Journal Article

Histological Characteristics and Management of Hepatitis on Immune Checkpoint Inhibitors: A Retrospective Descriptive Study

Mallet, Vincent, Pol, Stanislas, Parlati, Lucia, Hollande, Clémence, Terris, Benoit, Sogni, Philippe, Marcin, Kennie, Vallet-Pichard, Anaïs, Corouge, Marion

2023

Overview

Background and aims: the side effects of immune checkpoint inhibitors (ICI) pose a problem for the clinical management of cancer patients. There is a lack of knowledge of the value of liver biopsy in patients with ICI-related drug-induced liver injury (ICI-DILI). The aim of this study was to explore the impact of liver biopsy on clinical management and response to corticosteroids, according to histological findings. Methods: We conducted a retrospective, single-center study to evaluate the biochemical, histological and clinical data of 35 patients with ICI-DILI between 2015 and 2021 in a university hospital in France. Results: Of the 35 patients with ICI-DILI (median [interquartile range] age 62 [48–73] years, 40% males) studied, 20 underwent a liver biopsy. There was no difference in the management of ICI-DILI according to liver biopsy in terms of ICI withdrawal, reduction or rechallenge. According to the histological profile, patients with toxic and granulomatous profiles had a better response to corticosteroids, while patients with cholangitic lesions had the worst response. Conclusion: In ICI-DILI, liver biopsy must not delay patient care but may be useful in identifying patients with a cholangitic profile who have a poorer response to corticosteroids.

• Publisher: MDPI AG,MDPI
• Subject: Antibodies / Biopsy / Cholangitis / Clinical medicine / Complications and side effects / Cytomegalovirus / Diagnosis / Drug therapy / Drug withdrawal / Granulomas / Hepatitis / Histology / Immune checkpoint inhibitors / Immunotherapy / Inflammation / Liver / Monoclonal antibodies / Patient outcomes / Statistical analysis / Steroids / Toxicity