Immune Checkpoint Inhibitors in Hepatocellular Carcinoma and Their Hepatic-Related Side Effects: A Review
Primary liver cancer is one of the leading causes of cancer mortality worldwide, with hepatocellular carcinoma (HCC) being the most prevalent type of liver cancer. The prognosis of patients with advanced, unresectable HCC has historically been poor. However, with the emergence of immunotherapy, spec...
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| Veröffentlicht in: | Cancers 2024-06, Vol.16 (11), p.2042 |
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| creator | Ruli, Jr, Thomas M Pollack, Ethan D Lodh, Atul Evers, 3rd, Charles D Price, Christopher A Shoreibah, Mohamed |
| description | Primary liver cancer is one of the leading causes of cancer mortality worldwide, with hepatocellular carcinoma (HCC) being the most prevalent type of liver cancer. The prognosis of patients with advanced, unresectable HCC has historically been poor. However, with the emergence of immunotherapy, specifically immune checkpoint inhibitors (ICIs), there is reason for optimism. Nevertheless, ICIs do not come without risk, especially when administered in patients with HCC, given their potential underlying poor hepatic reserve. Given their novelty in the management of HCC, there are few studies to date specifically investigating ICI-related side effects on the liver in patients with underlying HCC. This review will serve as a guide for clinicians on ICIs' role in the management of HCC and their potential side effect profile. There will be a discussion on ICI-related hepatotoxicity, the potential for hepatitis B and C reactivation with ICI use, the potential for the development of autoimmune hepatitis with ICI use, and the risk of gastrointestinal bleeding with ICI use. As ICIs become more commonplace as a treatment option in patients with advanced HCC, it is imperative that clinicians not only understand the mechanism of action of such agents but also understand and are able to identify hepatic-related side effects. |
| doi_str_mv | 10.3390/cancers16112042 |
| format | Article |
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The prognosis of patients with advanced, unresectable HCC has historically been poor. However, with the emergence of immunotherapy, specifically immune checkpoint inhibitors (ICIs), there is reason for optimism. Nevertheless, ICIs do not come without risk, especially when administered in patients with HCC, given their potential underlying poor hepatic reserve. Given their novelty in the management of HCC, there are few studies to date specifically investigating ICI-related side effects on the liver in patients with underlying HCC. This review will serve as a guide for clinicians on ICIs' role in the management of HCC and their potential side effect profile. There will be a discussion on ICI-related hepatotoxicity, the potential for hepatitis B and C reactivation with ICI use, the potential for the development of autoimmune hepatitis with ICI use, and the risk of gastrointestinal bleeding with ICI use. As ICIs become more commonplace as a treatment option in patients with advanced HCC, it is imperative that clinicians not only understand the mechanism of action of such agents but also understand and are able to identify hepatic-related side effects.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers16112042</identifier><identifier>PMID: 38893164</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Antigens ; Apoptosis ; Cancer therapies ; Complications and side effects ; Dendritic cells ; Development and progression ; Drug therapy ; Genetic aspects ; Hepatitis B ; Hepatocellular carcinoma ; Hepatoma ; Hepatotoxicity ; Immune checkpoint inhibitors ; Immune system ; Immunotherapy ; Kidney cancer ; Kinases ; Ligands ; Liver cancer ; Lymphocytes ; Malignancy ; Medical prognosis ; Methods ; Monoclonal antibodies ; Review ; Side effects</subject><ispartof>Cancers, 2024-06, Vol.16 (11), p.2042</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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The prognosis of patients with advanced, unresectable HCC has historically been poor. However, with the emergence of immunotherapy, specifically immune checkpoint inhibitors (ICIs), there is reason for optimism. Nevertheless, ICIs do not come without risk, especially when administered in patients with HCC, given their potential underlying poor hepatic reserve. Given their novelty in the management of HCC, there are few studies to date specifically investigating ICI-related side effects on the liver in patients with underlying HCC. This review will serve as a guide for clinicians on ICIs' role in the management of HCC and their potential side effect profile. There will be a discussion on ICI-related hepatotoxicity, the potential for hepatitis B and C reactivation with ICI use, the potential for the development of autoimmune hepatitis with ICI use, and the risk of gastrointestinal bleeding with ICI use. 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| subjects | Antigens Apoptosis Cancer therapies Complications and side effects Dendritic cells Development and progression Drug therapy Genetic aspects Hepatitis B Hepatocellular carcinoma Hepatoma Hepatotoxicity Immune checkpoint inhibitors Immune system Immunotherapy Kidney cancer Kinases Ligands Liver cancer Lymphocytes Malignancy Medical prognosis Methods Monoclonal antibodies Review Side effects |
| title | Immune Checkpoint Inhibitors in Hepatocellular Carcinoma and Their Hepatic-Related Side Effects: A Review |
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