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.