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Olaparib-Induced Immune-Mediated Liver Injury

Mohammad Alshelleh1, Jennifer Park2, Veena John2

  • 1Division of Gastroenterology, Zucker School of Medicine at Hofstra/Northwell Health System, Farmington, CT.

ACG Case Reports Journal
|January 14, 2022
PubMed

Insights

Olaparib, a PARP inhibitor for ovarian cancer, can cause severe liver injury. This case highlights the importance of monitoring liver function during treatment with this immunotherapy drug.

Area of Science:

  • Oncology
  • Hepatology
  • Pharmacology

Background:

  • Immune-mediated drug-induced liver injury (DILI) is a significant concern with various medications, including immunotherapies.
  • Olaparib, a poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor, is utilized in treating specific ovarian cancers with BRCA mutations.

Observation:

  • This report details the first documented case in the United States of acute and severe liver injury linked to olaparib.
  • The patient presented with jaundice and impaired liver synthetic function, indicative of significant hepatotoxicity.

Findings:

  • Cessation of olaparib led to the resolution of the drug-induced liver injury.
  • Treatment with a prednisone taper further supported the recovery of liver function.

Implications:

  • This case underscores the potential for olaparib to cause severe hepatotoxicity, necessitating vigilant liver function monitoring in patients undergoing treatment.
  • Awareness of this adverse effect is crucial for oncologists and hepatologists managing patients on olaparib therapy.
  • Early recognition and intervention, including drug withdrawal and corticosteroid treatment, can effectively manage olaparib-induced liver injury.

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