Results of the largest study of its kind may help quell longstanding controversy surrounding the impact of DAA therapy on recurrence of HCC.
Debate Over DAAs, HCC Recurrence. Chronic HCV is the most common cause of HCC, but there is controversy over the effects of DAAs for HCV infection on HCC recurrence and tumor aggressiveness. Interferon-based therapies can reduce recurrence, but they are not always tolerated in cirrhosis. DAAs are better tolerated and may reduce liver cancer or death, but some studies suggest an increase risk of HCC recurrence. Study authors sought to determine the impact of DAAs on HCC recurrence.
Largest Study of DAAs and HCC Recurrence. This retrospective cohort study looked at the electronic medical records at 31 clinical centers across the US and Canada. A total of 793 adults with HCV-associated HCC and complete radiologic response were included in the study; 38.3% of patients were treated with DAAs and 61.7% of patients went untreated.
DAAs Have No Impact on HCC Recurrence. HCC recurred in 42% of DAA-treated patients vs 58.9% of untreated patients and there was no significant impact of DAAs on overall or early HCC recurrence. The median time to recurrence was 13.2 months in DAA-treated patients vs 6 months in untreated patients. There was no difference in aggressiveness of HCC recurrence.
Take Home Points. The largest study of its kind found no impact of DAAs on HCC recurrence vs untreated controls. There was no impact of DAAs on HCC recurrence regardless of tumor type and HCC treatment. The use of DAAs appear safe and beneficial in HCV-associated HCC.
Reference: Singal AG, Rich NE, Mehta N, et al. Direct-acting antiviral therapy not associated with recurrence of hepatocellular carcinoma in a multicenter North American cohort study [published ahead of print January 17, 2019]. Gastroenterology. doi: 10.1053/j.gastro.2019.01.027.
In an effort to help clarify ongoingÂ controversy surrounding the effects of direct-acting antiviral (DAA) therapies for hepatitis C virus (HCV) infection on hepatocellular carcinoma (HCC) recurrence, researchers led by Amit G. Singal, MD, MS, conducted the largest study of its kind comparing HCC recurrence patterns between DAA-treated patients vs untreated patients across multiple clinical centers in the US and Canada. What did the study reveal? And how will the results impact clinical practice? Find out with our quick slideshow below.Â