Incidence of hepatitis B reactivation during epidermal growth factor receptor tyrosine kinase inhibitor treatment in non–small-cell lung cancer patients
Journal
European Journal of Cancer
Journal Volume
117
Pages
107-115
Date Issued
2019
Abstract
Background: Reactivation of hepatitis B virus (HBV) is a documented risk during cytotoxic chemotherapy in patients with lung cancer. Cases of HBV reactivation in non–small-cell lung cancer (NSCLC) patients receiving epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment have been reported; however, the incidence of HBV reactivation in patients treated with EGFR TKIs has not yet been reported. Materials and methods: We enrolled 171 patients who were diagnosed as having NSCLC from 2011 through 2017 and who also had positive hepatitis B surface antigen (HBsAg). All patients had received EGFR TKIs as anticancer treatment for at least 2 weeks during their treatment course. Reactivation of HBV is defined as one of the following: an increase in HBV DNA by at least 10-fold compared to baseline or an absolute increase to >10?5 IU/mL with abnormal liver function. Results: The median duration of EGFR TKI treatment was 10.5 months (95% con?dence interval: 8.2–12.8). Sixteen (9.36%) patients met the criteria of HBV reactivation during EGFR TKI treatment, with an annual incidence of 7.86%. HBV reactivation occurred during erlotinib treatment in 6 patients, followed by 5 patients with gefitinib treatments, 3 patients with osimertinib treatment and 2 with afatinib treatment. No independent risk factor for HBV reactivation was identified. Conclusion: NSCLC patients receiving EGFR TKI treatment may have a clinically meaningful risk of HBV reactivation during the treatment period. Thus, monitoring liver function, HBV viral load and serology of HBV (i.e., HBeAg and anti-HBc) during EGFR TKI therapy is recommended for NSCLC patients with positive HBsAg. ? 2019 Elsevier Ltd
SDGs
Other Subjects
afatinib; carboplatin; cisplatin; docetaxel; erlotinib; gefitinib; gemcitabine; hepatitis B surface antigen; osimertinib; paclitaxel; pemetrexed; vinorelbine tartrate; virus DNA; EGFR protein, human; epidermal growth factor receptor; hepatitis B surface antigen; protein kinase inhibitor; adult; aged; Article; cancer patient; female; hepatitis; hepatitis B; human; incidence; liver function; major clinical study; male; non small cell lung cancer; priority journal; retrospective study; risk factor; serology; virus load; virus reactivation; drug effect; follow up; genetics; hepatitis B; Hepatitis B virus; liver tumor; lung adenocarcinoma; lung tumor; metabolism; middle aged; mutation; non small cell lung cancer; pathology; prognosis; squamous cell carcinoma; survival rate; Taiwan; very elderly; virology; virus activation; Adenocarcinoma of Lung; Adult; Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung; Carcinoma, Squamous Cell; ErbB Receptors; Female; Follow-Up Studies; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B virus; Humans; Incidence; Liver Neoplasms; Lung Neoplasms; Male; Middle Aged; Mutation; Prognosis; Protein Kinase Inhibitors; Retrospective Studies; Survival Rate; Taiwan; Virus Activation
Publisher
Elsevier Ltd
Type
journal article