Risk Factors and Biomarkers for Immune Checkpoint Inhibitor-mediated Hepatotoxicity: Emerging Insights and Future...

Area of Science:

• Oncology
• Immunology
• Hepatology

Background:

• Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy.
• Increased ICI use has led to a rise in immune-related adverse events, including immune-mediated hepatotoxicity (IMH).
• IMH poses significant risks, necessitating early detection and management strategies.

Purpose of the Study:

• To review current knowledge on risk factors for IMH in patients receiving ICI therapy.
• To explore potential predictive biomarkers for IMH.
• To highlight the need for further research in early IMH identification and management.

Main Methods:

• Literature review of risk factors and predictive biomarkers for IMH.
• Categorization of risk factors into patient-associated, tumor-associated, and agent-associated.
• Summary of potential biomarkers including blood cells, serum proteins, autoantibodies, cytokines, gene profiles, and gut microbiome.

Main Results:

• Patient factors (sex, age, BMI, ethnicity, liver disease), tumor factors (cancer type, prior ICI), and agent factors (dual ICI, concurrent therapies) are associated with higher IMH risk.
• Various biomarkers show promise but lack consistent predictive value.
• No definitive biomarker is currently established for routine clinical use.

Conclusions:

• Early identification and individualized management of IMH are critical for patients on ICI therapy.
• Further large-scale prospective studies are required to validate predictive biomarkers.
• Integrating validated biomarkers into clinical practice will enhance IMH prediction and patient care.