A problem-oriented approach to liver disease in oncology patients

McDonald, George B.; Frieze, Deborah

doi:10.1136/gut.2007.131136

Cited by 40 publications

(31 citation statements)

References 98 publications

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“…In the present study, the activities of AST, ALT, and ALP are increased in the serum which is considered a marker of liver damage. Hepatic dysfunction was the most common regimen-related toxicity reported in patients treated with CP and total body irradiation [37]. Hepatic tissues were the primary sites for the microsomal activation of the drugs.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Efficacy of Melatonin on Cyclophosphamide-Induced Liver Toxicity in Mice

Shokrzadeh

Ahmadi

Naghshvar

et al. 2014

BioMed Research International

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The current study aimed to evaluate the protective effects of melatonin, a pineal secretory product, against hepatotoxicity induced by cyclophosphamide (CP) in mice. Mice were pretreated with melatonin intraperitoneally for 7 consecutive days before the administration of a single intraperitoneal dose of 200 mg/kg CP. 24 hr after CP administration, the mice were anesthetized, blood was then removed, and serum toxicity enzymes activities were evaluated. After the blood sampling, all animals were killed, livers were then removed, and histological studies were conducted. Serum toxicity marker enzymes were significantly increased after CP treatment but restored in melatonin pretreated groups. In addition, administration of CP induced necrotic hepatocyte with small crushed nuclei, portal space with severe inflammation, and hepatocytes surrounded by lymphocytic infiltration in hepatic tissues. However, melatonin effectively protected against CP-induced histopathological abnormalities in the liver tissues. Our results reveal that melatonin produces a potent hepatoprotective mechanism against CP. Therefore, melatonin could be a potent candidate to use concomitantly as a supplement agent against hepatotoxicity of CP for the patients undergoing chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Prophylactic Efficacy of Melatonin on Cyclophosphamide-Induced Liver Toxicity in Mice

Shokrzadeh

Ahmadi

Naghshvar

et al. 2014

BioMed Research International

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“…CP administration under different conditions and doses has been demonstrated to be an excellent model to produce the syndromes of both oxidative stress and hepatic damage (Mathew & Kuttan, 1997;Stankiewicz et al, 2002;Sulkowska et al, 1999). Hepatic dysfunction was the most common regimen-related toxicity reported in patients treated with CP and total body irradiation (McDonald & Frieze, 2008). Hepatic tissues were the primary sites for the microsomal activation of drugs.…”

Section: Discussionmentioning

confidence: 99%

Protective effects ofOriganum vulgareethanol extract against cyclophosphamide-induced liver toxicity in mice

Habibi

Shokrzadeh²,

Chabra³

et al. 2014

Pharmaceutical Biology

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Context: Despite its wide clinical use, cyclophosphamide (CP), an alkylating chemotherapeutic agent, possesses many adverse effects, including hepatotoxicity. Because Origanum vulgare L. (Lamiaceae) has antioxidative properties, it might protect against above-mentioned damage.Objective: This study evaluated the protective effects of O. vulgare extract on CP-induced liver toxicity. Materials and methods: Mice were pretreated with aerial parts of O. vulgare ethanolic extract (intraperitoneally) at doses of 50, 100, 200, and 400 mg/kg for 7 consecutive days before the administration of a single 200 mg/kg intraperitoneal dose of CP 1 h after the last injection of O. vulgare. After 24 h, animals were anesthetized, blood samples and hepatic tissues were collected and used for biochemical and histological examination. Results: Serum levels of hepatic markers were increased after CP treatment but restored in the O. vulgare-pretreated groups. The serum ALT, AST, and ALP of the CP group were 196.49 ± 3.82, 143.78 ± 4.79, and 203.18 ± 3.81 IU/l, respectively. However, pretreatment with 400 mg/kg O. vulgare significantly decreased the serum ALT, AST, and ALP to 52.49 ± 2.18, 44.78 ± 2.06, and 65.62 ± 1.73 IU/l, respectively (p50.001). Histological examinations also confirmed the protective effects of O. vulgare against CP-induced liver toxicity. Discussion and conclusion: Our results reveal that O. vulgare with high amount of flavonoids and phenolic compounds induces potent hepatoprotective mechanisms against CP. Therefore, O. vulgare might help defend the body against the side effects, particularly hepatic damages induced by chemotherapeutic agents.

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“…McDonald et al [18] reported challenges in deciding appropriate medication dose adjustments for patients with liver disease based on the variable medication pharmacodynamics and kinetics. As seen below (Table 1), several antineoplastic agents are metabolized by the liver and contraindicated due to increased toxicity in the setting of hyperbilirubinemia.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Metastasis due to Breast Cancer in a Patient with Primary Biliary Cirrhosis: A Case Report

et al. 2016

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Background: Breast cancer is the most common solid tumor to cause cutaneous metastases. These are incurable and the treatment goal is geared toward local control with surgical excision, radiation, and chemotherapy. However, treatment can be challenging in subjects with end-stage liver disease and a multidisciplinary approach is warranted. Case Report: In this case report, we present a 61-year-old female with primary biliary cirrhosis and human epidermal growth factor-2 (HER-2)-positive breast cancer, who subsequently developed cutaneous metastases. We briefly describe the treatment challenges due to underlying end-stage liver disease, and an exceptional response to trastuzumab and nab-paclitaxel. Conclusion: A multidisciplinary approach to local control and attenuated doses of nab-paclitaxel and trastuzumab suggest a durable response to HER-2-positive breast cancer with cutaneous metastasis. Subjects with end-stage liver disease pose unique challenges and toxicities, warranting additional research and drug development for less hepatotoxic antineoplastic agents.

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A problem-oriented approach to liver disease in oncology patients

Cited by 40 publications

References 98 publications

Prophylactic Efficacy of Melatonin on Cyclophosphamide-Induced Liver Toxicity in Mice

Prophylactic Efficacy of Melatonin on Cyclophosphamide-Induced Liver Toxicity in Mice

Protective effects ofOriganum vulgareethanol extract against cyclophosphamide-induced liver toxicity in mice

Cutaneous Metastasis due to Breast Cancer in a Patient with Primary Biliary Cirrhosis: A Case Report

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