Histological Characteristics and Management of Hepatitis on Immune Checkpoint Inhibitors: A Retrospective Descriptive...

Area of Science:

• Hepatology
• Oncology
• Immunology

Background:

• Immune checkpoint inhibitors (ICI) can cause drug-induced liver injury (DILI), complicating cancer patient management.
• The diagnostic and therapeutic value of liver biopsy in ICI-DILI remains unclear.

Purpose of the Study:

• To investigate the impact of liver biopsy on clinical management decisions for ICI-DILI.
• To assess the correlation between histological findings and corticosteroid response in ICI-DILI.

Main Methods:

• Retrospective, single-center study of 35 patients with ICI-DILI (2015-2021).
• Evaluation of biochemical, histological, and clinical data.
• Analysis of liver biopsy impact on ICI management and corticosteroid efficacy.

Main Results:

• Liver biopsy did not influence decisions regarding ICI withdrawal, reduction, or rechallenge.
• Patients with toxic and granulomatous histological profiles showed better corticosteroid response.
• Patients with cholangitic lesions exhibited the poorest response to corticosteroids.

Conclusions:

• Liver biopsy in ICI-DILI should not delay patient care.
• Histological findings from liver biopsy can identify patients with cholangitic profiles who are less likely to respond to corticosteroids.