Immunotherapy has changed the treatment landscape for patients with cancer in the past decade. Immune checkpoint inhibitor (ICI)-based therapies have proven effective in a range of malignancies, including liver and gastrointestinal cancers, but they can cause diverse off-target organ toxicities. With the increasingly wider application of these drugs, immune-mediated liver injury from ICIs has become a commonly encountered challenge in clinical hepatology and gastroenterology. In this Review, we discuss the evidence from human and animal studies on the immunological mechanisms of immune-mediated liver injury from ICIs and summarize its clinical features and practical considerations for its management.

在过去十年中，免疫疗法改变了癌症患者的治疗格局。基于免疫检查点抑制剂 （ICI） 的疗法已被证明对一系列恶性肿瘤有效，包括肝癌和胃肠道癌，但它们会引起多种脱靶器官毒性。随着这些药物的日益广泛应用，ICIs 引起的免疫介导性肝损伤已成为临床肝病学和胃肠病学中常见的挑战。在本综述中，我们讨论了人类和动物研究中关于 ICIs 免疫介导肝损伤免疫机制的证据，并总结了其临床特征和治疗的实际考虑。