{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:18:48Z","timestamp":1790983128774,"version":"4.1.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>With the increasing use of immune checkpoint inhibitors (ICIs), acute hepatitis as an immune-related adverse event (irAE) is expected to rise, particularly with the growing use of combination regimens with chemotherapy. However, the hepatotoxic risk of this strategy remains unclear. We report a 47-year-old woman with breast cancer and no history of chronic liver disease who developed severe hepatic impairment after fewer than two cycles of combined chemotherapy and immunotherapy. The patient was successfully treated with immunosuppressive therapy and an artificial liver support system (ALSS). This case highlights the importance of close monitoring in patients receiving combined chemo-immunotherapy and early intervention for suspected immune-mediated liver injury.<\/jats:p>","DOI":"10.3389\/fmed.2026.1886401","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T09:10:24Z","timestamp":1786525824000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Successful management of severe hepatotoxicity induced by combined chemotherapy and immune checkpoint inhibitor: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Minjie","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, Shandong Provincial Hospital Affiliated to Shandong First Medical University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feifei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Shandong Provincial Hospital Affiliated to Shandong First Medical University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dezhao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Shandong Provincial Hospital Affiliated to Shandong First Medical University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1056\/NEJMoa1910549","article-title":"Pembrolizumab for early triple-negative breast cancer","volume":"382","author":"Schmid","year":"2020","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1016\/j.jhep.2018.07.009","article-title":"Reply to: \"mortality due to immunotherapy related hepatitis\"","volume":"69","author":"De 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