Journal of Hepatocellular Carcinoma (Nov 2023)

Tenofovir versus Entecavir on Outcomes of Hepatitis B Virus-Related Hepatocellular Carcinoma After FOLFOX-Hepatic Arterial Infusion Chemotherapy

  • Zheng Z,
  • Wang J,
  • Wu T,
  • He M,
  • Wang J,
  • Pan Y,
  • Chen J,
  • Hu D,
  • Xu L,
  • Zhang Y,
  • Chen M,
  • Zhou Z

Journal volume & issue
Vol. Volume 10
pp. 2117 – 2132

Abstract

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Zhikai Zheng,1,2,* Jiongliang Wang,1,2,* Tianqing Wu,1,2,* Minrui He,1,2,* Juncheng Wang,1,2 Yangxun Pan,1,2 Jinbin Chen,1,2 Dandan Hu,1,2 Li Xu,1,2 Yaojun Zhang,1,2 Minshan Chen,1,2 Zhongguo Zhou1,2 1Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China; 2Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhongguo Zhou; Minshan Chen, Department of Liver Surgery, Sun Yat-sen University Cancer Center, Dongfeng Road East 651, Guangzhou, Guangdong, 510060, People’s Republic of China, Tel +86-20-87343117, Email [email protected]; [email protected]: The efficacy of entecavir (ETV) versus tenofovir (TDF) on the prognosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients who underwent FOLFOX-hepatic arterial infusion chemotherapy (HAIC) remains unclear. In this study, we compared the outcomes between ETV and TDF in HBV-related advanced HCC patients who underwent FOLFOX-HAIC.Methods: A total of 683 patients diagnosed with HBV-related HCC who underwent FOLFOX-HAIC and received TDF or ETV between January 2016 and December 2021 were included. Overall survival (OS), progression-free survival (PFS), HBV reactivation, and liver function of patients were compared between the ETV and TDF groups by propensity score matching (PSM).Results: In the PSM cohort, for all patients and patients with ≥ 4 cycles of FOLFOX-HAIC, the median OS in the ETV group (15.2 months, 95% CI: 13.0– 17.4 months; 16.6 months, 95% CI: 14.8– 18.5 months; respectively) was shorter than that in the TDF group (23.0 months, 95% CI: 10.3– 35.6 months; 27.3 months, 95% CI: 16.5-NA months; p=0.024, p=0.028; respectively). The median PFS in the ETV group (8.7 months, 95% CI: 7.9– 9.5 months; 8.9 months, 95% CI: 8.0– 9.8 months; respectively) was also shorter than that in the TDF group (11.8 months, 95% CI: 8.0– 15.6 months; 12.7 months, 95% CI: 10.8– 14.6 months; p=0.036, p=0.025; respectively). The rate of HBV reactivation in the ETV group was higher than that in the TDF group (12.3% vs 6.3%, p=0.040; 16.5% vs 6.2%, p=0.037, respectively). For liver function, the rate of ALBI grade that remained stable or improved in the ETV group was lower than that in the TDF group (44.6% vs 57.6%, p=0.006; 37.2% vs 53.8%, p=0.019, respectively).Conclusion: Compared with ETV, TDF was associated with a better prognosis, lower proportion of HBV reactivation, and better preservation of liver function in advanced HBV-HCC patients who underwent FOLFOX-HAIC, especially those who received ≥ 4 cycles.Keywords: tenofovir, entecavir, hepatitis B virus, hepatocellular carcinoma, hepatic arterial infusion chemotherapy

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