Navigating the Hep C Treatment and Cancer Risk Minefield
Damian McNamara June 02, 2017
AMSTERDAM — Contradictory findings are driving disagreement over whether patients cured of hepatitis C after treatment with direct-acting antivirals should be monitored for hepatocellular carcinoma.
A flashpoint in the controversy was a Spanish study that revealed a 28% rate of radiologic tumor recurrence in 103 people with a history of liver cancer who were treated with direct-acting antivirals (J Hepatol. 2016;65:719-726). In that study, the investigators noted that the "high rate of cancer recurrence" after patients with a history of hepatocellular carcinoma were treated with direct-acting antivirals should prompt larger trials.
And it did.
"The original observations made by these researchers from the Barcelona Clinic Liver Cancer Group have sparked a huge number of studies aimed at verifying the potential association between direct-acting antiviral treatment and increased hepatocellular carcinoma recurrence after cure," said Francesco Negro, MD, from the University of Geneva, who is a governing board member of the European Association for the Study of the Liver.
"There is no reason to alter treatment guidelines until the issue is clarified," he pointed out. "We cannot exclude, however, that we may have to revise post-SVR surveillance in specific patient subgroups."
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