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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Frontiers Media S.A.
2025-08-01
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| 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. |
| format | Article |
| id | doaj-art-326de65a3a884f6896b71aadb908bc9c |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| 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 |
| work_keys_str_mv | AT chaoxialiu casereportimmunemediatedacuteliverfailureinducedbytislelizumabinapatientwithadvancedcervicalcancer AT xinchunli casereportimmunemediatedacuteliverfailureinducedbytislelizumabinapatientwithadvancedcervicalcancer AT yupingdeng casereportimmunemediatedacuteliverfailureinducedbytislelizumabinapatientwithadvancedcervicalcancer |