Hepatic immune-mediatedadverseeffects of immune checkpoint inhibitors: analysis of real-life experience
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.16/2897 |
Resumo: | Introduction and objectives: Immune Checkpoint Inhibitors (ICI) have shifted the paradigm of cancer therapy treatment. Despite their efficacy, ICIs may induce immune-related adverse events (irAE), which can affect various organs, namely the liver. This study intends to perform a comprehensive clinical description of the hepatic irAEs associated with ICI in a Portuguese population of a tertiary hospital centre. Materials and methods: A retrospective analysis of patients who developed immune-mediated liver injury (IMLI), among a cohort of patients treated with ICIs between March 15th of 2015 and December 15th of 2019 in a tertiary hospital. We used both Common Terminology Criteria for Adverse Events (CTCAE) and Drug-Induced Liver Injury Network (DILIN) criteria to define liver injury. Results: Among 151 patients, eight (5.3%) patients developed liver injury grade ≥3, of which five had hepatic metastasis. As such, only 3 cases were classified as IMLI. All IMLI presented with cholestasis pattern; the median duration from ICI initiation to IMLI was 84 days and/or 4 ICI cycles; one patient registered IMLI one month after nivolumab suspension; all were treated with steroids and one was successfully submitted to ICI re-challenge; a favourable outcome was seen in all patients; the median time to hepatic biochemistries normalization was 150 days. Among 10 patients with previous hepatic conditions, only one developed liver injury grade 2. Conclusions: Clinically significant ICI-related hepatotoxicity was uncommon; Immune-mediated liver injury may present a cholestatic pattern predominance. There was a low rate of liver injury of any kind in patients with previous hepatic disease while on ICI. |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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7160 |
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Hepatic immune-mediatedadverseeffects of immune checkpoint inhibitors: analysis of real-life experienceDrug Induced Liver InjuryDrug-Related Side Effects and Adverse ReactionsHepatotoxicityImmune-related adverse eventImmunotherapycancerIntroduction and objectives: Immune Checkpoint Inhibitors (ICI) have shifted the paradigm of cancer therapy treatment. Despite their efficacy, ICIs may induce immune-related adverse events (irAE), which can affect various organs, namely the liver. This study intends to perform a comprehensive clinical description of the hepatic irAEs associated with ICI in a Portuguese population of a tertiary hospital centre. Materials and methods: A retrospective analysis of patients who developed immune-mediated liver injury (IMLI), among a cohort of patients treated with ICIs between March 15th of 2015 and December 15th of 2019 in a tertiary hospital. We used both Common Terminology Criteria for Adverse Events (CTCAE) and Drug-Induced Liver Injury Network (DILIN) criteria to define liver injury. Results: Among 151 patients, eight (5.3%) patients developed liver injury grade ≥3, of which five had hepatic metastasis. As such, only 3 cases were classified as IMLI. All IMLI presented with cholestasis pattern; the median duration from ICI initiation to IMLI was 84 days and/or 4 ICI cycles; one patient registered IMLI one month after nivolumab suspension; all were treated with steroids and one was successfully submitted to ICI re-challenge; a favourable outcome was seen in all patients; the median time to hepatic biochemistries normalization was 150 days. Among 10 patients with previous hepatic conditions, only one developed liver injury grade 2. Conclusions: Clinically significant ICI-related hepatotoxicity was uncommon; Immune-mediated liver injury may present a cholestatic pattern predominance. There was a low rate of liver injury of any kind in patients with previous hepatic disease while on ICI.ElsevierRepositório Científico da Unidade Local de Saúde de Santo AntónioSilva, JoanaFalcão, DanielaCardoso, CláudiaPires, Ana LuísaAraújo, AntónioCastro-Poças, Fernando2023-12-21T11:19:24Z2021-122021-12-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.16/2897eng1665-268110.1016/j.aohep.2021.100561info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-11-21T04:36:18Zoai:repositorio.chporto.pt:10400.16/2897Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-11-21T04:36:18Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Hepatic immune-mediatedadverseeffects of immune checkpoint inhibitors: analysis of real-life experience |
