Tenofovir disoproxil linked to better long-term outcomes vs. entecavir in HBV-related HCC
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Key takeaways:
- At 5 years, overall survival rates were 54.2% in the entecavir group vs. 64% in the tenofovir disoproxil group.
- Recurrence-free survival rates were 43.3% vs. 51.4%, respectively, at the same time point.
Tenofovir disoproxil improved long-term overall and recurrence-free survival rates compared with entecavir among patients with hepatitis B virus-related hepatocellular carcinoma who underwent liver resection.
“Antivirus therapy has been shown to prevent tumor recurrence and prolong overall survival (OS) after liver resection, and it is now the cornerstone in treating liver cancer in patients with both high and low HBV DNA levels,” Pengpeng Li, MD, of the Third Affiliated Hospital of Naval Medical University, and colleagues wrote in JAMA Network Open. “Both tenofovir disoproxil and entecavir are widely used as the first-line antiviral treatment for patients with HBV-related HCC. It remains controversial whether these drugs result in different clinical benefits in terms of recurrence-free survival (RFS) and OS after liver resection.”
In a retrospective cohort study, Li and colleagues compared rates of recurrence and survival among 4,451 patients (mean age, 58.1 years; 84.6% men) with HBV-related HCC who underwent liver resection with curative intent between January 2015 and December 2018.
Following resection, 3,462 patients received entecavir and 989 received tenofovir disoproxil. Researchers performed propensity score matching to include 989 pairs of patients for analysis in each treatment group.
After a median follow-up of 50 months, the rates of OS among 1,978 patients were 91.6% at 1 year, 73% at 3 years and 59.1% at 5 years, while rates of RFS were 84.6%, 52.8% and 47.3%, respectively, at each timepoint.
Stratified by treatment, OS rates were 92.2% in the entecavir group vs. 90.9% in the tenofovir disoproxil group at 1 year, 70.9% vs. 75.2% at 3 years and 54.2% vs. 64% at 5 years, while rates of RFS were 83.9% vs. 85.3%, 50% vs. 55.6% and 43.3% vs. 51.4%, respectively.
Restricted mean survival time differences of entecavir compared with tenofovir disoproxil were –0.05 (95% CI, –0.18 to 0.08) months at 1 year, 0.2 (95% CI, –0.62 to 1.03) months at 3 years and 1.82 (95% CI, 0.14-3.51) months at 5 years.
Overall, researchers reported “significantly better” OS (HR = 0.82; 95% CI, 0.72-0.94) and RFS (HR = 0.81; 95% CI, 0.72-0.92) rates among those in the tenofovir disoproxil group on long-term follow-up but not in the short term.
“Tenofovir disoproxil could be considered the preferred long-term antiviral treatment for these patients,” Li and colleagues concluded.
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