Liver Disease and Anticancer Drug Treatment

Abstract

Anticancer drugs probably have the smallest therapeutic index of any drugs. They are one of the few classes of therapeutic agents that are routinely given to patients at doses producing moderate to severe toxicity. Significant patient toxicity is closely associated with the use of all the effective anticancer drugs (1). There is good evidence that higher doses of anticancer drugs offer a greater likelihood of therapeutic response and in order to achieve the maximum therapeutic activity significant patient morbidity has to be tolerated (2–4). An unfortunate sequela is that because of human variability there will be some patients who experience severe, even life threatening, toxic responses to the standard doses of anticancer drugs. Clinicians are well used to titrating the dose of anticancer drugs. However, an understanding of the causes of human variability in toxic response to anticancer drugs can go a long way to avoiding unnecessary toxicity and can improve the quality of life of cancer patients. A significant cause of pharmacokinetic variability in the response to anticancer drugs, and one that forms the basis for dose reduction of some anticancer drugs, is liver dysfunction (5).KeywordsAnticancer DrugLiver DysfunctionNormal Liver FunctionSerum Liver EnzymeHuman VariabilityThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.