IR-cholangitis has been reported in over 50 cases, mostly induced by anti–programmed cell death 1 (PD1) and far less by anti–PD-L1, with a median onset after 5 ICI cycles, ranging up to 27 cycles.1,3,4 The higher number of cases induced by anti-PD1 compared with anti–PD-L1, however, is most likely due to their earlier introduction to the market and consequently greater number of patients treated with anti-PD1.5 In our report in case 1, cholestatic liver injury emerged after 1 year on triplet therapy (24 atezolizumab cycles). This evidence concerns the gene PDCD1 and cholangitis.