Randomized clinical trial: Nucleos(t)ide analogues improved survival of CHB-related HCC patients via reducing severity and progression of malignancy.

Yun Wang,Weiliang Tang,Huijuan Zhou,Liwen Chen,Qing Xie,Zhujun Cao,Jie Lu,Shisan Bao,Rebecca Bao,Xiaogang Xiang,Lanyi Lin,Hui Wang

doi:10.18632/oncotarget.10155

Abstract

BackgroundThe influence of nucleos(t)ide analogues (NAs) to treat Chronic hepatitis B (CHB) related hepatocellular carcinoma (HCC) remains to be explored.AimTo investigate if NAs reduce the severity and progression of CHB-related HCC.ResultsAmong 532 patients, there were 118 or 414 CHB-related HCC with or without NAs therapy, respectively. BCLC scores, serum level of ALT/AST and HBV DNA were compared. During follow-up, the survival period of CHB-related HCC patients with sustained NAs is significantly longer than that with NAs post-HCC and NAs naïve (p < 0.05). Factors significantly associated with the poor overall survival of CHB-related HCC include BCLC scores (hazard ratio, 1.84 [95% confidence interval, 1.57−2.15], p < 0.001), NAs post-HCC or NAs naïve (1.33 [1.07−1.65], p < 0.01), serum AST ≥ 40 IU/L (1.48 [1.03−2.12], p < 0.05) and HBV DNA ≥ 104 copies/ml (1.36 [1.01−1.83], p < 0.001).MethodsOutcomes of 532 CHB-related HCC patients with/without NAs were investigated. Overall survival of CHB-related HCC patients, NAs naïve (n = 156), NAs received post-HCC (n = 258) and NAs sustained (n = 118) were determined.ConclusionsNAs reduced severity of CHB-related HCC patients. Sustained NAs is an important factor associated with the extended survival of CHB-related HCC patients.

Highlights

Hepatocellular carcinoma (HCC) is one of the most common malignancies with high morbidity and mortality worldwide [1], in China [2]
Factors significantly associated with the poor overall survival of Chronic hepatitis B (CHB)-related hepatocellular carcinoma (HCC) include Barcelona Clinic Liver Cancer (BCLC) scores, nucleos(t)ide analogues (NAs) post-HCC or NAs naïve (1.33 [1.07−1.65], p < 0.01), serum AST ≥ 40 IU/L (1.48 [1.03−2.12], p < 0.05) and HBV DNA ≥ 104 copies/ml (1.36 [1.01−1.83], p < 0.001)
Our current study demonstrated that NAs reduced severity and/or progression of CHB-related HCC patients significantly, according to BCLC score and the biochemical information

Summary

Introduction

Hepatocellular carcinoma (HCC) is one of the most common malignancies with high morbidity and mortality worldwide [1], in China [2]. CHB-related HCC patients accounted for ~80% in HCC patients in China [7], due to a high prevalence of HBV infection [8], which has attracted extensive attention in medical practitioners and policy makers in China. It has been demonstrated that high level of HBV viral load in CHB patients is a critical www.impactjournals.com/oncotarget risk factor for the progression of HCC [12]. Treatment for CHB aims to suppress viral proliferation, leading to reduce liver fibrosis and preventing hepatic decomposition and/or HCC [13]. It has been demonstrated that nucleos(t) ide analogues (NAs) are highly effective in the suppression circulating viral loads, but rarely eliminate the virus over the last ten years [14]. The influence of nucleos(t)ide analogues (NAs) to treat Chronic hepatitis B (CHB) related hepatocellular carcinoma (HCC) remains to be explored

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