The ABC of Immune-Mediated Hepatitis during Immunotherapy in Patients with Cancer: From Pathogenesis to Multidisciplinary Management
Immune-mediated hepatotoxicity (IMH) is not-so-rare complication during treatment with immune checkpoint inhibitors (ICIs). This narrative review aims to report the current knowledge on hepatic immune-related adverse events (irAEs) during immunotherapy from pathogenesis to multidisciplinary manageme...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-02-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/16/4/795 |
| _version_ | 1797298602963369984 |
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| author | Angioletta Lasagna Paolo Sacchi |
| author_facet | Angioletta Lasagna Paolo Sacchi |
| author_sort | Angioletta Lasagna |
| collection | DOAJ |
| description | Immune-mediated hepatotoxicity (IMH) is not-so-rare complication during treatment with immune checkpoint inhibitors (ICIs). This narrative review aims to report the current knowledge on hepatic immune-related adverse events (irAEs) during immunotherapy from pathogenesis to multidisciplinary management. The majority of cases of IMH are asymptomatic and only a few patients may have clinical conditions. The severity of IMH is usually stratified according to Common Terminology for Clinical Adverse Events (CTCAE) criteria, but these scores may overestimate the clinical severity of IMH compared to the Drug-Induced Liver Injury Network (DILIN) scale. The differential diagnosis of IMH is challenging because the elevated liver enzymes can be due to a number of etiologies such as viral infection, autoimmune and metabolic diseases, liver metastases, biliary diseases, and other drugs. The cornerstones of IMH management are represented by withholding or delaying ICI administration and starting immunosuppressive therapy. A multidisciplinary team, including oncologists, hepatologists, internists, and emergency medicine physicians, is essential for the management of IMH. |
| first_indexed | 2024-03-07T22:38:24Z |
| format | Article |
| id | doaj.art-264bf884c74c4087ae8e252bf5373b3f |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-07T22:38:24Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-264bf884c74c4087ae8e252bf5373b3f2024-02-23T15:11:16ZengMDPI AGCancers2072-66942024-02-0116479510.3390/cancers16040795The ABC of Immune-Mediated Hepatitis during Immunotherapy in Patients with Cancer: From Pathogenesis to Multidisciplinary ManagementAngioletta Lasagna0Paolo Sacchi1Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyDivision of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, ItalyImmune-mediated hepatotoxicity (IMH) is not-so-rare complication during treatment with immune checkpoint inhibitors (ICIs). This narrative review aims to report the current knowledge on hepatic immune-related adverse events (irAEs) during immunotherapy from pathogenesis to multidisciplinary management. The majority of cases of IMH are asymptomatic and only a few patients may have clinical conditions. The severity of IMH is usually stratified according to Common Terminology for Clinical Adverse Events (CTCAE) criteria, but these scores may overestimate the clinical severity of IMH compared to the Drug-Induced Liver Injury Network (DILIN) scale. The differential diagnosis of IMH is challenging because the elevated liver enzymes can be due to a number of etiologies such as viral infection, autoimmune and metabolic diseases, liver metastases, biliary diseases, and other drugs. The cornerstones of IMH management are represented by withholding or delaying ICI administration and starting immunosuppressive therapy. A multidisciplinary team, including oncologists, hepatologists, internists, and emergency medicine physicians, is essential for the management of IMH.https://www.mdpi.com/2072-6694/16/4/795hepatitisimmune checkpoint inhibitorsimmune-related adverse events (irAEs)CD8+ T cellsNAFLDdrug-induced liver injury (DILI) |
| spellingShingle | Angioletta Lasagna Paolo Sacchi The ABC of Immune-Mediated Hepatitis during Immunotherapy in Patients with Cancer: From Pathogenesis to Multidisciplinary Management Cancers hepatitis immune checkpoint inhibitors immune-related adverse events (irAEs) CD8+ T cells NAFLD drug-induced liver injury (DILI) |
| title | The ABC of Immune-Mediated Hepatitis during Immunotherapy in Patients with Cancer: From Pathogenesis to Multidisciplinary Management |
| title_full | The ABC of Immune-Mediated Hepatitis during Immunotherapy in Patients with Cancer: From Pathogenesis to Multidisciplinary Management |
| title_fullStr | The ABC of Immune-Mediated Hepatitis during Immunotherapy in Patients with Cancer: From Pathogenesis to Multidisciplinary Management |
| title_full_unstemmed | The ABC of Immune-Mediated Hepatitis during Immunotherapy in Patients with Cancer: From Pathogenesis to Multidisciplinary Management |
| title_short | The ABC of Immune-Mediated Hepatitis during Immunotherapy in Patients with Cancer: From Pathogenesis to Multidisciplinary Management |
| title_sort | abc of immune mediated hepatitis during immunotherapy in patients with cancer from pathogenesis to multidisciplinary management |
| topic | hepatitis immune checkpoint inhibitors immune-related adverse events (irAEs) CD8+ T cells NAFLD drug-induced liver injury (DILI) |
| url | https://www.mdpi.com/2072-6694/16/4/795 |
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