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Liver cancer recurrence rates similar regardless of DAA experience
Singal AG, et al. Gastroenterol. 2018;doi:10.1053/j.gastro.2019.01.027.
Patients with complete response to hepatocellular carcinoma and underwent direct-acting antiviral therapy for hepatitis C had similar rates of cancer recurrence compared with patients who did not receive DAA therapy, according to a study published in Gastroenterology.
"Our results suggest that use of DAA therapies is safe and potentially beneficial in hepatitis C-infected patients with a history of liver cancer," Amit G. Singal, MD, from the University of Texas Southwestern Medical Center and lead study author, said in a press release. "Based on these new data, providers can feel reassured that it is safe to treat hepatitis C in these patients and allow them to receive the known benefits of hepatitis C therapy."
Singal and colleagues analyzed data from 793 patients, 304 of whom underwent DAA therapy and 489 were untreated. Over a median follow-up of 10.4 months, the researchers observed 416 recurrences, including 128 in the DAA-treated patients and 288 in the untreated patients.
After adjusting for time-varying exposure, DAA therapy did not correlate with HCC recurrence in crude (HR = 0.79; 95% CI, 0.63-1) or adjusted (HR = 0.9; 95% CI, 0.7-1.16) or propensity score analyses (HR = 0.91; 95% CI, 0.69-1.19).
Additionally, the researchers confirmed that DAA therapy did not correlate with early HCC recurrence in crude (HR = 0.81; 95% CI, 0.6-1.1), adjusted (HR = 0.96; 95% CI, 0.7-1.34) or propensity score analyses (HR = 0.96; 95% CI, 0.67-1.38).
These results were consistent across all subgroup analyses including tumor burden and HCC treatment type.
"Our data are consistent with more recent studies, which have found most recurrences are detected at an early stage and can be treated with potentially curative treatments," Singal and colleagues wrote. "While it remains important to monitor patients for recurrence during and after DAA therapy, available data suggest HCC surveillance intervals and treatment decisions do not need to differ from DAA-naive patients." – by Talitha Bennett
Disclosure: Singal reports he was on the speakers bureau for Bayer, and Bristol-Meyers Squibb and Gilead; has served on advisory boards for AbbVie, Bayer, Eisai, Exact Sciences, Gilead, Roche and Wako Diagnostics; serves as a consultant to Bayer, Glycotest, Eisai and Roche; and has received research funding from AbbVie and Gilead. Please see the full study for the other authors' relevant financial disclosures.