Clinical characteristics analysis of immune checkpoint inhibitor-related hepatotoxicity
10.13431/j.cnki.immunol.j.20250100
- VernacularTitle:免疫检查点抑制剂相关肝毒性的临床特征分析
- Author:
Fan YANG
1
;
Hongjian WANG
1
;
Peng JIANG
1
;
Anxiang HU
1
;
Lisha CHU
1
Author Information
1. 滕州市中心人民医院肿瘤科,山东滕州 277500
- Publication Type:Journal Article
- Keywords:
immune checkpoint inhibitor-related hepatotoxicity;
immune-related adverse events;
alanine aminotransferase;
aspartate aminotransferase;
lactate dehydrogenase;
lymphocyte-to-monocyte ratio;
neutrophil-to-lymphocyte Ratio
- From:
Immunological Journal
2025;41(10):718-725
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical characteristics of immune checkpoint inhibitor(ICI)-related hepatotoxicity(ICIH)in cancer patients.Methods A retrospective analysis was conducted on clinical data of cancer patients with ICIH from January 2019 to December 2024.Patients with Grade 1-2 liver injury were defined as the mild group,and those with Grade 3-4 liver injury were defined as the severe group.Results Among 13 patients with ICIH,10(76.92%)were males and 3(23.08%)were females,with a mean age of 67.8±5.2 years.Twelve patients(92.3%)were aged 60 years or above.ICIH first occurred between cycle 1 and cycle 14 after initial treatment,with the highest incidence observed within cycles 1-5.Combination therapy(combination chemotherapy or targeted agents)was used in 10 patients(76.92%).Among the 13 patients,the distribution of liver injury grades was as follows:1 case of Grade 1(7.69%),2 cases of Grade 2(15.38%),5 cases of Grade 3(38.46%),and 5 cases of Grade 4(38.46%).Liver injury types included hepatocellular(38.46%),cholestatic(38.46%),and mixed(23.08%).After drug discontinuation and supportive care,9 patients(69.23%)fully recovered,2(15.38%)improved,and 2(15.38%)showed no improvement.No significant differences were observed between the mild and severe groups in terms of age,body mass index,baseline lymphocyte count,platelet count,neutrophil count,monocyte count,alanine aminotransferase,aspartate aminotransferase,lactate dehydrogenase,alkaline phosphatase,lymphocyte-to-monocyte ratio,neutrophil-to-lymphocyte ratio,and platelet-to-lymphocyte ratio(P>0.05).Conclusion ICIH typically occurs within 1 to 5 cycles after ICI administration,with non-specific clinical manifestations,which lead to a diagnosis of exclusion.Despite a generally favorable prognosis,severe ICIH can be fatal,particularly in patients with primary liver cancer.Prompt discontinuation of ICIs and initiation of Corticosteroid therapy can lead to timely improvement of patient's condition.
