Immunosuppressant therapy successfully improved regorafenib-induced severe hepatic injury in a patient with metastatic gastrointestinal stromal tumor: A case report

Miyuki Kuwayama, Keita Uchino, Kotoe Takayoshi, Masato Komoda, Motoyuki Kohjima, Makoto Nakamuta, Seiya Momosaki, Hitoshi Kusaba, Koichi Akashi, Eishi Baba

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A 75-year-old man diagnosed with ileal gastrointestinal tumor with peritoneal dissemination was subjected to salvage treatment with regorafenib at 120 mg/day. Following the initiation of the treatment, liver dysfunction appeared on day 28, and continued to worsen despite termination of the treatment. Since no increase in the levels of serum immunoglobulins of the patient was observed, and negative results were obtained for the analysis of viral markers and autoantibodies, a diagnosis of regorafenib-induced hepatitis was suggested. In consequence, the patient received steroid pulse therapy and continuous administration of prednisolone, without sufficient improvement. Liver biopsy revealed interface hepatitis with prominent plasma cell infiltration, suggesting regorafenib-induced autoimmune hepatitis. The patient was then administered azathioprine and prednisolone, which improved the hepatic injury. The present case represents the first report of successful treatment of regorafenib-induced severe hepatic injury by the use of an immunosuppressant.

Original languageEnglish
Pages (from-to)85-88
Number of pages4
JournalOncology Letters
Volume11
Issue number1
DOIs
Publication statusPublished - Jan 2016

Fingerprint

Gastrointestinal Stromal Tumors
Immunosuppressive Agents
Liver
Wounds and Injuries
Prednisolone
Hepatitis
Salvage Therapy
Autoimmune Hepatitis
Azathioprine
Therapeutics
Plasma Cells
Autoantibodies
Immunoglobulins
Liver Diseases
Biomarkers
Steroids
Biopsy
regorafenib
Serum
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Immunosuppressant therapy successfully improved regorafenib-induced severe hepatic injury in a patient with metastatic gastrointestinal stromal tumor : A case report. / Kuwayama, Miyuki; Uchino, Keita; Takayoshi, Kotoe; Komoda, Masato; Kohjima, Motoyuki; Nakamuta, Makoto; Momosaki, Seiya; Kusaba, Hitoshi; Akashi, Koichi; Baba, Eishi.

In: Oncology Letters, Vol. 11, No. 1, 01.2016, p. 85-88.

Research output: Contribution to journalArticle

@article{368ede1a3a3542539f84ef6ee8664740,
title = "Immunosuppressant therapy successfully improved regorafenib-induced severe hepatic injury in a patient with metastatic gastrointestinal stromal tumor: A case report",
abstract = "A 75-year-old man diagnosed with ileal gastrointestinal tumor with peritoneal dissemination was subjected to salvage treatment with regorafenib at 120 mg/day. Following the initiation of the treatment, liver dysfunction appeared on day 28, and continued to worsen despite termination of the treatment. Since no increase in the levels of serum immunoglobulins of the patient was observed, and negative results were obtained for the analysis of viral markers and autoantibodies, a diagnosis of regorafenib-induced hepatitis was suggested. In consequence, the patient received steroid pulse therapy and continuous administration of prednisolone, without sufficient improvement. Liver biopsy revealed interface hepatitis with prominent plasma cell infiltration, suggesting regorafenib-induced autoimmune hepatitis. The patient was then administered azathioprine and prednisolone, which improved the hepatic injury. The present case represents the first report of successful treatment of regorafenib-induced severe hepatic injury by the use of an immunosuppressant.",
author = "Miyuki Kuwayama and Keita Uchino and Kotoe Takayoshi and Masato Komoda and Motoyuki Kohjima and Makoto Nakamuta and Seiya Momosaki and Hitoshi Kusaba and Koichi Akashi and Eishi Baba",
year = "2016",
month = "1",
doi = "10.3892/ol.2015.3853",
language = "English",
volume = "11",
pages = "85--88",
journal = "Oncology Letters",
issn = "1792-1074",
publisher = "Spandidos Publications",
number = "1",

}

TY - JOUR

T1 - Immunosuppressant therapy successfully improved regorafenib-induced severe hepatic injury in a patient with metastatic gastrointestinal stromal tumor

T2 - A case report

AU - Kuwayama, Miyuki

AU - Uchino, Keita

AU - Takayoshi, Kotoe

AU - Komoda, Masato

AU - Kohjima, Motoyuki

AU - Nakamuta, Makoto

AU - Momosaki, Seiya

AU - Kusaba, Hitoshi

AU - Akashi, Koichi

AU - Baba, Eishi

PY - 2016/1

Y1 - 2016/1

N2 - A 75-year-old man diagnosed with ileal gastrointestinal tumor with peritoneal dissemination was subjected to salvage treatment with regorafenib at 120 mg/day. Following the initiation of the treatment, liver dysfunction appeared on day 28, and continued to worsen despite termination of the treatment. Since no increase in the levels of serum immunoglobulins of the patient was observed, and negative results were obtained for the analysis of viral markers and autoantibodies, a diagnosis of regorafenib-induced hepatitis was suggested. In consequence, the patient received steroid pulse therapy and continuous administration of prednisolone, without sufficient improvement. Liver biopsy revealed interface hepatitis with prominent plasma cell infiltration, suggesting regorafenib-induced autoimmune hepatitis. The patient was then administered azathioprine and prednisolone, which improved the hepatic injury. The present case represents the first report of successful treatment of regorafenib-induced severe hepatic injury by the use of an immunosuppressant.

AB - A 75-year-old man diagnosed with ileal gastrointestinal tumor with peritoneal dissemination was subjected to salvage treatment with regorafenib at 120 mg/day. Following the initiation of the treatment, liver dysfunction appeared on day 28, and continued to worsen despite termination of the treatment. Since no increase in the levels of serum immunoglobulins of the patient was observed, and negative results were obtained for the analysis of viral markers and autoantibodies, a diagnosis of regorafenib-induced hepatitis was suggested. In consequence, the patient received steroid pulse therapy and continuous administration of prednisolone, without sufficient improvement. Liver biopsy revealed interface hepatitis with prominent plasma cell infiltration, suggesting regorafenib-induced autoimmune hepatitis. The patient was then administered azathioprine and prednisolone, which improved the hepatic injury. The present case represents the first report of successful treatment of regorafenib-induced severe hepatic injury by the use of an immunosuppressant.

UR - http://www.scopus.com/inward/record.url?scp=84948764191&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84948764191&partnerID=8YFLogxK

U2 - 10.3892/ol.2015.3853

DO - 10.3892/ol.2015.3853

M3 - Article

AN - SCOPUS:84948764191

VL - 11

SP - 85

EP - 88

JO - Oncology Letters

JF - Oncology Letters

SN - 1792-1074

IS - 1

ER -