Preventive treatment helps avoid Hepatitis B relapse during chemotherapy

February 01, 2006

A new study on treating hepatitis B patients who have cancer with an antiviral drug at the same time as they undergo chemotherapy found that the treatment helped prevent relapse of hepatitis B.

The results of this study appear in the February 2006 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). Published by John Wiley & Sons, Inc., Hepatology is available online via Wiley InterScience at http://www.interscience.wiley.com/journal/hepatology.

Patients who develop hepatocellular carcinoma (HCC), a type of liver cancer caused by the hepatitis B virus, have up to a 55 percent chance of having the virus reactivated during chemotherapy. The idea of preemptively treating these patients with the antiviral drug lamivudine in order to prevent hepatitis B relapse and it varying complications is promising but has never been investigated in patients with HCC.

Researchers led by Jeong Won Jang of the Department of Internal Medicine at the Catholic University of Korea in Seoul, conducted a prospective randomized study on pretreating HCC patients undergoing chemotherapy with lamivudine between January 2004 and February 2005. The study involved 36 patients with HCC who were given the drug while undergoing transarterial chemo-lipiodolization (TACL) chemotherapy and a control group of 37 patients who underwent the chemotherapy without receiving lamivudine. The chemotherapy was continued every month without any limit on the number of cycles until the tumors disappeared, while treatment with lamivudine began with the chemotherapy and continued for 12 months following its completion.

In total, 43 percent of the patients in the control group developed overall clinical hepatitis during the follow-up period, compared to 17 percent of the patients who took lamivudine. In addition, there was a significantly higher incidence of severe hepatitis in the control group and the researchers established the level of viral load (>104 copies/ml) that predicted whether a patient would have a relapse of hepatitis B.

In addition to demonstrating that treatment with lamivudine significantly reduced hepatitis B reactivation, allowing chemotherapy to continue in these cancer patients, the study suggests that lamivudine therapy decreases the severity of clinical hepatitis if it develops during chemotherapy. "The beneficial effects of preemptive therapy on the severity of hepatitis most probably result from an elimination of any potential risk arising from viral reactivation," the authors state.

While previous studies have shown a higher viral load as a predictor of hepatitis B reactivation, the lower cutoff in the current study was identified as a better predictor and the authors urge the use of a highly sensitive test to detect and measure viral load in order to identify patients at the greatest risk of hepatitis B reactivation. In those patients with lower viral loads, it would still be beneficial to closely monitor virological and biochemical changes when they are undergoing repeated courses of chemotherapy, since the study demonstrated that even lower viral loads are associated with an approximately 30 percent risk of viral reactivation.

Although the study did not examine long-term survival in the patients who took lamivudine, the authors conclude: "Given that preemptive antiviral therapy ameliorates the hepatic morbidity seen during transarterial chemotherapy and facilitates further chemotherapy without disruptions in the treatment schedules, the expectation would be for an increased chance of survival with this approach."
-end-
Article: "A Randomized Controlled Study of Preemptive Lamivudine in Patients Receiving Transarterial Chemo-Lipiodolization," Jeong Won Jang, Jong Young Choi, Si Hyun Bae, Seung Kew Yoon, U Im Chang, Chang Wook Kim, Se Hyun Cho, Jun Yeol Han, Young Sok Lee, Hepatology; February 2006 (DOI: 10.1002.hep.21024).

Wiley

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.