A case of advanced gastric cancer with severe jaundice from multiple liver metastases that was significantly improved after capecitabine plus oxaliplatin treatment

A 74-year-old man with advanced gastric cancer was admitted to our hospital. His liver function was impaired (total bilirubin 1.6 mg/dL) with multiple liver metastases. He was treated with chemotherapy of S-1 plus cisplatin but it was discontinued due to severe diarrhea (CTCAE Grade 3) on day 6 and his liver dysfunction progressed (total bilirubin 10.3 mg/dL). After his diarrhea improved, he was treated with capecitabine plus oxaliplatin (capecitabine 3,600 mg/day on day 1-14, oxaliplatin 130 mg/m² on day 1, q3 weeks). His severe jaundice and general condition improved without severe non-hematological toxicity, and he was ultimately discharged. He achieved a partial response (RECIST vl.1) after capecitabine plus oxaliplatin treatment, and this therapy has been continued for 15 months. This case suggests that capecitabine plus oxaliplatin may be beneficial even in advanced gastric cancer patients with impaired liver function from multiple liver metastases.