Hepatobiliary complications of immune checkpoint inhibitors in cancer

Area of Science:

• Oncology
• Immunology
• Hepatology

Background:

• Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment, demonstrating significant efficacy in improving patient survival across various malignancies.
• Adverse effects of ICIs on multiple organ systems are known, with increasing interest in their real-world short- and long-term clinical implications.
• ICI-related hepatobiliary toxicities present diagnostic challenges, often mimicking other causes of abnormal liver function tests.

Purpose of the Study:

• To provide a comprehensive and current review of hepatobiliary complications associated with immune checkpoint inhibitors.
• To elucidate the pathogenesis, diagnostic approaches, and management strategies for ICI-induced liver injury.

Main Methods:

• Systematic literature review of studies investigating immune checkpoint inhibitors and their hepatobiliary effects.
• Analysis of clinical data and case reports on ICI-related liver toxicities.
• Synthesis of current understanding regarding the mechanisms, diagnosis, and treatment of these adverse events.

Main Results:

• Immune checkpoint inhibitors are associated with a spectrum of hepatobiliary toxicities.
• Distinguishing ICI-induced liver injury from other liver diseases requires careful clinical evaluation and diagnostic workup.
• Management strategies involve prompt recognition, appropriate interventions, and sometimes discontinuation of ICI therapy.

Conclusions:

• Understanding the nuances of ICI-related hepatobiliary complications is crucial for effective patient management.
• This review offers an updated perspective on the diagnosis and management of these challenging toxicities in clinical practice.
• Further research is needed to refine diagnostic criteria and optimize therapeutic approaches for ICI-induced liver injury.