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A case of nivolumab-related cholangitis and literature review: how to look for the right tools for a correct diagnosis of this rare immune-related adverse event

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Summary

Anti-programmed cell death-1 (PD-1) monoclonal antibodies, such as nivolumab, used for the treatment of several tumors, can trigger effector T-cells against tumor- and self-antigens, leading to the occurrence of different immune-related adverse events. Among them, liver injuries are rare and usually transient. To date, only four cases of immune-related cholangitis in non-small cell lung cancer (NSCLC) patients have been described during nivolumab treatment. Here, we describe laboratory tests, imaging and liver biopsy features that confirm this diagnosis as opposed to other forms of autoimmune liver disease; nevertheless, we also provide evidence of the presence of different clinical-pathological patterns of immune-related cholangitis.

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References

  1. Pardoll DM (2012) The blockade of immune checkpoints in cancer immunotherapy. Nat Rev Cancer 12:252–264

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Francisco LM, Sage PT, Sharpe AH (2010) The PD-1 pathway in tolerance and autoimmunity. Immunol Rev 236:219–242

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Brahmer JR, Tykodi SS, Chow LQ et al (2012) Safety and activity of anti-PD-L1 antibody in patients with advanced cancer. N Engl J Med 366:2455–2465

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Gettinger SN, Horn L, Gandhi L et al (2015) Overall survival and long-term safety of nivolumab (anti-programmed death 1 antibody, BMS-936558, ONO-4538) in patients with previously treated advanced non-small-cell lung cancer. J Clin Oncol 33:2004–2012

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Rizvi NA, Mazieres J, Planchard D et al (2015) Activity and safety of nivolumab, an anti-PD-1 immune checkpoint inhibitor, for patients with advanced, refractory squamous non-small-cell lung cancer (CheckMate 063): a phase 2, single-arm trial. Lancet Oncol 16:257–265

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Brahmer J, Reckamp KL, Baas P et al (2015) Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med 373:123–135

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Borghaei H, Paz-Ares L, Horn L et al (2015) Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. N Engl J Med 373:1627–1639

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Spain L, Diem S, Larkin J (2016) Management of toxicities of immune checkpoint inhibitors. Cancer Treat Rev 44:51–60

    Article  CAS  PubMed  Google Scholar 

  9. Gelsomino F, Vitale G, D’Errico A, Bertuzzi C, Andreone P, Ardizzoni A (2017) Nivolumab-induced cholangitic liver disease: a novel form of serious liver injury. Ann Oncol 28:671–672. doi:10.1093/annonc/mdw649

    Article  CAS  PubMed  Google Scholar 

  10. Kawakami H, Tanizaki J, Tanaka K et al (2017) Imaging and clinicopathological features of nivolumab-related cholangitis in patients with non-small cell lung cancer. Investig New Drugs. doi:10.1007/s10637-017-0453-0

  11. EASL Clinical Practice Guidelines: Management of cholestatic liver diseases. European Association for the Study of the Liver (2009) J Hepatol 51:237–267

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Correspondence to Francesco Gelsomino.

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Gelsomino, F., Vitale, G. & Ardizzoni, A. A case of nivolumab-related cholangitis and literature review: how to look for the right tools for a correct diagnosis of this rare immune-related adverse event. Invest New Drugs 36, 144–146 (2018). https://doi.org/10.1007/s10637-017-0484-6

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  • DOI: https://doi.org/10.1007/s10637-017-0484-6

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