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Outline
To analyze the occurrence pattern and clinical characteristics of liver injury related to cadonilimab, and provide a reference for formulating individualized medication regimens for patients.
The medical data of cancer patients who received cadonilimab treatment and developed liver injury in Hunan Cancer Hospital from January 2021 to December 2023 were collected. Information such as patients' personal information, disease information, medication information, liver injury status, and the outcomes of adverse reaction management were recorded in detail.
A total of 14 patients were included, with 11 males and 3 females, and the median age was 57 years. The primary disease was mainly lung cancer (57.14%). In terms of medication, 64.28% of the patients used cadonilimab according to the recommended dosage and administration method in the instruction manual, while 35.72% of the patients had off-label medication. A total of 11 patients were treated with combination therapy, and anlotinib combination therapy accounted for the highest proportion (45.45%), followed by lenvatinib (18.18%). The median occurrence time of cadonilimab-related liver injury was 65 days, and 71.43% of the patients developed it within 3 months after medication. Liver injury of grade 3 and above accounted for 60.00%. In terms of the type of liver injury, most patients (71.42%) showed hepatocellular injury type, and the median values of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) reached 324.0 U·L-1 and 430.9 U·L-1 respectively. The clinical manifestations were mainly fatigue (21.43%) and jaundice (7.14%). 71.43% of the patients improved after hormone and liver protection treatment, and 28.57% needed long-term follow-up and monitoring of liver function.
Cadonilimab-related liver injury mostly occurs in the early stage of medication, mainly in the form of hepatocellular injury, and the proportion of liver injury of grade 3 and above is relatively high. Combined medication (such as anlotinib) may increase the risk of liver injury. It is recommended to strengthen the monitoring of liver function in the initial stage of treatment, and the prognosis can be significantly improved after symptomatic treatment.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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