Liver Toxicity in Colorectal Cancer Patients Treated with First Line Folfiri-Containing Regimen: a Single Institution Experience

Abstract

ABSTRACT Aim: This study aims to evaluate the mechanisms of liver toxicity in the specific group of mCRC patients treated with FOLFIRI-based regimens, calculating the R ratio and the AST/ALT ratio and retrospectively comparing patients treated with SAMe supplementation with patients who did not receive the supplementation. Methods: 156 mCRC patients receiving a FOLFIRI backbone-based regimen were included in this analysis. Liver enzymes levels (AST, ALT, total bilirubin, gamma-glutamyltransferase, alkaline phosphatise) were assessed before starting the treatment (basal value) and then before every therapy course. R ratio and the AST/ALT ratio was calculated in patients developing liver toxicity. 46 out of 156 patients received an oral supplementation of SAMe (400 mg twice a day). Results: AST, ALT and alkaline phosphatase (AP) has shown a significant modification after the beginning of first line treatment. Specifically, both AST level (123.87 vs 41.05U/l; P Conclusions: For the first time in literature, pattern of chemotherapy-induced liver injury has been indirectly defined upon the evaluation of R-Ratio, revealing the mixed pattern of liver damage. SAMe supplementation prevent hepatotoxicity in a specific group of mCRC patients treated with FOLFIRI-containing regimens reducing Grade 3-4 hypertransaminase (2.17% vs 16.37%; P=0.029) and treatment delays (4.35% vs 20.90%, P=0.020). Disclosure: All authors have declared no conflicts of interest.