ArticleFrontiers in oncology2026
Successful diagnosis and treatment of autoimmune hepatitis leading to liver failure following PD-1 immunotherapy in a patient with nasopharyngeal carcinoma: a case report.
Article in Frontiers in oncology, 2026. 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
Background: Immune checkpoint inhibitors (ICIs), particularly programmed cell death protein 1 (PD-1) inhibitors, are widely used in oncology but can cause immune-related adverse events, including hepatotoxicity. Severe ICI-induced liver injury progressing to acute or subacute liver failure carries a poor prognosis and presents a significant management challenge. Case presentation: We present the case of a 58-year-old male with recurrent nasopharyngeal carcinoma who developed severe autoimmune hepatitis and subacute liver failure following his first cycle of tislelizumab (an anti-PD-1 antibody) combined with chemotherapy. Despite initial management with corticosteroids and hepatoprotective agents, his liver function deteriorated rapidly, characterized by progressive hyperbilirubinemia and coagulopathy. After transfer to a tertiary center, he was managed with high-dose intravenous methylprednisolone, mycophenolate mofetil, and three sessions of artificial liver support (plasma exchange and bilirubin adsorption). His liver function gradually stabilized and ultimately recovered. At follow-up, he achieved normal liver biochemistry and a good quality of life. Conclusion: This case underscores the potential severity of ICI-induced hepatotoxicity. It highlights the critical importance of early recognition, prompt grading according to guidelines (e.g., CSCO), and aggressive, multimodal immunosuppressive therapy combined with artificial liver support in managing life-threatening immune-mediated liver failure. Close monitoring of liver function before, during, and after ICI therapy is essential.
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