A study of clinical characteristics of immune checkpoint inhibitor-related hepatitis in non-small cell lung cancer

Cheng Kunxiang; Cui Linhong; Wei Zixin; Cui Mingxin; Li Xiaomei

doi:10.3969/j.issn.1674-3245.2024.06.010

Abstract：Objective Retrospective analysis the clinical characteristic features and potential risk factors of immune checkpoint inhibitors-related hepatitis(ICIH)of non-small cell lung cancer patients(NSCLC),and provide effective prevention measures of ICIH.Methods Cases of NSCLC treated with immune checkpoint inhibitors(ICIs)from January 2018 to August 2024 in our hospital were collected.ICIH cases were initially screened according to diagnostic criteria and confirmed by an expert diagnostic panel.Clinical characteristics,treatment,and outcomes were compared between ICIH and non-ICIH patients,as well as the mild and severe ICIH patients.Results A total of 915 patients were included,11 cases were diagnosed with ICIH.The incidence rate was 1.2%.ICIH was not associated with age,gender,underlying liver disease,liver metastasis,or combination therapy of ICIs.Patients with hepatitis B virus(HBV)infection were more likely to develop ICIH compared to non-infected patients(27.3%vs.3.3%,P=0.006).5(45.5%)of the 11 ICIH cases were mild,in which 4 recovered while continuing ICI treatment.Among the 6(54.5%)severe cases,two recovered after discontinuing ICI.5 patients(45.5%)from both mild and severe groups stopped ICIs and received steroid treatment,in which 4 improved,while 1(9.1%)died due to ICI-related multi-organ damage and failure.Conclusion HBV infection is a potential risk factor for the occurrence of ICIH.Overall,the prognosis of ICIH is good.However,the prognosis for patients experiencing multiple organ damage related to ICIs is poor,contributing significantly to mortality.Active steroid therapy and close monitoring for ICIs-related multiple organ damage are important measures to reduce the mortality rate of ICIH.