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However, despite discontinuation, ALT levels continued to rise, as did bilirubin levels. Liver biopsy confirmed inflammatory infiltrate primarily affecting the lobule with hepatocyte cell loss, consistent with DILI, and prednisolone was started. Liver function rapidly improved on prednisolone, and liver chemistry has remained normal since cessation of both vismodegib and prednisolone. This case highlights the need for careful liver monitoring in patients on vismodegib, emphasising the potential for significant DILI on re-exposure.<\/jats:p>","DOI":"10.1136\/bcr-2024-264500","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T02:29:13Z","timestamp":1743647353000},"page":"e264500","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Recurrent vismodegib drug-induced liver injury with corticosteroid response"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1419-6269","authenticated-orcid":false,"given":"Maya","family":"Bienz","sequence":"first","affiliation":[{"name":"Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Fife","sequence":"additional","affiliation":[{"name":"Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Paterson","sequence":"additional","affiliation":[{"name":"Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwilym","family":"Webb","sequence":"additional","affiliation":[{"name":"Cambridge Liver Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"2025082709495555000_18.4.e264500.1","doi-asserted-by":"publisher","DOI":"10.1002\/mc.22690"},{"key":"2025082709495555000_18.4.e264500.2","unstructured":"Cancer Research UK . 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