Eiichi Ogawa1, Hidenori Toyoda2, Etsuko Iio3, Dae Won Jun4, Chung-Feng Huang5, Masaru Enomoto6, Yao-Chun Hsu7, Hiroaki Haga8, Shinji Iwane9, Grace Wong10,11, Dong Hyun Lee12, Toshifumi Tada2, Chen-Hua Liu13,14, Wan-Long Chuang5, Jun Hayashi15, Ramsey Cheung16,17, Satoshi Yasuda2, Cheng-Hao Tseng7, Hirokazu Takahashi9,18, Sally Tran16, Yee Hui Yeo16, Linda Henry16, Scott D Barnett16, Hideyuki Nomura19, Makoto Nakamuta20, Chia-Yen Dai5, Jee-Fu Huang5, Hwai-I Yang21, Mei-Hsuan Lee22, Mi Jung Jun12, Jia-Horng Kao13,14, Yuichiro Eguchi9, Yoshiyuki Ueno8, Akihiro Tamori6, Norihiro Furusyo1, Ming-Lung Yu5, Yasuhito Tanaka3, Mindie H Nguyen16. 1. Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan. 2. Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan. 3. Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 4. Department of Gastroenterology, Hanyang University, Seoul, South Korea. 5. Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 6. Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan. 7. Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan. 8. Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan. 9. Liver Center, Saga University Hospital, Saga, Japan. 10. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong. 11. State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong. 12. Department of Gastroenterology, Good Gang-An Hospital, Busan, Korea. 13. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. 14. Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan. 15. Kyushu General Internal Medicine Center, Haradoi Hospital, Fukuoka, Japan. 16. Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, California, USA. 17. Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA. 18. Division of Metabolism and Endocrinology, Saga University Faculty of Medicine, Saga, Japan. 19. The Center for Liver Disease, Shin-Kokura Hospital, Kitakyushu, Japan. 20. Department of Gastroenterology, Kyushu Medical Center, National Hospital Organization, Fukuoka, Japan. 21. Genomics Research Center, Academia Sinica, Taipei, Taiwan. 22. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Abstract
BACKGROUND: Cure rates of hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) for patients with active and inactive hepatocellular carcinoma (HCC) may differ, but well-controlled studies are limited. We aimed to evaluate DAA outcomes in a large East Asian HCV/HCC population compared with HCV/non-HCC patients. METHODS: Using data from the Real-World Evidence from the Asia Liver Consortium (REAL-C) registry (Hong Kong, Japan, South Korea, and Taiwan), we used propensity score matching (PSM) to match HCC and non-HCC (1:1) groups for age, sex, cirrhosis, prior treatment, HCV genotype, treatment regimen, baseline platelet count, HCV RNA, total bilirubin, alanine aminotransferase, and albumin levels to evaluate DAA treatment outcomes in a large population of HCV/HCC compared with HCV/non-HCC patients. RESULTS: We included 6081 patients (HCC, n = 465; non-HCC, n = 5 616) treated with interferon-free DAAs. PSM of the entire study population yielded 436 matched pairs with similar baseline characteristics. There was no statistically significant difference in the overall SVR rate of HCC (92.7%) and non-HCC (95.0%) groups. Rates of treatment discontinuation, adverse effects, and death were also similar between HCC and non-HCC groups. Among patients with HCC, those with active HCC had a lower SVR than inactive HCC cases (85.5% vs 93.7%; P = .03). On multivariable analysis, active HCC, but not inactive HCC, was significantly associated with lower SVR (OR, 0.28; P = .01) when compared with non-HCC. CONCLUSIONS: Active HCC but not inactive HCC was independently associated with lower SVR compared with non-HCC patients undergoing DAA therapy, although cure rate was still relatively high (85%) in active HCC patients.
BACKGROUND: Cure rates of hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) for patients with active and inactive hepatocellular carcinoma (HCC) may differ, but well-controlled studies are limited. We aimed to evaluate DAA outcomes in a large East Asian HCV/HCC population compared with HCV/non-HCCpatients. METHODS: Using data from the Real-World Evidence from the Asia Liver Consortium (REAL-C) registry (Hong Kong, Japan, South Korea, and Taiwan), we used propensity score matching (PSM) to match HCC and non-HCC (1:1) groups for age, sex, cirrhosis, prior treatment, HCV genotype, treatment regimen, baseline platelet count, HCV RNA, total bilirubin, alanine aminotransferase, and albumin levels to evaluate DAA treatment outcomes in a large population of HCV/HCC compared with HCV/non-HCCpatients. RESULTS: We included 6081 patients (HCC, n = 465; non-HCC, n = 5 616) treated with interferon-free DAAs. PSM of the entire study population yielded 436 matched pairs with similar baseline characteristics. There was no statistically significant difference in the overall SVR rate of HCC (92.7%) and non-HCC (95.0%) groups. Rates of treatment discontinuation, adverse effects, and death were also similar between HCC and non-HCC groups. Among patients with HCC, those with active HCC had a lower SVR than inactive HCC cases (85.5% vs 93.7%; P = .03). On multivariable analysis, active HCC, but not inactive HCC, was significantly associated with lower SVR (OR, 0.28; P = .01) when compared with non-HCC. CONCLUSIONS: Active HCC but not inactive HCC was independently associated with lower SVR compared with non-HCCpatients undergoing DAA therapy, although cure rate was still relatively high (85%) in active HCCpatients.
Authors: Neehar D Parikh; Neil Mehta; Maarouf A Hoteit; Ju Dong Yang; Binu V John; Andrew M Moon; Reena J Salgia; Anjana Pillai; Ihab Kassab; Naba Saeed; Emil Thyssen; Piyush Nathani; Jeffrey McKinney; Wesley Chan; Claire Durkin; Matthew Connor; Manaf Alsudaney; Rajesh Konjeti; Brenda Durand; Nicholas N Nissen; Hannah P Kim; Raghavendra Paknikar; Nicole E Rich; Matthew J Schipper; Amit G Singal Journal: Cancer Date: 2022-07-07 Impact factor: 6.921