Departments of Infectious Diseases, Infection Control and Employee Health, USA.
Departments of Infectious Diseases, Infection Control and Employee Health, USA; Departments of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Clin Microbiol Infect. 2022 Oct;28(10):1321-1327. doi: 10.1016/j.cmi.2022.02.042. Epub 2022 Mar 10.
Cancer patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are at high risk of viral reactivation after cancer treatment. However, there is a paucity of data regarding HBV or HCV reactivation in cancer patients who receive newer anticancer drugs such as immune checkpoint inhibitors; Bruton tyrosine kinase (BTK) inhibitors; agents targeting CD22, CD38, and CC chemokine receptor 4 (CCR4); and chimeric antigen receptor (CAR) T-cell therapies.
In this narrative review article, we describe the rate, characteristics, and outcomes of HBV and HCV reactivation in patients receiving novel systemic anticancer therapies.
We searched MEDLINE for all original research articles, case reports, and systematic reviews published in English between July 2013 and December 2021 on cancer patients with HBV or HCV infection receiving novel systemic anticancer therapy.
The risk of HBV or HCV reactivation is not well defined in cancer patients receiving immune checkpoint inhibitors (durvalumab, atezolizumab, nivolumab, pembrolizumab, ipilimumab, and tremelimumab); BTK inhibitors (ibrutinib and acalabrutinib); agents targeting CD22 (inotuzumab ozogamicin), CD38 (daratumumab, isatuximab), and CCR4 (mogamulizumab); and CAR T-cell therapy (axicabtagene-ciloleucel). However, screening for chronic HBV and HCV infections and routine monitoring of patients with such infections during novel anticancer therapy are recommended for early identification of viral reactivation, which can impact outcomes of oncologic treatment or be fatal.
Specific strategies for risk assessment, monitoring, and management should be designed to reduce the risk of reactivation after novel anticancer therapy in patients with chronic HBV or HCV infections.
患有乙型肝炎病毒 (HBV) 和丙型肝炎病毒 (HCV) 感染的癌症患者在癌症治疗后存在病毒再激活的高风险。然而，关于接受新型抗癌药物（如免疫检查点抑制剂；布鲁顿酪氨酸激酶 (BTK) 抑制剂；靶向 CD22、CD38 和 CC 趋化因子受体 4 (CCR4) 的药物；以及嵌合抗原受体 (CAR) T 细胞疗法）的癌症患者中 HBV 或 HCV 再激活的数据很少。
在这篇叙述性综述文章中，我们描述了接受新型全身抗癌治疗的患者中 HBV 和 HCV 再激活的发生率、特征和结局。
我们在 MEDLINE 上搜索了 2013 年 7 月至 2021 年 12 月期间发表的所有关于 HBV 或 HCV 感染的癌症患者接受新型全身抗癌治疗的原始研究文章、病例报告和系统评价。
在接受免疫检查点抑制剂（度伐鲁单抗、阿替利珠单抗、纳武利尤单抗、帕博利珠单抗、伊匹单抗和替西木单抗）；BTK 抑制剂（依鲁替尼和阿卡替尼）；靶向 CD22（伊妥珠单抗奥佐米星）、CD38（达雷妥尤单抗、伊沙妥昔单抗）和 CCR4（莫格利珠单抗）；以及 CAR T 细胞疗法（阿基仑赛）的癌症患者中，HBV 或 HCV 再激活的风险尚未得到很好的定义。然而，建议对患有此类感染的癌症患者进行慢性 HBV 和 HCV 感染的筛查，并在新型抗癌治疗期间对其进行常规监测，以便早期发现病毒再激活，这可能会影响肿瘤治疗的结果或导致致命后果。
应设计特定的风险评估、监测和管理策略，以降低慢性 HBV 或 HCV 感染患者接受新型抗癌治疗后再激活的风险。
