To address the low rates of hepatitis B virus (HBV) screening among cancer patients initiating anti-CD20 therapy or hematopoietic cell transplantation, the American Society of Clinical Oncology (ASCO) is updating a clinical opinion to incorporate a risk-adaptive strategy to better identify patients with HBV infection and reduce the risk of HBV reactivation. The provisional clinical opinion, published online May 11 in the Journal of Clinical Oncology, advises that screening tests for HBV should be performed on patients before starting anti-CD20 monoclonal antibodies and hematopoietic cell transplants. However, patients who have risk factors for HBV infection should also be screened before initiating systemic cancer therapy. The ASCO panel found that since the 2010 release of national recommendations, HBV screening remains “suboptimal” among patients at high risk for HBV infection or HBV reactivation after cytotoxic or immunosuppressive therapy. Additionally, despite the U.S. Food and Drug Administration’s 2013 box warning about the risk of HBV reactivation with monoclonal antibody products, “a small but substantial group” of patients with cancer receiving the therapy remain unscreened for HBV infection. While screening strategies vary by cancer center (with some employing risk-based screening and others adopting universal screening before cancer therapy), the panel concluded that they could […]