Hepatocellular carcinoma recurrence after treatment with direct-acting antivirals: First, do no harm by withdrawing treatment

Torres, Harrys A.; Vauthey, Jean Nicolas; Economides, Minas P.; Mahale, Parag; Kaseb, Ahmed O.

doi:10.1016/j.jhep.2016.05.034

Cited by 79 publications

(88 citation statements)

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“…The random-effects meta-analysis of 12 studies yielded a pooled proportion of 16.7% (95% CI 10.2% to 26%; I 2 =84.8) with evidence of substantial statistical heterogeneity among the included studies as shown in figure 4. Estimates of individual studies ranged from as low as 0% (in a study that included only eight participants with pre-existing HCC)41 to as high as 42.6% 39…”

Section: Resultsmentioning

confidence: 99%

Oral direct-acting antivirals and the incidence or recurrence of hepatocellular carcinoma: a systematic review and meta-analysis

Singh

Nautiyal

Loke

2018

Frontline Gastroenterol

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Section: Resultsmentioning

confidence: 99%

Oral direct-acting antivirals and the incidence or recurrence of hepatocellular carcinoma: a systematic review and meta-analysis

Singh

Nautiyal

Loke

2018

Frontline Gastroenterol

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“…The other study showed similar results with a recurrence rate of 28.8% [12]. The first study has been seriously criticized by other researchers [30][31][32]. For instance, one article criticized the too heterogeneous treatment types, including both palliative and curative therapies for HCC [30].…”

Section: Hcc Recurrence In Two Different Eras: Ifn Based Versus Ifn-fmentioning

confidence: 83%

“…This study included three different cohorts and further details of each cohort is highlighted in Table II. Moreover, three other letters to the editor and one poster presentation from AASLD 2017 meeting found no evidence of the increased risk of HCC recurrence [30,31,37,38].…”

Section: Hcc Recurrence In Two Different Eras: Ifn Based Versus Ifn-fmentioning

confidence: 96%

“…The first study has been seriously criticized by other researchers [30][31][32]. For instance, one article criticized the too heterogeneous treatment types, including both palliative and curative therapies for HCC [30]. Moreover, the investigators did not clearly specify whether all patients experienced complete remission of their cancer before being deemed disease-free prior to starting surveillance scans [30].…”

Section: Hcc Recurrence In Two Different Eras: Ifn Based Versus Ifn-fmentioning

confidence: 99%

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Hepatocellular Carcinoma Occurrence and Recurrence after Antiviral Treatment in HCV-Related Cirrhosis. Are Outcomes Different after Direct Antiviral Agents? A Review

Spârchez

Mocan²

2017

JGLD

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Hepatitis C virus (HCV) infection is one of the major causes of hepatocellular carcinoma (HCC) worldwide. In the last decades, several studies have showed a lower rate of HCC occurrence or recurrence in patients with HCV-related cirrhosis after interferon-based antiviral therapies compared to untreated controls, even without reaching viral clearance. Unfortunately, interferon regimens could only yield viral clearance in approximately half of the patients. The recent development of new all-oral regimens with direct-acting antivirals (DAAs) has radically improved the cure rate to above 90%. In respect to these findings, many would have thought that interferon-free regimens would decrease the development and recurrence of HCC. Literature data have unexpectedly reported high rates of both the occurrence and recurrence of HCC after therapy with DAAs. However, it is probably too early to express some concerns. More recent data showed that both occurrence and recurrence of HCC are decreased by the DAAs. Interferon-free therapy is definitely not without limits. Together with the initial thoughts of an increased risk of HCC, these may lead to an unwanted restricted access to interferon-free regimens in specific subpopulations. This issue should be settled as soon as possible because millions of hepatitis C patients are and will be using DAAs in the present and future. Our purpose is to review the existing literature and to offer a more precise and rational interpretation of the existing data.Key words: – – e – .Abreviations: AFP: alpha-fetoprotein; DAA: direct antiviral agent; HCC: hepatocellular carcinoma; HCV: hepatitis C virus; HR: hazard ratio; IFN: interferon; LDV: Ledispavir; SMV: Simeprevir; SOF: Sofosbuvir; SVR: sustained virologic response.

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“…Combined with the current researches (48,(60)(61)(62), the conclusion that DAAs may increase the risk for early HCC recurrence still needs more large -scale data and prospective studies to confirm. Therefore, the relevant research in the future should consider the following: a large enough sample size, a long follow -up, a prospective study design, and the same baseline.…”

Section: "Hcc Recurrence" In Daa -Treated Patientsmentioning

confidence: 88%

Hepatitis C Virus - Related Hepatocellular Carcinoma in the Era of Direct - Acting Antiviral Agents

Gao

Niu

2018

Hepat Mon

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Context: The emergence of direct -acting antiviral agents (DAAs) with high sustained virological responses (SVR) is an epoch -making revolution. However, the value of antiviral agents in the field of hepatitis C -related hepatocellular carcinoma (HCC) is not clear. Further, the risk of tumor occurrence or recurrence following an antiviral regimen is not yet reached a consensus. Evidence Acquisition: All scientific evidence was collected through a systematic review of studies discussing DAA regimen and hepatitis C-related HCC, in PubMed, EMBASE, and Web of Science. The relevant articles were obtained and reviewed carefully before working on the paper. Results: The current review study aimed at discussing recent studies on hepatitis C -related HCC in the era of DAAs, including application of DAAs in the field of treatment of hepatitis C virus (HCV), efficacy of DAAs on HCV-associated HCC, and the effect of DAAs on occurrence and recurrence of HCC. Conclusions: It was shown that DAAs had a relatively poor therapeutic effect on HCV patients with HCC, based on the current studies. After analyzing the existing data, the conclusion cannot yet be reached that DAA treatment influences the risk of HCC in patients with HCV infection.

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Hepatocellular carcinoma recurrence after treatment with direct-acting antivirals: First, do no harm by withdrawing treatment

Cited by 79 publications

References 5 publications

Oral direct-acting antivirals and the incidence or recurrence of hepatocellular carcinoma: a systematic review and meta-analysis

Oral direct-acting antivirals and the incidence or recurrence of hepatocellular carcinoma: a systematic review and meta-analysis

Hepatocellular Carcinoma Occurrence and Recurrence after Antiviral Treatment in HCV-Related Cirrhosis. Are Outcomes Different after Direct Antiviral Agents? A Review

Hepatitis C Virus - Related Hepatocellular Carcinoma in the Era of Direct - Acting Antiviral Agents

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