ArticleFrontiers in oncology2025
Case Report: Immune-mediated acute liver failure induced by tislelizumab in a patient with advanced cervical cancer.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Tislelizumab, an anti-PD-1 monoclonal antibody, is associated with immune-related hepatitis in 1.8% of cases, but reports of acute liver failure (ALF) remain exceedingly rare. We present a case of fulminant hepatitis and ALF following Tislelizumab therapy in a 55-year-old woman with locally advanced cervical adenocarcinoma. After three cycles of concurrent chemoradiotherapy and Tislelizumab, she developed grade 4 immune-mediated hepatitis and ALF following a fourth Tislelizumab dose, marked by severe transaminitis (AST 5329 U/L, ALT 2384 U/L), coagulopathy (INR 5.85), hyperbilirubinemia (TBIL 56.99 IU/L), and hepatic encephalopathy. Management included plasma exchange, continuous hemofiltration, high-dose corticosteroids, and immunosuppressive agents. Despite aggressive intervention, the patient's condition deteriorated, underscoring the rapid progression of Tislelizumab-induced hepatotoxicity. This case highlights the critical need for vigilant monitoring of high-risk patients receiving immune checkpoint inhibitors and early intervention for suspected immune-mediated liver injury.
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