title |
Hepatic immune-mediatedadverseeffects of immune checkpoint inhibitors: analysis of real-life experience |
spellingShingle |
Hepatic immune-mediatedadverseeffects of immune checkpoint inhibitors: analysis of real-life experience Silva, Joana Drug Induced Liver Injury Drug-Related Side Effects and Adverse Reactions Hepatotoxicity Immune-related adverse event Immunotherapy cancer |
title_short |
Hepatic immune-mediatedadverseeffects of immune checkpoint inhibitors: analysis of real-life experience |
title_full |
Hepatic immune-mediatedadverseeffects of immune checkpoint inhibitors: analysis of real-life experience |
title_fullStr |
Hepatic immune-mediatedadverseeffects of immune checkpoint inhibitors: analysis of real-life experience |
title_full_unstemmed |
Hepatic immune-mediatedadverseeffects of immune checkpoint inhibitors: analysis of real-life experience |
title_sort |
Hepatic immune-mediatedadverseeffects of immune checkpoint inhibitors: analysis of real-life experience |
author |
Silva, Joana |
author_facet |
Silva, Joana Falcão, Daniela Cardoso, Cláudia Pires, Ana Luísa Araújo, António Castro-Poças, Fernando |
author_role |
author |
author2 |
Falcão, Daniela Cardoso, Cláudia Pires, Ana Luísa Araújo, António Castro-Poças, Fernando |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico da Unidade Local de Saúde de Santo António |
dc.contributor.author.fl_str_mv |
Silva, Joana Falcão, Daniela Cardoso, Cláudia Pires, Ana Luísa Araújo, António Castro-Poças, Fernando |
dc.subject.por.fl_str_mv |
Drug Induced Liver Injury Drug-Related Side Effects and Adverse Reactions Hepatotoxicity Immune-related adverse event Immunotherapy cancer |
topic |
Drug Induced Liver Injury Drug-Related Side Effects and Adverse Reactions Hepatotoxicity Immune-related adverse event Immunotherapy cancer |
description |
Introduction and objectives: Immune Checkpoint Inhibitors (ICI) have shifted the paradigm of cancer therapy treatment. Despite their efficacy, ICIs may induce immune-related adverse events (irAE), which can affect various organs, namely the liver. This study intends to perform a comprehensive clinical description of the hepatic irAEs associated with ICI in a Portuguese population of a tertiary hospital centre. Materials and methods: A retrospective analysis of patients who developed immune-mediated liver injury (IMLI), among a cohort of patients treated with ICIs between March 15th of 2015 and December 15th of 2019 in a tertiary hospital. We used both Common Terminology Criteria for Adverse Events (CTCAE) and Drug-Induced Liver Injury Network (DILIN) criteria to define liver injury. Results: Among 151 patients, eight (5.3%) patients developed liver injury grade ≥3, of which five had hepatic metastasis. As such, only 3 cases were classified as IMLI. All IMLI presented with cholestasis pattern; the median duration from ICI initiation to IMLI was 84 days and/or 4 ICI cycles; one patient registered IMLI one month after nivolumab suspension; all were treated with steroids and one was successfully submitted to ICI re-challenge; a favourable outcome was seen in all patients; the median time to hepatic biochemistries normalization was 150 days. Among 10 patients with previous hepatic conditions, only one developed liver injury grade 2. Conclusions: Clinically significant ICI-related hepatotoxicity was uncommon; Immune-mediated liver injury may present a cholestatic pattern predominance. There was a low rate of liver injury of any kind in patients with previous hepatic disease while on ICI. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-12 2021-12-01T00:00:00Z 2023-12-21T11:19:24Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.16/2897 |
url |
http://hdl.handle.net/10400.16/2897 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
1665-2681 10.1016/j.aohep.2021.100561 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
mluisa.alvim@gmail.com |
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1817549544836038656 |