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
4331 - STING Agonist, ADU-S100, Yields Potent Antitumor Activity and Therapeutically Favorable Immune Profile in an Esophageal Adenocarcinoma Model
Presenter: Ali Zaidi
Session: Poster Display session 2
Resources:
Abstract
1770 - Increased assessment of HER2 in metastatic gastroesophageal cancer patients: a nationwide population-based cohort study
Presenter: Willemieke Dijksterhuis
Session: Poster Display session 2
Resources:
Abstract
3755 - A new docetaxel (DOC)-based triplet regimen does not improve the outcome of metastatic (M) or locally advanced (LA) gastric cancer (GC) as compared with an epirubicin (EPI) standard triplet regimen: a GISCAD trial.
Presenter: Roberto Labianca
Session: Poster Display session 2
Resources:
Abstract
2439 - The analysis of T cell subsets and clinical efficacy of immune checkpoint blockades in patients with advanced gastric cancer using multiplex immunohistochemistry
Presenter: Tae-yong Kim
Session: Poster Display session 2
Resources:
Abstract
2211 - First-line pembrolizumab (P), trastuzumab (T), capecitabine (C) and oxaliplatin (O) in HER2-positive metastatic esophagogastric adenocarcinoma.
Presenter: Yelena Janjigian
Session: Poster Display session 2
Resources:
Abstract
3046 - Monitoring patient-specific mutation in ctDNA and CTC for tumor response evaluation after neoadjuvant chemotherapy in locally advanced gastric cancer (NCT03425058)
Presenter: Tao Fu
Session: Poster Display session 2
Resources:
Abstract
4628 - Gastric cancer screening in BRCA 2 gene mutation carriers: should it be recommended?
Presenter: Inês Oliveira
Session: Poster Display session 2
Resources:
Abstract
2127 - Interim analysis of an observational/translational study for nivolumab treatment in advanced gastric cancer: JACCRO GC-08 (DELIVER trial)
Presenter: Yu Sunakawa
Session: Poster Display session 2
Resources:
Abstract
2264 - Prediction of S-1 adjuvant chemotherapy efficacy in Stage II/III gastric cancer treatment based on comprehensive gene expression analysis
Presenter: Masanori Terashima
Session: Poster Display session 2
Resources:
Abstract
2444 - Assessing the clinical utility of circulating tumour DNA through longitudinal liquid biopsy sampling in Oesophageal adenocarcinoma
Presenter: Emma Ococks
Session: Poster Display session 2
Resources:
Abstract