{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T02:01:41Z","timestamp":1760061701765,"version":"3.44.0"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"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. Oncol."],"abstract":"<jats:p>Tislelizumab, an anti-PD-1 monoclonal antibody, is associated with immune-related hepatitis in 1.8% of cases, but reports of acute liver failure (ALF) remain exceedingly rare. We present a case of fulminant hepatitis and ALF following Tislelizumab therapy in a 55-year-old woman with locally advanced cervical adenocarcinoma. After three cycles of concurrent chemoradiotherapy and Tislelizumab, she developed grade 4 immune-mediated hepatitis and ALF following a fourth Tislelizumab dose, marked by severe transaminitis (AST 5329 U\/L, ALT 2384 U\/L), coagulopathy (INR 5.85), hyperbilirubinemia (TBIL 56.99 IU\/L), and hepatic encephalopathy. Management included plasma exchange, continuous hemofiltration, high-dose corticosteroids, and immunosuppressive agents. Despite aggressive intervention, the patient\u2019s condition deteriorated, underscoring the rapid progression of Tislelizumab-induced hepatotoxicity. This case highlights the critical need for vigilant monitoring of high-risk patients receiving immune checkpoint inhibitors and early intervention for suspected immune-mediated liver injury.<\/jats:p>","DOI":"10.3389\/fonc.2025.1604601","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T04:10:52Z","timestamp":1755835852000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Immune-mediated acute liver failure induced by tislelizumab in a patient with advanced cervical cancer"],"prefix":"10.3389","volume":"15","author":[{"given":"Chaoxia","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinchun","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuping","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.03.025","article-title":"High volume plasma exchange in patients with acute liver failure","volume":"65","author":"Bernuau","year":"2016","journal-title":"J Hepatol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-020-01286-z","article-title":"Tislelizumab: first approval","volume":"80","author":"Lee","year":"2020","journal-title":"Drugs"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-0160-6","article-title":"Immune-related adverse events of checkpoint inhibitors","volume":"6","author":"Ramos-Casals","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.10.001","article-title":"Management of toxicities from immunotherapy: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"33","author":"Haanen","year":"2022","journal-title":"Ann Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.7326\/M17-2073","article-title":"Use of immune checkpoint inhibitors in the treatment of patients with cancer and preexisting autoimmune disease: A systematic review","volume":"168","author":"Abdel-Wahab","year":"2018","journal-title":"Ann Intern Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2018-0563","article-title":"Peripheral blood markers identify risk of immune-related toxicity in advanced non-small cell lung cancer treated with immune-checkpoint inhibitors","volume":"24","author":"Pavan","year":"2019","journal-title":"Oncologist"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.03.015","article-title":"Acute cholestatic hepatitis in a patient with metastatic melanoma","volume":"79","author":"De Martin","year":"2023","journal-title":"J Hepatol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s40425-017-0298-2","article-title":"Safety in treatment of hepatocellular carcinoma with immune checkpoint inhibitors as compared to melanoma and non-small cell lung cancer","volume":"5","author":"Brown","year":"2017","journal-title":"J Immunother Cancer"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/imm.13141","article-title":"Immunotoxicity from checkpoint inhibitor therapy: clinical features and underlying mechanisms","volume":"159","author":"Fessas","year":"2020","journal-title":"Immunology"},{"key":"B10","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1016\/j.ccell.2022.04.004","article-title":"Interleukin-6 blockade abrogates immunotherapy toxicity and promotes tumor immunity","volume":"40","author":"Hailemichael","year":"2022","journal-title":"Cancer Cell"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1604601\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T04:10:55Z","timestamp":1755835855000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2025.1604601\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,22]]},"references-count":10,"alternative-id":["10.3389\/fonc.2025.1604601"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2025.1604601","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,22]]},"article-number":"1604601"}}