The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.
Hepatotoxicity From Immune Checkpoint Inhibitors: A Systematic Review and Management Recommendation
Abstract
Immune checkpoint inhibitors (ICIs) are monoclonal antibodies targeting immune checkpoint molecules. ICIs are an immunotherapy for the treatment of many advanced malignancies. The advent of ICIs has been a major breakthrough in the field of oncology, a fact recognized by the 2018 Nobel Prize in Physiology or Medicine being awarded for the discovery. The Food and Drug Administration approved the first ICI, ipilimumab, in 2011 for the treatment of metastatic melanoma. Seven ICIs are now used in clinical practice, including nivolumab and pembrolizumab for treatment of advanced hepatocellular carcinoma. ICIs are increasingly used across the spectrum of hepatobiliary neoplasia. The utility of ICI therapy has been limited by immune‐related adverse reactions (irAEs) affecting multiple organ systems. Hepatotoxicity is an important irAE, occurring in up to 16% of patients receiving ICIs. Optimizing outcomes in patients receiving ICI therapy requires awareness of and familiarity with diagnosing and management of ICI‐induced immune‐mediated hepatotoxicity (IMH), including approaches to treatment and ICI dose management. The aim of this review article is to (1) provide a comprehensive, evidence‐based review of IMH; (2) perform a systematic review of the management of IMH; and (3) present algorithms for the diagnosis and management of IMH.
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The incidence of any grade of immune checkpoint inhibitor-related hepatitis in combination therapy is higher than that in monotherapy, for both the combination of two immune checkpoint inhibitors and a combination of an immune checkpoint inhibitor with targeted therapy.
“The incidence of any grade of ICI-related hepatitis in combination therapy is higher than that in monotherapy, for both the combination of two ICIs and a combination of an ICI with targeted therapy [152].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [152]
Immune checkpoint inhibitor-related hepatotoxicity is an indirect form of drug-induced liver injury.
“However, ICI-related hepatotoxicity is an indirect form of DILI [22,152].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [152]
The incidence of any grade of immune checkpoint inhibitor-related hepatitis is usually less than 10% with monotherapy.
“The incidence of any grade of ICI-related hepatitis is usually < 10% with monotherapy”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [152]
The incidence of liver injury induced by cytotoxic T-lymphocyte antigen 4 inhibitors is higher than that induced by programmed cell death 1 inhibitors, particularly at high doses.
“the incidence of liver injury induced by cytotoxic T-lymphocyte antigen 4 inhibitors is higher than that induced by programmed cell death 1 inhibitors, particularly at high doses.”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [152]
The incidence of immune checkpoint inhibitor-related hepatitis depends on the class of drugs, dose, and whether they are used as monotherapy or combination therapy.
“The incidence of ICI-related hepatitis depends on the class of drugs, dose, and whether they are used as monotherapy or combination therapy [152,153].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [152]
The Common Terminology Criteria for Adverse Events-based severity grading is different from the DILIN or international DILI severity grading and may not truly reflect the clinical severity of liver-related adverse events.
“which is different from the DILIN or international DILI severity grading and may not truly reflect the clinical severity of liver-related adverse events [152].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [152]
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“The benefits of liver biopsy are (1) to exclude other causes of liver disease such as liver metastasis; (2) to confirm the diagnosis of IMH, especially if granulomatous hepatitis is found in patients who are on anti-CTLA4; and (3) to evaluate the histologic severity of IMH.”
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Metadata
- Authors
- Peeraphatdit, T. (., Wang, J., Odenwald, M. A., Hu, S., Hart, J., & Charlton, M. R.
- Venue
- Hepatology
- Published
- 2020-07
- Volume
- 72
- Issue
- 1
- Pages
- 315-329
- ISSN
- 0270-9139
- 1527-3350
- Cited by
- 264
- References
- 10
- Language
- en
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