Recent data suggest that hepatitis B virus (HBV) reactivation develops in 41% of breast cancer (BC) patients carrying HBV after chemotherapy.
Dr Chao and colleagues in Taipei, Taiwan undertook a study that aimed to determine the role of preemptive use of lamivudine in BC patients undergoing chemotherapy.
The researchers included a total of 11 female patients with BC who were seropositive for hepatitis B surface antigen (HBsAg) in the test group.
The research team treated 10 of these patients in an adjuvant setting and 1 for metastatic disease.
The researchers gave lamivudine from the start of chemotherapy and this was maintained until 1 month after the last infusion of chemotherapy.
|Serum ALT remained unchanged without rebound hepatitis after cessation of chemotherapy and withdrawal of lamivudine|
The control group consisted of 9 historical breast cancer patients carrying hepatitis B virus and the researchers gave them similar systemic chemotherapy without preemptive lamivudine.
The research team monitored variables including HBsAg, HBV envelope antigen, anti-HBV envelope antibody, serial serum alanine transaminase (ALT), quantitative HBV viral DNA analysis, and HBV-DNA precore promoter and precore sequence.
The researchers performed a test for the emergence of mutant strains, notably nucleotide 550, 6 months after the completion of chemotherapy.
The researchers found that all patients tolerated lamivudine well without development of evident HBV reactivation or overt hepatitis.
In addition, the team noted that serum ALT remained unchanged without rebound hepatitis after cessation of chemotherapy and withdrawal of lamivudine.
No emergence of lamivudine-selective resistant strain (so-called tyrosinemethionineaspartateaspartate mutations) was observed.
Dr Chao concluded, "Our results encourage preemptive use of lamivudine for prevention of HBV reactivation in patients who need short-term chemotherapy."