Yes, nivolumab can cause liver damage, which is a recognized potential side effect of this immunotherapy medication used in cancer treatment.
Nivolumab is a type of immune checkpoint inhibitor (ICI) that works by activating the body's immune system to fight cancer cells. While effective, this activation can sometimes lead to immune-related adverse events, including inflammation and damage to healthy organs like the liver.
Patterns of Liver Injury
The liver injury associated with immune checkpoint inhibitors, including nivolumab, can manifest in different ways. These patterns of liver damage range from direct damage to liver cells to inflammation of the bile ducts.
Here's a breakdown of the types of liver injury that can occur:
| Type of Liver Injury | Description |
|---|---|
| Hepatocellular | This is the most common form of liver injury seen with nivolumab. It involves damage primarily to the hepatocytes, which are the main functional cells of the liver. This can lead to elevated liver enzymes in blood tests. |
| Cholangitic | While less common, nivolumab can also induce a cholangitic type of liver injury. This pattern is characterized by inflammation of the bile ducts within the liver, which can impair bile flow and liver function. Cases of nivolumab-induced cholangitis have been reported. |
Why Liver Damage Occurs
Liver damage from nivolumab, often referred to as immune-related hepatitis or liver injury, occurs when the activated immune system mistakenly targets and attacks healthy liver cells or bile ducts. This inflammatory response can lead to varying degrees of liver dysfunction, from mild and asymptomatic enzyme elevations to more severe cases requiring medical intervention.
Healthcare providers closely monitor liver function tests during nivolumab treatment to detect any signs of liver injury early. If liver damage is suspected or confirmed, treatment may be temporarily paused or discontinued, and corticosteroids or other immunosuppressive medications may be administered to manage the immune response and reduce inflammation.
For more general information on nivolumab and its potential side effects, you can refer to reputable medical resources such as the Mayo Clinic's drug information on Nivolumab.
