Background: Oxaliplatin has shown activity in several malignancies. In patients with normal renal function, 40-50% of the drug is renally excreted. Increased platinum exposure in patients with impaired renal function is not associated with increased toxicity, and patients with hepatic dysfunction did not show altered clearance of oxaliplatin. No data is available regarding safety of oxaliplatin in patients with combined renal and hepatic dysfunction.
Case report: A 64-year-old chemotherapy-naïve woman with metastatic breast cancer was admitted with dyspnea, jaundice, massive peripheral edema and combined renal and hepatic failure. After correction of fluid and electrolyte imbalances, weekly oxaliplatin 50 mg/m2 was started.
Results: Within 5 weeks of treatment, the performance status improved significantly. Normalization of renal function and improvement of liver function was achieved. Apart from anemia, no toxicities > grade I were observed. After 6 cycles, the patient's condition deteriorated again, with signs of progressive disease. The overall status of the patient declined, and chemotherapy was stopped.
Conclusion: Weekly doses of oxaliplatin could be safely administered to a patient with metastatic breast cancer and combined hepatic and renal failure, achieving a good, albeit transient palliative effect.