Abstract
Immune checkpoint inhibition targeted against cytotoxic T-lymphocyte–associated antigen
4 (CTLA-4) and programmed cell death protein 1 (PD-1) has shown clinically significant
survival benefit when used to treat multiple types of advanced cancer. These drugs
have gained approval by the US Food and Drug Administration and their indications
continue to increase. Checkpoint inhibitor therapy is associated with a unique side-effect
profile characterized as immune-related adverse events (irAEs), which can result in
significant morbidity and rarely mortality. Hepatotoxicity from checkpoint inhibitors
is a less common irAE and often mild, while its incidence and severity vary based
on the class and dose of checkpoint inhibitor, monotherapy versus combination therapy,
and the type of cancer. Histological assessment of suspected irAEs is nonspecific
and can show a variety of features. Hepatic irAEs can require discontinuation of checkpoint
inhibitor therapy and treatment with immunosuppressive agents.
Keywords
hepatotoxicity - immune-related adverse events - checkpoint inhibitor - CTLA-4 - programmed
cell death protein 1
