Liver damage related to immune checkpoint inhibitors
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Recently, immune checkpoint inhibitors are becoming one of the key agents of systemic treatment of cancer. The anti-cancer mechanism of this type of agent is totally different from that of conventional therapies; blockade of regulatory receptors and ligand of immune checkpoint molecules arose anti-tumor immunity with durable response. However, owing to its unique action to host immune system, immune checkpoint inhibitors sometimes induce immune-related adverse events (irAEs) which has not been observed for conventional chemotherapies. It has been reported that irAEs are manageable by discontinuation of immune checkpoint inhibitors and corticosteroid. However, severe irAEs might lead to the unsuccessful management of cancer treatment. It is conceivable that irAEs during the treatment of immune checkpoint blockade might mimic the autoimmune disease of the specific organ, such as autoimmune hepatitis (AIH). However, detail of the pathogenesis of irAEs has not been well estimated. In this review, we specially focused on this important issue and discussed the liver toxicity of this type of agent in the context of comparison of clinical and pathological findings of liver damage related to irAEs and AIH.
KeywordsLiver damage Immune checkpoint inhibitors Autoimmune hepatitis Hepatocellular carcinoma Granuloma
This work was supported in part by a Grant-in-Aid for Scientific Research (KAKENHI: 16K09382) from the Japanese Society for the Promotion of Science (N. Nishida) and a Grant from the Smoking Research Foundation (N. Nishida).
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Conflict of interest
Naoshi Nishida and Masatoshi Kudo have no conflicts of interest to disclose.
Ethical approval and informed consent
This is not a research paper involving human participants and/or animals; informed consent is not required.