Volume 1 Issue 3
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Article Navigation >  Clinical Cancer Bulletin  > 2022  >  1(3): 176-181
Tengteng ZHANG, Yan ZHANG, Yiyin ZHANG. Immune Checkpoint Inhibitor-induced Immune-mediated Hepatitis in A Lung Cancer Patient Undergoing Long-term Immunotherapy: A Case Report[J]. Clinical Cancer Bulletin, 2022, 1(3): 176-181. doi: 10.11910/j.issn.2791-3937.2022.20220023
Citation: Tengteng ZHANG, Yan ZHANG, Yiyin ZHANG. Immune Checkpoint Inhibitor-induced Immune-mediated Hepatitis in A Lung Cancer Patient Undergoing Long-term Immunotherapy: A Case Report[J]. Clinical Cancer Bulletin, 2022, 1(3): 176-181. doi: 10.11910/j.issn.2791-3937.2022.20220023
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Immune Checkpoint Inhibitor-induced Immune-mediated Hepatitis in A Lung Cancer Patient Undergoing Long-term Immunotherapy: A Case Report

doi: 10.11910/j.issn.2791-3937.2022.20220023

  • Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022 China

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  • Corresponding author: E-mail: zhangyiyin@ahmu.edu.cn
  • Received Date: 09 Dec 2022
  • Accepted Date: 27 Feb 2023
  • Publish Date: 25 Dec 2022
    Abstract
  • Immune-mediated hepatitis (IMH) induced by immune checkpoint inhibitors (ICIs) is an immune-related adverse event (irAE). IMH usually occurs 8–12 weeks after the first dose of ICI therapy. We report an unusual case of a lung cancer patient who developed IMH 2 years after initial ICI treatment and relapsed during corticosteroid therapy. A 55-year-old male with stage Ⅳ B lung cancer received ICIs (for over 2 years) and chemotherapy as a second-line therapy. Grade 4 IMH occurred 2 years after initial immunotherapy and was diagnosed as hepatitis via laboratory and imaging tests with the simultaneous exclusion of other causes. The patient responded well to the corticosteroids; however, he decided to discontinue treatment prematurely, meaning that the total treatment period was less than 4 weeks. This led to IMH reoccurrence and the need to readminister corticosteroids at a higher dose than before. Ultimately, the patient's IMH was controlled and did not reoccur. This case illustrates that immune-related toxicity needs to be monitored in patients undergoing long-term ICI therapy. Improving patient education is also essential for the management and treatment of irAEs.

     

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