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Published on: May 24, 2024
Impact of direct-acting antiviral therapy for hepatitis C-related hepatocellular carcinoma
Wei-Chen Lin1,2,3, Yang-Sheng Lin1,2,3, Chen-Wang Chang1,2,3
1Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Abstract:
With the introduction of direct-acting antiviral (DAA) agents, hepatitis C virus (HCV) treatment has dramatically improved. However, there are insufficient data on the benefits of DAA therapy in hepatocellular carcinoma (HCC). The purpose of this study was to investigate the outcome of patients who received DAA therapy after HCC treatment. We retrospectively reviewed patients with HCV-related HCC in a single medical center, and the outcome of patients with or without DAA therapy was analyzed. In total, 107 HCC patients were enrolled, of whom 60 had received DAA therapy after treatment for HCC. There were no significant intergroup differences in age, sex, laboratory results, or tumor burden. A more advanced stage was noted in the no DAA group (P = 0.003). In the treatment modality, sorafenib was commonly prescribed in the no DAA group (P = 0.007). The DAA group had a longer overall survival (OS) time than the no DAA group (P<0.001). When stratified by Barcelona Clinic Liver Cancer staging, the DAA group had better OS in the HCC stages 0-A and B-C (P = 0.034 and P = 0.006). There were 35 patients who received DAA therapy after curative HCC therapy. At a median follow-up of 20 months, 37.1% patients had HCC recurrence after DAA therapy. There was no statistical difference in recurrence-free survival between patients receiving and those not receiving DAA (P = 0.278). DAA therapy improved the survival outcome of HCC patients and did not increase recurrent HCC after curative therapy. .
Insights
Direct-acting antiviral (DAA) therapy significantly improves overall survival for patients with hepatitis C virus-related hepatocellular carcinoma (HCC). DAA treatment did not increase the recurrence of HCC after curative therapy.
Area of Science:
- Hepatology
- Oncology
- Virology
Background:
- Direct-acting antiviral (DAA) agents have revolutionized hepatitis C virus (HCV) treatment.
- Limited data exist on the impact of DAAs on outcomes for patients with hepatocellular carcinoma (HCC).
Purpose of the Study:
- To evaluate the efficacy of DAA therapy in patients with HCV-related HCC following treatment.
- To compare overall survival and recurrence rates between patients with and without DAA therapy.
Main Methods:
- Retrospective review of 107 patients with HCV-related HCC.
- Analysis of outcomes comparing patients who received DAA therapy post-HCC treatment versus those who did not.
- Stratification by Barcelona Clinic Liver Cancer (BCLC) staging.
Main Results:
- The DAA group demonstrated significantly longer overall survival (OS) compared to the no DAA group (P<0.001).
- Improved OS was observed in the DAA group across BCLC stages 0-A and B-C.
- No significant difference in recurrence-free survival was found between groups (P = 0.278).
Conclusions:
- DAA therapy is associated with improved survival outcomes in patients with HCV-related HCC.
- DAA treatment does not appear to increase the risk of HCC recurrence after curative therapies.
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