Severe steroid-resistant anti-PD1 T-cell checkpoint inhibitor-induced hepatotoxicity driven by biliary injury.

However, there is clearly significant heterogeneity in pathological reports to date. 9 Given the numbers of patients affected, there are surprisingly few reports concerning investigation, management strategies and long-term outcomes for patients with T-cell checkpoint-induced hepatotoxicity. 10 Steroids appear to be effective in reversing hepatotoxicity in the majority of patients with the condition (with a median time to resolution of 7 weeks in the registration trial of nivolumab and ipilimumab), 7 and reports of responses have also been observed with mycophenolate mofetil (MMF; see for example ref 11 ).

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