Z Gastroenterol 2023; 61(08): e489
DOI: 10.1055/s-0043-1771889
Abstracts | DGVS/DGAV
Kurzvorträge
Tumorimmunologie in der GI-Onkologie
Freitag, 15. September 2023, 08:00–09:28, Saal 6

PD-1/PD-L1 immune checkpoint therapy demonstrates favorable safety profile in patients with autoimmune liver disease

L. Kocheise
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
I. Piseddu
3   Department of Internal Medicine II, University Hospital, LMU Munich, Munich, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
J. Vonderlin
4   Department of Hepatology and Gastroenterology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum and Campus Charité Mitte, Berlin, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
E. Tjwa
5   Department of Gastroenterology and Hepatology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, Niederlande
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
G. Buescher
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
L. Meunier
6   Service Hépato-Gastro Entérologie, Hôpital St-Eloi, CHU Montpellier, Montpellier, Frankreich
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
P. Goeggelmann
7   Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Deutschland
,
A. Gasbarrini
8   Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, Roma, Italien
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
J. Dumortier
9   Service d'hépato-gastroentérologie, Hôpital Edouard Herriot – Hospices civils de Lyon, and Université de Lyon, Lyon, Frankreich
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
M. Riveiro-Barciela
10   Liver Unit, Department of Internal Medicine, Hospital Universitari Valle d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spanien
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
T.J G Gevers
11   Department of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, Niederlande
12   Nutrim School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Niederlande
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
B. Terziroli
13   Epatocentro Ticino, Lugano, Schweiz
14   Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Schweiz
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
M. C. Londoño
15   Liver Unit, Hospital Clinic Barcelona, FCRB-IDIBAPS, CIBEREHD, University of Barcelona, Barcelona, Spanien
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
S. Frankova
16   Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, Tschechische Republik
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
T. Roesner
17   Department of Medical Oncology, National Center of Tumor Diseases (NCT) Heidelberg and Universitätsklinikum Heidelberg, Heidelberg, Deutschland
,
V. Joerg
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
C. Schmidt
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
F. Glaser
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
A. W. Lohse
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
S. Huber
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
J. von Felden
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
M. Sebode
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
,
K. Schulze
1   I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
2   European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Hamburg, Deutschland
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    Introduction Immune checkpoint inhibitors (ICI) have revolutionized the treatment of many malignancies in recent years. However, immune-related adverse events (irAE) are a frequent concern in clinical practice. The safety profile of ICI for the treatment of malignancies in patients diagnosed with autoimmune liver disease (AILD) remains unclear. Due to this uncertainty, these patients were excluded from ICI clinical trials and ICI are approached with caution for this patient group. In this retrospective multicenter study, we assessed the safety of ICI for patients with AILD.

    Methods We contacted tertiary referral hospitals for AILD in Europe via the ERN RARE-LIVER network. Fourteen centers treated malignancies with ICI in patients with AILD, three centers had not treated patients with AILD due to fear of irAEs, and 13 centers could not identify any AILD patients with an indication for ICI.

    Results In this study, 21 AILD patients treated with ICI could be identified. Among these patients, 12 had primary biliary cholangitis (PBC), four had primary sclerosing cholangitis (PSC), four had autoimmune hepatitis (AIH), and one patient had an AIH-PSC variant syndrome. Ten patients had hepatobiliary cancers and the other 11 patients presented with non-hepatic tumors, two of whom had liver metastasis. The applied immune checkpoint inhibitors were Atezolizumab (n=7), Durvalumab (n=4), Pembrolizumab (n=4), Nivolumab (n=4), Spartalizumab (n=1), and in one case dual immune checkpoint therapy with Nivolumab plus Ipilimumab. Among seven patients who presented with grade 1 or 2 irAEs, two demonstrated hepatic involvement, which is consistent with the expected 5-10% incidence of hepatic irAEs in the general population receiving PD-1/PD-L1 monotherapy. No irAEs with a grade≥3 occurred. No significant changes in mean ALT, total bilirubin, and INR levels were observed during the first year after the start of immune checkpoint therapy.

    Conclusion: This multinational, multicenter study demonstrates that PD-1/PD-L1 inhibitors appear to be safe in patients with AILD. Further studies on the safety of more potent dual immune checkpoint therapy are needed. We conclude that immunotherapeutic therapies should not be withheld from patients with AILD.


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    Publication History

    Article published online:
    28 August 2023

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