Prognosis for patients with HBV-related HCC better after tenofovir vs entecavir treatment

Patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) appear to fare better with tenofovir than with entecavir, with a recent study showing that prognosis is better for those who have been treated with tenofovir.

The study included CHB patients who received a diagnosis of HCC and were treated with either entecavir (n=3,469) or tenofovir (n=3,056) at a tertiary centre in Korea. Researchers performed multivariable-adjusted Cox regression and propensity score (PS)-matched analyses to compare the effect of tenofovir vs entecavir on the prognosis of HBV-related HCC. Various predefined subgroup analyses were also conducted.

Results showed that over a median follow-up period of 3.0 years, the mortality rate was lower among tenofovir-treated patients than among those who received entecavir (34.6 percent vs 41.2 percent). Compared with entecavir, tenofovir was associated with significantly better overall survival (OS) (adjusted hazard ratio [aHR], 0.79; p<0.001). This held true in the PS-matched analysis.

The OS benefit with tenofovir was substantially greater for patients with longer HCC history (treatment initiated 2 years after diagnosis: aHR, 0.50; p<0.001; treatment initiated within 2 years of diagnosis: aHR, 0.88; p=0.005) and more pronounced in patients with earlier HCC stages.

Subgroup analyses yielded consistent results, with tenofovir associated with better OS compared with entecavir, except in the subgroup of patients with shorter life expectancy, such as those with compromised liver function.