Thursday, August 1, 2013

The Safety of Chemotherapy for Breast Cancer Patients with Hepatitis C Virus Infection


2013 Jul 24;4(6):519-23. doi: 10.7150/jca.6231. Print 2013.
 
The safety of chemotherapy for breast cancer patients with hepatitis C virus infection.
 
 
Source
1. Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan.

Abstract
Background: Hepatitis C virus (HCV) infection is one of the major causes of chronic liver disease, and more than 880,000 people are estimated to be infected with HCV in Japan. Little information is available on the outcomes of HCV during chemotherapy for solid tumors, and the impact of HCV infection on toxicity of chemotherapy is unknown.

Materials and methods: We performed a retrospective survey of 1,110 patients diagnosed with breast cancer between January 2006 and March 2011 at our institution. All patients had been screened for hepatitis C serology at diagnosis of breast cancer. We retrospectively investigated the change in HCV load and the toxicities of chemotherapy, based on review of their medical records.

Results: 23 patients were identified as having a positive test for anti-HCV antibodies. Ten of these patients received chemotherapy. Their median age was 66 years. No patient had decompensated liver disease at baseline. Eight patients received cytotoxic agents with or without trastuzumab, and two patients received trastuzumab alone. Four of eight patients who received cytotoxic chemotherapy developed febrile neutropenia and one developed transaminases elevation. Serum HCV-ribonucleic acid (RNA) level before and after chemotherapy was evaluated in six patients. Median serum HCV-RNA level at baseline and after chemotherapy was 6.5 and 6.7 logIU/ml, respectively.

Conclusion: Chemotherapy for breast cancer patients with HCV infection is feasible, and viral load doesn't change during the chemotherapy.

Keywords: HCV, HCV-RNA, febrile neutropenia, Child-Pugh criteria, liver cirrhosis, chemotherapy.

Introduction Only

Full Article Available Here

Hepatitis C virus (HCV) infection is one of the major causes of chronic liver disease, and more than 880,000 people are estimated to be infected with HCV in Japan (1). The estimated number of HCV carriers increases with age, therefore, carriers aged from 40 to 69 years account for more than 80% of cases (1). Breast cancer is the most common cancer among Japanese women (2). Furthermore, the age-adjusted breast cancer incidence rate has been increasing since 1975, and the incidence rate of breast cancer is highest in the age group of 40-49 years in Japan (2).

Little information is available on the status of HCV during chemotherapy for solid tumors and the influence of HCV infection on toxicity of chemotherapy is also unknown. Although there are guidelines for management of patients with Hepatitis B virus during chemotherapy, there are no data to support the use of chemotherapy to treat HCV-positive patients with solid tumors (3, 4). Some reports have noted the reactivation of HCV in patients with lymphoma who have received rituximab and combination chemotherapy (5, 6). However, there are substantial differences in immunosuppressive mechanisms between rituximab-based chemotherapy for hematologic malignancies and conventional chemotherapy for solid tumor, because rituximab, an anti-CD20 antigen, mainly inhibits B-cell function. Therefore, it may not be appropriate to use the same management during chemotherapy for HCV carrier patients with solid tumors.

The purpose of this study was to evaluate the safety profile and the change in HCV viral load during chemotherapy for HCV-carrier patients with breast cancer

Miura Y, Theriault RL, Naito Y, Suyama K, Shimomura A, Iwatani T, Miura D, Kawabata H, Kumada H, Takano T. The Safety of Chemotherapy for Breast Cancer Patients with Hepatitis C Virus Infection. J Cancer 2013; 4(6):519-523. doi:10.7150/jca.6231.

Full Text Article Available from http://www.jcancer.org/v04p0519.htm

Received 2013-3-11
Accepted 2013-5-23
Published 2013-7-24


 

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