Abstract 2277
Background
Singapore has a relative higher prevalence of Hepatitis B carriage at 3.6%. The risk of Hepatitis B virus (HBV) flare which is increased in patients receiving anthracycline chemotherapy has clinical relevance due to associated morbidity. Guidelines recommend a risk-adaptive screening strategy. This study aims to analyze the practice of HBV screening, and incidence of flare among non-metastatic breast cancer patients treated with anthracyclines.
Methods
This is a retrospective review of all non-metastatic breast cancer in the Joint Breast Cancer Registry (JBCR) treated with (neo)adjuvant doxorubicin based therapy between August 2015 and December 2016, across 3 tertiary institutions in Singapore. We examined data collected prior to chemotherapy initiation regarding HBV status, including liver function (LFT), HBV surface antigen (HBsAg), antibody to HBV (Anti HBs), HBV core total antibody (Anti HBc) and HBV deoxyribonucleic levels (HBV DNA). We reviewed the course of HBV carriers (HBsAg positive) or prior HBV exposed patients (Anti HBc total positive and HBsAg negative) during chemotherapy for any HBV flare (abrupt rise of alanine aminotransferase levels to more than 5 times upper limit of normal in a carrier).
Results
492 early breast cancer patients were examined. 484 (98.3%) had HBsAg, 159 (32.3%) had Anti HBs and 16 (3.3%) had Anti HBc performed prior to starting chemotherapy. There were 12 HBV carriers and 4 with previous HBV exposure. Among the 12 HBV carriers, 4 were on antivirals prior to the diagnosis of breast cancer, and 8 were started on antivirals following diagnosis. 1 patient received doxorubicin prior to starting antivirals and developed HBV flare after the first cycle. The patient was started on entecavir, with improvement in HBV DNA levels and LFT, and chemotherapy was resumed. Remaining carriers did not develop flares. The patients with prior HBV exposure were monitored with serial LFT, and did not develop transaminitis.
Conclusions
Patients are almost universally screened for HBV with HBsAg prior to anthracyclines. Our data was consistent with local carriage rate. The incidence of flare is low with appropriate antiviral prophylaxis. HBsAg alone may be sufficient for screening.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
733 - Clinical experience: ramucirumab with FOLFIRI/XELIRI as a second line for patients with metastatic gastric cancer
Presenter: Tatiana Titova
Session: Poster Display session 2
Resources:
Abstract
2186 - Efficacy and safety of apatinib for the treatment of AFP-producing gastric cancer
Presenter: Ningning Li
Session: Poster Display session 2
Resources:
Abstract
3172 - Apatinib in combination with docetaxol and S1 chemotherapy in the first line treatment of metastatic gastric cancer
Presenter: Ling Xia
Session: Poster Display session 2
Resources:
Abstract
3982 - Parameters of local cellular immunity in metastatic gastric cancer
Presenter: Aleksandr Sagakyants
Session: Poster Display session 2
Resources:
Abstract
5102 - Germline pathogenic mutations in Chinese patients with gastric cancer identified by next-generation sequencing (NGS)
Presenter: Xiaotian Zhang
Session: Poster Display session 2
Resources:
Abstract
5012 - Inhibition of the PI3K pathway in HER2-positive gastric cancer
Presenter: Sinead Toomey
Session: Poster Display session 2
Resources:
Abstract
4803 - Investigation on gastric cancer susceptibility genes in Chinese early-onset diffuse gastric cancer
Presenter: Yi Feng
Session: Poster Display session 2
Resources:
Abstract
4778 - A correlation analysis between survival rate and the characteristic gene of gastric cancer based on bioinformatics analysis
Presenter: Yi-wen Zhang
Session: Poster Display session 2
Resources:
Abstract
4805 - Phase I study of apatinib combined with POF (paclitaxel plus FOLFOX) in patients (pts) with treatment-naïve advanced gastric cancer (TNAGC)
Presenter: Rongbo LIN
Session: Poster Display session 2
Resources:
Abstract
3248 - Second-line palliative systemic treatment for synchronous metastatic esophagogastric cancer: a population-based study
Presenter: Willemieke Dijksterhuis
Session: Poster Display session 2
Resources:
Abstract