Hepatitis drug can reduce risk of liver cancer return

PUBLISHED : Thursday, 16 August, 2012, 12:00am
UPDATED : Thursday, 16 August, 2012, 3:52am

Antiviral therapy used to combat hepatitis can reduce the risk of liver cancer recurring in patients who have had surgery.

Chinese University researchers, who made the discovery, expect the drug, which now costs HK$1,500 a month, to be covered by government subsidy soon.

The study found that the treatment can reduce the risk of recurrence by more than 40 per cent in patients whose cancer was caused by hepatitis B and who had undergone tumour removal surgery. The risk of death was reduced by more than two-thirds.

Professor Henry Chan Lik-yuen, director of the university's Centre for Liver Health, which conducted the study, estimates there are about 200 such patients a year in Hong Kong.

"Cancer relapse in these patients is a tragic event. You have had a big operation, you're told that you have a relapse, and you may not be able to repeat the surgery as your liver is too small to be cut again," Chan said. About 70 per cent of the patients have a relapse within five years of surgery.

A new guideline for hepatitis B treatment published by the Asian Pacific Association for the Study of the Liver in June, and based on the study, recommends the treatment in patients suitable for surgery and with viral levels in the body at middle to high levels.

The antiviral drug is currently used for liver cirrhosis and active hepatitis. There was no previous consensus on whether it would help hepatitis B-caused liver cancer patients.

The cancer patients are recommended to receive life-long treatment with the drug to prevent a relapse. Chan said he expected that government subsidies would soon extend to cover it because the number of patients requiring it is few and the impact is significant.

One of the most common hepatitis B antiviral drugs, Entecavir, which is listed as a "special drug" in the Hospital Authority's Drug Formulary, is used under specified clinical conditions and charged at a standard fee.

The university's study, conducted in 2010, analysed nine previous Asian studies from 2005 to 2010. The sample size of most individual studies was too small to give a firm conclusion, Chan said. But combined, with a total of 551 patients involved, researchers established that the antiviral treatment reduced the risk of recurrence by 41 per cent compared to untreated patients. It also found that the treatment reduces the risk of liver failure and death by 85 per cent and 70 per cent respectively.

According to the Hong Kong Cancer Registry, there were 1,832 new cases of liver cancer in Hong Kong in 2009, about 80 per cent caused by hepatitis B.