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In Reply:

Dana-Farber Cancer Institute, Boston, MA

We appreciate the comments of Kramar et al. Our study was a secondary analysis of baseline bilirubin measurements in a cohort of patients participating in one randomized clinical trial of two methods of administration of single-agent irinotecan.¹ We concentrated on pretreatment levels since we wanted to determine if this "crude" measurement of glucuronidation activity could be used in clinical decision making when treating patients with irinotecan. Nonetheless, our database was limited in that we did not have routine bilirubin follow-up measurements available. We are intrigued by the results of Kramar et al, though would caution that they should be replicated in a larger patient population before advocating prophylactic granulocyte colony-stimulating factor support (the result that 50% of patients with bilirubin > 1.5 mg/dL experienced grade 3/4 neutropenia is based on a group of three patients).

Authors’ Disclosures of Potential Conflicts of Interest

The following authors or their immediate family members have indicated a financial interest. No conflict exists for drugs or devices used in a study if they are not being evaluated as part of the investigation. Consultant/Advisory Role: Charles S. Fuchs, Sanofi-Synthelabo. For a detailed description of these categories, or for more information about ASCO’s conflict of interest policy, please refer to the Author Disclosure Declaration and the "Disclosures of Potential Conflicts of Interest" section of Information for Contributors found in the front of every issue.

REFERENCE

1. Meyerhardt JA, Kwok A, Ratain MJ, et al: Analysis of relationship of baseline serum bilirubin to efficacy and toxicity of single-agent irinotecan in patients with metastastic colorectal cancer. J Clin Oncol 22:1439-1446, 2004[Abstract/Free Full Text]

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Related Correspondence

• Relationship of Serum Bilirubin to Toxicity in Patients With Metastatic Colorectal Cancer Treated With Single-Agent High-Dose Irinotecan
  Andrew Kramar, Sophie Gourgou-Bourgade, and Marc Ychou
  JCO 2005 23: 650 [Full Text]

This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Meyerhardt, J. A. Articles by Fuchs, C. S. Search for Related Content PubMed Articles by Meyerhardt, J. A. Articles by Fuchs, C. S. Related Articles Related Correspondence Social Bookmarking                            What's this?