Incidence of hepatitis B reactivation during epidermal growth factor receptor tyrosine kinase inhibitor treatment in non-small-cell lung cancer patients.
Adenocarcinoma of Lung
/ drug therapy
Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung
/ drug therapy
Carcinoma, Squamous Cell
/ drug therapy
ErbB Receptors
/ antagonists & inhibitors
Female
Follow-Up Studies
Hepatitis B
/ chemically induced
Hepatitis B Surface Antigens
/ metabolism
Hepatitis B virus
/ drug effects
Humans
Incidence
Liver Neoplasms
/ drug therapy
Lung Neoplasms
/ drug therapy
Male
Middle Aged
Mutation
Prognosis
Protein Kinase Inhibitors
/ adverse effects
Retrospective Studies
Survival Rate
Taiwan
/ epidemiology
Virus Activation
/ drug effects
EGFR tyrosine kinase inhibitors
Hepatitis B reactivation
Non–small-cell lung cancer
Journal
European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
04
03
2019
revised:
18
05
2019
accepted:
23
05
2019
pubmed:
7
7
2019
medline:
29
5
2020
entrez:
7
7
2019
Statut:
ppublish
Résumé
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. 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 >10ˆ5 IU/mL with abnormal liver function. The median duration of EGFR TKI treatment was 10.5 months (95% confidence 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. 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.
Sections du résumé
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 >10ˆ5 IU/mL with abnormal liver function.
RESULTS
The median duration of EGFR TKI treatment was 10.5 months (95% confidence 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.
Identifiants
pubmed: 31279301
pii: S0959-8049(19)30359-4
doi: 10.1016/j.ejca.2019.05.032
pii:
doi:
Substances chimiques
Hepatitis B Surface Antigens
0
Protein Kinase Inhibitors
0
EGFR protein, human
EC 2.7.10.1
ErbB Receptors
EC 2.7.10.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
107-115Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.