Reversibility of liver failure secondary to metast

Authors: Ricky A Sharma Marios P Decatris Sundar Santhanam Rajarshi Roy Ahmed E Osman Christine B Clarke Subhash Khanna Kenneth J OByrne

Publish Date: 2003/07/18

Volume: 52, Issue: 5, Pages: 367-370

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Abstract

The development of liver metastases from breast cancer is associated with a very poor prognosis estimated at 4 months median survival Since treatment with many chemotherapeutic agents is relatively contraindicated we assessed the safety tolerability and potential efficacy of combination chemotherapy with vinorelbine and cisplatin ViPPilot study in 11 patients with histologically confirmed breast carcinoma radiological evidence of liver metastases and serum bilirubin greater than 15 times the upper limit of normal Patients received up to six cycles of cisplatin 75 mg/m2 every 21 days and vinorelbine 20 mg/m2 on days 1 and 8 of every 21day cycle Measurement of liver lesions was performed on CT scan every 8 weeks into treatmentThe most frequently reported adverse event was myelosuppression Other adverse effects included nausea vomiting and mild neurotoxicity Two patients died after one treatment with ViP one of whom suffered an intracerebral haemorrhage that was possibly treatmentrelated Improvement in liver function tests was observed in 10 patients and mean time to normalization of bilirubin levels was 36 days Partial responses were documented radiologically in 7 out of 11 patients treated Median overall survival from trial entry was 65 months range 11–364 days with one patient alive 13 months from trial entryNormalization of liver function is possible with ViP treatment of metastatic breast cancer offering the potential to prolong survival Phase II clinical trials of this regimen in this patient group should include measurement of quality of life in order to assess risk versus benefit

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