Front Med: Low incidence of viral hepatitis reactivation reduces impact of suboptimal screening rates in subjects receiving immunotherapy

Background: Immune checkpoint inhibitors (ICIs) have been a breakthrough in the treatment of many advanced cancer.

OBJECTIVE: The purpose of this study was to analyze hepatitis B and C detection rates prior to initiation of ICIs as a way to assess oncologists' awareness of viral hepatitis in the immunotherapy populatio.

Methods: Retrospective-prospective study including all patients who started ICIs at university hospitals from January 2019 to December 2020. Viral hepatitis screening data were collected prior to the initiation of ICI.

RESULTS: During the 2-year study period, 595 subjects received ICIs (62% men, mean age 63 years.

Figure 1 | Summary of potential cancers for immune checkpoint inhibitor therapy (A) and immune checkpoint inhibitor regimens prescribed for enrolled patients (B.

Figure 2 | (A) Rates of viral hepatitis markers ordered prior to ICIs initiation (dark grey) and results of these tests (light grey.

Figure 3 | Rates of required viral hepatitis testing prior to initiation of ICIs by prescription of concomitant medications (all combination therapies); concomitant chemotherapy; concomitant systemic therapy distinct from chemotherapy, primarily tyrosine kinase inhibitors, IL-2 Agonists, inducible co-stimulators-ICOS and anti-VEGF drugs, as summarized in Supplementary Table 1: (HCV screeningbefore ICI.

Conclusion: Screening for HBV and HCV before immunotherapy is not idea.

Original source: Aceituno L, Bañares J, Ruiz-Ortega L, et a.