What is your preferred chemotherapy when dealing with hepatic visceral crisis in metastatic breast cancer?
How does this change for patients with elevated bilirubin?
Answer from: Medical Oncologist at Academic Institution
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 2...
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Answer from: Medical Oncologist at Community Practice
This is a difficult scenario. I suggest the following:
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.
I usually use a combination of chemotherapy drugs (Cisplatin plus Vinorelbine) bas...
Answer from: Medical Oncologist at Community Practice
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 reco...
Answer from: Medical Oncologist at Community Practice
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...