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- Characteristics of Immune Checkpoint Inhibitor–Related Hepatotoxicity Based on the Baseline Liver Function
- Won-Jung Jung, Eun-Jung Jo, Ye-Jee Kim, Mihyun Park, Eunji Kim, Yu-Seon Jung, Sook Ryun Park, Ji Seon Oh, So-Hui Kim, Jeongbin Park, Sun-Young Jung, Nakyung Jeon
- Cancer Res Treat. 2026;58(3):709-719. Published online July 18, 2025
- DOI: https://doi.org/10.4143/crt.2025.040
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Abstract
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Supplementary Material
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ePub - Purpose
This study estimated the incidence of immune checkpoint inhibitor–related hepatotoxicity (ICH), identified risk factors, and characterized patients who developed ICH.
Materials and Methods
Adult patients treated with immune checkpoint inhibitors (ICIs) from January 2015 to June 2022 in a tertiary hospital were included, excluding those without liver function tests or those with liver cancer but normal baseline liver function. Patients were stratified by baseline liver function status; in overall and each of stratified cohorts ICH incidence was calculated as the number of events per 100 person-years with grade 3 hepatotoxicity as the primary outcome. Patient characteristics were assessed using descriptive statistics, and risk factors were identified through multivariable Cox regression. Causality between ICI use and hepatotoxicity was assessed using the Naranjo Algorithm.
Results
Among 803 patients, the ICH incidence was 19.5 cases per 100 person-years, with a higher incidence (47.3 vs. 9.3 cases per 100 person-years) and earlier onset (13 vs. 15 days) in the abnormal compared to the normal group. Significant risk factors for ICH included female sex in the normal group and liver cancer in the abnormal group. According to the Naranjo Algorithm, all the 60 ICH cases were classified as “probable” or “possible”. Among the 60 cases, 61.7% (n=37) resulted in ICI discontinuation. The baseline liver function did not impact on the severity or the likelihood of ICI discontinuation.
Conclusion
Future studies are needed to evaluate whether the impact of ICI discontinuation on survival outcomes in patients with ICH varies based on baseline liver function abnormalities. -
Citations
Citations to this article as recorded by
- Integrative multi-omics profiling identifies infiltrative hepatocellular carcinoma as an immunotherapy-resistant subtype with distinct molecular features
Won Suk Lee, Seonjeong Woo, Sung Hwan Lee, Gae Hoon Jo, Ilhwan Kim, Hyeyeong Kim, Chansik An, Sanghoon Jung, Gwangil Kim, Haeyoun Kang, Beodeul Kang, Jung Sun Kim, Ho Yeong Lim, Incheon Kang, Hannah Yang, So Jung Kong, Dahyeon Son, Dong Jun Shin, Woo Youn
Clinical and Molecular Hepatology.2026; 32(1): 258. CrossRef
- Integrative multi-omics profiling identifies infiltrative hepatocellular carcinoma as an immunotherapy-resistant subtype with distinct molecular features
- 1,943 View
- 102 Download
- 1 Crossref
- Lung and Thoracic cancer
- The Additive Impact of Transbronchial Cryobiopsy Using a 1.1-mm Diameter Cryoprobe on Conventional Biopsy for Peripheral Lung Nodules
- Soo Han Kim, Jeongha Mok, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee, Jung Seop Eom
- Cancer Res Treat. 2023;55(2):506-512. Published online November 1, 2022
- DOI: https://doi.org/10.4143/crt.2022.1008
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Abstract
PDFSupplementary MaterialPubReaderePub
- Purpose
The diagnostic yield of transbronchial biopsy (TBB) using radial probe endobronchial ultrasound (RP-EBUS) is 71%, which is lower than that of transthoracic needle biopsy. We investigated the performance and safety of sequential transbronchial cryobiopsy (TBC) using a novel 1.1-mm diameter cryoprobe, after conventional TBB using RP-EBUS for the diagnosis of peripheral lung lesions (PLLs).
Materials and Methods
From April 2021 to November 2021, 110 patients who underwent bronchoscopy using RP-EBUS for the diagnosis of PLL ≤ 30 mm were retrospectively included in our study. All records were followed until June 2022.
