Presence of Autoantibodies in Serum Does Not Impact the Occurrence of Immune Checkpoint Inhibitor-induced Hepatitis in a Prospective Cohort of Cancer Patients

Overview

Journal J Cancer Res Clin Oncol

Specialty Oncology

Date 2021 Dec 7

PMID 34874490

Citations 8

Authors

Mette-Triin Purde

Rebekka Niederer

Nikolaus B Wagner

Stefan Diem

Fiamma Berner

Omar Hasan Ali

Dorothea Hillmann

Irina Bergamin

Markus Joerger

Martin Risch

Christoph Niederhauser

Tobias L Lenz

Martin Fruh

Lorenz Risch

David Semela

Lukas Flatz

Affiliations

Soon will be listed here.

Abstract

Purpose: Immune checkpoint inhibitor (ICI)-induced hepatitis belongs to the frequently occurring immune-related adverse events (irAEs), particularly with the combination therapy involving ipilimumab and nivolumab. However, predisposing factors predicting the occurrence of ICI-induced hepatitis are barely known. We investigated the association of preexisting autoantibodies in the development of ICI-induced hepatitis in a prospective cohort of cancer patients.

Methods: Data from a prospective biomarker cohort comprising melanoma and non-small cell lung cancer (NSCLC) patients were used to analyze the incidence of ICI-induced hepatitis, putatively associated factors, and outcome.

Results: 40 patients with melanoma and 91 patients with NSCLC received ICI between July 2016 and May 2019. 11 patients developed ICI-induced hepatitis (8.4%). Prior to treatment, 45.5% of patients in the hepatitis cohort and 43.8% of the control cohort showed elevated titers of autoantibodies commonly associated with autoimmune liver diseases (p = 0.82). We found two nominally significant associations between the occurrence of ICI-induced hepatitis and HLA alleles associated with autoimmune liver diseases among NSCLC patients. Of note, significantly more patients with ICI-induced hepatitis developed additional irAEs in other organs (p = 0.0001). Neither overall nor progression-free survival was affected in the hepatitis group.

Conclusion: We found nominally significant associations of ICI-induced hepatitis with two HLA alleles. ICI-induced hepatitis showed no correlation with liver-specific autoantibodies, but frequently co-occurred with irAEs affecting other organs. Unlike other irAEs, ICI-induced hepatitis is not associated with a better prognosis.

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