Etoposide dosage adjustment in two patients with neuroendocrine tumors and severe liver impairment

Limited data are available on dosing etoposide in patients with liver impairment.

We report the dosing strategies for etoposide utilized in two patients with neuroendocrine tumors and severe liver impairment.

Treatment consisted of platinum-based chemotherapy regimens, with the decision of whether to administer etoposide and at what doses being based on the liver function before each chemotherapy cycle. By the end of treatment, total bilirubin was normal, and the performance status of both patients had improved, with stable computed tomography scan findings.

The reported two cases suggest that the administration of etoposide at reduced doses with close monitoring in patients with neuroendocrine tumors and severe liver impairment may still be considered as an option and may improve outcomes.