Hepatic immune-mediatedadverseeffects of immune checkpoint inhibitors: analysis of real-life experience

Detalhes bibliográficos
Autor(a) principal: Silva, Joana
Data de Publicação: 2021
Outros Autores: Falcão, Daniela, Cardoso, Cláudia, Pires, Ana Luísa, Araújo, António, Castro-Poças, Fernando
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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spelling 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
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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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