An analysis on the influencing factors of liver injury caused by immunotherapy in lung cancer patients

Abstract

Abstract: Objective To explore the characteristics and influencing factors of immunotherapy-mediated liver injury in lung cancer patients. Methods The clinical data of lung cancer patients with complete information who received immunotherapy with Immune checkpoint inhibitors (ICIs) from July 2018 to July 2021 were retrospectively analyzed. The patients were divided into non-liver injury group (n=189) and liver injury group (n=81) according to whether they had liver function abnormalities during immunotherapy. Alternatively, they were divided into immunotherapy group (n=25), immunotherapy combined with anti-angiogenic agents group (n=6), and immunotherapy combined with chemotherapy group (n=50) according to different treatment regimes, and the clinical data among all groups were compared. Results The proportion of female patients in the liver injury group was higher than that in the non-liver injury group (30.86% vs 18.52%,P=0.025). The lymphocyte count [1.52 (1.13, 1.94),P=0.010], erythrocyte level [4.29 (3.96,4.67),P=0.004] and hemoglobin level [131.0 0(121.50, 145.00),P<0.001] before immunotherapy in the liver injury group were higher. However, neutrophil count/lymphocyte count [2.62 (1.86, 3.98),P=0.004] and platelet/lymphocyte count [132.39 (92.60,183.27),P<0.001] were lower. Multiple logistic regression analysis showed that gender (P=0.018, OR=2.142, 95%CI 1.137-4.035) was an independent risk factor. Between different immunotherapy regimens, patients in the immunotherapy combined with chemotherapy group showed earlier elevation of transaminase. Conclusion The clinical symptoms of patients with immune-mediated hepatitis are not typical, which is more common in female patients. There is no obvious correlation between the liver injury with age, pathological type, underlying disease, whereas gender is an independent risk factor.

Key words: Immune checkpoint inhibitors;Drug-induced liver injury;Lung cancer

WANG Han, PENG Jin, JIN Hui-ru, WANG Xiao, DAI Jing-jing, Li Jun, JIANG Long-feng. An analysis on the influencing factors of liver injury caused by immunotherapy in lung cancer patients[J]. Chinese Hepatolgy, 2023, 28(6): 688-693.

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