Hepatitis <scp>B</scp> viral load predicts survival in hepatocellular carcinoma patients treated with sorafenib

Lim, Seung Taek; Han, Jungwoo; Kim, Gun Min; Han, Kwang Hyub; Choi, Hye Jin

doi:10.1111/jgh.12898

Cited by 19 publications

(28 citation statements)

References 45 publications

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“…[7][8][9] Moreover, higher HBV DNA levels are associated with a poorer response to transarterial chemoembolization (TACE) and sorafenib. [10][11][12][13] Studies have also reported that antiviral treatment can prolong the survival of HCC patients with HBV infection. 7,10,14 To date, few studies have reported the impact of HBV load on immunotherapy for HCC patients.…”

Section: Introductionmentioning

confidence: 99%

<p>Baseline HBV Loads Do Not Affect the Prognosis of Patients with Hepatocellular Carcinoma Receiving Anti-Programmed Cell Death-1 Immunotherapy</p>

Sun

Yang

et al. 2020

JHC

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Background: A high hepatitis B virus (HBV) load is a common exclusion criterion in hepatocellular carcinoma (HCC) clinical trials for anti-programmed cell death (PD)-1 immunotherapy. However, the validity of this criterion is barely verified. This study aimed to evaluate the impact of baseline HBV DNA levels and antiviral therapy on the oncological outcomes and liver functions of patients with HCC receiving anti-PD-1 immunotherapy. Methods: We reviewed HCC trials related to anti-PD-(L)1 immunotherapy and whether they ruled out patients with increased HBV loads on clinicaltrials.gov. Then, for this retrospective study, we enrolled 253 HCC patients treated with anti-PD-1 blockade in our institution. Baseline information was compared between patients with low and high HBV loads. Overall survival (OS) and progression-free survival (PFS) were compared, and univariate and multivariate analyses were applied to identify potential risk factors for oncological outcomes and hepatic impairment. Results: Among 76 HCC clinical trials including 13,927 patients receiving anti-PD-(L)1 blockade, 41 (53.9%) excluded patients with relatively high baseline HBV loads. The PFS and OS did not differ significantly between patients with baseline HBV loads ≤ 2000 IU/mL and those with viral loads >2000 IU/mL (p=0.615 and 0.982). The incidence of hepatic impairment showed no association with the baseline HBV load (p=0.319). Patients receiving antiviral therapy had a better OS than those without antiviral therapy in the high baseline HBV load group (p= 0.001). Conclusion: High HBV loads did not compromise the clinical outcomes of HCC patients receiving anti-PD-1 blockade. Antiviral therapy could improve the OS of HCC patients with high HBV loads.

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Section: Introductionmentioning

confidence: 99%

<p>Baseline HBV Loads Do Not Affect the Prognosis of Patients with Hepatocellular Carcinoma Receiving Anti-Programmed Cell Death-1 Immunotherapy</p>

Sun

Yang

et al. 2020

JHC

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“…Indeed, high viral load is considered a risk factor for development of HCC and its recurrence. Recently Lim et al in their study of sorafenib treatment in HCC patients observed that high HBV DNA was associated with poor response to sorafenib [10]. Incidentally, our case had low baseline HBV DNA of 85 IU/ml (494 copies/ml) at the time of HCC diagnosis as the result of prior antiviral therapy.…”

Section: Discussionmentioning

confidence: 84%

A case of advanced hepatocellular carcinoma cured with antiviral therapy and sorafenib

