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

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Title: Hepatitis B viral load predicts survival in hepatocellular carcinoma patients treated with sorafenib.
Authors: Lim, Seungtaek, Han, Jungwoo, Kim, Gun Min, Han, Kwang ‐ Hyub, Choi, Hye Jin
Source: Journal of Gastroenterology & Hepatology; Jun2015, Vol. 30 Issue 6, p1024-1031, 8p, 5 Charts, 3 Graphs
Subject Terms: HEPATITIS B, VIRAL load, LIVER cancer patients, MULTIVARIATE analysis, ANTIBIOTIC prophylaxis
Abstract: Background and Aim Sorafenib is now considered as a standard treatment for advanced hepatocellular carcinoma ( HCC). We evaluated the effect of hepatitis B virus ( HBV) DNA titers on prognosis in HCC patients treated with sorafenib. Methods From 2008 to 2012, 78 HBV-related HCC patients who received sorafenib treatment at Severance Hospital were included in our analysis. The effect of pretreatment HBV- DNA levels on clinical outcomes for use in predicting prognosis after treatment with sorafenib was examined by univariate and multivariate analysis. Results Median overall survival and median progression-free survival were 5.2 months (95% confidence interval: 4.0-6.4) and 3.5 months (95% confidence interval: 2.3-4.7), respectively. Multivariate analysis revealed high levels of HBV- DNA (> 2000 IU/mL) to be an independent risk factor for worse overall survival ( P = 0.005; hazard ratio, 2.85) and disease progression among patients who did not receive concomitant prophylactic antiviral therapy during sorafenib treatment ( P = 0.008; hazard ratio, 87.4). Moreover, viral reactivation occurred more frequently in patients who did not receive concomitant prophylactic antiviral therapy than in those who did (4/38 vs 0/40; P = 0.025). Conclusion Higher HBV- DNA levels prior to sorafenib treatment were associated with poorer prognosis and increased viral reactivation thereafter. These results suggest the potential usefulness of prophylactic antiviral therapy when treating HBV-related HCC patients with sorafenib. [ABSTRACT FROM AUTHOR]
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Database: Complementary Index
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Abstract:Background and Aim Sorafenib is now considered as a standard treatment for advanced hepatocellular carcinoma ( HCC). We evaluated the effect of hepatitis B virus ( HBV) DNA titers on prognosis in HCC patients treated with sorafenib. Methods From 2008 to 2012, 78 HBV-related HCC patients who received sorafenib treatment at Severance Hospital were included in our analysis. The effect of pretreatment HBV- DNA levels on clinical outcomes for use in predicting prognosis after treatment with sorafenib was examined by univariate and multivariate analysis. Results Median overall survival and median progression-free survival were 5.2 months (95% confidence interval: 4.0-6.4) and 3.5 months (95% confidence interval: 2.3-4.7), respectively. Multivariate analysis revealed high levels of HBV- DNA (> 2000 IU/mL) to be an independent risk factor for worse overall survival ( P = 0.005; hazard ratio, 2.85) and disease progression among patients who did not receive concomitant prophylactic antiviral therapy during sorafenib treatment ( P = 0.008; hazard ratio, 87.4). Moreover, viral reactivation occurred more frequently in patients who did not receive concomitant prophylactic antiviral therapy than in those who did (4/38 vs 0/40; P = 0.025). Conclusion Higher HBV- DNA levels prior to sorafenib treatment were associated with poorer prognosis and increased viral reactivation thereafter. These results suggest the potential usefulness of prophylactic antiviral therapy when treating HBV-related HCC patients with sorafenib. [ABSTRACT FROM AUTHOR]
ISSN:08159319
DOI:10.1111/jgh.12898