Results
The overall diagnostic yield of combined TBB and TBC was 79.1%, which was higher than 60.9% of TBB alone (p=0.005). The diagnostic yield of sequential TBC was 65.5%, which increased the overall diagnostic yield by 18.2%. The surface area of tissues by TBC (mean area, 18.5 mm2) was significantly larger than those of TBB by 1.5-mm forceps (3.4 mm2, p < 0.001) and 1.9-mm forceps (3.7 mm2, p=0.011). In the multivariate analysis, PLLs with the longest diameter of ≤ 22 mm were found to be related to additional diagnostic benefits from sequential TBC (odds ratio, 3.51; 95% confidence interval, 1.043 to 11.775; p=0.042). Complications were found in 10.5% of the patients: pneumothorax (1.0%), infection (1.0%), and significant bleeding (8.6%). None of the patients developed any life-threatening complications.
Conclusion
Sequential TBC with a 1.1-mm cryoprobe improved the performance of conventional TBB using RP-EBUS without serious complications. -
Citations
Citations to this article as recorded by- A refined diagnostic approach for interstitial lung disease: efficient and safe transbronchial cryobiopsy using a 1.1-mm cryoprobe
Qinghua Zhang, Jinyan Yu, Xiaohao Zhang, Tiangang Ma, Yan Wang
Frontiers in Medicine.2026;[Epub] CrossRef - Comparative study of transbronchial cryobiopsy and transbronchial biopsy for diagnostic yield in peripheral pulmonary lesions
Hao-Chun Chang, Ching-Kai Lin, Lun‑Che Chen, Ling‑Kai Chang, Shun‑Mao Yang, Li-Ta Keng, Chong‑Jen Yu
Annals of Medicine.2026;[Epub] CrossRef - Clinical applications of cryobiopsy in the diagnosis of thoracic malignancies: a comprehensive review
Miwa Kamatani, Nobuyasu Awano, Takehiro Izumo
Japanese Journal of Clinical Oncology.2026; 56(4): 373. CrossRef - Complete resolution of non-tuberculous mycobacterial pulmonary nodule following cryobiopsy: The first case report
Sung Joon Han, Chaeuk Chung, Dongil Park
Diagnostic Pathology.2025;[Epub] CrossRef - Feasibility of a Modified Bronchoscopic Transparenchymal Nodule Access Technique (‘Essen Tunnel’) for Improving the Diagnosis of Intraparenchymal Pulmonary Lesions
Erik Büscher, Faustina Funke, Jane Winantea, Hanna Zellerhoff, Johannes Wienker, Marcel Opitz, Christian Taube, Kaid Darwiche
Respirology.2025; 30(9): 851. CrossRef - Enhanced Detection of Druggable Mutations in Non–Small Cell Lung Cancer Using Targeted Collection of Bronchial Washing Fluid Compared With Plasma and Tumor Tissue
Mi-Hyun Kim, Soo Han Kim, Hayoung Seong, Jung Seop Eom
JCO Precision Oncology.2025;[Epub] CrossRef - Comparison of sequential cryoprobe and biopsy forceps in endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal and hilar lesions: a prospective observational study
Ching-Kai Lin, Sheng-Yuan Ruan, Hung-Jen Fan, Hao-Chun Chang, Yen-Ting Lin, Chao-Chi Ho
Annals of Medicine.2025;[Epub] CrossRef - Numerical simulation of bioheat transfer during bronchial cryobiopsy using cryoprobes of different diameters
Junhong Tang, Yudong Bao, Wenqing Du, Wen Wei
Cryobiology.2025; 121: 105320. CrossRef - American Association for Bronchology and Interventional Pulmonology (AABIP) Evidence-Based Guidelines on Bronchoscopic Diagnosis and Staging of Lung Cancer
Russell J. Miller, Ara A. Chrissian, Fayez Kheir, Majid Shafiq, Abigail T. Chua, Neal Navani, Francisco A. Almeida, Abdul H. Alraiyes, Paul A. Bain, Christina R. Bellinger, Cherng H. Chao, George Z. Cheng, Rebecca Cloyes, Javier Diaz-Mendoza, David M. DiB
Journal of Bronchology & Interventional Pulmonology.2025;[Epub] CrossRef - Transbronchial cryobiopsy for diagnosing pulmonary hyalinizing granuloma: a case report
