What is your bilirubin threshold to treat a metastatic pancreaticobiliary tumor with FOLFOX?
Quite often we encounter cholestatic hyperbilirubinemia, wherein GI and IR do not believe ERCP with stents or PTC will alleviate jaundice. If the patient still maintains a performance status ECOG <2, how would you adjust the chemo regimen to allow for treatment?
1 Answer
Mednet MemberInvited Expert
Medical Oncology · Mayo Clinic
Answered on
I am not aware of any particular threshold, but as the clearance of 5-FU and oxaliplatin is minimally affected by hepatic dysfunction, both drugs can be used. In my personal experience, I have treated patients with bilirubin more than 10 with FOLFOX (generally without a 5-FU bolus which likely has m...
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