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Inicio Annals of Hepatology O-7 LIVER TOXICITY OF TYROSINE KINASE INHIBITORS: A DESCRIPTIVE ANALYSIS FROM SL...
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Vol. 28. Issue S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(March 2023)
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Vol. 28. Issue S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(March 2023)
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O-7 LIVER TOXICITY OF TYROSINE KINASE INHIBITORS: A DESCRIPTIVE ANALYSIS FROM SLATINDILI NETWORK
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Nelia Hernández1, Fernando Bessone2, Daniela Chiodi1, Norberto Tamagnone2, Inmaculada Medina-Caliz3, María Isabel Lucena3, Raúl Andrade3
1 Gastroenterology Clinic, Clinic's Hospital, University of the Republic, Montevideo, Uruguay
2 Department of Gastroenterology, Centenary Hospital, National University of Rosario, Rosario, Argentina
3 Digestive System CMU, Clinical Pharmacology Service, Institute of Biomedical Research Institute of Malaga and Nanomedicine Platform-IBIMA. BIONAND Platform, Virgen de la Victoria University Hospital, University of Malaga, ciberehd. Malaga, Spain
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Vol. 28. Issue S1

Abstracts of the 2022 Annual Meeting of the ALEH

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Introduction and Objectives

Tyrosine kinases (TKs) are a family of proteins with a critical role in controlling cancer phenotypes, and many TK inhibitors (TKI) as anti-cancer agents are available. Mandatory black box warning has been issued for some TKI since 2012, and DILI is the most frequent adverse event quoted. This study aimed to describe the most crucial aspects of DILI linked to TKI in the SLATINDILI registry.

Materials and Methods

We revised data concerning liver injury related to any TKI in the SLATINIDLI registry and consigned epidemiological information, latency, implied drug, biochemical, severity, and evolution.

Results

From thirteen cases identified, imatinib and pazopanib represented four and three cases each. The mean age was 58 years, and eleven were female. Median latency was 64 days, with median ALT and ALP at the onset of 452 U/L (range 233-941) and 199 U/L (range 85-1621), respectively; a hepatocellular pattern was seen in ten cases. Autoimmune/Allergic features were present in seven patients. Resolution of liver injury occurred on an average of 183 days. No death was consigned. Liver function tests (LFTs) worsened during an initial period (>7 days) after drug withdrawal in six patients (cases 1,2,3,5,9 and 12), and two of them were treated with corticoids. Table 1 resumes data.

Conclusions

Hepatocellular acute liver injury with/without jaundice is the most common presentation of DILI linked to TKI. Clinicians should be aware that LFTs may worsen after drug withdrawal and monitor these patients before making a treatment decision.

Age /Sex

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Table

  Age /Sex  TKI /Likelihood Score*  Indication  Latency (days)  Pattern  TB onset/peak  ALT U/L onset/peak  Resolution (days) 
r1*  61/F  IMATINIB/B  Leukemia  92  HC  1/11  791/880  510 
2*  73/F  IMATINIB/B  Renal cancer  124  HC  1.85/3.19  941/988  138 
3*  58/M  MASITINIB/-  ALS  14  HC  0.4/0.4  351/436  230 
4  50/F  BOSUTINIB/D  Leukemia  43  HC  0.3/0.3  233/233  169 
5*  28/F  IMATINIB/B  Leukemia  176  HC  3.6/24  658/658  217 
6  68/M  PAZOPANIB/C  Renal cancer  64  3.7/3.7  775/445 
7  75/F  PAZOPANIB/C  Renal cancer  44  11/11  508/508  203 
8  75/F  PAZOPANIB/C  Renal cancer  HC  3.8/3.8  403/403  204 
9*  40/F  LENVATINIB/D  HCC  42  HC  2.5/12.6  750/750  120 
10  65/F  IMATINIB/B  Breast cancer  150  HC  0.89/0.89  452/452  62 
11  70/F  BOSUTINIB/D  Leukemia  112  0.3/0.3  341/341  83 
12*  49/F  PALBOCICLIB/  Breast cancer  28  HC  0.37/0.96  281/1796  76 
13  41/F  CABOZANTINIB/E  Renal cancer  84  HC  0.34/0.34  247/247 

*Likelihood of association with DILI, based upon the known potential of the drug to cause such injury. HCC hepatocellular carcinoma; ALS amyotrophic lateral sclerosis; HC hepatocellular pattern; M mixed pattern; M male; F: female.

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