{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T05:38:04Z","timestamp":1740893884688,"version":"3.38.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2016,3,17]],"date-time":"2016-03-17T00:00:00Z","timestamp":1458172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Med Oncol"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> 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) \u00b1 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. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> Consecutive patients with severe hyperbilirubinemia [&gt;2 \u00d7 upper limit of the normal range (ULN) and &gt;2.4 mg\/dl] due to liver metastases of GI cancer without options for drainage receiving oxaliplatin, FP\/FA \u00b1 moAb were analyzed. To collect further data a review of the literature was performed. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> A total of 12 patients were identified between 2011 and 2015. At treatment start, median bilirubin level was 6.1 mg\/dl (&gt;5 \u00d7 ULN, range 2.7\u201313.6). The majority of patients ( n = 11) received dose-reduced regimen with oxaliplatin (60\u201376%) and FP\/FA (0\u201377%), 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\u201316.0 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\u201310.22]. In addition, case reports or series comprising a further 26 patients could be identified. Based on the obtained data a treatment algorithm was developed. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> Treatment with oxaliplatin, FP\/FA \u00b1 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. <\/jats:p><\/jats:sec>","DOI":"10.1177\/1758834016637585","type":"journal-article","created":{"date-parts":[[2016,3,18]],"date-time":"2016-03-18T01:59:54Z","timestamp":1458266394000},"page":"144-152","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Treatment approach in patients with hyperbilirubinemia secondary to liver metastases in gastrointestinal malignancies: a case series and review of literature"],"prefix":"10.1177","volume":"8","author":[{"given":"Julia","family":"Quidde","sequence":"first","affiliation":[{"name":"University Medical Center Hamburg-Eppendorf, Department of Oncology, Hematology, Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumor Center, Martinistra\u00dfe 52, 20246 Hamburg, Germany"}]},{"given":"Marc","family":"Az\u00e9mar","sequence":"additional","affiliation":[{"name":"Tumor Biology Center Freiburg, Freiburg, Germany"}]},{"given":"Carsten","family":"Bokemeyer","sequence":"additional","affiliation":[{"name":"University Medical Center Hamburg-Eppendorf, Department of Oncology, Hematology, Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumor Center, Hamburg, Germany"}]},{"given":"Dirk","family":"Arnold","sequence":"additional","affiliation":[{"name":"Tumor Biology Center Freiburg, Freiburg, Germany CUF Hospitals Cancer Centre, Lisbon, Portugal"}]},{"given":"Alexander","family":"Stein","sequence":"additional","affiliation":[{"name":"University Medical Center Hamburg-Eppendorf, Department of Oncology, Hematology, Bone Marrow Transplantation with Section Pneumology, 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