title: Efficacy of Prophylactic Entecavir for Hepatitis B Virus-Related Hepatocellular Carcinoma Receiving Transcatheter Arterial Chemoembolization.
abstract: OBJECTIVE
  Hepatitis B virus (HBV) reactivation was reported to be induced by transcatheter arterial chemoembolization (TACE) in HBV-related hepatocellular carcinonma (HCC) patients with a high incidence. The effective strategy to reduce hepatitis flares due to HBV reactivation in this specific group of patients was limited to lamivudine. This retrospective study was aimed to investigate the efficacy of prophylactic entecavir in HCC patients receiving TACE.
  
  
  METHODS
  A consecutive series of 191 HBV-related HCC patients receiving TACE were analyzed including 44 patients received prophylactic entecavir. Virologic events, defined as an increase in serum HBV DNA level to more than 1 log10 copies/ml higher than nadir the level, and hepatitis flares due to HBV reactivation were the main endpoints.
  
  
  RESULTS
  Patients with or without prophylactic were similar in host factors and the majorities of characteristics regarding to tumor factors, HBV status, liver function and LMR. Notably, cycles of TACE were parallel between the groups. Ten (22.7%) patients receiving prophylactic entecavir reached virologic response. The patients receiving prophylactic entecavir presented significantly reduced virologic events (6.8% vs 54.4%, p=0.000) and hepatitis flares due to HBV reactivation (0.0% vs 11.6%, p=0.039) compared with patients without prophylaxis. Kaplan-Meier analysis illustrated that the patients in the entecavir group presented significantly improved virologic events free survival (p=0.000) and hepatitis flare free survival (p=0.017). Female and Eastern Cooperative Oncology Group (ECOG) performance status 2 was the only significant predictors for virological events in patients without prophylactic antiviral. Rescue antiviral therapy did not reduce the incidence of hepatitis flares due to HBV reactivation.
  
  
  CONCLUSIONS
  Prophylactic entecavir presented promising efficacy in HBV-related cancer patients receiving TACE. Lower performance status and female gender might be the predictors for HBV reactivation in these patients.
authors.affiliation: Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China E-mail : wuxiangy@mail.sysu.edu.cn; gzliqu@163.com.
authors.forename: Xing
authors.initials: X
authors.lastname: Li
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhong
authors.forename: Zhan-Hong
authors.initials: ZH
authors.lastname: Chen
authors.forename: Tian-Tian
authors.initials: TT
authors.lastname: Wang
authors.forename: Xiao-Kun
authors.initials: XK
authors.lastname: Ma
authors.forename: Yan-Fang
authors.initials: YF
authors.lastname: Xing
authors.forename: Dong-Hao
authors.initials: DH
authors.lastname: Wu
authors.forename: Min
authors.initials: M
authors.lastname: Dong
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Dan-Yun
authors.initials: DY
authors.lastname: Ruan
authors.forename: Ze-Xiao
authors.initials: ZX
authors.lastname: Lin
authors.forename: Jing-Yun
authors.initials: JY
authors.lastname: Wen
authors.forename: Li
authors.initials: L
authors.lastname: Wei
authors.forename: Xiang-Yuan
authors.initials: XY
authors.lastname: Wu
authors.forename: Qu
authors.initials: Q
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000628:therapy* / Q000821:virology; D016022:Case-Control Studies; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006499:Hepatic Artery; D006509:Hepatitis B / Q000628:therapy* / Q000821:virology; D006515:Hepatitis B virus / Q000187:drug effects*; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D014775:Virus Activation / Q000187:drug effects; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; C413685:entecavir; D006147:Guanine