Li SF, Ouyang X, Feng S, Wan MZ, Zhou KN, Wen BY, Yin YZ, Yi H, Chen XY. Oncohepatology: Navigating liver injury in the era of modern cancer therapy. World J Hepatol 2025; 17(6): 106932 [DOI: 10.4254/wjh.v17.i6.106932]
Corresponding Author of This Article
Xin-Yuan Chen, Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. chenxinyuan_pumc@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jun 27, 2025; 17(6): 106932 Published online Jun 27, 2025. doi: 10.4254/wjh.v17.i6.106932
Oncohepatology: Navigating liver injury in the era of modern cancer therapy
Shuo-Feng Li, Xu Ouyang, Shi Feng, Ming-Zhong Wan, Kai-Nan Zhou, Bo-Yuan Wen, Yu-Ze Yin, Hang Yi, Xin-Yuan Chen
Shuo-Feng Li, Shi Feng, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Kai-Nan Zhou, Peking University Health Science Center, Beijing 100191, China
Bo-Yuan Wen, Hang Yi, Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Yu-Ze Yin, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Xin-Yuan Chen, Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Co-corresponding authors: Hang Yi and Xin-Yuan Chen.
Author contributions: Li SF, Ouyang X, Feng S, Wan MZ, Zhou KN, Wen BY, and Yin YZ reviewed the literature and wrote the first draft of the paper; Li SF, Ouyang X, and Feng S contributed to searching the literature; Zhou KN, Wen BY, and Yin YZ completed the table and edited the paper; Yi H and Chen XY contributed to writing the paper, conceived the idea, edited it extensively, and made equal contributions as co- corresponding authors. All authors approved the final version manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Yuan Chen, Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. chenxinyuan_pumc@163.com
Received: March 16, 2025 Revised: April 24, 2025 Accepted: June 3, 2025 Published online: June 27, 2025 Processing time: 103 Days and 3.8 Hours
Abstract
In recent years, the rapid evolution of cancer therapies has markedly increased patient survival rates. However, the incidence of adverse events caused by anticancer treatments remains high, leading to significant clinical challenges. As the central hub of drug metabolism and detoxification, the liver is susceptible to therapeutic insults. The specific mechanisms of liver injury caused by different types of antineoplastic treatments vary. Chemotherapy induces hepatic damage via oxidative stress and mitochondrial dysfunction, whereas targeted therapy disrupts signaling pathways in hepatic cells. Immunotherapy triggers immune-mediated hepatitis through cytokine storms and immune cell infiltration, and radiation therapy causes hepatic microvascular injury. Additionally, patients with preexisting chronic liver diseases (such as cirrhosis, hepatitis B/C, or nonalcoholic fatty liver disease) are more likely to face increased risks of hepatic injury during cancer treatment. Therefore, early detection and timely treatment are crucial for these high-risk populations. This review introduces the emerging field of “oncohepatology”, which illuminates the mechanisms underlying hepatic injury due to cancer treatments, summarizes the influence and management of preexisting liver disease during cancer treatment, analyzes diagnostic and therapeutic strategies for cancer treatment-associated liver function damage, and discusses potential future research directions to provide valuable insights for liver injury management in clinical oncology.
Core Tip: Oncohepatology has emerged as a vital subspecialty bridging oncology and hepatology to address liver injury associated with modern cancer therapies. This manuscript unveils mechanisms of hepatic damage caused by chemotherapy, targeted therapy, immunotherapy, and radiation. It further highlights elevated risks of adverse events during cancer treatment in patients with preexisting liver diseases, thereby underscoring the necessity for tailored clinical management. Integrating diagnostic biomarkers and hepatoprotective strategies, this work also proposes a comprehensive roadmap for early detection and management of cancer treatment-induced hepatotoxicity.
