After three cycles of concurrent chemoradiotherapy and Tislelizumab, she developed grade 4 immune-mediated hepatitis and ALF following a fourth Tislelizumab dose, marked by severe transaminitis (AST 5329 U/L, ALT 2384 U/L), coagulopathy (INR 5.85), hyperbilirubinemia (TBIL 56.99 IU/L), and hepatic encephalopathy. The gene discussed is GPT; the disease is Hyperbilirubinemia.