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Hepatotoxicity of targeted therapy for cancer
Authors:Kirsty Wai-Chung Lee
Institution:Sir YK Pao Center for Cancer, Department of Clinical Oncology, State Key Laboratory in Oncology in South China, The Chinese University of Hong Kong, Hong Kong Cancer Institute and Prince of Wales Hospital, Shatin, Hong Kong
Abstract:Introduction: Understanding the mechanism of DILI with MTA, and how to avoid and manage these toxicities is essential for minimising inferior cancer treatment outcomes. An organised and comprehensive overview of MTA-associated hepatotoxicity is lacking; this review aims to fill the gap.

Areas covered: A literature review was performed based on published case reports and relevant studies or articles pertaining to the topics on PubMed. Food and Drug Administration drug information documents and search on the US National Library of Medicine LiverTox database was performed for all relevant MTA.

Expert opinion: MTA-associated hepatotoxicity is common but rarely fatal. The pattern of hepatotoxicity is predominantly idiosyncratic. Pharmacogenomics show potential in predicting patients at risk of poorly metabolising or developing immunoallergic responses to MTA, but prospective data is scant. Preventing reactivation of viral hepatitis using anti-viral drugs, and avoidance of drug combinations at high risk of negative interactions are the most readily preventable measures for DILI.
Keywords:CYP polymorphisms  hepatitis reactivation  hepatotoxicity  immunotherapy  molecular targeted therapy  monoclonal antibodies  multikinase inhibitors  pharmacogenomics  tyrosine kinase inhibitors
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