Silencing Hepatitis B Virus Prevents Recurrence of Liver Cancer

liver411

<http://www.sciencedaily.com/releases/2010/06/100624122052.htm>

Silencing Hepatitis B Virus Prevents Recurrence of Liver Cancer

ScienceDaily (June 25, 2010) — Previous studies have shown that antiviral
treatment reduces the incidence of hepatocellular carcinoma (HCC) in patients
with chronic hepatitis B (CHB). But now, researchers from the Division of
Gastroenterology and Hepatology at Thomas Jefferson University are reporting
that the antiviral therapy also prevents recurrence of HCC and extends
patients' lives.

The standard of care for patients with HCC is local ablation of the tumor,
unless it is large or has metastasized. However, HCC tumors often recur, or
new lesions develop. In the International Journal of Cancer, Hie-Won Hann,
M.D., professor of Medicine at Jefferson Medical College of Thomas Jefferson
University, and colleagues reported that the median survival in patients who
received antiviral therapy after HCC diagnosis was 60 months in patients. In
those who did not receive antiviral therapy, the median survival was 12.5
months.

"Before the antiviral drugs were developed, patients would often develop new
lesions within a few months of tumor ablation because we were not treating the
underlying virus that is causing the liver cancer," Dr. Hann said. "The virus
drives the cancer, and by suppressing the virus and making it undetectable we
can extend the survival for these patients."

The small study included 15 CHB patients who received local ablation of a
single HCC tumor that was less than four cm. The first six patients were
diagnosed between 1991 and 1997, prior to the development of antiviral
therapy. These patients were considered historical controls.

The other nine patients were diagnosed between 2000 and 2004. These patients
began ongoing antiviral therapy with lamivudine immediately after HCC
diagnosis. Other antiviral medications, such as tenofovir and adefovir were
added to the regimen if resistance to lamivudine developed, or even without
drug resistance.

All patients who received the antiviral therapy maintained undetectable
hepatitis B virus in serum and continued the therapy. Seven of the nine
patients have not developed a new HCC or recurrence. The longest survivors are
the two patients who came with HCC in 2000. They are doing well, free of caner
for more than 10 years. All patients continue with the antiviral therapy and
are followed at three to four month intervals.

"The other option for these patients is liver transplantation, which carries
its own risks," said Robert Coben, M.D., associate professor of Medicine at
Jefferson Medical College of Thomas Jefferson University, who was involved in
the study. "This is an attractive alternative for this patient population."

Other researchers include Anthony J. DiMarino, M.D., William Rorer Professor
of Medicine at Jefferson Medical College of Thomas Jefferson University, and
Diane Bergin, M.D., who is now at the University Hospital Galway in Ireland.

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Story Source:
The above story is reprinted (with editorial adaptations by ScienceDaily
staff) from materials provided by Thomas Jefferson University, via
EurekAlert!, a service of AAAS.
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