Sofosbuvir-based therapy in hepatitis C virus-infected cancer patients
Data are sparse on treatment of chronic hepatitis C virus ( HCV ) in cancer patients.
Researchers have evaluated the efficacy and safety of Sofosbuvir-based therapy in cancer patients.
Patients treated with Sofosbuvir-based therapy at University of Texas during 2014–2017 were included in a prospective observational study.
Efficacy [ sustained virologic response at 12 weeks after the end of treatment ( SVR12 ) ], cancer-related outcomes and adverse events were assessed.
153 patients were included. Most were men ( 109; 71% ), white ( 92; 60% ), non-cirrhotic ( 105; 69% ), and with HCV genotype 1 ( 110; 72% ).
The most common cancers were hepatocellular carcinoma ( 27; 18% ) and multiple myeloma ( 14; 9% ).
The overall SVR12 rate was 91% ( 128/141 ). SVR12 was 100% in patients treated with Ledipasvir / Sofosbuvir ( Harvoni ) for 8 weeks.
Of the 32 patients initially excluded from cancer clinical trials because of HCV, 27 ( 84% ) were granted cancer therapy access after starting Sofosbuvir-based therapy.
Six patients with indolent non-Hodgkin’s lymphoma ( NHL ) received Sofosbuvir-based therapy without cancer treatment.
Two achieved complete remission, one had partial remission, and two had stable cancer.
Within 6 months after Sofosbuvir-based therapy, 5% ( 6/121 ) of patients in remission or with stable cancer, had progression or recurrence ( two with hepatocellular carcinoma and one each with esophageal cancer, cholangiocarcinoma, non-Hodgkin’s lymphoma, and tonsillar cancer ).
No de novo hepatocellular carcinomas occurred.
Adverse effects were most commonly grade 1–2 ( 90% ).
Sofosbuvir-based therapy in HCV-infected cancer patients is effective and safe, may permit access to investigational cancer therapy expanding treatment options, may induce remission of non-Hodgkin’s lymphoma, and may be used for 8 weeks. ( Xagena )
Source: American Journal of Gastroenterology, 2018
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