Cancer immunotherapy has become a stronghold in modern oncology. Immune checkpoint inhibitors,in particular anti-PD-1 and anti-PD-L1 antibodies, are approved for the treatment of several solid cancers. In the near future, an increasing number of patients will be eligible for immunotherapy. Therefore,the management of immune-related adverse events is a daily challenge in clinical practice, among whichhepatic immune-related toxicity has been described as a rare adverse event. We report the case of a patient treated with nivolumab (an anti-PD-L1 antibody) for a stage IV resected melanoma who developedrecurrence of steroid-refractory liver toxicity that was later discovered to be associated with acute exacerbation of chronic undiagnosed hepatitis B. The patient significantly benefited from antiviral treatment.We conclude that serological viral screening is strongly recommended before starting immune checkpointinhibitor treatment.
Steroid-refractory immune related hepatitis may hide viral re-activation / Citarella, F; Galletti, A; Russano, M; Gallo, P; Vespasiani Gentilucci, U; Picardi, A; Tonini, G; Vincenzi, B; Santini, D. - In: FUTURE SCIENCE OA. - ISSN 2056-5623. - 6:9(2020). [10.2144/fsoa-2020-0056]
Steroid-refractory immune related hepatitis may hide viral re-activation
Gallo P;Vespasiani Gentilucci U;Santini D
2020
Abstract
Cancer immunotherapy has become a stronghold in modern oncology. Immune checkpoint inhibitors,in particular anti-PD-1 and anti-PD-L1 antibodies, are approved for the treatment of several solid cancers. In the near future, an increasing number of patients will be eligible for immunotherapy. Therefore,the management of immune-related adverse events is a daily challenge in clinical practice, among whichhepatic immune-related toxicity has been described as a rare adverse event. We report the case of a patient treated with nivolumab (an anti-PD-L1 antibody) for a stage IV resected melanoma who developedrecurrence of steroid-refractory liver toxicity that was later discovered to be associated with acute exacerbation of chronic undiagnosed hepatitis B. The patient significantly benefited from antiviral treatment.We conclude that serological viral screening is strongly recommended before starting immune checkpointinhibitor treatment.File | Dimensione | Formato | |
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