Antineoplastics
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Reactions 1491, p8 - 8 Mar 2014 S Antineoplastics Reactivation of hepatitis B virus in an elderly patient: case report A 74-year-old man experienced reactivation of hepatitis B virus while receiving antineoplastics for metastatic rectal cancer. The man, who had a prior hepatitis B virus infection, was diagnosed with rectal cancer with liver and lung metastases. He was given one cycle of mFOLFOX6 therapy, comprising oxaliplatin, calcium levofolinate and fluorouracil, followed by eight cycles of bevacizumab 5mg/kg plus mFOLFOX6. He was then given four cycles of bevacizumab plus sLV5FU2, comprising calcium levofolinate 200 mg/m 2 /2h, and fluorouracil 400 mg/m 2 bolus 2400 mg/m 2 /46h [routes not stated]. A complete response was attained, and an abdominoperineal resection of the primary tumour was conducted. Following surgery, a recurrence of liver metastases and an exacerbation of the lung metastases occurred. He was therefore administered bevacizumab 10mg/kg plus FOLFIRI, comprising irinotecan 150 mg/m 2 /1.5h, calcium levofolinate 200 mg/m 2 /2h, fluorouracil 400 mg/m 2 bolus, 2400 mg/m 2 /46h; he received 21 cycles. Chemotherapy was then stopped due to significant elevations in liver enzymes, and he was hospitalised. Tests clearly showed a reactivation of hepatitis B virus. The man was started on entecavir, and eventually underwent plasmapharesis. However, he subsequently died due to liver failure. Author comment: "In conclusion, our case has shown that [hepatitis B virus] reactivates during bevacizumab + FOLFIRI therapy even in patients with solid tumours and a prior [hepatitis B virus] infection." Noguchi Y, et al. A case of hepatitis B virus reactivation in a patient with prior resolved hepatitis B infection during bevacizumab plus FOLFIRI treatment. Gan to Kagaku Ryoho 40: 1561-1563, No. 11, Nov 2013 [Japanese; summarised from an English translation]. - Japan 803100032 1 Reactions 8 Mar 2014 No. 1491 0114-9954/14/1491-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1491, p8 - 8 Mar 2014
SAntineoplastics
Reactivation of hepatitis B virus in an elderlypatient: case report
A 74-year-old man experienced reactivation of hepatitis Bvirus while receiving antineoplastics for metastatic rectalcancer.
The man, who had a prior hepatitis B virus infection, wasdiagnosed with rectal cancer with liver and lung metastases.He was given one cycle of mFOLFOX6 therapy, comprisingoxaliplatin, calcium levofolinate and fluorouracil, followed byeight cycles of bevacizumab 5mg/kg plus mFOLFOX6. He wasthen given four cycles of bevacizumab plus sLV5FU2,comprising calcium levofolinate 200 mg/m2/2h, andfluorouracil 400 mg/m2 bolus 2400 mg/m2/46h [routes notstated]. A complete response was attained, and anabdominoperineal resection of the primary tumour wasconducted. Following surgery, a recurrence of liver metastasesand an exacerbation of the lung metastases occurred. He wastherefore administered bevacizumab 10mg/kg plus FOLFIRI,comprising irinotecan 150 mg/m2/1.5h, calcium levofolinate200 mg/m2/2h, fluorouracil 400 mg/m2 bolus,2400 mg/m2/46h; he received 21 cycles. Chemotherapy wasthen stopped due to significant elevations in liver enzymes,and he was hospitalised. Tests clearly showed a reactivation ofhepatitis B virus.
The man was started on entecavir, and eventuallyunderwent plasmapharesis. However, he subsequently dieddue to liver failure.
Author comment: "In conclusion, our case has shown that[hepatitis B virus] reactivates during bevacizumab + FOLFIRItherapy even in patients with solid tumours and a prior[hepatitis B virus] infection."Noguchi Y, et al. A case of hepatitis B virus reactivation in a patient with priorresolved hepatitis B infection during bevacizumab plus FOLFIRI treatment. Gan toKagaku Ryoho 40: 1561-1563, No. 11, Nov 2013 [Japanese; summarised from anEnglish translation]. - Japan 803100032
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Reactions 8 Mar 2014 No. 14910114-9954/14/1491-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved
