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Abstract Details
The Clinical Spectrum and Diagnosis of Oxaliplatin Liver Injury in the Era of Nonalcoholic Fatty Liver Disease
Hannah P Kim1, Victor Navarro2, Steven Zacks3, Joseph Odin4, David E Kleiner5, Paul H Hayashi6, Drug-Induced Liver Injury Network Investigators
Author information
1Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina.
2Department of Digestive Disease and Transplantation, Albert Einstein Medical Center, Philadelphia, Pennsylvania.
3Division of Hepatology, Atrium Health, Carolinas Medical Center, Charlotte, North Carolina.
4Icahn School of Medicine at Mount Sinai, New York, New York.
5Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
6Division of Hepatology and Nutrition, Food and Drug Administration, Center for Drug Evaluation and Research/Office of New Drugs/Office of Immunology and Inflammation, Silver Spring, Maryland. Electronic address: Paul.Hayashi@fda.hhs.gov.
Abstract
Oxaliplatin is an alkylating agent given with fluorouracil and leucovorin as a mainstay adjuvant chemotherapy for stage III colorectal cancer (CRC). Liver injury from oxaliplatin ranges from mild liver enzyme increases in 42% to 57% of patients in clinical trials1 to rare severe injury leading to acute liver failure.2 Chronic injury from endothelial cell damage and architectural distortion may manifest years later with nodular regenerative hyperplasia (NRH), portal sclerosis, and noncirrhotic portal hypertension (NCPH).2,3 Chronic subclinical injury occurs in up to 78% of patients.3Diagnosis may be confounded by nonalcoholic fatty liver disease (NAFLD), and long-term outcomes from chronic injury are unclear.