Seven days after initiation of radiation (week 52), 88 days after the last durvalumab infusion, and 26 days after discontinuation of steroids, the patient exhibited escalating liver enzyme levels, culminating in grade 4 acute hepatitis 116 days after the last durvalumab infusion, with the following levels: ALT 1057 U/L (21.1x ULN), AST 648 U/L (13x ULN), total bilirubin 3.3 mg/dL (2.8x ULN), AP 375 U/L (2.9x ULN), and GGT 388 U/L (6.5x ULN), accompanied by a skin rash (Fig. 3a) and flare in CA 19.9 986 U/L (Fig. 3b). This evidence concerns the gene DHCR7-DT and Acute hepatitis.