TABLE 3.
Pattern of raised alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST), with or without the elevation of total bilirubin (TBili) during the use of immune checkpoint inhibitors (ICIs) according to cancer types
| Any raised ALT and/or AST during ICIs a | Raised ALT and/or AST and normal TBili during ICIs b |
Raised ALT and/or AST and elevated G1 TBili during ICIs b |
Raised ALT and/or AST and elevated G2‐4 TBili during ICIs b |
|
|---|---|---|---|---|
| All cancer (N = 1,480) | ||||
| Grade 1‐2 | 568 (38.4) | 345 (60.7) | 87 (15.3) | 136 (23.9) |
| Grade 3‐4 | 143 (9.7) | 38 (26.6) | 17 (11.9) | 88 (61.5) |
| Lung cancer (N = 586) | ||||
| Grade 1‐2 | 183 (31.2) | 153 (83.6) | 18 (9.8) | 12 (6.6) |
| Grade 3‐4 | 24 (4.1) | 14 (58.3) | 3 (12.5) | 7 (29.2) |
| Gastrointestinal cancer (N = 148) | ||||
| Grade 1‐2 | 69 (46.6) | 38 (55.1) | 9 (13.0) | 22 (31.9) |
| Grade 3‐4 | 15 (10.1) | 2 (13.3) | 2 (13.3) | 11 (73.3) |
| Liver cancer (N = 244) | ||||
| Grade 1‐2 | 133 (54.5) | 34 (25.6) | 27 (20.3) | 72 (54.1) |
| Grade 3‐4 | 44 (18.0) | 2 (4.5) | 6 (13.6) | 36 (81.8) |
| Hematological cancer (N = 143) | ||||
| Grade 1‐2 | 67 (46.9) | 38 (56.7) | 17 (25.4) | 12 (17.9) |
| Grade 3‐4 | 25 (17.5) | 6 (24.0) | 2 (8.0) | 17 (68.0) |
| Others (N = 359) c | ||||
| Grade 1‐2 | 116 (32.3) | 82 (70.7) | 16 (13.8) | 18 (15.5) |
| Grade 3‐4 | 35 (9.7) | 14 (40.0) | 4 (11.4) | 17 (48.6) |
Grade 1 raised ALT and/or AST referred to ALT and/or AST > 1xULN‐3xULN if baseline was normal; 1.5‐3x baseline if baseline was abnormal. Grade 2 raised ALT and/or AST referred to ALT and/or AST > 3xULN‐5xULN if baseline was normal; >3‐5x baseline if baseline was abnormal. Grade 3 raised ALT and/or AST referred to ALT and/or AST > 5xULN‐20xULN if baseline was normal; >5‐20x baseline if baseline was abnormal. Grade 4 raised ALT and/or AST referred to ALT and/or AST > 20xULN if baseline was normal; >20x baseline if baseline was abnormal. Grade 1 raised total bilirubin referred to total bilirubin > 1xULN‐1.5xULN if baseline was normal; >1‐1.5x baseline if baseline was abnormal. Grade 2 raised total bilirubin referred to total bilirubin > 1.5xULN‐3xULN if baseline was normal; >1.5‐3x baseline if baseline was abnormal. Grade 3 raised total bilirubin referred to total bilirubin > 3xULN‐10xULN if baseline was normal; >3‐10x baseline if baseline was abnormal. Grade 4 raised total bilirubin referred to total bilirubin > 10xULN if baseline was normal; >10x baseline if baseline was abnormal. During ICIs referred to the period from start of ICIs till 4 weeks after the last dose of ICIs.
Abbreviations: ALT = alanine aminotransferase, AST = aspartate aminotransferase, FU = follow‐up, G1 = grade 1, G2‐4 = grade 2‐4, ICIs = immune checkpoint inhibitors, TBili = total bilirubin, ULN = upper limit of normal.
Results are presented as N (%) of that cancer type.
Results are presented as n/N (%). The percentage represents the proportion among patients of that cancer type who had any raised ALT and/or AST during ICIs.
The four commonest types of other cancers included kidney cancer, breast cancer, skin cancer, and pharyngeal cancer.