Breast Cancer Patients with HCV Can Be Treated with Cytotoxic Therapy

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By Laura Dean

MedWire News: Patients with breast cancer and chronic hepatitis C virus (HCV) infection can be treated effectively with cytotoxic chemotherapy, US researchers have found.

“Although HCV is the most common blood-borne infection in the United States, little information exists about treatment of breast cancer in the setting of chronic HCV,” note Phuong Khanh Morrow and colleagues from the University of Texas MD Anderson Cancer Center in Houston.

To gain further insight, Morrow and colleagues retrospectively reviewed data for 45 patients (98% women) with invasive breast cancer and HCV who were treated at the MD. Anderson Cancer Center between 2000 and 2008.

In all, 36 (80%) patients received chemotherapy for their breast cancer. The remaining nine patients received either endocrine therapy alone (n=7), or no systemic therapy at all (n=2).

During chemotherapy, nine (25%) patients experienced elevations in aminotransferases and 16 (44%) patients required dose reductions, or had delays in chemotherapy.

“In almost all cases, dose reductions or delays were necessitated by complications of therapy, rather than due to elevations of transaminases,” say Morrow et al.

“However, it is possible that elevations in baseline transaminases could have contributed to the side effects observed, as liver function is a determinant of the metabolism of several of the chemotherapeutic agents utilized,” they add.

There was a high rate (63.9%) of complications that were grade 2 or greater, based on the National Cancer Institute Common Terminology Criteria for Adverse Events. The most common complications were neutropenic fever or infection, non-neutropenic infection, and neuropathy.

In spite of this, the vast majority (92%) of patients were able to complete the number of cycles specified in the initial chemotherapy plan.

“As the majority of these breast cancer patients completed the initial chemotherapy plan, this study indicates that breast cancer patients with HCV can be treated with cytotoxic therapy,” conclude Morrow and co-authors in the Annals of Oncology.

“Comparison with historical controls showed similar rates of hepatic toxicity in the presence (or absence) of HCV, indicating that incidence of transaminitis may not be significantly affected by HCV,” they add.

Ann Oncol 2010; 21: 1233–1236

http://www.hcvadvocate.org/news/newsRev/2010/NewsRev-365.html#_Breast_Cancer_Patients