Akihiko Amano, Takashi Niwa, Masamitsu Hamakawa, Yasushi Fukuda, Toshihide Yokoyama, Tadashi Ishida
BMC Pulmonary Medicine.2025;[Epub] CrossRef - Advances in Invasive Diagnostics in Lung Cancer
Pascalin Roy, Sara Shadchehr, Anne V. Gonzalez
Seminars in Respiratory and Critical Care Medicine.2025; 46(05): 530. CrossRef - The role of bronchoscopy in the diagnosis of solitary pulmonary nodules in 2025
Jiří Votruba
Vnitřní lékařství.2025; 71(5): E6. CrossRef - Transbronchial lung cryobiopsy for peripheral pulmonary lesions. A narrative review
Y. Tang, S. Tian, H. Chen, X. Li, X. Pu, X. Zhang, Y. Zheng, Y. Li, H. Huang, C. Bai
Pulmonology.2024; 30(5): 475. CrossRef - Transbronchial Tumor Ablation
Russell Miller, George Cheng
Current Pulmonology Reports.2024; 13(1): 103. CrossRef - Using cryoprobes of different sizes combined with cone-beam computed tomography-derived augmented fluoroscopy and endobronchial ultrasound to diagnose peripheral pulmonary lesions: a propensity-matched study
Ching-Kai Lin, Sheng-Yuan Ruan, Hung-Jen Fan, Hao-Chun Chang, Yen-Ting Lin, Chao-Chi Ho
Respiratory Research.2024;[Epub] CrossRef - Next‐generation sequencing using tissue specimen collected with a 1.1 mm‐diameter cryoprobe in patients with lung cancer
Mi‐Hyun Kim, Soo Han Kim, Geewon Lee, Jeongha Mok, Min Ki Lee, Ju Sun Song, Jung Seop Eom
Respirology.2024; 29(4): 333. CrossRef - Development of the Korean Association for Lung Cancer Clinical Practice Guidelines: Recommendations on Radial Probe Endobronchial Ultrasound for Diagnosing Lung Cancer - An Updated Meta-Analysis
Soo Han Kim, Hyun Sung Chung, Jinmi Kim, Mi-Hyun Kim, Min Ki Lee, Insu Kim, Jung Seop Eom
Cancer Research and Treatment.2024; 56(2): 464. CrossRef - Navigational bronchoscopy with tranbronchial cryobiopsy in differential diagnosis of peripheral pulmonary lesions
Ya.O. Chesalina, I.Yu. Shabalina, L.A. Semenova, I.V. Sivokozov
Pirogov Russian Journal of Surgery.2024; (6): 36. CrossRef - Advanced Bronchoscopic Diagnostic Techniques in Lung Cancer
Dongil Park
Tuberculosis and Respiratory Diseases.2024; 87(3): 282. CrossRef - Clinical utility of rapid on-site evaluation of brush cytology during bronchoscopy using endobronchial ultrasound with a guide sheath
Kazuhiro Nishiyama, Kei Morikawa, Shotaro Kaneko, Makoto Nishida, Aya Matsushima, Yoshihiro Nishi, Yu Numata, Yusuke Shinozaki, Hajime Tsuruoka, Hirotaka Kida, Hiroshi Handa, Naoki Shimada, Chie Okawa, Nobuyuki Ohike, Junki Koike, Masamichi Mineshita
Scientific Reports.2024;[Epub] CrossRef - Bronchial branch tracing navigation in ultrathin bronchoscopy-guided radial endobronchial ultrasound for peripheral pulmonary nodule
Sze Shyang Kho, Shirin Hui Tan, Swee Kim Chan, Chan Sin Chai, Siew Teck Tie
BMC Pulmonary Medicine.2024;[Epub] CrossRef - The diagnosis of peripheral lung lesions: transbronchial biopsy using a radial probe endobronchial ultrasound
Jung Seop Eom
Journal of the Korean Medical Association.2023; 66(3): 166. CrossRef - Clinical outcomes of transbronchial cryobiopsy using a 1.1-mm diameter cryoprobe for peripheral lung lesions - A prospective pilot study
Soo Han Kim, Jeongha Mok, Saerom Kim, Wan Ho Yoo, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee, Jung Seop Eom
Respiratory Medicine.2023; 217: 107338. CrossRef
- A refined diagnostic approach for interstitial lung disease: efficient and safe transbronchial cryobiopsy using a 1.1-mm cryoprobe
- 8,471 View
- 277 Download
- 30 Web of Science
- 23 Crossref
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