Oncohepatology: Navigating liver injury in the era of modern cancer therapy

Table 1 Clinical-pathological modes of liver injury caused by common anticancer treatments

Treatment type	Examples of common drugs	Clinical-pathological modes of liver injury
Chemotherapy
Platinum-based drugs	Cisplatin, oxaliplatin	HSOS, steatohepatitis, HBV reactivation, nodular regenerative hyperplasia
Metabolism antagonists	Methotrexate, 5-fluorouracil	Steatohepatitis, cholestasis, liver cirrhosis, HBV reactivation
Alkylating agent	Cyclophosphamide, busulfan	Hepatocellular injury, cholestasis, HSOS, HBV reactivation
Alkaloids (derivatives)	Paclitaxel, irinotecan	Steatohepatitis, HSOS, hypersensitivity reaction, HBV reactivation
Antitumor antibiotics	Doxorubicin, mitomycin	HSOS, hepatocellular injury, hypersensitivity reaction
Targeted therapy
BCR-ABL kinase inhibitor	Imatinib, nilotinib	Cholestasis, hepatocellular injury, HBV reactivation
VEGFR kinase inhibitor	Sunitinib, sorafenib	Hepatocellular injury, HSOS
EGFR kinase inhibitor	Gefitinib, afatinib	Cholestasis, hepatocellular injury, autoimmune hepatitis
Immunotherapy
PD-1/PD-L1 inhibitors	Pembrolizumab, durvalumab	Autoimmune hepatitis, bile duct injury or cholangitis, HBV reactivation
CTLA-4 inhibitors	Ipilimumab	Autoimmune hepatitis, bile duct injury or cholangitis, HSOS, HBV reactivation
CAR-T cell therapy		CRS, HBV reactivation
Radiotherapy		Hepatocellular injury, HSOS, Budd-Chiari syndrome

HSOS: Hepatic sinusoidal obstruction syndrome; HBV: Hepatitis B virus; BRC-ABL: Breakpoint cluster region-Abelson; VEGFR: Vascular endothelial growth factor receptor; EGFR: Epidermal growth factor receptor; PD-1/PD-L1: Programmed cell death protein/ligand 1; CTLA-4: Cytotoxic T lymphocyte-associated antigen-4; CAR-T: Chimeric antigen receptor T; CRS: Cytokine release syndrome.