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What is your preferred chemotherapy when dealing with hepatic visceral crisis in metastatic breast cancer?

How does this change for patients with elevated bilirubin?
Community PollStarted

Would you consider using CDK 4/6i over chemotherapy in ER+/HER2- mBC patients with hepatic visceral crisis?

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4 Answers
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Medical Oncology · Warren Alpert Medical School of Brown University
Answered on

This, of course, depends on the cancer's subtype.

For patients with ER+/HER2- cancers, I would consider an initial trial of endocrine therapy and a CDK 4/6 inhibitor (and ovarian function suppression if the patient is premenopausal), based on results from the RIGHT CHOICE study presented at SABCS 20...

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Medical Oncology · IHA Hem Onc Consult
Answered on

This is a difficult scenario. I suggest the following:

  1. Rule out biliary obstruction and discuss prognosis (guarded). Palliative treatment is reasonable if the patient’s PS is 2 or less and she wants treatment.
  2. I usually use a combination of chemotherapy drugs (Cisplatin plus Vinorelbine) based on th...

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Medical Oncology · University of Iowa Holden Comprehensive Cancer Center
Answered on · Updated on

There is a lack of data around most chemotherapy agents when it comes to their usage in patients with significant liver dysfunctions/impairment, as these patients are routinely excluded from clinical trials. If there is severe liver impairment like bilirubin of > 5 mg/dL, it would be hard to recomme...

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Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty
Answered on · Updated on

In all comer patients with high-burden metastatic Breast Cancer (mBC), the efficacy of CDK4/6 inhibitors combined with aromatase inhibitors (AI) has shown longer PFS and OS in Hormone Receptor positive (HR+), Her2 negative (Her2-) breast cancer patients when treated with Endocrine Therapy (ET) compa...

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