Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster Display session 2

2277 - Hepatitis B screening and incidence of flare among non-metastatic breast cancer patients treated with anthracyclines

Date

29 Sep 2019

Session

Poster Display session 2

Topics

Tumour Site

Breast Cancer

Presenters

Zewen Zhang

Citation

Annals of Oncology (2019) 30 (suppl_5): v55-v98. 10.1093/annonc/mdz240

Authors

Z. Zhang1, W. Lian1, E. Lim1, R. Kumar2, F.Y. Wong3, T. Tang1, R. Dent4, T. Tan1

Author affiliations

  • 1 Medical Oncology, NCCS - National Cancer Centre Singapore, 169610 - Singapore/SG
  • 2 Gastroenterology, Singapore General Hospital, 169608 - Singapore/SG
  • 3 Radiation Oncology, NCCS - National Cancer Centre Singapore, 169610 - Singapore/SG
  • 4 Medical Oncology, National Cancer Centre Singapore, 169610 - Singapore/SG

Resources

Login to get immediate access to this content.

If you do not have an ESMO account, please create one for free.

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.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.