What is your bilirubin threshold to treat a metastatic pancreaticobiliary tumor with FOLFOX?

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...