In a new cohort study of patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC), a disease with a high recurrence rate, researchers at the Osaka City University Graduate School of Medicine reported that after receiving cancer treatment, the oral administration of direct-acting antivirals (DAA) reduces the risk of tumor progression following recurrence of the liver disease. Results appeared in the Journal of Viral Hepatitis.
The study, led by Norifumi Kawada of the Department of Hepatology, looked at how eradicating HCV affected early-stage HCC tumor growth. Hepatitis C virus (HCV) eradication with DAA therapy, says Professor Kawada. “While it is deemed low or unclear if DAA therapy helps prevent HCC recurrence, nothing is known about how the antiviral therapy influences progression of the liver disease following cancer treatment.”
The study included 165 patients with early-stage HCC getting curative HCC therapy. Following treatment, 72 patients received DAA while 93 did not. According to the Barcelona Clinic Liver Cancer staging method, 75% of the 96 HCC recurrences were early stage. To account for the single-center retrospective study’s bias, a multivariate adjusted time-varying Cox regression analysis indicated a 72% reduction in tumor growth and an 88% reduction in HCC death in the DAA-treated group. The number of cancer treatments administered before the cancer advanced decreased by 59%, from 0.83 per year in non-DAA patients to 0.24 in DAA patients.
Usually, cancer cells grow over long periods of time before they can be detected as a tumor. Our study showed that eliminating the hepatitis C virus with DAA suppresses tumor progression, which we suggest contributes to overall patient survival.”
Hiroko Ikenaga, First Author
HCV infection affects 71 million people globally and is responsible for around 65 percent of liver cancer cases in Japan. While the team will continue to look into issues like how much liver cirrhosis and function improve after antiviral treatment, “the suppressing effect of DAA therapy on cancer progression revealed by our study gives us hope to improve the overall quality of life for people with HCC,” as supporting author and Lecturer Sawako Uchida-Kobayashi puts it.
When HCC advances to more than 4 nodules in the liver, portal invasion, or extrahepatic metastasis, it is considered tumor progression.
Ikenaga, H., et al. (2021) Direct-Acting Antivirals Reduce the Risk of Tumor Progression of Hepatocellular Carcinoma after Curative Treatment.