Advanced liver mets + jaundice from HER2+ metastatic breast cancer. 2 weeks ago SGOT- 650, SGPT 350, Bilirubin 18.Now SGOT- 390, SGPT 190, Bilirubin 24. Patient on weekly Herceptin (150mg)+ carboplatin (100mg) dose since 2 weeks. Taking ciprofloxacin and linezolid for infections.Advice request: continue carboplatin OR change chemo OR which tests to determine next steps.What might be causing increase in bilirubin? Please suggest.
Sorry to hear about your problem. The most probable cause for rise in bilirubin is metastasis to the liver. This can explain the rise in the enzymes and bilirubin. This can be confirmed by a simple ultrasound of the abdomen. Metastatic breast cancer can be quite challenging to treat. Carbonation and Herceptin are some chemotherapy agents used to treat such a disease and do not lead to a rise in liver enzymes. As the patient is HER positive, it is prudent to continue Herceptin. If the patients' disease is progressing on carbonation, you can discuss the change of this agent with your oncologist. Hoping for the best.