Management of drug-induced liver injury associated with anticancer therapy

Bruno Vincenzi ¹ Yimin Mao ² Raúl J Andrade ³ Mauricio Morales Castillo ⁴ Gamar Akhundova-unadkat ^4* Jose M Mato ⁵

• ¹ Department of Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Lazio, Italy
• ² Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
• ³ Biomedical Research Institute of Malaga, University of Malaga, Málaga, Andalusia, Spain
• ⁴ ABB (Switzerland), Zurich, Switzerland
• ⁵ CIC bioGUNE, Bilbao, Basque Country, Spain

Drug-induced liver injury (DILI) is a leading cause of drug withdrawal and is a particular cause for concern among patients receiving anti-cancer treatment. This review presents the available evidence evaluating the efficacy of hepatoprotective drugs in normalizing liver enzyme abnormalities among patients who developed DILI as a result of treatment with anti-cancer therapies. Hepatoprotective agents consistently demonstrated improvements in liver enzyme elevations following treatment. Generally, treatment with hepatoprotective agents was combined with cessation of the causative anti-cancer therapy. However, ademetionine and bicyclol were given prophylactically, enabling patients to continue with their anti-cancer therapy with reduced chance for liver toxicity. While we acknowledge that further research is needed, this review summarizes the evidence to date for the benefits of hepatoprotective agents among patients with DILI due to treatment with anti-cancer therapy.