Sofosbuvir-Based Therapy Safe in Patients With HCV and Certain Cancers

Existing data are limited on the treatment of chronic hepatitis C virus (HCV) in patients with cancer. In a study recently published in Nature, researchers sought to evaluate the safety and efficacy of sofosbuvir (Sovaldi)-based therapy in this patient population.

The authors enrolled 153 patients in the prospective observational study, of which 12 were later excluded due to discontinuation of HCV therapy. The most common cancers seen in the study were hepatocellular carcinoma (27; 18%), multiple myeloma (14; 9%), and diffuse large B-cell lymphoma (7%).

The overall rate of sustained virologic response at 12 weeks (SVR12) after the end of treatment was 91% (128/141). Of the 110 patients enrolled with genotype 1, the overall SVR12 rate was also 91%. Additionally, 17 patients with genotype 1 who received sofosbuvir/ledipasvir for 8 weeks were able to achieve sustained virologic response (SVR). For the12 patients with genotype 3, the SVR12 rate was 67%.

The trial had also enrolled 27/32 patients who were previously excluded from early-phase cancer clinical trials due to HCV at the time of enrollment. These patients were granted access to investigational cancer treatments after starting direct acting antiviral therapy, 19 of whom did not have an HCV-related malignancy.

In total, 6 patients with indolent non-Hodgkin lymphoma received sofosbuvir-based treatment without cancer treatment. Of these, 2 achieved complete remission, 1 achieved partial remission, and 2 had stable cancer.

“No recommendations are yet available for HCV-infected patients with cancer. Our results show that sofosbuvir-based therapy is safe and effective in HCV-infected patients with various malignancies and it may be administered for [a] short duration,” wrote the study authors.

Researchers also found that the adverse events (AEs) were similar in type and prevalence to the general population. All 7 patients that experienced a serious AE also achieved SVR and had no cancer progression or relapse at 6 months post therapy.

“We also found that sofosbuvir-based therapy was generally safe and well tolerated, opening access to investigational cancer treatment for many patients and improving oncologic outcomes of patients…” concluded the authors.

Reference

Torres H, Economides M, Angelidakis G, et al. Sofosbuvir-based therapy in hepatitis C virus-infected cancer patients: a prospective observational study [published online November 8, 2018]. Nature. doi: 10.1038/s41395-018-0383-2.