NAs and HCC after Curative Treatment

[The_PS]

Nucleot(s)ide Analogues for Hepatitis B Virus-Related Hepatocellular Carcinoma after Curative Treatment: A Systematic Review and Meta-Analysis
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Sun P1, Dong X2, Cheng X1, Hu Q1, Zheng Q1.
Author information

Abstract

AIM:
The benefit of nucleot(s)ide analogues (NA) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative treatment has been widely debated due to the relatively weak evidence. The objective of this systematic review was to evaluate the effect of NA on recurrence and survival after curative treatment of HBV-HCC.

METHODS:
A systematic electronic search was performed. All controlled trials comparing NA versus placebo or no treatment were considered for inclusion. Results were expressed as Hazard Ratio for recurrence and survival with 95% confidence intervals using RevMan 5.2.

RESULTS:
We included 13 trials with 6350 patients. There were significant improvements for recurrence-free survival (HR 0.66, 95% CI 0.54-0.80; p<0.0001) and overall survival (HR 0.56, 95% CI 0.43-0.73; p<0.0001) in the adjuvant NA group compared with the control group. Sensitivity analyses confirmed the robustness of the results. There were no serious adverse effects being reported. Lamivudine resistance was from 28.6% to 37.5% but could be rescued by other types of NA or combination therapy.

CONCLUSION:
Our study suggested benefits of adjuvant NA therapy following curative treatment of HBV-HCC. Since the great proven efficacy of NA in improving clinical and viral parameters besides HCC, further studies should be focused on broadening the indications for NA therapy after curative treatment of HBV-HCC.

[veteranB]

What I dont get about these studies is this. NUCS  themselves are carcinogenic. So what is the benefit of long term using them to prevent liver cancer?

Seems to me these drug companies desperately try to hold on to this nucs hbv market. When in fact there are better treatment strategies and drugs can be  used.

[veteranB]

They should instead focus on stem cell liver tissue repair. This is another way flush out hbv if one on treatment.

That is why it is disturbing to know that there are so many treatment strategies out there and so old fashioned so called  standard treatment care is being used.