Clinical course of liver injury induced by immune checkpoint inhibitors in patients with advanced malignancies View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2021-08-09

AUTHORS

Takanori Ito, Masatoshi Ishigami, Takafumi Yamamoto, Kazuyuki Mizuno, Kenta Yamamoto, Norihiro Imai, Yoji Ishizu, Takashi Honda, Hiroki Kawashima, Satoshi Yasuda, Hidenori Toyoda, Kenji Yokota, Tetsunari Hase, Naoki Nishio, Osamu Maeda, Masashi Kato, Naozumi Hashimoto, Hideharu Hibi, Yasuhiro Kodera, Michihiko Sone, Yuichi Ando, Masashi Akiyama, Yoshie Shimoyama, Mitsuhiro Fujishiro

ABSTRACT

BackgroundThe clinical course of liver injury induced by immune checkpoint inhibitors (ICIs) varies among individuals, and there were few reports on the therapeutic effects of corticosteroids based on the patterns of liver injury.MethodsWe evaluated the characteristics and clinical course of immune-related liver injury in 1214 patients treated with ICIs for advanced malignancies except for hepatocellular carcinoma between August 2014 and May 2021.ResultsDuring the follow-up period (median, 252 days), 58 patients (4.8%) had an immune-related liver injury (≥ Grade 3). The liver-injury patterns were hepatocellular (n = 26, 44.8%), mixed (n = 11, 19.0%), or cholestatic (n = 21, 36.2%), and the median time to onset of liver injury was 39, 81, and 53 days, respectively; the hepatocellular pattern occurred earlier than the other types (p = 0.047). Corticosteroids were administered to 30 (51.7%) patients; while liver injury was improved in almost all patients with the hepatocellular pattern (n = 13/14, 92.9%), that failed to show improvement in over half of the patients with the non-hepatocellular patterns, and three patients with mixed patterns needed secondary immunosuppression with mycophenolate mofetil. Liver biopsies performed in 13 patients mainly showed lobular injury, endothelialitis, and spotty necrosis with infiltration of T cells positive for CD3 and CD8, but not CD4 or CD20.ConclusionThe incidence pattern and therapeutic response to corticosteroids in immune-related liver injury differ according to the injury type. Although corticosteroids were effective for the hepatocellular pattern, an additional strategy for refractory non-hepatocellular patterns is needed. More... »

PAGES

1278-1287

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12072-021-10238-y

DOI

http://dx.doi.org/10.1007/s12072-021-10238-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1140292851

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/34373964


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    "description": "BackgroundThe clinical course of liver injury induced by immune checkpoint inhibitors (ICIs) varies among individuals, and there were few reports on the therapeutic effects of corticosteroids based on the patterns of liver injury.MethodsWe evaluated the characteristics and clinical course of immune-related liver injury in 1214 patients treated with ICIs for advanced malignancies except for hepatocellular carcinoma between August 2014 and May 2021.ResultsDuring the follow-up period (median, 252\u00a0days), 58 patients (4.8%) had an immune-related liver injury (\u2265\u2009Grade 3). The liver-injury patterns were hepatocellular (n\u2009=\u200926, 44.8%), mixed (n\u2009=\u200911, 19.0%), or cholestatic (n\u2009=\u200921, 36.2%), and the median time to onset of liver injury was 39, 81, and 53\u00a0days, respectively; the hepatocellular pattern occurred earlier than the other types (p\u2009=\u20090.047). Corticosteroids were administered to 30 (51.7%) patients; while liver injury was improved in almost all patients with the hepatocellular pattern (n\u2009=\u200913/14, 92.9%), that failed to show improvement in over half of the patients with the non-hepatocellular patterns, and three patients with mixed patterns needed secondary immunosuppression with mycophenolate mofetil. Liver biopsies performed in 13 patients mainly showed lobular injury, endothelialitis, and spotty necrosis with infiltration of T cells positive for CD3 and CD8, but not CD4 or CD20.ConclusionThe incidence pattern and therapeutic response to corticosteroids in immune-related liver injury differ according to the injury type. Although corticosteroids were effective for the hepatocellular pattern, an additional strategy for refractory non-hepatocellular patterns is needed.", 
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337 grid-institutes:grid.416762.0 schema:alternateName Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
338 schema:name Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
339 rdf:type schema:Organization
340 grid-institutes:grid.437848.4 schema:alternateName Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
341 Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan
342 Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
343 schema:name Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
344 Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan
345 Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
346 rdf:type schema:Organization
 




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