemic toxicity. 10 , 14 Similarly, antiviral treatment could improve the OS in HBV-related HCC treated with FOLFOX-HAIC compared with nonantiviral treatment.…”

Linoleate-pazopanib conjugation as active pharmacological ingredient to abolish hepatocellular carcinoma growth

“…Due to the rich neo-vasculature pattern of HCC ( Anisha et al, 2021 ), many angiogenesis-targeting Multikinase Inhibitor (MKIs) have been developed ( Rahbari et al, 2016 ). Clinically, only a few inhibitors with limited efficacy, such as sorafenib ( Stra et al, 2021 ), lenvatinib ( Lee et al, 2022 ), regorafenib ( Iavarone et al, 2021 ) and cabozantinib ( Kelley et al, 2022 ), were employed. However, the overall survival rate of patients with advanced HCC is low and has not improved ( Toyoda et al, 2022 ).…”