Immune checkpoint inhibitor-related hepatotoxicity: A review
The application of immune checkpoint inhibitors (ICI) in advanced cancer has been a major development in the last decade. The indications for ICIs are constantly expanding into new territory across different cancers, disease stages and lines of therapy. With this increased use, adverse events includ...
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| Published in: | World journal of gastroenterology : WJG Vol. 27; no. 32; pp. 5376 - 5391 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Baishideng Publishing Group Inc
28-08-2021
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | The application of immune checkpoint inhibitors (ICI) in advanced cancer has been a major development in the last decade. The indications for ICIs are constantly expanding into new territory across different cancers, disease stages and lines of therapy. With this increased use, adverse events including immune checkpoint inhibitor-related hepatotoxicity (ICH) have emerged as an important clinical problem. This along with the introduction of ICI as first- and second-line treatments for advanced hepatocellular carcinoma makes ICH very relevant to gastroenterologists and hepatologists. The incidence of ICH varies between 1%-20% depending on the number, type and dose of ICI received. Investigation and management generally involve excluding differential diagnoses and following a stepwise escalation of withholding or ceasing ICI, corticosteroid treatment and adding other immunosuppressive agents depending on the severity of toxicity. The majority of patients with ICH recover and some may even safely recommence ICI therapy. Guideline recommendations are largely based on evidence derived from retrospective case series which highlights a priority for future research. |
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| Bibliography: | Author contributions: McKenzie C, Kao S, Strasser SI and Liu K were involved in the conception of the review, and critically revised the article; Remash D, Prince DS and Liu K performed the literature review, and drafted the article; all authors have read and approved the final version. Corresponding author: Ken Liu, BSc, FRACP, MBBS, Consultant Physician-Scientist, Senior Lecturer, Staff Physician, AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney 2050, NSW, Australia. ken.liu@health.nsw.gov.au |
| ISSN: | 1007-9327 2219-2840 |
| DOI: | 10.3748/wjg.v27.i32.5376 |