ASCO/NCCN免疫治疗毒性管理指南解读  

Comments on ASCO/NCCN management guidelines of toxicities from immunotherapy

作　　者：彭智[1] 袁家佳 王正航 刘丹[1] 王雅坤[1] 姬智 张静[1] 张小田[1] 沈琳[1] PENG Zhi;YUAN Jia-jia;WANG Zheng-hang;LIU Dan;WANG Ya-kun;JI Zhi;ZHANG Jing;ZHANG Xiao-tian;SHEN Lin(Department of Gastrointestinal Oncology,Key Laboratory of Carcinogenesis and Translational Research（Ministry of Education）,Peking University Cancer Hospital ＆ Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所消化肿瘤内科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《肿瘤综合治疗电子杂志》2018年第2期38-47,共10页Journal of Multidisciplinary Cancer Management(Electronic Version)

基　　金：北京市医管局青苗计划(QML20171102);北京大学临床医学+X青年专项

摘　　要：随着免疫检查点抑制剂在肿瘤治疗中的应用迅速增多,其不良反应的处理逐渐成为临床实践的重要内容。2017年,欧洲临床肿瘤协会(European Society for Medical Oncology,ESMO)率先发表了《免疫治疗的毒性管理:ESMO诊断、治疗和随访临床实践指南》,为肿瘤科医生对不良反应的管理带来了极大的帮助。随着临床经验和证据的不断积累,2018年,美国临床肿瘤学会(American Society of Clinical Oncology,ASCO)联合美国国家综合癌症网络(National Comprehensive Cancer Network,NCCN)发表了《免疫检查点抑制剂治疗相关毒性的管理指南》,更加系统地介绍和讨论了不良反应的管理流程。本解读将简要介绍ASCO/NCCN指南的内容,并对比其与ESMO指南的差异,以期为不良反应的管理带来更深层次的理解。Immune checkpoint inhibitors （ICPis） have been used in an increasing number of cancer patients. The management of immune related toxicities has become a common situation that oncologists may be faced with. European Society for Medical Oncology （ESMO） published Management of toxicities from immunotherapy： ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upin 2017, which provided significant help for oncologist to deal with ICPi-related toxicities. Recently, American Society of Clinical Oncology （ASCO） has developed ASCO/National Comprehensive Cancer Network （NCCN） toxicity management guideline in collaboration with NCCN, in which more detailed strategies have been recommended for specific organ- and system-based toxicity diagnosis and management. Here, the ASCO/NCCN guideline will be introduced briefly. We will also compare these two guidelines in aspects of identifying patients at risk, diagnosis and differential diagnosis, treatment strategies and re-challenging with ICPis, hoping to get a thorough and in-depth understanding of managing immune-related toxicities.

关 键 词：免疫检查点抑制剂 不良反应 管理 ESMO ASCO/NCCN 

分 类 号：R730.51[医药卫生—肿瘤]