title: Prophylactic use of lamivudine for hepatitis B exacerbation in post-operative breast cancer patients receiving anthracycline-based adjuvant chemotherapy.
abstract: BACKGROUND
  With the increasing incidence of breast cancer worldwide, in particular in southeast Asia (including Korea), and the common use of anthracyclines in the adjuvant and metastatic settings, the occurrence of Hepatitis B virus (HBV) reactivation may develop in this patient population. The use of prophylactic antiviral agents in cancer patients may result in a reduced HBV exacerbation. The purpose of the current study was to assess the efficacy of prophylactic lamivudine in reducing the incidence and severity of HBV reactivation in post-operative breast cancer patients undergoing adjuvant doxorubicin-containing chemotherapy.
  
  
  METHODS
  The medical records of patients undergoing anthracycline-based adjuvant chemotherapy at Samsung Medical Center between January 2001 and September 2008 were reviewed.
  
  
  RESULTS
  From the database, 1912 breast cancer patients who had received anthracycline-based adjuvant chemotherapy were identified. Of 131 patients who were HBV surface antigen positive, 55 and 76 did and did not receive prophylactic lamivudine, respectively. In all, 30 patients (23%) developed hepatitis during doxorubicin-containing adjuvant chemotherapy. Of the 30 patients, 5 (9%) were in the prophylactic lamivudine group and 25 (33%) in the control group (P=0.001). In the prophylactic lamivudine group, there was significantly less HBV reactivation (1 patient (2%) vs 20 patients (16%); P=0.002), less disruption of chemotherapy (7 vs 14%; P=0.04), and less severe hepatitis (0 vs 17%; P=0.002).
  
  
  CONCLUSIONS
  Prophylactic lamivudine significantly reduced the incidence and severity of HBV reactivation in breast cancer patients undergoing anthracycline-based adjuvant chemotherapy.
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul 135-710, Korea.
authors.forename: J
authors.initials: J
authors.lastname: Yun
authors.forename: K H
authors.initials: KH
authors.lastname: Kim
authors.forename: E S
authors.initials: ES
authors.lastname: Kang
authors.forename: G-Y
authors.initials: GY
authors.lastname: Gwak
authors.forename: M S
authors.initials: MS
authors.lastname: Choi
authors.forename: J E
authors.initials: JE
authors.lastname: Lee
authors.forename: S J
authors.initials: SJ
authors.lastname: Nam
authors.forename: J-H
authors.initials: JH
authors.lastname: Yang
authors.forename: Y H
authors.initials: YH
authors.lastname: Park
authors.forename: J S
authors.initials: JS
authors.lastname: Ahn
authors.forename: Y-H
authors.initials: YH
authors.lastname: Im
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D018943:Anthracyclines / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000379:methods; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D002277:Carcinoma / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D019259:Lamivudine / Q000627:therapeutic use*; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies
chemical_list: D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D000998:Antiviral Agents; D019259:Lamivudine