Prophylactic Effect of Lamivudine for Chemotherapy-Induced Hepatitis B Reactivation in Breast Cancer: A Meta-Analysis.
Three strategies using lamivudine have been proposed to prevent chemotherapy-induced HBV (hepatitis B virus) reactivation in the clinical setting. The purpose of this meta-analysis is to evaluate the efficacy of the early preemptive strategy, deferred preemptive strategy and therapeutic strategy in...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2015-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4461354?pdf=render |
| _version_ | 1818616132111695872 |
|---|---|
| author | Wei Tang Lun Chen Ruohui Zheng Lingxiao Pan Jin Gao Xigang Ye Xiaoshen Zhang Wenbo Zheng |
| author_facet | Wei Tang Lun Chen Ruohui Zheng Lingxiao Pan Jin Gao Xigang Ye Xiaoshen Zhang Wenbo Zheng |
| author_sort | Wei Tang |
| collection | DOAJ |
| description | Three strategies using lamivudine have been proposed to prevent chemotherapy-induced HBV (hepatitis B virus) reactivation in the clinical setting. The purpose of this meta-analysis is to evaluate the efficacy of the early preemptive strategy, deferred preemptive strategy and therapeutic strategy in patients with HBsAg-positive breast cancer during chemotherapy.Clinical studies published from database inception until Nov 1, 2014, were included for analysis. The primary outcomes were overall survival, rate of chemotherapy disruption and virological and clinical reactivation. The secondary outcomes were the rates of HBV-related chemotherapy disruption, HBV-related mortality, YMDD mutations and withdrawal hepatitis.Four hundred and thirty patients in four studies that compared the early preemptive strategy with a therapeutic strategy were included. Application of early preemptive lamivudine was superior in reducing HBV recurrence (pooled OR: 0.12, 95% CI, 0.04 to 0.31, P< 0.0001), the incidence of HBV-related hepatitis (pooled OR: 0.13, 95% CI, 0.04 to 0.37, P< 0.0001) and the rate of chemotherapy disruption (pooled OR: 0.37, 95% CI, 0.23 to 0.60, P< 0.0001). In these two groups, no significant difference was found in overall mortality (P = 0.32), YMDD mutant rate (P = 0.13) or incidence of withdrawal hepatitis (P = 0.38). Of the two studies that compared the efficacy of an early and a deferred preemptive strategy, one showed that an early preemptive strategy significantly reduced the incidence of hepatitis (P = 0.046), whereas the other showed no significant difference (P = 0.7).An early preemptive strategy is superior to a therapeutic strategy in decreasing the incidence of HBV reactivation, incidence of HBV-related hepatitis and rate of chemotherapy disruption in patients with breast cancer. A deferred preemptive strategy might be an alternative approach to controlling viral replication. |
| first_indexed | 2024-12-16T16:44:56Z |
| format | Article |
| id | doaj.art-2cb0431ee43146758fb671d466bc2995 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-16T16:44:56Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-2cb0431ee43146758fb671d466bc29952022-12-21T22:24:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01106e012867310.1371/journal.pone.0128673Prophylactic Effect of Lamivudine for Chemotherapy-Induced Hepatitis B Reactivation in Breast Cancer: A Meta-Analysis.Wei TangLun ChenRuohui ZhengLingxiao PanJin GaoXigang YeXiaoshen ZhangWenbo ZhengThree strategies using lamivudine have been proposed to prevent chemotherapy-induced HBV (hepatitis B virus) reactivation in the clinical setting. The purpose of this meta-analysis is to evaluate the efficacy of the early preemptive strategy, deferred preemptive strategy and therapeutic strategy in patients with HBsAg-positive breast