Direct-Acting Antivirals Not Tied to Liver Cancer Recurrence
Among patients with previous complete response to HCC tx, DAA not linked to overall or early recurrence
FRIDAY, Jan. 25, 2019 (Pharmacist's Briefing) -- Direct-acting antiviral (DAA) therapy is not associated with increased overall or early hepatocellular carcinoma (HCC) recurrence among patients with a previous complete response to HCC treatment, according to a study published online Jan. 17 in Gastroenterology.
Amit G. Singal, M.D., from the UT Southwestern Medical Center in Dallas, and colleagues retrospectively studied 793 patients at 31 health systems in the United States and Canada with hepatitis C virus (HCV)-related HCC and a complete response to resection, local ablation, transarterial chemoembolization or radioembolization, or radiation therapy (2013 through 2017). The authors sought to compare HCC recurrence patterns between DAA-treated and untreated HCV-infected patients.
The researchers found that 38.3 percent of patients received DAA therapy and 61.7 percent were untreated. HCC recurred in 42.1 percent of DAA-treated patients (early recurrence in 52 of 128 patients) and 58.9 percent of untreated patients (early recurrence in 227 of 288 patients). DAA therapy was not associated with HCC recurrence (hazard ratio, 0.9; 95 percent confidence interval, 0.7 to 1.16) or early HCC recurrence (hazard ratio, 0.96; 95 percent confidence interval, 0.7 to 1.34) after adjustment for study site, age, sex, Child Pugh score, alpha-fetoprotein level, tumor burden, and HCC treatment type. Compared with untreated patients, a larger proportion of DAA-treated patients received potentially curative HCC therapy for recurrent HCC (32 versus 24.6 percent) and achieved a complete or partial response (45.3 versus 41 percent), although neither achieved statistical significance.
"Our results suggest that use of DAA therapies is safe and potentially beneficial in hepatitis C-infected patients with a history of liver cancer," Singal said in a statement.
Several authors disclosed financial ties to pharmaceutical companies, including Abbvie, which partially funded the study.