免疫检查点抑制剂相关皮肤不良反应诊治中国专家共识(2024版)

Chinese expert consensus on diagnosis and treatment of immune checkpoint inhibitor-related skin adverse reactions(2024 edition)

免疫检查点抑制剂(ICIs)通过激活机体免疫系统抵御肿瘤细胞,目前已成为多种恶性肿瘤的重要治疗手段。但其使用过程中可能发生多种不同类型的皮肤不良反应,包括斑丘疹、瘙痒、水疱病变、色素减退和脱发等,严重者出现类似Steven-Johnson综合征/中毒性表皮坏死松解症(SJS/TEN)样表现。这些ICIs相关皮肤相关不良反应(cirAEs)发生率高,严重影响患者的生活质量和医师的治疗决策,部分严重的皮肤不良反应(SCARs)甚至危及生命。为此,中华医学会皮肤性病学分会、中国医师协会皮肤科医师分会、中国老年医学学会皮肤医学分会和其他相关领域的专家共同讨论并制订了《免疫检查点抑制剂相关皮肤不良反应诊治中国专家共识(2024版)》。此共识包括cirAEs的命名与流行病学、发病机制、临床特征、分类分级、诊断依据、治疗策略与ICIs的重启治疗等,旨在为中国cirAEs的诊治提供更科学、更权威的参考依据。

Immune checkpoint inhibitors(ICIs)have emerged as crucial therapeutic agents for various malignancies by activating the host immune system against tumor cells.However,many different types of skin adverse reactions may occur during its use,including eruption,pruritus,blistering,hypopigmentation,alopecia,and even severe cases,Stevens-Johnson syndrome(SJS)/toxic epidermal necrolysis(TEN).These cutaneous immune-related adverse events(cirAEs)had a high incidence,which seriously affected patients′quality of life and antitumor treatment decisions.Some severe cutaneous adverse reactions(SCARs)even endanger patients′lives.Therefore,the Chinese Society of Dermatology,the Chinese Dermatologist Association of the Chinese Medical Doctor Association,the Dermatology Division of the Chinese Geriatrics Society,and other relevant experts jointly discussed and formulated the′Chinese Expert Consensus on the Diagnosis and Treatment of Immune Checkpoint Inhibitor-Related Cutaneous Adverse Reactions′.This consensus covers the name,epidemiology,pathogenesis,clinical features,classification and grading of cirAEs,principles of management and the re-initiation of ICIs.It aims to provide a more scientific and authoritative reference for the diagnosis and treatment of cirAEs in China in the future.