ArticleHepatology international2024
Management and treatment of severe immune-related hepatotoxicity based on clinical and pathological characteristics.
Article in Hepatology international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Advancing immune checkpoint inhibitor rechallenge: key insights into efficacy, safety, and personalized strategies in advanced solid tumors.Frontiers in oncology · 2026Pooled it
- Autoimmune Hepatitis Induced by Immune Checkpoint Inhibitors in Adults: A Systematic Review.Diagnostics (Basel, Switzerland) · 2026Review
- Article
- Targeting NLRP3 inflammasome: a novel strategy for improving immune checkpoint inhibitor-associated pneumonitis.Translational lung cancer research · 2026Article
- Immunotherapy rechallenge in gastric cancer: resistance mechanisms, molecular stratification, and precision decision-making.Frontiers in immunology · 2026Review
- Sintilimab-Induced Sequential Multi-System Severe Immune-Related Adverse Events in an Elderly Patient with Esophageal Squamous Cell Carcinoma: A Case Report and Literature Review.OncoTargets and therapy · 2026Article
- From mechanisms to practice: risk management and multidisciplinary decision-making for systemic treatment-related liver injury in HBV-associated hepatocellular carcinoma.Frontiers in pharmacology · 2026Review
- Neoadjuvant immunotherapy for resectable primary liver cancer (Review).Oncology letters · 2025Review
- Navigating liver toxicity in the age of novel oncological agents.JHEP reports : innovation in hepatology · 2025Review
- Advances in mechanistic investigation and treatment of steroid-refractory ICI-induced liver injury.Clinical and experimental medicine · 2025Review
- Oncohepatology: Navigating liver injury in the era of modern cancer therapy.World journal of hepatology · 2025Review
- A retrospective study of clinical characteristics and steroid therapy in immune checkpoint inhibitor-mediated hepatitis.Therapeutic advances in medical oncology · 2025Article
- Hepatotoxicity in Cancer Immunotherapy: Diagnosis, Management, and Future Perspectives.Cancers · 2024Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundThe management of severe immune-related hepatotoxicity (irH) needs to be further optimized. This study aims to analyze the clinical characteristics of severe irH; improve the therapeutic strategy, especially salvage treatment in steroid-refractory irH; and determine the safety of immune checkpoint inhibitor (ICPi)-rechallenge.
methodsThis multicenter retrospective study included patients who developed severe irH and those without irH after immunotherapy between May 2019 and June 2023. Propensity score matching was used to match these two cohorts with similar baseline characteristics.
resultsAmong 5,326 patients receiving ICPis, 51 patients developed severe irH. irH occurred after a median duration of 36 days and a median of two doses after the first ICPi administration. Patients receiving PD-L1 inhibitors faced a lower risk of developing severe irH. A higher dose of glucocorticoids (GCS) was administered to grade 4 irH than grade 3 irH. For steroid-sensitive patients, grade 4 irH individuals received a higher dosage of GCS than those with grade 3 irH, with no difference in time to resolution. Meanwhile, a significantly higher dose of GCS plus immunosuppression was needed in the steroid-refractory group. Liver biopsy of the steroid-refractory patients exhibited heterogeneous histological features. Twelve patients were retreated with ICPi. No irH reoccurred after a median follow-up of 9.3 months.
conclusionirH requires multidimensional evaluation. PD-L1 inhibitors correlated with a lower risk of severe irH. Grade 4 irH demands a higher dose of GCS than recommended. Pathology may guide the salvage treatment for steroid-refractory irH. ICPi rechallenge in severe irH is feasible and safe.
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