Your browser doesn't support javascript.
loading
Comparison of hepatitis B virus reactivation in hepatocellular carcinoma patients who received tyrosine kinase inhibitor alone or together with programmed cell death protein-1 inhibitors.
Lei, Jin; Yan, Tao; Zhang, Linzhi; Chen, Bowen; Cheng, Jiamin; Gao, Xiaoqiang; Liu, Zherui; Li, Yinyin; Zuo, Shi; Lu, Yinying.
Affiliation
  • Lei J; Guizhou Medical University, Guiyang, China.
  • Yan T; Comprehensive Liver Cancer Center, The 5th Medical Center of the PLA General Hospital, Beijing, China.
  • Zhang L; Comprehensive Liver Cancer Center, The 5th Medical Center of the PLA General Hospital, Beijing, China.
  • Chen B; Peking University 302 Clinical Medical School, Beijing, China.
  • Cheng J; Comprehensive Liver Cancer Center, The 5th Medical Center of the PLA General Hospital, Beijing, China.
  • Gao X; Guizhou Medical University, Guiyang, China.
  • Liu Z; Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
  • Li Y; Peking University 302 Clinical Medical School, Beijing, China.
  • Zuo S; Comprehensive Liver Cancer Center, The 5th Medical Center of the PLA General Hospital, Beijing, China.
  • Lu Y; Guizhou Medical University, Guiyang, China. drzuoshi@gmc.edu.cn.
Hepatol Int ; 17(2): 281-290, 2023 Apr.
Article in En | MEDLINE | ID: mdl-36580258
BACKGROUND AND AIMS: Programmed cell death protein-1 (PD-1) inhibitors plus tyrosine kinase inhibitor (TKI) have dramatically improved survival of patients with advanced hepatocellular carcinoma (HCC). However, the risk of hepatitis B virus (HBV) reactivation from these antitumor medications remains unclear. METHODS: Patients receiving TKI monotherapy (TKI group) or TKI combined with PD-1 inhibitors (combination group) were included. The primary endpoint was HBV reactivation as defined by an increase in HBV DNA titer by at least 1 log (tenfold) from baseline. The secondary endpoints included tumor progression and overall survival. RESULTS: Four hundred and ninety-nine patients met the inclusion criteria, including 296 patients in the TKI group and 203 patients in the combination group. The 3-, 6- and 12-month cumulative incidence rates of HBV reactivation in the TKI group vs. combination group were 7.8%, 12.8% and 21.3% vs. 9.9%, 19.2% and 30.0%, respectively (p = 0.02). The Cox proportional hazard model indicated that combination therapy (HR 1.41, 95% CI 1.00-1.99, p = 0.05), ALT > 40 U/ml (HR 1.50, 95% CI 1.05-2.16, p = 0.03), and tumor size > 5 cm (HR 1.58, 95% CI 1.10-2.28, p = 0.01) were independent risk factors for HBV reactivation. Compared with the HBV reactivation group, the progression-free survival and overall survival of patients in the HBV non-reactivation group were significantly prolonged (p < 0.001 and p = 0.001). CONCLUSIONS: Patients who received TKI combined with PD-1 inhibitors had a greater risk for HBV reactivation, and those with HBV reactivation had a higher rate of tumor progression and shorter survival time, than those receiving TKI alone.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Virus Activation / Carcinoma, Hepatocellular / Immune Checkpoint Inhibitors / Hepatitis B / Liver Neoplasms Type of study: Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Hepatol Int Year: 2023 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Virus Activation / Carcinoma, Hepatocellular / Immune Checkpoint Inhibitors / Hepatitis B / Liver Neoplasms Type of study: Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Hepatol Int Year: 2023 Document type: Article Affiliation country: Country of publication: