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Timing of DAA therapy and HCC response may impact recurrence rate
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AMSTERDAM — Unexpectedly high hepatocellular carcinoma recurrence rates were reported among patients who achieved sustained virologic response after receiving direct-acting antiviral therapy, according to data presented at the International Liver Congress.
“This update further supports our findings about an unexpected high recurrence rate associated in time with DAA, but also exposes a more aggressive pattern of recurrence and faster tumor evolution,” Maria Reig, MD, of the Barcelona Clinic Liver Cancer Group, Liver Unit, Hospital Clinic Barcelona, at the University of Barcelona, said in her presentation.
Reig updated data from last year’s program with the current data set comprised of 77 patients with radiological assessment of HCC. “All patients were treated for HCV according to guidelines,” Reig said.
Patients were followed every 6 months using imaging or other modalities of HCC surveillance. HCC complete response was reported in 52 patients. The SVR12 rate was 97.4%.
The researchers broke down the time between cancer therapy and last assessment of radiology; the window between the last complete response assessment and DAA initiation; the window between DAA initiation and last assessment with complete response; the time between the first dose of DAA and the first radiologic tumor recurrence; and the first radiologic tumor recurrence or progression.
There were 24 cases of recurrence in the cohort. After starting DAA therapy, 31.2% had a recurrence of HCC. “If we focus on the group of patients who started HCV treatment within 4 months after complete response, their rate of recurrence was higher, at 45%,” Reig said. “Thirty percent developed recurrence within the first 6 months.”
Twenty-eight patients underwent resection, while 41 underwent ablation. Overall, approximately half of the cohort underwent ablation, resection or transplantation. Comparatively, 33.3% of patients were treated with Nexavar (sorafenib, Bayer and Onyx Pharmaceuticals), Stivarga (regorafenib, Bayer) or other pharmacotherapy. – by Rob Volansky
Reference: Reig M, et al. Abstract #PS-031 Presented at: International Liver Congress; April 19-24, 2017; Amsterdam.
Disclosure: Reig reports consulting for Bayer and delivering sponsored lectures for Bayer and Gilead.