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Hepatotoxicity of Chemotherapy

^a Gastroenterology and Hepatology, ^b Hematology and Medical Oncology, Department of Internal Medicine, University of Missouri-Columbia, Columbia, Missouri, USA

Correspondence: Michael C. Perry, M.D., Division of Hematology/Oncology, University of Missouri Ellis Fischel Cancer Center, 115 Business Loop 70 West, Columbia, Missouri 65203, USA. Telephone: 573-882-4979; Fax: 573-884-6050; e-mail: perrym{at}health.missouri.edu

After assessment of tumor histology, the next important factor to consider in the selection of a chemotherapy regime is organ function. Patients who are to receive chemotherapy require careful assessment of liver function prior to treatment to determine which drugs may not be appropriate, and which drug doses should be modified. Following therapy abnormalities of liver function tests may be due to the therapy rather than to progressive disease, and this distinction is of critical importance. Furthermore, not all abnormalities in liver function are due to the tumor or its treatment, and other processes, such as hepatitis, must be kept in mind. This article reviews the hepatic toxicity of chemotherapeutic agents, and suggests dose modifications based upon liver function abnormalities. Emphasis is placed on agents known to be hepatotoxic, and those agents with hepatic metabolism.

Key Words. Hepatotoxicity • Chemotherapy • Cancer therapy • Liver function

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