Salvage therapy in cancer patients with hepatitis C without sustained virologic response after direct-acting antivirals-A prospective study
© 2019 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd..
BACKGROUND AND AIM: No information exists regarding direct-acting antivirals (DAAs) salvage therapy for Hepatitis C (HCV)-infected patients with any type of cancer. We prospectively evaluated the safety and efficacy (SVR12) of salvage therapy in these patients.
METHODS: Patients who failed initial DAAs (01/2015-01/2018) were analyzed. Resistance-associated substitutions to NS5A and NS3 were investigated by population sequencing.
RESULTS: Of 164 patients enrolled, 16 (10%) experienced treatment failure. Of these, 11 patients received salvage therapy. The majority (91%) were men; 55% had genotype 1a, 45% had cirrhosis, and 45% had hepatocellular carcinoma. Four patients failed the first salvage therapy, and two of them required a second salvage therapy. Overall, 9 of 11 (82%) patients achieved SVR12. All four patients treated with sofosbuvir/velpatasvir/voxilaprevir (+/- ribavirin) achieved SVR12. The presence of resistance-associated substitutions did not impact response. Seven patients developed grade 1/2 adverse events. No patient had grade 3/4 adverse events. No patient required interruption of DAA therapy because of clinical or laboratory abnormalities.
CONCLUSIONS: This is the first prospective study in HCV-infected cancer patients failing DAAs. The efficacy of salvage therapy in this group appears to be lower than previously reported in non-cancer patients, but better response rates are observed with newer regimens. Salvage therapy is associated with minimal toxicity.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:4 |
|---|---|
| Enthalten in: |
JGH open : an open access journal of gastroenterology and hepatology - 4(2020), 3 vom: 12. Juni, Seite 541-544 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Pritchard, Haley [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cancer |
|---|
| Anmerkungen: |
Date Revised 14.04.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1002/jgh3.12294 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM310939143 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM310939143 | ||
| 003 | DE-627 | ||
| 005 | 20231225141156.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/jgh3.12294 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1036.xml |
| 035 | |a (DE-627)NLM310939143 | ||
| 035 | |a (NLM)32514467 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Pritchard, Haley |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Salvage therapy in cancer patients with hepatitis C without sustained virologic response after direct-acting antivirals-A prospective study |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 14.04.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2019 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. | ||
| 520 | |a BACKGROUND AND AIM: No information exists regarding direct-acting antivirals (DAAs) salvage therapy for Hepatitis C (HCV)-infected patients with any type of cancer. We prospectively evaluated the safety and efficacy (SVR12) of salvage therapy in these patients | ||
| 520 | |a METHODS: Patients who failed initial DAAs (01/2015-01/2018) were analyzed. Resistance-associated substitutions to NS5A and NS3 were investigated by population sequencing | ||
| 520 | |a RESULTS: Of 164 patients enrolled, 16 (10%) experienced treatment failure. Of these, 11 patients received salvage therapy. The majority (91%) were men; 55% had genotype 1a, 45% had cirrhosis, and 45% had hepatocellular carcinoma. Four patients failed the first salvage therapy, and two of them required a second salvage therapy. Overall, 9 of 11 (82%) patients achieved SVR12. All four patients treated with sofosbuvir/velpatasvir/voxilaprevir (+/- ribavirin) achieved SVR12. The presence of resistance-associated substitutions did not impact response. Seven patients developed grade 1/2 adverse events. No patient had grade 3/4 adverse events. No patient required interruption of DAA therapy because of clinical or laboratory abnormalities | ||
| 520 | |a CONCLUSIONS: This is the first prospective study in HCV-infected cancer patients failing DAAs. The efficacy of salvage therapy in this group appears to be lower than previously reported in non-cancer patients, but better response rates are observed with newer regimens. Salvage therapy is associated with minimal toxicity | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a cancer | |
| 650 | 4 | |a direct‐acting antivirals | |
| 650 | 4 | |a hepatitis C virus | |
| 650 | 4 | |a salvage therapy | |
| 700 | 1 | |a Jandhyala, Deeksha |e verfasserin |4 aut | |
| 700 | 1 | |a Hosry, Jeff |e verfasserin |4 aut | |
| 700 | 1 | |a Angelidakis, Georgios |e verfasserin |4 aut | |
| 700 | 1 | |a Torres, Harrys A |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t JGH open : an open access journal of gastroenterology and hepatology |d 2017 |g 4(2020), 3 vom: 12. Juni, Seite 541-544 |w (DE-627)NLM291146678 |x 2397-9070 |7 nnns |
| 773 | 1 | 8 | |g volume:4 |g year:2020 |g number:3 |g day:12 |g month:06 |g pages:541-544 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/jgh3.12294 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 4 |j 2020 |e 3 |b 12 |c 06 |h 541-544 | ||