Krawitz¹,

Guglielmo²,

Hann³

2016

Integr Cancer Sci Therap

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Hepatocellular carcinoma (HCC) continues to be a devastating complication of chronic hepatitis B virus (HBV) infection. Local ablative therapies for small HCC are successful, but treatment of advanced HCC is severely lacking. Sorafenib is the only current therapy for advanced HCC. However its benefit is limited to a short gain in survival. Recently, studies have shown survival benefit of antiviral therapy for HBV associated HCC. We present a case where a large advanced HCC achieved a cure following combined therapy with sorafenib and anti-HBV drugs. It appears that in addition to sorafenib, continuous suppression/elimination of the virus with anti-HBV therapy prevented new/recurrent HCC while the remaining tumor was locally ablated.Core tip: In addition to sorafenib to control the existing tumor, antiviral drugs can prevent the development of new or recurrent cancer by suppressing the viral (the hepatocarcinogen) replication. Another point is the patient's attitude and compliance. This patient was determined to receive maximum sorafenib treatment and tolerated the severe side effects and was able to achieve this favorable result.

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“…It was also found that patients administered sorafenib combined with other locoregional therapies such as HR, RFA, TACE or RTO had better OS rates than those receiving sorafenib only (11.1 months vs. HCC patients. 21,22 Antiviral therapy for the management of HBV infection could help reduce liver hepatic inflammation and preserve liver function during antitumor treatment. Actually, higher risk for Propensity score matching analysis was performed to control selection bias and confounding tumor factors; however, small sample size limited the evidence level of analysis.…”

Section: Clinical Characteristics Between Hbv-hcc and Hcv-hcc Groups After Propensity Score Matching Analysismentioning

confidence: 99%

Sorafenib use in hepatitis B virus‐ or hepatitis C virus‐related hepatocellular carcinoma: A propensity score matching study

Lee

Wang

Chen

et al. 2021

The Kaohsiung J of Med Scie

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Sorafenib is the recommended first-line treatment option for patients with advanced hepatocellular carcinoma (HCC). Hepatitis C virus (HCV)-related advanced HCC (HCV-HCC) seemed to have a better response than hepatitis B virus (HBV)-related HCC (HBV-HCC) in sorafenib use, but it was undetermined. Hence, we aimed to investigate the effect of sorafenib between HBV-HCC and HCV-HCC patients in Taiwan. From August 2012 to December 2016, 575 consecutive advanced HCC patients received sorafenib under the reimbursement of Taiwan national health insurance in our hospital. Radiologic assessment was performed at a 2-month interval.Those patients with tumor progression or liver function deterioration were disallowed for further sorafenib use. Patients with HBV or HCV infection were, retrospectively, enrolled and followed till December 2018. There were 277 (62.4%) HBV-HCC patients and 167 (37.6%) HCV-HCC patients. Before sorafenib, 192 (69.3%) HBV-HCC patients who had used nucleoside analogs (NAs) for HBV management, whereas only 5 (3%) HCV-HCC patients received interferon-based antiviral therapy.Overall survival (OS) of HCV-HCC patients was significantly superior to HBV-HCC patients without NAs (8.8 months vs. 4.9 months, p = 0.006), but was noninferior to HBV-HCC patients with NAs (8.8 months vs. 10.7 months, p = 0.54). Using propensity score matching, progression-free survival (2.0 months vs. 2.1 months, p = 0.374) and OS (10.5 months vs. 9.6 months, p = 0.746) between HBV-HCC and HCV-HCC groups were not different. Antiviral therapy might increase survival benefits of advanced HBV-HCC patients underwent sorafenib use, leading to a comparable OS to HCV-HCC patients in Taiwan.

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Hepatitis B viral load predicts survival in hepatocellular carcinoma patients treated with sorafenib

Cited by 19 publications

References 45 publications

<p>Baseline HBV Loads Do Not Affect the Prognosis of Patients with Hepatocellular Carcinoma Receiving Anti-Programmed Cell Death-1 Immunotherapy</p>

<p>Baseline HBV Loads Do Not Affect the Prognosis of Patients with Hepatocellular Carcinoma Receiving Anti-Programmed Cell Death-1 Immunotherapy</p>

A case of advanced hepatocellular carcinoma cured with antiviral therapy and sorafenib

Sorafenib use in hepatitis B virus‐ or hepatitis C virus‐related hepatocellular carcinoma: A propensity score matching study

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