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Intestinal metabolism (not shown in above graphic): In the gut, bacterial enzymes deconjugate bilirubin and convert it into: Urobilinogen , which has several fates: Some is reabsorbed into the portal circulation ( enterohepatic circulation ) A small amount is excreted in urine as urobilin (yellow pigment) Most is converted to stercobilin and excreted in feces (brown pigment) Indirect hyperbilirubinemia Indirect (unconjugated) hyperbilirubinemia occurs when there is an excess of bilirubin in the bloodstream before it has been processed by the liver

doi: 10.1097/00000542-198304000-00018

CANTATA: Randomized, international, double-blind study of CB-839 plus cabozantinib versus cabozantinib plus placebo in patients with metastatic renal cell carcinoma

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