Publication
Treatment approach in patients with hyperbilirubinemia secondary to liver metastases in gastrointestinal malignancies: a case series and review of literature
| dc.contributor.author | Quidde, J | |
| dc.contributor.author | Azémar, M | |
| dc.contributor.author | Bokemeyer, C | |
| dc.contributor.author | Arnold, D | |
| dc.contributor.author | Stein, A | |
| dc.date.accessioned | 2016-06-26T17:39:55Z | |
| dc.date.available | 2016-06-26T17:39:55Z | |
| dc.date.issued | 2016-05 | |
| dc.description.abstract | BACKGROUND: Treatment of patients with severe liver dysfunction including hyperbilirubinemia secondary to liver metastases of gastrointestinal (GI) cancer is challenging. Regimen of oxaliplatin and fluoropyrimidine (FP)/folinic acid (FA) ± a monoclonal antibody (moAb), represents a feasible option considering the pharmacokinetics. Clinical data on the respective dosage and tolerability are limited and no recommendations are available. METHODS: Consecutive patients with severe hyperbilirubinemia [>2 × upper limit of the normal range (ULN) and >2.4 mg/dl] due to liver metastases of GI cancer without options for drainage receiving oxaliplatin, FP/FA ± moAb were analyzed. To collect further data a review of the literature was performed. RESULTS: A total of 12 patients were identified between 2011 and 2015. At treatment start, median bilirubin level was 6.1 mg/dl (>5 × ULN, range 2.7-13.6). The majority of patients (n = 11) received dose-reduced regimen with oxaliplatin (60-76%) and FP/FA (0-77%), rapidly escalating to full dose regimen. During treatment, bilirubin levels dropped more than 50% within 8 weeks or normalized within 12 weeks in 6 patients (responders). Median overall survival was 5.75 months (range 1.0-16.0 months) but was significantly prolonged in responders compared to nonresponders [9.7 and 3.0 months, p = 0.026 (two-sided test); 95% confidence interval (CI): 1.10-10.22]. In addition, case reports or series comprising a further 26 patients could be identified. Based on the obtained data a treatment algorithm was developed. CONCLUSION: Treatment with oxaliplatin, FP/FA ± moAb is feasible and may derive relevant benefits in patients with severe liver dysfunction caused by GI cancer liver metastases without further options of drainage. | pt_PT |
| dc.identifier.citation | Ther Adv Med Oncol. 2016 May;8(3):144-52 | pt_PT |
| dc.identifier.doi | 10.1177/1758834016637585 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.26/14198 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.subject | Neoplasias Gastrointestinais | pt_PT |
| dc.subject | Hiperbilirrubinemia | pt_PT |
| dc.subject | Neoplasias Hepáticas/secundária | pt_PT |
| dc.subject | Gastrointestinal Neoplasms | pt_PT |
| dc.subject | Hyperbilirubinemia | pt_PT |
| dc.subject | Liver Neoplasms/secondary | pt_PT |
| dc.title | Treatment approach in patients with hyperbilirubinemia secondary to liver metastases in gastrointestinal malignancies: a case series and review of literature | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 152 | pt_PT |
| oaire.citation.issue | 3 | pt_PT |
| oaire.citation.startPage | 144-52 | pt_PT |
| oaire.citation.title | Therapeutic advances in medical oncology | pt_PT |
| oaire.citation.volume | 8 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |
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