Case Report: Immune-mediated acute liver failure induced by tislelizumab in a patient with advanced cervical cancer

Tislelizumab, an anti-PD-1 monoclonal antibody, is associated with immune-related hepatitis in 1.8% of cases, but reports of acute liver failure (ALF) remain exceedingly rare. We present a case of fulminant hepatitis and ALF following Tislelizumab therapy in a 55-year-old woman with locally advanced...

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Main Authors: Chaoxia Liu, Xinchun Li, Yuping Deng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1604601/full
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author Chaoxia Liu
Xinchun Li
Yuping Deng
author_facet Chaoxia Liu
Xinchun Li
Yuping Deng
author_sort Chaoxia Liu
collection DOAJ
description Tislelizumab, an anti-PD-1 monoclonal antibody, is associated with immune-related hepatitis in 1.8% of cases, but reports of acute liver failure (ALF) remain exceedingly rare. We present a case of fulminant hepatitis and ALF following Tislelizumab therapy in a 55-year-old woman with locally advanced cervical adenocarcinoma. After three cycles of concurrent chemoradiotherapy and Tislelizumab, she developed grade 4 immune-mediated hepatitis and ALF following a fourth Tislelizumab dose, marked by severe transaminitis (AST 5329 U/L, ALT 2384 U/L), coagulopathy (INR 5.85), hyperbilirubinemia (TBIL 56.99 IU/L), and hepatic encephalopathy. Management included plasma exchange, continuous hemofiltration, high-dose corticosteroids, and immunosuppressive agents. Despite aggressive intervention, the patient’s condition deteriorated, underscoring the rapid progression of Tislelizumab-induced hepatotoxicity. This case highlights the critical need for vigilant monitoring of high-risk patients receiving immune checkpoint inhibitors and early intervention for suspected immune-mediated liver injury.
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spelling doaj-art-326de65a3a884f6896b71aadb908bc9c2025-08-22T04:10:37ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.16046011604601Case Report: Immune-mediated acute liver failure induced by tislelizumab in a patient with advanced cervical cancerChaoxia LiuXinchun LiYuping DengTislelizumab, an anti-PD-1 monoclonal antibody, is associated with immune-related hepatitis in 1.8% of cases, but reports of acute liver failure (ALF) remain exceedingly rare. We present a case of fulminant hepatitis and ALF following Tislelizumab therapy in a 55-year-old woman with locally advanced cervical adenocarcinoma. After three cycles of concurrent chemoradiotherapy and Tislelizumab, she developed grade 4 immune-mediated hepatitis and ALF following a fourth Tislelizumab dose, marked by severe transaminitis (AST 5329 U/L, ALT 2384 U/L), coagulopathy (INR 5.85), hyperbilirubinemia (TBIL 56.99 IU/L), and hepatic encephalopathy. Management included plasma exchange, continuous hemofiltration, high-dose corticosteroids, and immunosuppressive agents. Despite aggressive intervention, the patient’s condition deteriorated, underscoring the rapid progression of Tislelizumab-induced hepatotoxicity. This case highlights the critical need for vigilant monitoring of high-risk patients receiving immune checkpoint inhibitors and early intervention for suspected immune-mediated liver injury.https://www.frontiersin.org/articles/10.3389/fonc.2025.1604601/fulltislelizumabimmune-mediated hepatitisacute liver failureimmune checkpoint inhibitor toxicitycervical cancer
spellingShingle Chaoxia Liu
Xinchun Li
Yuping Deng
Case Report: Immune-mediated acute liver failure induced by tislelizumab in a patient with advanced cervical cancer
Frontiers in Oncology
tislelizumab
immune-mediated hepatitis
acute liver failure
immune checkpoint inhibitor toxicity
cervical cancer
title Case Report: Immune-mediated acute liver failure induced by tislelizumab in a patient with advanced cervical cancer
title_full Case Report: Immune-mediated acute liver failure induced by tislelizumab in a patient with advanced cervical cancer
title_fullStr Case Report: Immune-mediated acute liver failure induced by tislelizumab in a patient with advanced cervical cancer
title_full_unstemmed Case Report: Immune-mediated acute liver failure induced by tislelizumab in a patient with advanced cervical cancer
title_short Case Report: Immune-mediated acute liver failure induced by tislelizumab in a patient with advanced cervical cancer
title_sort case report immune mediated acute liver failure induced by tislelizumab in a patient with advanced cervical cancer
topic tislelizumab
immune-mediated hepatitis
acute liver failure
immune checkpoint inhibitor toxicity
cervical cancer
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1604601/full
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AT xinchunli casereportimmunemediatedacuteliverfailureinducedbytislelizumabinapatientwithadvancedcervicalcancer
AT yupingdeng casereportimmunemediatedacuteliverfailureinducedbytislelizumabinapatientwithadvancedcervicalcancer