Friday, May 26, 2017

Do HCV DAAs Increase HCC Recurrence Risk or Not?

Published in Clinical Thought

Do HCV DAAs Increase HCC Recurrence Risk or Not?
Paul Y. Kwo, MD - 5/25/2017
More from this author
Does the administration of direct-acting antiviral (DAA) therapy increase a patient’s risk of hepatocellular carcinoma (HCC) recurrence?

Recent data presented at EASL 2017 from Reig and colleagues extended their previous findings of an unexpectedly high rate of HCC recurrence following previous complete response to resection, ablation, or transarterial chemoembolization in the DAA era. Of 77 patients who initiated DAA therapy after presumed control of HCC, confirmed by radiologic assessment, 24 (31.2%) developed recurrence of HCC. Most individuals were Child-Pugh A (86%) and BCLC 0/A stage (97%).
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MedPage Today
Published in AGA Reading Room      

New Hep C Treatment Not Linked to Liver Cancer
by Liz Highleyman
Contributing Writer, MedPage Today
Contrary to some earlier research, most recent studies see no association between response to DAAs and HCC.

Most Researchers Find No Link
The Barcelona group stood alone among several other research groups presenting at the EASL meeting that did not see an increased risk of HCC after taking into account other factors including liver disease severity:
  • Etienne Audureau from Henri Mondor University Hospital in Paris reported that lack of SVR -- not the type of treatment -- was the strongest predictor of liver cancer in cirrhotic patients; older age, alcohol use, and impaired liver function also predicted HCC
  • Hamish Innes from Glasgow Caledonian University said that HCC risk following SVR was associated with baseline patient risk factors, but not DAA use; in a multivariate analysis, HCC risk was similar for patients treated with either DAAs or interferon
  • Dong Ji from the Hong Kong Humanity and Health Medical Center in Beijing reported no increase in HCC incidence among patients cured with DAAs compared with interferon
  • Masaaki Korenaga from Kohnodai Hospital in Japan said that SVR after treatment with sofosbuvir/ledipasvir (Harvoni) led to a reduction in HCC incidence, similar to the drop seen in patients cured with interferon
  • Vincenza Calvaruso from the University of Palermo in Sicily reported no increase in the development of new HCC among patients who achieved SVR with DAAs, compared with those cured with interferon
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Liver Cancer After Treatment For Hepatitis C
A collection of research articles investigating the possible risk of developing liver cancer (hepatocellular carcinoma, or HCC) during and after direct-acting antiviral therapy in patients with hepatitis C. 

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