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BRIEF RESEARCH REPORT article

Front. Pharmacol.
Sec. Gastrointestinal and Hepatic Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1453595

Difficulty in differentiating liver injury from an immune checkpoint inhibitor from chemotherapy

Provisionally accepted
Shike Lou Shike Lou 1Xiaoyin Wang Xiaoyin Wang 1Fei Yuan Fei Yuan 2*Gangde Zhao Gangde Zhao 1Mingyang Feng Mingyang Feng 1*Yezhou Ding Yezhou Ding 1*Lanyi Lin Lanyi Lin 1*Kehui Liu Kehui Liu 1*Xiaolin Wang Xiaolin Wang 1*Wanqing Chi Wanqing Chi 3*Hui Wang Hui Wang 1*
  • 1 Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
  • 2 Department of Pathology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
  • 3 Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States

The final, formatted version of the article will be published soon.

    This study investigated the potential of immune checkpoint inhibitors (ICIs) combined with chemotherapy as a promising treatment approach for malignancies. This report focuses on a patient with drug-induced liver injury (DILI) following the administration of chemotherapy and ICIs. A 63-year-old patient with non-small cell lung adenocarcinoma (NSCLC) initially underwent knife treatment and subsequently received a combination of chemotherapy comprising bevacizumab and camrelizumab. Due to liver abnormalities, both chemotherapy and ICIs were stopped on day 21. The patient's liver function improved within a month after methylprednisolone treatment. Subsequently, the patient received carboplatin, pemetrexed, and bevacizumab without complications. This finding supported the notion that DILI was likely triggered by the ICI. This case series details a complex instance of DILI resulting from the use of ICIs and pemetrexed/carboplatin. The alignment of the pathological findings and clinical presentation strongly suggested ICI-induced DILI, which was further supported by the definitive response to steroid treatment. This information is important for clinicians, as it emphasizes the importance of closely monitoring liver function and being aware of potential adverse effects associated with ICIs. Such insights contribute to more effective patient care.

    Keywords: Immune checkpoint inhibitors (ICIs), chemotherapy, DILI, combined therapy, lung cancer Immune checkpoint inhibitors, Lung Adenocarcinoma, liver biopsy

    Received: 23 Jun 2024; Accepted: 30 Jul 2024.

    Copyright: © 2024 Lou, Wang, Yuan, Zhao, Feng, Ding, Lin, Liu, Wang, Chi and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Fei Yuan, Department of Pathology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China
    Mingyang Feng, Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
    Yezhou Ding, Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
    Lanyi Lin, Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
    Kehui Liu, Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
    Xiaolin Wang, Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
    Wanqing Chi, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States
    Hui Wang, Department of Infectious Diseases, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.