Cisplatin as Single-Agent Chemotherapy in Patients with Liver Dysfunction Due to Metastases

Abstract

Background: Chemotherapeutic options are often limited for patients with hepatic dysfunction induced by advanced metastases. The toxicity and efficacy of cytotoxic drugs are often unpredictable due to altered drug activation or inactivation and excretion. Therefore, numerous chemotherapeutic agents should not be administered to patients with liver failure. Patients and Methods: We retrospectively analysed 14 patients with solid tumours presenting with liver dysfunction induced by metastasis who were treated with cisplatin single-agent chemotherapy. Results: Tolerance of therapy was acceptable with 1 grade I and 1 grade II renal toxicity. 6 patients experienced grade III haematological toxicity. Partial remission of the disease was observed in 6 cases, and 6 patients could receive combination chemotherapy after improvement of liver function. The median overall survival of the patient cohort was 4.8 months. Conclusion: Cisplatin monotherapy may thus be considered as a treatment option for patients with liver dysfunction induced by different solid tumours.

Weekly cisplatin may reverse liver dysfunction and jaundice caused by diffuse liver metastases of solid tumors

“…16 Its unique renal elimination permits administration in patients with severe jaundice and subsequent poor liver function. 17,18 The results of this retrospective analysis suggest that 4 to 6 courses of weekly cisplatin rapidly lead to normalization in serum bilirubin and other liver tests, which permits subsequent chemotherapy with cytotoxics with hepatic metabolism such as etoposide, cyclophosphamide and taxanes. Four patients died after the first administration, mostly due to concomitant pulmonary disease and low WHO performance score at baseline.…”