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High-Content Screening Assay for the Identification of Antibody-Dependent Cellular Cytotoxicity Modifying Compounds

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Trastuzumab-induced hepatotoxicity.

Sridhar Srinivasan¹, Venkata Parsa, Chin Y Liu

¹Division of Hematology/Oncology, Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA.

The Annals of Pharmacotherapy

|September 11, 2008

Summary

This case study highlights probable trastuzumab-induced hepatotoxicity in a breast cancer patient. Liver enzyme levels normalized after drug discontinuation and rose upon rechallenge, indicating a causal link.

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Area of Science:

Oncology
Pharmacology
Hepatology

Background:

Trastuzumab is a targeted therapy for HER2-positive breast cancer.
Hepatotoxicity is a potential adverse effect of cancer therapeutics.
Early identification and management of drug-induced liver injury are crucial.

Observation:

A patient with HER2-positive breast cancer developed elevated liver enzymes during trastuzumab treatment.
Paclitaxel was initially withheld, but trastuzumab was continued due to lack of prior reports.
Liver enzymes normalized upon trastuzumab discontinuation and re-elevated upon rechallenge.

Findings:

Trastuzumab was identified as the probable cause of hepatotoxicity using a validated drug-induced liver injury scale.
The patient had no prior comorbidities affecting liver function.
This is the first reported case of trastuzumab-induced hepatotoxicity necessitating drug discontinuation.

Implications:

Close monitoring of liver function tests is essential for patients undergoing trastuzumab therapy.
This case expands the known adverse event profile of trastuzumab.
Further research into trastuzumab-related hepatotoxicity is warranted.