Chemotherapy in patients with hepatobiliary cancers and abnormal hepatic function

Jun Gong, May Cho, Marwan Fakih

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

Sorafenib and cisplatin plus gemcitabine currently represent first-line treatment standards in advanced hepatocellular carcinoma and biliary cancer, respectively. Conventional cytotoxic agents (monotherapy or combination therapy) have demonstrated activity in the second-line setting or in those in which first-line agents are contraindicated. A strategy for safe yet effective administration of such systemic therapies in patients with advanced hepatobiliary cancer and abnormal liver function needs to be strongly considered. Here, we highlight the safety and tolerability of systemic therapies routinely used for the treatment of advanced hepatobiliary cancer in patients with hepatic dysfunction. Based on data from available clinical studies, we review dosing strategies recommended for chemotherapy and targeted therapy in those with liver dysfunction. Dose modifications for many agents in this population remain empiric due to limited clinical evidence. Future dedicated phase I studies are needed to provide further dosing considerations for combination therapy in those with abnormal liver function in which data is lacking.

Original languageEnglish (US)
Pages (from-to)314-323
Number of pages10
JournalJournal of Gastrointestinal Oncology
Volume8
Issue number2
DOIs
StatePublished - Apr 1 2017
Externally publishedYes

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Keywords

  • Abnormal liver function
  • Biliary cancer
  • Chemotherapy
  • Hepatocellular carcinoma

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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