Direct-acting antivirals as primary treatment for HCV-associated indolent non-Hodgkin lymphomas

Retrospective observations have shown evidence for an etiologic role of hepatitis C virus (HCV) in indolent non-Hodgkin lymphomas. The phase 2 BArT study of the Fondazione Italiana Linfomi is the first prospective study to evaluate genome-appropriate direct-acting antivirals (DAAs) in untreated HCV-positive patients with indolent lymphomas without criteria for immediate conventional antilymphoma treatment. HCV eradication was achieved in all patients, and lymphoma response in 45%. Responses were durable. Three-years OS rate was 93% and three years PFS rate was 76%. The authors conclude that treatment with DAAs should be considered as first-line therapy in this setting.