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

Quite often we encounter cholestatic hyperbilirubinemia, wherein GI and IR do not believe ERCP with stents or PTC will alleviate jaundice. If the patient still maintains a performance status ECOG <2, how would you adjust the chemo regimen to allow for treatment?

Answer from: Medical Oncologist at Academic Institution

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...

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Medical Oncologist at Kettering Cancer Center
Thank you!

Medical Oncologist at Florida Cancer Specialists and Research Institute
@Thorvardur R. Halfdanarson, if you have time, cou...

Medical Oncologist at Mayo Clinic
Sorry for the delay answering that question @Muham...

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

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