- Patients must have adequate liver function defined as: for patients with no liver metastases, aspartate transaminase (AST), alanine transaminase (ALT), and bilirubin levels can be up to 1.5 times the upper limit of normal (ULN). For patients with liver metastases, ALT, AST, and bilirubin levels can be up to 2.5 times the ULN.