CANCER CHEMOTHERAPY AND HEPATOTOXICITY: AN UPDATE

Abstract

Article history Cytotoxic chemotherapy prolongs survival of patients with advanced and metastatic tumors. Since the liver has a rich blood supply and plays an active role in the metabolism of medications, it is not surprising that there can be hepatic toxicity related to chemotherapy. In addition, radioembolization may affect the parenchyma of normal and cirrhotic livers. The administration of chemotherapy is a challenge for the tight regulation and balance of these processes. As most drugs tend to be lipophilic, they are readily taken up by the liver. Under chemotherapy, up to 85% of patients develop liver steatosis. Steatohepatitis is the more serious event, especially if accompanied by an increase in bilirubin levels. Modern understanding of the efficacy, safety and tolerability of combination chemotherapy has to increasingly include the individual context of a patient, such as age, gender, nutritional status, underlying diseases, genetic predisposition, as well as the cross-reactivity of the different drugs. This review tries to capture the various effects of chemotherapy on the liver and highlight the pharmacogenomics of such liver insults.