Non-Small Cell Lung Cancer Coverage from Every Angle

Risk of HBV Reactivation During Therapy for Non–Small Cell Lung Cancer

By: Lauren Harrison, MS
Posted: Wednesday, September 11, 2019

Patients with non–small cell lung cancer (NSCLC) who receive EGFR tyrosine kinase inhibitor therapy seem to have a clinically meaningful risk of hepatitis B virus (HBV) reactivation during treatment. Reactivation of HBV is defined as an increase in HBV DNA by at least 10-fold compared with baseline or an absolute increase to greater than 105 IU/mL with abnormal liver functioning. Zong-Han Yao, MD, of the National Taiwan University College of Medicine, and colleagues published their study findings in the European Journal of Cancer.

“In [a] high HBV prevalence area such as Taiwan, HBV screening before EGFR tyrosine kinase inhibitor treatment is recommended. For patients with known HBV infection, we suggest regular liver function tests monitoring (including aspartate aminotransferase/alanine aminotransferase) every 4 weeks,” proposed the authors.

To determine the risk of HBV reactivation, 171 patients with NSCLC and positive HBV surface antigen were enrolled in the study between 2011 and 2017. These patients were all treated with EGFR tyrosine kinase inhibitors for at least 2 weeks, and the median duration of treatment was 10.5 months.

A total of 16 patients (9.36%) met criteria for HBV reactivation during treatment. The annual incidence of reactivation was 7.86%, with no significant differences in age, gender, liver function, liver metastasis, prior therapy, or pathology. HBV reactivation occurred during treatment in six patients receiving erlotinib, five patients receiving gefitinib, three patients receiving osimertinib, and two patients receiving afatinib. Of note, there was no significant difference in overall survival between patients with and without reactivation of HBV, and there were no reported deaths caused by an HBV reactivation complication.

Disclosure: The study authors’ disclosure information may be found at

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