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多国癌症支持治疗协会(MASCC)2020 年关于检查点抑制剂引起的严重皮肤毒性管理的临床实践建议。

Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of severe dermatological toxicities from checkpoint inhibitors.

机构信息

Division of Oncodermatology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Faculty of Health Sciences, Department of Immunology, University or Pretoria, Corner Doctor Savage Road and Bophelo Road, PO Box 667, Pretoria, 0002, South Africa.

出版信息

Support Care Cancer. 2020 Dec;28(12):6119-6128. doi: 10.1007/s00520-020-05706-4. Epub 2020 Aug 27.

Abstract

Immune checkpoint inhibitors (ICIs) frequently result in cutaneous immune-related adverse events (IrAEs). Although the majority of these events are mild-to-moderate in severity, up to 5% are severe, which may lead to morbidity and dose interruption or discontinuation of ICI therapy. In addition, up to 25% of dermatologic IrAEs are corticosteroid-refractory or corticosteroid-dependent. These 2020 MASCC recommendations cover the diagnosis and management of cutaneous IrAEs with a focus on moderate-to-severe and corticosteroid-resistant events. Although the usage of immune-suppressive therapy has been advocated in this setting, there is a lack of randomized clinical trial data to provide a compelling level of evidence of its therapeutic benefit.

摘要

免疫检查点抑制剂(ICIs)经常导致皮肤免疫相关不良反应(IrAEs)。虽然这些事件多数为轻度至中度严重程度,但高达 5%的事件为重度,这可能导致发病率增加,并中断或停止 ICI 治疗。此外,高达 25%的皮肤 IrAEs 对皮质类固醇难治或依赖。这些 2020 年 MASCC 建议涵盖了皮肤 IrAEs 的诊断和管理,重点是中重度和皮质类固醇耐药的事件。尽管在这种情况下主张使用免疫抑制治疗,但缺乏随机临床试验数据提供其治疗益处的令人信服的证据水平。

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