2227. Short-duration of Direct-acting Antivirals in Hepatitis C Virus Infected Cancer Patients
Session: Poster Abstract Session: Hepatitis A, B, and C
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • Short course of AVT-IDweek 2018.pdf (571.8 kB)
  • Background: Short-duration with an 8-week course of ledipasvir/sofosbuvir (LDV/SOF) or glecaprevir/pibrentasvir (GLE/PIB) is considered adequate to treat hepatitis C virus (HCV) infection in selected patients. However, immunocompromised patients with HCV/HIV are not eligible for this approach. Herein, we study the efficacy and safety of an 8-week therapy with direct-acting antivirals (DAAs) in HCV-infected cancer patients.

    Methods: HCV-infected patients with any type of cancer followed at MD Anderson Cancer Center (6/2014 - 4/2018) and treated with an 8-week course of LDV/SOF or GLE/PIB were enrolled in a prospective observational study. Efficacy was calculated based on achieving sustained virologic response at 12 weeks (SVR12) after end of treatment per intention to treat (ITT) analysis. A posthoc per-protocol (PP) analysis was done in patients with 12 weeks of follow-up post DAAs. Safety was assessed by emergence of adverse events (AEs) and clinically significant drug-drug interactions (DDIs).

    Results: Twenty-four patients were treated with a short-duration of DAAs, 22 with LDV/SOF and 2 with GLE/PIB. General characteristics are described in Table 1. Five patients received concomitant cancer treatment (nivolumab, sorafenib, lenalidomide, tamoxifen and leuprolide), without DDIs noted. Among the patients who have completed DAAs, SVR rates were 87% per ITT (20/23) and 100% PP (20/20) analyses. No patients had grade 2, 3 or 4 AEs.

    Conclusion: This is the first prospective study to evaluate the use of short-duration of DAAs in HCV-infected cancer patients where these regimens were found to be effective and safe.

    Table 1. General characteristics

    Characteristics

    Patients N (%)

    Number of patients

    24

    Age, median (Interquartile range)

    61 (57 - 66)

    Male sex

    18 (75)

    Black race

    9 (38)

    Obesity (Body Mass Index >30)

    10 (42)

    HCV genotype

    1a

    17 (71)

    1b

    5 (21)

    2

    2 (8)

    Type of cancer

    Hematologic a

    6 (25)

    Solid b

    18 (75)

    a Multiple myeloma (2), acute myeloid leukemia (2), non-Hodgkin lymphoma (2).

    b Prostate (3), head and neck (3), lung (3), renal (2), anal (2), ovarian (2), breast (1), thyroid (1), gastrointestinal stromal tumor (1).

    Jeff Hosry, M.D.1,2, Georgios Angelidakis, MD2, Bruno Granwehr, M.D.2 and Harrys Torres, M.D.2,3, (1)Infectious Diseases, The University of Texas Health Science at Houston, Houston, TX, (2)Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, (3)Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX

    Disclosures:

    J. Hosry, None

    G. Angelidakis, None

    B. Granwehr, None

    H. Torres, Gilead Sciences, Merck & Co., Inc.: Grant Investigator , Grant recipient . Vertex Pharmaceuticals: Grant Investigator , Grant recipient .

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.