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New research · Pathology
Hepatology communications · 1d
Cohort studyHepatology communications · 2026

Liver biopsy findings and clinical correlates in immune-mediated liver injury from checkpoint inhibitors.

Lucy Meunier, David E Kleiner, Benjamin Riviere … Drug-Induced Liver Injury Network
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PathologyCohort study

About half of patients with immune-mediated liver injury had acute hepatocellular injury.

Liver biopsy findings and clinical correlates in immune-mediated liver injury from checkpoint inhibitors.

Lucy Meunier et al. · Hepatology communications · 2026
Background

Immune-mediated liver injury from checkpoint inhibitors develops in up to 10% of treated patients.

Purpose

The aim of this study was to describe the relationship between standard liver histopathological findings and clinical presentation and outcomes in a cohort of 67 adult patients.

Methods

Liver biopsies from 67 ICI-treated patients enrolled in the Drug-Induced Liver Injury Network and from the Montpellier, France, registry were scored for 42 features.

n = 67 adult
Results
More than half of patients had sudden, severe damage to their liver cells
n = 67 adult
More results

The median age of patients was 62.5 years, 45% received pembrolizumab, and 24% received ipilimumab-nivolumab.

The median latency to liver injury onset was 72 days, and the median time to liver biopsy was 20 days.

Patients biopsied on corticosteroids had significantly less severe inflammation, fewer granulomas, and less cholestasis.

More results

Mild macrovesicular steatosis was common (65%) and associated with diabetes and patient BMI but not corticosteroid use.

“
Conclusion · 1 of 2

Liver histology findings were associated with presenting laboratory features in this retrospective, exploratory study of 67 ICI hepatitis patients.

Conclusion · 2 of 2

Necroinflammatory activity was substantially less in subjects biopsied while on corticosteroids, which may impact clinical management decisions.

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