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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Have Advanced Liver Mets + Jaundice From HER2+ Metastatic Breast Cancer. On Herceptin,carboplatin. Causes For Increase In Bilirubin?

Advanced liver mets + jaundice from HER2+ metastatic breast cancer. 2 weeks ago SGOT- 650, SGPT 350, Bilirubin 18.
Now SGOT- 390, SGPT 190, Bilirubin 24. Patient on weekly Herceptin (150mg)+ carboplatin (100mg) dose since 2 weeks. Taking ciprofloxacin and linezolid for infections.
Advice request: continue carboplatin OR change chemo OR which tests to determine next steps.
What might be causing increase in bilirubin? Please suggest.
Mon, 6 May 2013
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Oncologist, Surgical,  's  Response
Sorry to hear about your problem.

The most probable cause for rise in bilirubin is metastasis to the liver. This can explain the rise in the enzymes and bilirubin. This can be confirmed by a simple ultrasound of the abdomen.
Metastatic breast cancer can be quite challenging to treat. Carboplatin and herceptin are some of the chemotherapy agents used to treat such a disease and do not lead to a rise in liver enzymes.
As the patient is HER positive, it is prudent to continue herceptin. If the patient's disease is progressing on carboplatin, you can discuss the change of this agent with your oncologist.

Hoping for the best.
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Oncologist, Radiation,  Dr. Vinay Kumar's  Response
Simple obstruction of CBD- Common Bile Duct is the reason for increase in billirubin.

ERCP or PTC may help if ur doctor feel u fit for it.

Sincerely,

Dr. Vinay Kumar,

Senior Consultant Oncology and Radiotherapy
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Oncologist, Radiation,  Dr. Vinay Kumar's  Response
Simple obstruction of CBD- Common Bile Duct is the reason for increase in billirubin.

ERCP or PTC may help if ur doctor feel u fit for it.

Sincerely,

Dr. Vinay Kumar,

Senior Consultant Oncology and Radiotherapy
I find this answer helpful
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Have Advanced Liver Mets + Jaundice From HER2+ Metastatic Breast Cancer. On Herceptin,carboplatin. Causes For Increase In Bilirubin?

Sorry to hear about your problem. The most probable cause for rise in bilirubin is metastasis to the liver. This can explain the rise in the enzymes and bilirubin. This can be confirmed by a simple ultrasound of the abdomen. Metastatic breast cancer can be quite challenging to treat. Carboplatin and herceptin are some of the chemotherapy agents used to treat such a disease and do not lead to a rise in liver enzymes. As the patient is HER positive, it is prudent to continue herceptin. If the patient s disease is progressing on carboplatin, you can discuss the change of this agent with your oncologist. Hoping for the best.