For Lymphoma Patients Receiving R-CHOP, Entecavir More Effective for HBV-Related Hepatitis Prophylaxis
the Cancer Therapy Advisor take:
According to a new study published in JAMA, researchers at Sun Yat-sen University Cancer Center in Guangzhou, China, have found that the risk of hepatitis B virus (HBV) related hepatitis and HBV reactivation is lower with entecavir and lamivudine in patients with diffuse large B-cell lymphoma receiving the R-CHOP chemotherapy regimen.
For the study, researchers randomly assigned 121 patients with untreated diffuse large B-cell lymphoma who tested seropositive for the hepatitis B surface antigen to receive either entecavir or lamivudine during treatment with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone). Patients received the antivirals starting 1 week before beginning R-CHOP until 6 months following the completion of R-CHOP.
Results showed that patients in the entecavir group had an 8.2% rate of hepatitis compared with 23.3% in the lamivudine group.
In addition, the entecavir group had no cases of HBV-related hepatitis versus 13.3% in the lamivudine group, and 6.6% of those who received entecavir experienced HBV reactivation versus 30% of those who received lamivudine. Treatment-related adverse events were also about 5% lower in the entecavir group than the lamivudine group.
Despite the fact that these findings support the use of entecavir in this patient population to prevent HBV-related hepatitis and HBV reactivation, entecavir is more expensive. Therefore, researchers suggest further studies to determine which patients would benefit most from entecavir prophylaxis.
Risk of HBV related hepatitis and HBV reactivation is lower with entecavir and lamivudine in lymphoma.
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