Longer Survival for HBV-Related Hepatocellular Carcinoma with Entecavir
SAN FRANCISCO, CA—Entecavir is associated with longer survival times than lamivudine among patients with hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC), according to a study reported at the The Liver Meeting® 2015.
Lamivudine may represent a “valuable option” for patients with short expected survival times, but “a potent antiviral drug [entecavir] should be the preferred choice in the rest of HBV-related HCC patients,” concluded coauthor Jung Hee Kim, MD, of the Samsung Medical Center in Seoul, Korea, and colleagues.
"Antiviral therapy is a key element in the management of HBV-related HCC patients, however, whether the potent drug, entecavir, is more effective than a less potent drug, lamivudine, in HBV-related HCC is not clear," Dr. Kim noted.
The researchers therefore conducted a retrospective cohort study of 451 patients diagnosed with HBV-related HCC who did not have a history of antiviral therapy at diagnosis, and who initiated antiviral therapy after diagnosis with entecavir (n=249 patients) or lamivudine (n=202).
"Overall survival, new-onset hepatic decompensation (eg, ascites, variceal bleeding, hepatic encephalopathy), and recurrence after curative therapy were compared,” Dr. Kim reported.
Overall survival (OS), decompensation-free survival, and HCC recurrence-free survival were all longer among patients in the entecavir group than the lamivudine group in both univariate and multivariate analyses, Dr. Kim reported. In multivariate analysis, the OS hazard ratio (HR) for the two study groups (lamivudine vs. entecavir) was 1.49 (95% CI: 1.15, 1.92; P=0.002).
In multivariate analysis of decompensation, the HR for the two study groups was 1.67 (95% CI: 1.12, 2.48; P=0.010), and for HCC recurrence, the multivariate HR for the two study groups was 1.84 (95% CI: 1.25, 2.72; P=0.002), Dr. Kim reported.