Personalized Cytokine-Directed Therapy With Tocilizumab for Refractory Immune Checkpoint Inhibitor–Related Cholangiohepatitis

IntroductionFor patients with corticosteroid (CS)-refractory immune checkpoint inhibitor–related cholangiohepatitis (irCH), no consensus exists regarding treatment, and outcomes remain poor. We evaluated the possibility of personalized treatment according to patient’s cytokine profile immunohistopathologic assessment predominant infiltrate type liver tissue.MethodsNSCLCs CS-refractory irCH were analyzed by immunohistochemistry biopsy specimen, serum panel, peripheral blood mononuclear cell monitoring mass cytometry.ResultsA total three consecutive identified. found a T-cell an interferon-gamma or T helper 1 proinflammatory profile. Here, we report for first time that T-cell–targeted therapy interleukin (IL)-6 receptor-neutralizing antibody tocilizumab, which inhibits signaling downstream several other Janus kinase–dependent cytokines, is effective single cytokine-directed irCH. Three severe, who treated tocilizumab have persistent clinical biological remission.ConclusionsDysregulation IL-6/T-cell axis may contribute pathogenesis Our observations suggest IL-6 blockade seems promise in The results from our need be confirmed larger patient population.