HCC recurrence under all-oral DAAs-based antiviral therapy in HCV-infected patients: data from Navigatore web platform

Gambato, M.; Russo, Filippo; Piovesan, Sara; Romano, A.; Zanetto, Alberto; Anastassopoulos, George; Capra, Franco; Paon, Veronica; Franceschet, I.; Carlotto, Antonio; Storato, Silvia; Bona, Manuela De; Rovere, Pierangelo; Manuppelli, C.; Giordani, Mauro; Lomonaco, L.; Angeli, Paolo; Alberti, Alberto; Burra, P.

doi:10.1016/s0168-8278(18)30389-1

Cited by 4 publications

(3 citation statements)

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“…Study characteristics were summarised in Tables and . Fifty‐six studies were included, with a total of 5522 patients with HCC, while 27 studies enrolled non‐HCC patients as control groups. Fifty‐three (95%) studies were observational cohorts (45 retrospective and eight prospective) and three studies were clinical trials.…”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: effectiveness of direct‐acting antiviral treatment for hepatitis C in patients with hepatocellular carcinoma

Lockart

Alavi

et al. 2019

Aliment Pharmacol Ther

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Summary Background Direct‐acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection is highly curative and tolerable. Among patients with hepatocellular carcinoma (HCC), optimal timing of DAA therapy remains unclear. Data on efficacy of DAA therapy in patients with HCC would inform this decision‐making. Aim To evaluate response to DAA therapy among patients diagnosed with HCV infection and HCC. Methods Bibliographic databases and conference abstracts were searched. Meta‐analysis was conducted to pool sustained virologic response (SVR) estimates. Results Fifty‐six studies with 5522 patients with HCV and HCC were included. Overall SVR was 88.3% (95% CI 86.1‐90.4). Twenty‐seven studies included patients with prior or present HCC (n = 3126) and patients without HCC (n = 49 138), in which SVR was 88.2% (95% CI 85.0‐91.4) and 92.4% (95% CI 91.1‐93.7) among patients with and without HCC, respectively (odds ratio: 0.54, 95% CI 0.43‐0.68, P < .001). In the subgroup analyses, higher SVR was seen in patients who received curative HCC management (SVR 90.4%, 95% CI 88.3‐92.4), or treated with sofosbuvir + NS5A inhibitor DAAs (SVR 96.9%, 95% CI 94.3‐99.4), or in patients with HCV genotype 1 infection (SVR 92.0%, 95% CI 88.1‐95.6). Conclusion Response to DAA therapy was lower in patients with HCC compared to those without HCC, regardless of cirrhosis status. Among HCC patients, there was an impact of proportion with curative HCC management on DAA therapy response.

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Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: effectiveness of direct‐acting antiviral treatment for hepatitis C in patients with hepatocellular carcinoma

Lockart

Alavi

et al. 2019

Aliment Pharmacol Ther

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“…In this study there was no difference in recurrence rate in patients who received DAA early after HCC treatment (less than 3 months) and those who received it later (more than 6 months). However another report presented in international liver conference 2018 pointed to the importance of time elapsed since HCC complete response after treatment and HCC recurrence rate after DAA exposure but still waiting full data [42].…”

Section: Potential Pitfalls Of Studies and Reasons Of Disparity In Rementioning

confidence: 99%

Impact of treating chronic hepatitis C infection with direct-acting antivirals on the risk of hepatocellular carcinoma: The debate continues – A mini-review

Kassas

Elbaz

Salaheldin

et al. 2019

Journal of Advanced Research

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“…HCC recurrence post‐DAAs has proved more controversial, with studies suggesting that not only was the incidence of HCC recurrence higher, but also recurrent tumors were more aggressive post‐DAAs . Furthermore, recent data suggest an impact of the timing of DAA therapy with a higher rate of HCC recurrence reported in patients treated with DAAs ≤6 months after achieving a complete response to HCC compared with those treated >6 months . A recent study focused on patients waitlisted for LT, using a contemporaneous untreated control group to better assess the benefits vs harms of DAA therapy .…”

Section: Daa Therapy and Hepatocellular Carcinoma In The Lt Settingmentioning

confidence: 99%

The road map toward an hepatitis C virus-free transplant population

Berenguer

Agarwal

Burra

et al. 2018

American Journal of Transplantation

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Antiviral therapy to eradicate hepatitis C virus (HCV) infection improves outcomes in patients undergoing liver transplantation (LT) for advanced chronic HCV with or without hepatocellular carcinoma. Traditionally, antiviral therapy focused on the use of interferon (IFN)-based regimens, with antiviral treatment initiated in the posttransplant period once recurrent HCV disease with fibrosis in the allograft was identified. The use of IFN-based therapy was limited in pretransplant patients with advanced liver disease. Earlier intervention, either before transplantation or early after LT, is now feasible with the advent of second-generation direct-acting antiviral agents (DAAs) with superior tolerability and efficacy to IFN-based therapy. These agents have the potential to reduce the number of patients developing HCV-related complications requiring LT and retransplantation, as well as reducing the demand for donor organs. We discuss the pros and cons of pretransplant, peritransplant, and posttransplant therapy with current DAAs, citing available data from clinical trials and real-world experience.

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HCC recurrence under all-oral DAAs-based antiviral therapy in HCV-infected patients: data from Navigatore web platform

Cited by 4 publications

References 0 publications

Systematic review with meta‐analysis: effectiveness of direct‐acting antiviral treatment for hepatitis C in patients with hepatocellular carcinoma

Systematic review with meta‐analysis: effectiveness of direct‐acting antiviral treatment for hepatitis C in patients with hepatocellular carcinoma

Impact of treating chronic hepatitis C infection with direct-acting antivirals on the risk of hepatocellular carcinoma: The debate continues – A mini-review

The road map toward an hepatitis C virus-free transplant population

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