Abstract | BACKGROUND: This study aimed to assess the efficacy of lamivudine prophylaxis on hepatic complications in HBsAg-positive patients with breast cancer undergoing adjuvant chemotherapy and to describe the temporal trend in HBV surveillance and prophylaxis during the last decade. METHODS: Patients with stage I-III curatively resected invasive breast cancer who received adjuvant and/or neoadjuvant chemotherapy between 2000 and 2009 were eligible for this study. Patients with positive HBsAg and normal liver function were enrolled. Hepatotoxicity, defined as alanine aminotransferase (ALT) ≥100 IU/ml, and HBV reactivation were compared according to lamivudine prophylaxis. Annual trends in HBV surveillance and use of lamivudine prophylaxis were also reviewed. RESULTS: One hundred sixty-five HBsAg-positive patients with breast cancer were enrolled. After the year 2004, surveillance of HBV infection status and use of lamivudine prophylaxis increased significantly (2.5 vs. 57.6 %, P < 0.001). Seventy-three (44.2 %) patients received lamivudine prophylaxis and 92 (55.8 %) patients did not. The incidence of hepatotoxicity was significantly lower in the group receiving prophylaxis (2.7 vs. 14.1 %, P = 0.011) with fewer premature terminations of planned adjuvant chemotherapy (0 vs. 10.9 %, P = 0.004) in the prophylaxis group. Among the patients for whom the baseline HBV DNA titer was available, the HBV reactivation rate was lower, albeit not significantly, in the prophylaxis group (0 %) compared with the no prophylaxis group (20 %) (P = 0.104). Lamivudine-withdrawal hepatitis was not detected; however, one case of breakthrough HBV reactivation during lamivudine treatment was observed in this study. CONCLUSIONS:
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Authors | Hyun Jung Lee, Dae Young Kim, Bhumsuk Keam, Jeong Hoon Lee, Sae-Won Han, Do-Youn Oh, Jung Hwan Yoon, Tae-You Kim, Yu Jung Kim, Keun Wook Lee, Jin-Wook Kim, Sook-Hyang Jeong, Jong Seok Lee, Jee Hyun Kim, Seock-Ah Im |
Journal | Breast cancer (Tokyo, Japan)
(Breast Cancer)
Vol. 21
Issue 4
Pg. 387-93
(Jul 2014)
ISSN: 1880-4233 [Electronic] Japan |
PMID | 23073741
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- DNA, Viral
- Hepatitis B Surface Antigens
- Reverse Transcriptase Inhibitors
- Lamivudine
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Topics |
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Breast Neoplasms
(drug therapy, pathology, virology)
- Chemotherapy, Adjuvant
- DNA, Viral
(genetics)
- Female
- Follow-Up Studies
- Hepatitis B
(drug therapy, pathology, virology)
- Hepatitis B Surface Antigens
(metabolism)
- Hepatitis B virus
(genetics, isolation & purification)
- Humans
- Lamivudine
(therapeutic use)
- Liver Function Tests
- Middle Aged
- Neoadjuvant Therapy
- Neoplasm Staging
- Polymerase Chain Reaction
- Premedication
- Prognosis
- Prospective Studies
- Reverse Transcriptase Inhibitors
(therapeutic use)
- Virus Activation
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