Reactivation of Hepatitis B after Irinotecan
LCY Lui,1 RTT Chan,1 CCH Kwok,1 WM Wong,2 CC Yau,1 GKH Au,1 CL Lai2
1Department of Clinical Oncology and 2Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
Objective: To analyse the incidence of hepatitis B reactivation following treatment with irinotecan-based combined chemotherapy and the outcomes of patients with hepatitis B reactivation.
Patients and Methods: A prospective phase II study investigating the response to irinotecan, leucovorin, and 5-fluorouracil in 34 patients with stage IV colorectal cancers. All patients had hepatitis B virus status checked at baseline.
Results: Three patients were identified to be hepatitis B virus carriers. Two of the patients had hepatitis B reactivation after chemotherapy commenced, while the third patient, who was given lamivudine before commencement of chemotherapy, did not have any adverse hepatic event.
Conclusions: In view of the increasing use of irinotecan as palliative treatment for advanced colorectal cancer, further studies on the probable causal relationship between irinotecan and reactivation of hepatitis B infection are recommended. The prophylactic use of lamivudine in patients at risk might be beneficial.
Key Words: Chemotherapy, Hepatitis
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