Effect of adjuvant interferon therapy on hepatitis B virus-related hepatocellular carcinoma: a systematic review

Abstract

ObjectiveThe objective of this study is to evaluate the efficacy of adjuvant interferon therapy for hepatitis B virus-related hepatocellular carcinoma (HCC) after different previous therapy.MethodsAn electronic search for articles about adjuvant treatment with IFN for patients with HCC published between 2000 and 2015 was conducted in MEDLINE, PubMed, Cochrane Library, and EMBASE databases. All data was tested with Stata12.0 software.ResultsSix trials with a total of 1054 subjects were screened according to inclusion and exclusion standards. Five hundred and seventeen HCC patients were treated with adjuvant treatment with IFN and 537 patients with placebo. Compared to the control group, both the recurrence rate and death rate of HCC in IFN group were statistically lower, especially after transhepatic arterial chemotherapy and embolization (TACE) treatment and both TACE and resection according to subgroup analysis.There is no statistical significance on the both recurrence and death rate of HBV-related hepatocellular carcinoma after surgical resection treatment (RR = 0.96, 95 % CI, 0.84 to 1.1, p = 0.59 for recurrence and RR = 0.78, 95 % CI, 0.60 to 1.04, p = 0.09 for death rates).ConclusionsAdjuvant IFN therapy may significantly reduced mortality as well as recurrence rate of patients with HBV-related HCC after no matter what the previous treatment. On the other hand, there is no statistical significance on the recurrence rate and mortality after surgical resection only. More research is needed into the relationship between effect of adjuvant interferon therapy and previous therapy, especially TACE.

Consensus on Pegylated Interferon Alpha in Treatment of Chronic Hepatitis B

“…Interferon has an effect on HBV DNA suppression, immunoregulation, inhibition of malignant cell proliferation and antiangiogenesis, which provide a solid theoretical basis for prevention of recurrence after HBV-related HCC resection. 38 , 44 Systematic review and meta-analysis in 2016 also confirmed that interferon-alpha adjuvant therapy significantly reduced the recurrence of HBV-related HCC surgery/interventional therapy (RR = 0.90, p = 0.02) and mortality risk (RR = 0.72, p = 0.001), as compared with the placebo control group. This benefit is more significant after hepatic arterial chemoembolization or hepatic arterial chemoembolization combined surgical treatment.…”

“…In the natural history of CHB, the annual incidence rate of HCC in CHB patients with non liver cirrhosis ranges from 0.5% to 1%, and with cirrhosis ranges from 3% to 6%, 5 which is far higher than the general population and the incidence of liver cancer in China (0.026%). 37 Interferon has a variety of biological functions, including antiviral, antiproliferation, antiangiogenesis and immunomodulatory effects, and interferon can also achieve its antitumor effect 38 by inhibiting tumor angiogenesis and antitumor cell proliferation.…”

“…This benefit is more significant after hepatic arterial chemoembolization or hepatic arterial chemoembolization combined surgical treatment. 38 The “ Expert Consensus on Antiviral Therapy to Hepatitis B/C Virus-Related Hepatocellular Carcinoma ” published in 2014 also stressed that in the synthesized project of HBV-related HCC patients, interferon-alpha adjuvant therapy can be chosen if no contraindications exist (1, A). 41…”

Complete cure of a patient with HBV‑associated hepatocellular carcinoma with lung metastasis using interferon and survival up to 108 months: A case report and literature review

“…A variety of meta-analyses indicated that IFN improved the nonrecurrence survival and overall survival following surgical resection of virus-related HCC ( 17 – 19 ). Moreover, IFN intervention remarkably attenuated mortality and recurrence in HBV-related patients with HCC having a therapeutic history of TACE ( 20 ). In the patient in the present case study, TACE was used comprising CDDP and FUDR for HCC, and CDDP/FUDR achieved a good tumor response ( 21 ).…”

Efficacy of interferon therapy in patients with hepatitis B virus‐related primary hepatic carcinoma after transcatheter arterial chemoembolization

“…Interferon (IFN) has immunomodulatory, antiviral, antiproliferative, and antitumoral effects. Most studies have shown that IFN can delay the progression of HBV‐related liver diseases and reduce the risk of HCC recurrence, although some have shown the opposite . To assess the therapeutic value of adjuvant IFN therapy in patients with HBV‐related HCC after TACE, we carried out a randomized controlled trial in which the effects of IFN therapy on cellular immune function, HBV replication, liver fibrosis, tumor recurrence, and survival were analyzed.…”