There exists little guidance on chemotherapy toxicity management in patients with a history of or active hepatitis C viral infection. We report four cases of patients with solid organ tumors and hepatitis C viral infection, who have experienced severe or unexpected toxicities with chemotherapy. Based on the four case reports, we recommend increased laboratory monitoring for toxicities, initial dose reductions for chemotherapy given with palliative intent, or pre-emptive use of growth factor support, even if the patient presents with normal liver function tests. In this patient population, we also recommend treating active hepatitis C viral infection prior to chemotherapy treatment when possible.
HwangJPSuarez-AlmazorMETorresHAet al.Hepatitis C virus screening in patients with cancer receiving chemotherapy. J Oncol Pract2014; 10: e167–174.
4.
Advances in medications to treat hepatitis C. American Liver Foundation. Available at: Hepc.liverfoundation.org (2016, accessed 1 May 2017).
5.
EdwardsDJCoppensDGMPrasadTLet al.Access to hepatitis C medicines. Bull World Health Organ2015; 93: 799–805.
6.
“Monitoring patients who are starting hepatitis C treatment, are on treatment, or have completed therapy.” HCV guidance: recommendations for testing, managing, and treating hepatitis C. American Association for the Study of Liver Disease, Infectious Disease Society of America. Available at: www.hcvguidelines.org (2017, accessed 7 June 2017).
7.
EklungJWTrifilioSMulcahyMFet al.Chemotherapy dosing in the setting of liver dysfunction. Oncology (Williston Park)2005; 19: 1057–1063.
8.
“When and in whom to initiate HCV therapy.” HCV guidance: recommendations for testing, managing, and treating hepatitis C. American Association for the Study of Liver Disease, Infectious Disease Society of America. Available at: www.hcvguidelines.org (2016, accessed 7 August 2017).
9.
KorenGBeattyKSetoAet al.The effects of impaired liver function on the elimination of antineoplastic agents. Ann Pharmacother1992; 26: 363–371.
10.
JoergerM. Metabolism of taxanes including nab-paclitaxel. Expert Opin Drug Metab Toxicol2015; 11: 691–702.
11.
Docetaxel (package insert). Bridgewater, NJ: Sanofi-aventis US LLC, 2010.
CiccoliniJSerdjebiCPetersGJet al.Pharmacokinetics and pharmacogenetics of gemcitabine as a mainstay in adult and pediatric oncology: an EORTC-PAMM perspective. Cancer Chemother Pharmacol2016; 78: 1–12.
16.
JohnstonDE. Special considerations in interpreting liver function tests. Am Fam Physician1999; 59: 2223–2230.
17.
MaySRBogleMABodeyGP. Cutaneous fungal infections in the oncology patient: recognition and management. Am J Clin Dermatol2006; 7: 31–43.
18.
KitagawaRKatsumataNShibataTet al.Paclitaxel plus carboplatin versus paclitaxel plus cisplatin in metastatic or recurrent cervical cancer: the open-label randomized phase III trial JCOG0505. J Clin Oncol2015; 33: 2129–2135.
OzolsRFBundyBNGreerBEet al.Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a gynecologic oncology group study. J Clin Oncol2003; 21: 3194–3200.
22.
Du BoisALuckHJMeierWet al.A randomized clinical trial of cisplatin/paclitaxel versus carboplatin/paclitaxel as first-line treatment of ovarian cancer. J Natl Cancer Inst2003; 95: 1320–1329.
23.
Gemcitabine. LiverTox, clinical and research information on drug-induced liver injury. National Institute of Health, US Department of Health & Human Services. Available at: http://livertox.nih.gov (2017, accessed 7 June 2017).
24.
VenookAPEgorinMJRasnerGLet al.Phase I and pharmacokinetic trial of gemcitabine in patients with hepatic or renal dysfunction: cancer and leukemia group B 9565. J Clin Oncol2000; 18: 2780–2787.
25.
DogliottiLCarteniGSienaSet al.Gemcitabine plus cisplatin versus gemcitabine plus carboplatin as first-line chemotherapy in advanced transitional cell carcinoma of the urothelium: results of a randomized phase 2 trial. Eur Urol2007; 52: 134–141.
26.
Von der MaaseHHansenSWRobertsJTet al.Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol2000; 18: 3068–3077.
27.
BaselgaJCortesJKimSet al.Pertuzumab plus trastuzumab plus docetaxel in metastatic breast cancer. N Engl J Med2012; 366: 109–119.
28.
JainADubashiB. Docetaxel-induced hand foot syndrome: ”No dose is a safe dose„. J Pharmacol Pharmacother2012; 3: 200–201.
29.
MorrowPKHTarrandJJTaylorSHet al.Effects of chronic hepatitis C infection on the treatment of breast cancer patients. Ann Oncol2010; 21: 1233–1236.
30.
TorresHAChongPPde LimaMet al.Hepatitis C virus infection among hematopoietic cell transplant donors and recipients: American society for blood and marrow transplantation task force recommendations. Biol Blood Marrow Transplant2015; 21: 1870–1882.
31.
D’AngeloSDeutscherMDicklerMet al.Hepatitis C virus infection does not preclude standard breast cancer-directed therapy. Clin Breast Cancer2009; 9: 51–52.
