Do you have a cut-off for bilirubin for treatment of patients with poorly differentiated NSCLC with good PS and liver dysfunction due to mets?

The management of patients with extensive liver mets resulting in elevated bilirubin depends upon the clinical scenario. The question posed indicates this patient has a good performance status and a lung cancer histology of "poorly differentiated NSCLC". The factors that I would consider when treating such patients include other co-morbidities, nutritional status, the wishes of the patient, and likelihood of benefit with therapy compared with the risks of therapy. I would always avoid drugs that require significant hepatic metabolism or drugs that have a higher incidence of hepatotoxicity. Platinum agents can be safely given to these patients, in most instances. I would like use carboplatin in this non-curative setting. This would allow me ...