Immune Checkpoint Inhibitors Induced Hepatotoxicity; Gastroenterologists’ Perspectives

Farshidpour, Maham; Hutson, William R.

doi:10.34172/mejdd.2022.279

Cited by 3 publications

(3 citation statements)

References 80 publications

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“…(5) Grade 5 liver injury: fatal liver injury ( 31 ). Histologically, ICIs can cause various forms of pathological damage to hepatocytes, including panlobular hepatitis, perivenular infiltrating endotheliitis or a cholestatic pattern with proliferative bile duct injury, and mixed portal inflammation with mild lobular necrotizing inflammation ( 82 ). Hepatotoxicity has been reported in 2% to 10% of patients receiving monotherapy with ipilimumab, nivolumab, and pembrolizumab.…”

Section: Common Iraesmentioning

confidence: 99%

“…The mechanism of hepatotoxicity is currently unknown, and secondary activation of CD8+ cytotoxic T lymphocytes, various CD4+ T-cell populations, cytokines, and the innate immune system has been found to lead to liver injury (81). According to the serum aspartate aminotransferase (AST)/alanine aminotransferase (ALT) levels, liver injury can be divided into five grades: (1) Grade 1 liver damage: AST/ALT increased, less than 3 times the upper limit of the normal value: the level of total positive rates increased less than 1.5 times the upper limit of the normal value.…”

Section: Immune-mediated Hepatotoxicitymentioning

confidence: 99%

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Immune-related adverse events of immune checkpoint inhibitors: a review

Yin

Han

et al. 2023

Front. Immunol.

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Since the first Immune Checkpoint Inhibitor was developed, tumor immunotherapy has entered a new era, and the response rate and survival rate of many cancers have also been improved. Despite the success of immune checkpoint inhibitors, resistance limits the number of patients who can achieve a lasting response, and immune-related adverse events complicate treatment. The mechanism of immune-related adverse events (irAEs) is unclear. We summarize and discuss the mechanisms of action of immune checkpoint inhibitors, the different types of immune-related adverse events and their possible mechanisms, and describe possible strategies and targets for prevention and therapeutic interventions to mitigate them.

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Section: Common Iraesmentioning

confidence: 99%

Section: Immune-mediated Hepatotoxicitymentioning

confidence: 99%

Immune-related adverse events of immune checkpoint inhibitors: a review

Yin

Han

et al. 2023

Front. Immunol.

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“…The condition most commonly manifests as isolated elevations in liver transaminases but can vary in severity, up to and including fulminant hepatic failure [7]. Early identification and appropriate management are critical components of mitigating the risks associated with ICI-induced hepatitis [8,9]. This review aims to provide overview of the epidemiology of ICI-induced hepatitis, exploring its clinical manifestations, diagnostic criteria, and management strategies.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2023

J Gastro & Digestive Systems

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The introduction of immune checkpoint inhibitors (ICIs) has revolutionized cancer therapy, offering promising outcomes in various malignancies. However, the use of these agents is associated with a spectrum of immunerelated adverse events (irAEs), including liver complications commonly referred to as ICI-induced hepatitis. This review article aims to provide a comprehensive overview of the epidemiology, pathophysiology, clinical manifestations, diagnosis, and management strategies for ICI-induced hepatitis. We also discuss the histopathological features that distinguish this condition from other liver diseases like autoimmune hepatitis. Additionally, the article explores existing guidelines and recommendations for managing ICI-induced hepatitis. As the application of ICIs continues to expand, understanding the nuances of associated hepatic complications becomes increasingly critical for clinicians involved in cancer care. Therefore, this review serves as a timely resource for oncologists, gastroenterologists, and other healthcare professionals engaged in the management of patients undergoing ICI therapy.

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Multiorgan Toxicity from Dual Checkpoint Inhibitor Therapy, Resulting in a Complete Response—A Case Report

Astašauskaitė,

Kupčinskaitė-Noreikienė,

Zaborienė

et al. 2024

Medicina

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Immunotherapy treatment with checkpoint inhibitors (ICIs) has led to a breakthrough in the treatment of oncological diseases. Despite its clinical effectiveness, this treatment differs from others, such as cytotoxic chemotherapy, in that it causes immune-related adverse events. This type of toxicity can affect any organ or organ system of the body. We present a literature review and a rare clinical case from our clinical practice, in which a patient with metastatic clear cell renal carcinoma was treated with a single dose of dual checkpoint blockade (cytotoxic T-lymphocyte-4 (CTLA-4) and programmed death-1 (PD-1)) and simultaneously diagnosed with colitis, hepatitis, and nephritis. After early immunosuppressive treatment with the glucocorticoids, complete organ function recovery was achieved. The follow-up revealed a sustained complete response lasting more than a year.

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Immune Checkpoint Inhibitors Induced Hepatotoxicity; Gastroenterologists’ Perspectives

Cited by 3 publications

References 80 publications

Immune-related adverse events of immune checkpoint inhibitors: a review

Immune-related adverse events of immune checkpoint inhibitors: a review

Untitled

Multiorgan Toxicity from Dual Checkpoint Inhibitor Therapy, Resulting in a Complete Response—A Case Report

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