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Updated: Dec 23, 2025

Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
Published on: May 24, 2024
Safe administration of anti-PD-1 immunotherapy in a patient with pre-existing primary biliary cholangitis
Prachi Bhave1, Alan Pham2, Adam Gordon3
1Department of Medical Oncology, Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia.
Abstract:
A 63-year-old female presented with cholestatic liver function tests in November 2016. Screening tests were negative for other causes and liver biopsy revealed primary biliary cholangitis (PBC) with autoimmune hepatitis (AIH) overlap. Ursodeoxycholic acid and azathioprine was initiated. In September 2018 she was diagnosed with Stage III BRAF wild-type melanoma. Azathioprine was ceased and adjuvant immunotherapy was not recommended due to the risk of worsening PBC/AIH. Surveillance PET revealed metastatic disease and she commenced pembrolizumab. Restaging PET after 4 cycles showed a complete metabolic response, with no hepatitis or other significant toxicity. We believe this is the first reported case of the safe administration of pembrolizumab in a patient with known PBC/AIH. Treatment duration in such high risk patients needs further investigation.
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