Nivolumab-induced liver injury with a steroid-refractory increase in biliary enzymes, in a patient with malignant mesothelioma: An autopsy case report

Kazumori Arai; Masanori Matsuda; Hiromasa Nakayasu; Shiori Meguro; Takafumi Kurokami; Aki Kubota; Tomohiro Iwasaki; Makoto Suzuki; Shinya Kawaguchi; Toshihide Iwashita

doi:10.1002/ccr3.5174

Nivolumab-induced liver injury with a steroid-refractory increase in biliary enzymes, in a patient with malignant mesothelioma: An autopsy case report

Clin Case Rep. 2021 Dec 23;9(12):e05174. doi: 10.1002/ccr3.5174. eCollection 2021 Dec.

Affiliations

¹ Department of Pathology Shizuoka General Hospital Shizuoka Japan.
² Department of Gastroenterology Shizuoka General Hospital Shizuoka Japan.
³ Department of Respiratory Medicine Shizuoka General Hospital Shizuoka Japan.
⁴ Department of Regenerative and Infectious Pathology Hamamatsu University School of Medicine Hamamatsu Japan.

Abstract

This is the first autopsy report of hepatotoxicity from nivolumab immunotherapy for malignant mesothelioma. The increase in levels of biliary enzymes and randomly distributed endothelial damage were steroid-refractory, but second-line option was abandoned because of cachexia. Further discussions are needed regarding the customized management of immune-related toxicities.

Keywords: autopsy; endothelialitis; immune checkpoint inhibitors; immune‐related adverse events; liver; necrosis; nivolumab.

Publication types

Case Reports