cancer during chemotherapy.Clinical studies published from database inception until Nov 1, 2014, were included for analysis. The primary outcomes were overall survival, rate of chemotherapy disruption and virological and clinical reactivation. The secondary outcomes were the rates of HBV-related chemotherapy disruption, HBV-related mortality, YMDD mutations and withdrawal hepatitis.Four hundred and thirty patients in four studies that compared the early preemptive strategy with a therapeutic strategy were included. Application of early preemptive lamivudine was superior in reducing HBV recurrence (pooled OR: 0.12, 95% CI, 0.04 to 0.31, P< 0.0001), the incidence of HBV-related hepatitis (pooled OR: 0.13, 95% CI, 0.04 to 0.37, P< 0.0001) and the rate of chemotherapy disruption (pooled OR: 0.37, 95% CI, 0.23 to 0.60, P< 0.0001). In these two groups, no significant difference was found in overall mortality (P = 0.32), YMDD mutant rate (P = 0.13) or incidence of withdrawal hepatitis (P = 0.38). Of the two studies that compared the efficacy of an early and a deferred preemptive strategy, one showed that an early preemptive strategy significantly reduced the incidence of hepatitis (P = 0.046), whereas the other showed no significant difference (P = 0.7).An early preemptive strategy is superior to a therapeutic strategy in decreasing the incidence of HBV reactivation, incidence of HBV-related hepatitis and rate of chemotherapy disruption in patients with breast cancer. A deferred preemptive strategy might be an alternative approach to controlling viral replication.http://europepmc.org/articles/PMC4461354?pdf=render |
| spellingShingle | Wei Tang Lun Chen Ruohui Zheng Lingxiao Pan Jin Gao Xigang Ye Xiaoshen Zhang Wenbo Zheng Prophylactic Effect of Lamivudine for Chemotherapy-Induced Hepatitis B Reactivation in Breast Cancer: A Meta-Analysis. PLoS ONE |
| title | Prophylactic Effect of Lamivudine for Chemotherapy-Induced Hepatitis B Reactivation in Breast Cancer: A Meta-Analysis. |
| title_full | Prophylactic Effect of Lamivudine for Chemotherapy-Induced Hepatitis B Reactivation in Breast Cancer: A Meta-Analysis. |
| title_fullStr | Prophylactic Effect of Lamivudine for Chemotherapy-Induced Hepatitis B Reactivation in Breast Cancer: A Meta-Analysis. |
| title_full_unstemmed | Prophylactic Effect of Lamivudine for Chemotherapy-Induced Hepatitis B Reactivation in Breast Cancer: A Meta-Analysis. |
| title_short | Prophylactic Effect of Lamivudine for Chemotherapy-Induced Hepatitis B Reactivation in Breast Cancer: A Meta-Analysis. |
| title_sort | prophylactic effect of lamivudine for chemotherapy induced hepatitis b reactivation in breast cancer a meta analysis |
| url | http://europepmc.org/articles/PMC4461354?pdf=render |
| work_keys_str_mv | AT weitang prophylacticeffectoflamivudineforchemotherapyinducedhepatitisbreactivationinbreastcancerametaanalysis AT lunchen prophylacticeffectoflamivudineforchemotherapyinducedhepatitisbreactivationinbreastcancerametaanalysis AT ruohuizheng prophylacticeffectoflamivudineforchemotherapyinducedhepatitisbreactivationinbreastcancerametaanalysis AT lingxiaopan prophylacticeffectoflamivudineforchemotherapyinducedhepatitisbreactivationinbreastcancerametaanalysis AT jingao prophylacticeffectoflamivudineforchemotherapyinducedhepatitisbreactivationinbreastcancerametaanalysis AT xigangye prophylacticeffectoflamivudineforchemotherapyinducedhepatitisbreactivationinbreastcancerametaanalysis AT xiaoshenzhang prophylacticeffectoflamivudineforchemotherapyinducedhepatitisbreactivationinbreastcancerametaanalysis AT wenbozheng prophylacticeffectoflamivudineforchemotherapyinducedhepatitisbreactivationinbreastcancerametaanalysis |