Any experience on elevated liver enzymes & FOLFOX

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CancerBum21
Posts: 24
Joined: Fri Feb 26, 2021 6:27 am

Any experience on elevated liver enzymes & FOLFOX

Postby CancerBum21 » Thu May 27, 2021 4:40 pm

I’m on round 4 of FOLFOX and started to see elevated liver enzymes. Has anyone else experienced this? I’m wondering how high your levels got before it conserend your doctors.

ALT 171 and trending up
AST 68 and tending up
Total Bilirubin 1.0 which is pretty normal for me. I generally run high historically 1-2 over the past 10 years.
34/M
DX:(Rectal Cancer) 2/15/21
Stage: T1N0M0
TAMIS Surgery 3/10/21
Pathology: T1NxM0 - LIV positive, 1/1 lymph positive Stage IIIA
Chemo starting soon

Claudine
Posts: 524
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Any experience on elevated liver enzymes & FOLFOX

Postby Claudine » Thu May 27, 2021 5:03 pm

After recent posts on liver values, I checked my husband's over time and noticed a big spike when he was on Xelox: both ALT and AST around/above 100. They were in the normal range previously, and dropped back down in normal range after he finished treatment. So maybe it's a side effect of oxaliplatin?
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: high 58, low 3.2, now 75.5
Scan 03/19: Multiple small lung nodules, now gone/calcified
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 06/17/2021: stable

CancerBum21
Posts: 24
Joined: Fri Feb 26, 2021 6:27 am

Re: Any experience on elevated liver enzymes & FOLFOX

Postby CancerBum21 » Thu May 27, 2021 5:34 pm

Good to know. I think you’re right. Did they spike after the first round or trend up over the cycles or just one spike on round one?
34/M
DX:(Rectal Cancer) 2/15/21
Stage: T1N0M0
TAMIS Surgery 3/10/21
Pathology: T1NxM0 - LIV positive, 1/1 lymph positive Stage IIIA
Chemo starting soon

Claudine
Posts: 524
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: Any experience on elevated liver enzymes & FOLFOX

Postby Claudine » Thu May 27, 2021 5:44 pm

It looks like they spiked suddenly after he started treatment, stayed elevated but stable throughout (he did 6 cycles), then dropped back down after he finished.
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: high 58, low 3.2, now 75.5
Scan 03/19: Multiple small lung nodules, now gone/calcified
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 06/17/2021: stable

roadrunner
Posts: 109
Joined: Sun Jan 12, 2020 8:46 pm

Re: Any experience on elevated liver enzymes & FOLFOX

Postby roadrunner » Thu May 27, 2021 8:50 pm

I did two rounds of FOLFOX, 4 cycles each time. The first time ALT and AST were interesting indeed. I just did a quick look at the results, and saw values as high as AST 129 and ALT 299. They may have gone higher, but that range seems right for the higher end going by memory. My medical oncologist was never too concerned, but he did hold Oxi once and that seemed to help. I remember debating whether it was the Lovenox I was taking or the Oxi, but he was pretty strong about it being the Oxi, and the values did return to normal after chemo (though there is some literature on the body “acclimating” to Lovenox, so?) I did a lot of research at the time, and overall I don’t think it was a big deal. For what it’s worth, FOLFOX reduced my rectal tumor from close to 5 cm to a nCCR.
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (lots of side effects/reduced size est. 70-75%)
Switched to neoadjuvant chemorad in 11/19 (Xeloda and approx. IMRT, 60 Gy, 33 fractions)
Trying to achieve cCR.


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