Evidence map›Paper›PMID 36102989›Full record

ArticleJournal of cancer research and clinical oncology2023

Outcomes of immunotherapy-related hepatotoxicity from a multi-disciplinary toxicity team.

Christopher Fan, Ahyoung Kim, Sean Li, Jarushka Naidoo, Laura C Cappelli, Julie R Brahmer, Robert A Anders, Amy K Kim

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cancer research and clinical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. [Several issues and considerations in the clinical diagnosis and treatment of immune checkpoint inhibitor-associated liver injury].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025
    Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Christopher FanDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Ahyoung KimDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Sean LiDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Jarushka NaidooDepartment of Oncology, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA.
Laura C CappelliBeaumont RCSI Cancer Centre, Dublin, Ireland.
Julie R BrahmerDepartment of Oncology, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA.
Robert A AndersDepartment of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Amy K KimDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, MD, USA. akim97@jhmi.edu.
Johns Hopkins University · USSidney Kimmel Cancer Center · USSidney Kimmel Comprehensive Cancer Center · US

Funding

Clinical Pharmacology Training ProgramT32GM066691 · NIGMS · JOHNS HOPKINS UNIVERSITY · PI Matthew Michael Ippolito · 2003 to 2026
$6.4M
Improved early prognostic algorithm for hepatocellulcar carcinomaK08CA237624 · NCI · JOHNS HOPKINS UNIVERSITY · PI KIM, AMY K · 2020 to 2024
$1.3M
NCI NIH HHS K08 CA237624NIGMS NIH HHS T32 GM066691NIH HHS K08 CA237624NIH HHS NIH T32 GM06669
6 · The paper itself

Abstract

backgroundDespite the efficacy of immune checkpoint inhibitors (ICIs), adverse events including hepatotoxicity limit their ongoing use. We investigated the outcomes and management of patients with immune-mediated hepatitis (IMH) and clinical predictors of toxicity resolution.

methodsPatients referred to our multidisciplinary immunotherapy-related toxicity group from August 2017 to December 2020 for IMH were evaluated. Toxicity was defined according to CTCAEv4.0. IMH resolution was defined as liver enzyme normalization after steroid initiation.

resultsThirty-three patients were included in the study, 62% female, and 71% Caucasian. The most common ICI used was PD-1/PD-L1 (76%). Peak IMH occurred at a median of 89 [45,193] days, for which most patients received 1-2 mg/kg/day prednisone equivalent with 35% requiring MMF. Median follow-up was 123 [33,472] days with IMH resolution seen in 48% of patients at a median of 111 [41,214] days. While high-dose steroid use was not associated with IMH resolution, liver enzyme improvement one week after steroids predicted resolution in univariate analysis (p = 0.041). All 11 patients without IMH resolution died from cancer progression or complications with three patients having acute liver failure. Available liver biopsies showed bile duct injury, with varying degrees of portal and lobular inflammation.

conclusionIMH improvement one week after steroid initiation may predict ultimate IMH resolution.

Indexed as

Chemical and Drug Induced Liver InjuryDrug-Related Side Effects and Adverse ReactionsHepatitisNeoplasmsFemaleHumansImmunotherapyMaleRetrospective StudiesCheckpoint inhibitorDrug toxicityHepatitisimmunotherapy

Identifiers

PMID36102989
PMCPMC10888511
OpenAlexW4295568102

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.