Immune checkpoint inhibitor (ICI)-induced hepatitis diagnosed by liver biopsy followed by ICI-free chemotherapy leading to therapeutic effect: A case of lung cancer treatment.

Autor:	Okuno T; Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan., Nakashima K; Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan., Mitarai Y; Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan., Kataoka M; Department of Gastroenterology and Hepatology, Shimane University Faculty of Medicine, Japan., Tobita H; Department of Gastroenterology and Hepatology, Shimane University Faculty of Medicine, Japan., Nagase M; Department of Organ Pathology, Shimane University Faculty of Medicine, Japan., Isobe T; Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan., Tsubata Y; Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan.
Jazyk:	angličtina
Zdroj:	Respiratory medicine case reports [Respir Med Case Rep] 2022 Nov 08; Vol. 40, pp. 101773. Date of Electronic Publication: 2022 Nov 08 (Print Publication: 2022).
DOI:	10.1016/j.rmcr.2022.101773
Abstrakt:	In recent years, the combination of platinum-based chemotherapy and immune checkpoint inhibitors (ICIs) has become the standard treatment for patients with lung cancer. Hepatitis is one of the common toxicities following ICI/chemotherapy. When drug-induced hepatitis occurs, the suspected drug must be discontinued. Since it may be difficult to determine the exact drug causing the hepatitis, liver biopsy may help identify this. We report the case of a patient diagnosed with immune-related adverse event hepatitis from liver biopsy and clinical course. A 45-year-old man with lung adenocarcinoma (stage IV, cT4N3M1c) negative for driver gene mutation was treated with carboplatin (CBDCA), pemetrexed (PEM), and pembrolizumab. Elevated blood aspartate aminotransferase and alanine aminotransferase levels after chemotherapy indicated hepatitis induced by cytotoxic anticancer agents and ICIs. As autoimmune hepatitis was also suspected, liver biopsy was performed and the findings suggested ICI-induced hepatitis. Pembrolizumab was discontinued and CBDCA/PEM was resumed, following which, the primary lesion shrank. When drug-induced hepatitis is suspected, clinicians should actively perform liver biopsy to confirm the diagnosis, so that appropriate therapeutic regimen can be administered. Competing Interests: None. (© 2022 Published by Elsevier Ltd.)
Databáze:	MEDLINE
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