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Immunotherapy pp 159-164 | Cite as

Immune Checkpoint Inhibitors-Induced Hepatitis

  • Yun Tian
  • Hamzah Abu-Sbeih
  • Yinghong WangEmail author
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 995)

Abstract

Immune checkpoint inhibitors (ICIs) have been increasingly used for multiple cancer types in the past decade. ICIs include CTLA-4 inhibitors (e.g., ipilimumab) and the PD-1 and PD-L1 inhibitors (e.g., nivolumab and pembrolizumab). Hepatotoxicity is not uncommon secondary to ICI treatment. It can occur 8–12 weeks after the initiation of ICI and presents with elevation of aspartate transaminase and alanine transaminase. ICI-induced hepatitis is usually asymptomatic but may present with fever, malaise, and even death in rare cases. It is a diagnosis of exclusion after other etiologies are excluded based on medical history, laboratory evaluation, and imaging and histological findings. ICI-induced hepatitis might require discontinuation of ICI and/or treatment with immunosuppressants.

Keywords

Immune checkpoint inhibitors Hepatitis Anti-CTLA-4 Anti-PD-1/anti-PD-L1 Corticosteroids Transaminitis Liver injury 

Notes

Disclosure

The authors declared no financial conflict of interest.

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of OncologyShanghai Dermatology Hospital, Tongji UniversityShanghaiChina
  2. 2.Tongji University Cancer Center, The Shanghai Tenth People’s Hospital, Tongji UniversityShanghaiChina
  3. 3.Department of Gastroenterology, Hepatology and Nutrition, Division of Internal MedicineThe University of Texas MD Anderson Cancer CenterHoustonUSA

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