Hepatotoxicity following vincristine therapy

Area of Science:

• Oncology
• Pharmacology
• Hepatology

Background:

• Small cell lung cancer (SCLC) is a type of lung cancer.
• Combination chemotherapy is a common treatment for SCLC.
• Vincristine is a chemotherapeutic agent used in SCLC treatment.

Observation:

• A patient undergoing combination chemotherapy (cyclophosphamide, vincristine, and etoposide [VP-16-213]) for SCLC experienced adverse effects.
• Transient liver function abnormalities were observed during vincristine therapy.

Findings:

• Serum transaminase (SGOT, SGPT), lactic dehydrogenase (LDH), alkaline phosphatase, and gamma-glutamyl transpeptidase (GGTP) levels increased significantly.
• Enzyme elevations appeared by day 6 and normalized within 16–48 days, with GGTP persisting longer.
• Rechallenge with vincristine confirmed the drug-induced transaminitis.

Implications:

• Vincristine can cause moderate, transient liver damage (transaminitis).
• Healthcare providers should monitor liver function in patients receiving vincristine.
• Vincristine may exacerbate radiation-induced liver injury.