Safe use of capecitabine-cisplatin in metastatic gastric carcinoma with severe liver dysfunction

A case report from Algeria

Authors

  • Lasgaa Meryem MD. Medical Oncology Specialist, Medical Oncology Departement of Public Hospital of Ghazaouet, Tlemcen, Algeria , Laboratory Toxicomed, University Abou Beker Belkaid, Tlemcen, Algeria

Keywords:

Gastric cancer, Liver dysfunction, Capecitabine, Cisplatin

Abstract

health problem worldwide. The liver is the most frequent site of metastases. Advanced cancer in the setting of liver dysfunction poses a dilemma for physicians, as many cancer chemotherapeutic agents undergo hepatic metabolism. This paper reports the case of a patient with liver failure due to liver metastases of gastric cancer. The initial liver function tests showed an elevation of transaminases (aspartate amino transferase 180 IU/l, alanine aminotransferase 110 UI/l), hyperbilirubinemia (total bilirubin at 24 mg/dl), alkaline phosphatase at 1127 UI/l and elevation of tumor markers (carcinoembryonic antigen >1000 ng/ml and CA19,9 at 180 UI/l). We initiated capecitabine/cisplatin based combination chemotherapy. Our data supports the safety and feasibility of cisplatin-capecitabine regimen in patients with severe liver dysfunction secondary to liver metastases of gastric cancer.

References

WHO; International Agency for Research on Cancer. globocan 2012: Estimated Cancer Incidence,

Mortality and Prevalence Worldwide in 2012. Available from: http://globocan.iarc.fr/Default.aspx.

Sasson AR, Sigurdson ER. Surgical treatment of liver metastases. Semin Oncol. 2002; 29(2): 107‑18. doi:

1053/sonc.2002.31676. PMID: 11951208.

Pyrhonen S, Kuitunen T, Nyandoto P, Kouri M. Randomized comparison of fluorouracil, epidoxorubicin

and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable

gastric cancer. Br J Cancer. 1995; 71(3): 587-91. doi: 10.1038/bjc.1995.114. PMID: 7533517, PMCID:

PMC2033628.

Glimelius B, Ekstrom K, Hoffman K, Graf W, Sjoden PO, Haglund U, et al. Randomized comparison

between chemotherapy plus best supportive care with best supportive care in advancer gastric cancer. Ann

Oncol. 1997; 8(2): 163-8. doi: 10.1023/A:1008243606668. PMID: 9093725.

Fleming GF, Schilsky RL, Schumm LP, Meyerson A, Hong AM, Vogelzang NJ, et al. Phase I and

pharmacokinetic study of 24-hour infusion 5FU and leucovorin in patients with organ dysfunction. Ann

oncol. 2003; 14(7): 1142-7. PMID: 12853359.

Twelves C, Glynne-jonesR ,Cassidyj , SchullerJ ,Goggin T , Roos B , Banken L, Utoh M, Wridekamm E ,

Reigner B :Effect of hepatic dysfunction due to liver metastases on the pharmacokinetics of capecitabine

and its metabolites. Clin cancer Res 1999 Jul;5(7):1696-702.

Sharma RA, Decatris MP, Santhanam S, Roy R, Osman AE, Clarke CB, et al. Reversibility of liver failure

secondary to metastatic breast cancer by vinorelbine and cisplatin chemotherapy. Cancer Chemother

Pharmacol. 2003; 52(5): 367-70. doi: 10.1007/s00280-003-0679-8. PMID: 12879281.

Doroshow JH, Synold TW, Gandara D, Mani S, Remick SC, Mulkerin D, et al. Pharmacology of

oxaliplatin in solid tumor patients with hepatic dysfunction: a preliminary report of the National Cancer

Institute Organ Dysfunction Working Group. Semin Oncol. 2003; 30(4 Suppl 15): 14-9. PMID: 14523790.

Hwang SJ, Park JW, Lee SD, Kim GJ, Sin CH, Nam SH, et al. Capecitabine and Oxaliplatin (XELOX) for

the Treatment of Patients with Metastatic Gastric Cancer and Severe Liver Dysfunction. Korean J Intern

Med. 2006; 21(4): 252–5. doi: 10.3904/kjim.2006.21.4.252. PMID: 17249509, PMCID: PMC3891032.

UCLH. Dosage Adjustment for Cytotoxics in Hepatic Impairment. 2009.

Quidde J, Azémar M, Bokemeyer C, Arnold D, Stein A. Treatment approach in patients with

hyperbilirubinemia secondary to liver metastases in gastrointestinal malignancies: a case series and review

of literature. Ther Adv Med Oncol. 2016; 8(3): 144–52. doi: 10.1177/1758834016637585. PMID:

, PMCID: PMC4872252.

Published

2022-01-18

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Section

Articles