Immune checkpoint inhibitors and the liver: balancing therapeutic benefit and adverse events

Gut, Год журнала: 2024, Номер unknown, С. gutjnl - 332125

Опубликована: Дек. 10, 2024

Immune checkpoint inhibitors (ICI) have led to breakthrough improvements in the management of malignancy including hepatocellular (HCC) and biliary tract cancer, improving decades-old standards care increasing patient survival. In both liver tumour types, which commonly arise context inflammation underlying functional impairment, lack validated predictors response underscores need balance predicted gains survival with risk treatment-related hepatoxicity decompensation chronic disease.In addition, is implicated toxicity associated ICI therapy for non-liver cancers, exhibits a high degree variability presentation severity. An accurate assessment mandatory diagnosis ICI-induced injury.In this Recent Advances article, we provide an overview mechanisms efficacy anticancer immunotherapy tumours extrahepatic malignancies.We compare contrast characteristics, strategies outcomes from immune-related injury patients hepatitis/cirrhosis or healthy discuss latest findings on how may impact outlook malignancies offering insights into future directions clinical research practice field.

Язык: Английский

New Scenarios in Liver Transplantation for Hepatocellular Carcinoma

Liver International, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 4, 2024

ABSTRACT Background and Aims Despite liver transplantation (LT) is considered the optimal treatment for hepatocellular carcinoma (HCC), particularly in patients with impaired function, shortage of donors has forced application very restrictive criteria selecting ideal candidates whom LT can offer best outcome. With evolving landscape due to advent direct‐acting antivirals (DAAs) steady increase donors, major efforts have been made expand transplant eligibility HCC. In addition, emergence immune checkpoint inhibitors (ICIs) HCC, demonstrated efficacy earlier stages, revolutionized therapeutic approach these patients, their integration setting challenging. Management immunological compromise from ICIs, including wash‐out period before post‐LT immunosuppression adjustments, crucial balance risk graft rejection against HCC recurrence. Additionally, effects increased on non‐hepatic complications must be understood prevent them becoming obstacles long‐term OS. Methods Results this review, we will evaluate emerging evidence its implications future Addressing novel challenges opportunities, while integrating current clinical predictive algorithms, would ensure a fair between individual patient needs overall population benefit system.

Язык: Английский

Immune-mediated liver injury from checkpoint inhibitors: mechanisms, clinical characteristics and management

Nature Reviews Gastroenterology & Hepatology, Год журнала: 2024, Номер unknown

Опубликована: Дек. 11, 2024

Язык: Английский