ESMO免疫治疗的毒性管理指南解读

Comments on ESMO Management Guidelines of Toxicities from Immunotherapy

免疫治疗是肿瘤治疗中革命性的突破,目前已成功用于治疗多种实体瘤(黑色素瘤、非小细胞肺癌、泌尿系统肿瘤、消化系统肿瘤及经典霍奇金淋巴瘤等)。随着应用人群的迅速增加,越来越多的不良反应被报道,其中一些不良反应与治疗后产生的免疫系统功能增强有关,但是,现阶段人们对于这种不良反应的认知仍存在诸多不足。基于现有经验,欧洲临床肿瘤协会(European Society for Medical Oncology,ESMO)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》,中国临床肿瘤学会(Chinese Society of Clinical Oncology,CSCO)翻译小组进行了翻译。本指南解读将以ESMO指南为基础,结合临床实践,详细阐述各不良反应的特点、临床管理路径及未来研究方向。

Immunotherapy has revolutionized the management of patients with advanced cancers and has been approved for treatment of diverse solid tumors （melanoma, non-small cell lung cancer, genitourinary cancers, gastrointestinal cancers, classic Hodgkin＇s disease and so oh）. An increasing number of patients will be exposed to immunotherapy, and more and more treatment- related adverse events （AEs） have been reported, among which some are characterized with presumed immune-related etiology. Our knowledge of AEs is limited. Recently, European Society for Medical Oncology （ESMO） has published Management of toxicities from immunotherapy： ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up in Annals of Oncology, which has been translated to Chinese by Chinese Society of Clinical Oncology （CSCO） Translation Group. Here, based on the guidelines and our own clinical experience, we will detail the characteristics and management strategies of immune-related AEs and lay out our perspectives in this field.